ABSTRACT
In recent years, trans fatty acids in foods have raised health concerns largely from reports that high levels in the diet, compared to high levels of cis fatty acids, have resulted in unfavorable effects on both low-density lipoprotein cholesterol (LDL-cholesterol) and high-density lipoprotein cholesterol (HDL-cholesterol). In response, many health professional organizations have recommended reduced consumption of foods containing trans fatty acids, and the U.S. Food and Drug
I. Introduction ....................................................................................................................... 757 II. Occurrence of Trans Fatty Acids in the U.S. Food Supply ............................................... 758 III. Human Studies Relating Dietary Trans Fatty Acids to Risk of Coronary Heart Disease ...... 760 A. Review Articles ........................................................................................................... 760 a. Reviews of Studies Reported Prior to 1990 ............................................................ 760 b. Reviews of Studies Reported Since 1990 ............................................................... 760 B. Human Trials Reporting Changes in Blood Lipid and Lipoprotein Levels with
Dietary Trans Fatty Acids ............................................................................................ 762 a. Experimental Studies .............................................................................................. 762 b. Collective Consideration of Human Trials ............................................................. 767 C. Studies on Clotting Tendency, Blood Pressure, and LDL Oxidation .......................... 771 D. Epidemiologic and Case-Control Studies ................................................................... 771 E. Other Studies ............................................................................................................... 774 IV. Studies Relating Dietary Trans Fatty Acids to Cancer, Maternal and
Child Health, Type 2 Diabetes, and Macular Degeneration .............................................. 775 A. Trans Fatty Acids in Relation to Cancer ...................................................................... 775 B. Trans Fatty Acids in Relation to Maternal and Child Health ...................................... 776 C. Trans Fatty Acids in Relation to Type 2 Diabetes ....................................................... 777 D. Trans Fatty Acids in Relation to Macular Degeneration ............................................. 778 V. Dietary Recommendations Regarding Saturated and Trans Fatty Acids .......................... 779 VI. Alternatives for Replacing or Reducing Trans Fatty Acids in Foods ............................... 780 A. Modi: cation of the Hydrogenation Process ................................................................ 780 B. Use of Interesteri: cation ............................................................................................. 781 C. Use of Fractions High in Solids .................................................................................. 782 D. Use of Trait-Enhanced Oils ......................................................................................... 783 VII. Current Status of Usage of Zero-and Low-Trans Fats ..................................................... 784 VIII. Summary and Conclusions ............................................................................................... 784 Acknowledgments ....................................................................................................................... 785 References ................................................................................................................................... 785
Administration (FDA) issued regulations requiring the labeling of trans fatty acids on packaged foods effective from January 1, 2006. In addition, many food manufacturers, who have used partially hydrogenated oils in their products, have developed or are considering ways to reduce or eliminate trans fatty acids from these products.
