Diet and CVD risk

– A complicated story!! - epidemiological and

clinical results
• 280,000 participants in 28 cohort studies.
• 6,600 CHD deaths
• Intake of Total Fat or Saturated Fat was
not significantly associated with CHD
mortality or CHD events.
 (AJCN, 2010)

• Data were derived from 347,747 participants, of

whom 11,006 developed CVD.
• Insufficient evidence from prospective
epidemiologic studies to conclude that
dietary saturated fat is associated with an
increased risk of CHD, stroke, or CVD.
Siri-Tarino et al. 2010. Curr Atheroscler Rep 12:384–390.

• Substituting PUFA for SAFA reduces LDL-C and the T-C to

HDL-C ratio.
• However, replacement of SAFA by refined carbohydrates
and sugars increases levels of triglyceride and small LDL
particles and reduces HDL-C,
• Epidemiologic studies and RCTs have provided
consistent evidence that replacing SAFA with
PUFA, but not carbohydrates, is beneficial for
coronary heart disease.
“The observational evidence does not support the hypothesis
that dairy fat or high-fat dairy foods contribute to obesity or
cardiometabolic risk, and suggests that high-fat dairy
consumption within typical dietary patterns is inversely
associated with obesity risk.”
Ann Intern Med. 2014;160:398-406.
32 observational studies (512 420 participants)
Relative risks for coronary disease were:
• 1.03 (95% CI, 0.98 to 1.07) for saturated,
• 1.00 (CI, 0.91 to 1.10) for monounsaturated,
• 0.87 (CI, 0.78 to 0.97) for long-chain n-3 polyunsaturated,
• 0.98 (CI, 0.90 to 1.06) for n-6 polyunsaturated,
• 1.16 (CI, 1.06 to 1.27) for trans fatty acids
Conclusion: Current evidence does not clearly support cardio-
vascular guidelines that encourage high consumption of poly-
unsaturated fatty acids and low consumption of total saturated fats.
• Saturated fat increases LDL levels in the blood. High LDL is a risk
factor for CHD. Replacing saturated fats with mono- and poly-
unsaturated fats decreases LDL.
• The research on saturated fat consumption and effects on health
health is not clear. There is emerging evidence to suggest that the
health effects of saturated fats could vary depending on the food
sources in which they are found.
•
Diet and CVD risk
– A complicated story!! - epidemiological and
clinical results
– Fats: the risk of CVD increases with total fat
consumption: increases chylomicrons and
circulating blood triglyceride

– the risk of CVD increases with intake of trans

PUFA : increase LDLs and lower HDLs:
double negative – more later
Diet and CVD risk (continued)
– the risk of CVD decreases with
polyunsaturated C18:2 n-6, C18:3 n-3 and
C20:5 n-3 : they increase HDLs
– n-3 long-chain FAs (DHA and EPA) – anti-
platlet and anti-inflammatory responses in
addition to HDL effects
– But, excessive intakes of PUFAs (>10% of
total energy) may reduce HDL and promote
oxidation of LDL, enhancing plaque
formation
– Oleic (C18:1) may have a mildly beneficial effect on
lowering LDL
– Stearic (C18:0) is considered to be neutral, rapidly
converted to C18:1

– Lauric acid, C12:0, also neutral: increases LDL but

increases HDL comparably.
– C14:0-C16:0, seem to be neutral on TC:HDL ratio

– SCFAs (~10:0 and less) are transported through the

portal blood to the liver, not incorporated into
chylomicrons or VLDL, and burned directly for
energy, not stored in adipose: may be more neutral in
terms of effects on LDL and HDL, although not much
work
– Other Dietary components:
• Antioxidants: Vits. E, C, Flavonoids - reduce the
oxidation of LDL, and hence may reduce risk of
plaque formation

• Vit. B6 seems to play a role in CVD where it is

involved with the metabolism of methionine - if B6
is low, then there is an accumulation of
homocystine in the blood (this elevated
homocystine is a risk factor for CVD problems);
Low levels of B6, B12 and folate all seem to be
involved in high homocystine – more later
– Other Dietary components:
• Dietary starch/glucose: low levels of carbs
decreases LDL cholesterol – interesting
ramifications: low fat vs. low carb question;
remember where LDL’s (VLDL’s) come from –
dietary carbs!
• Plant Sterols: reduce LDL
• Non-starch polysaccharides (fibre): reduce LDLs,
bile acid binding
Foods associated with reduced risk of CVD:
• Specific fats
• Fish
– salmon and tuna are especially good sources of n-3 FA
– two meals per week of these fish will reduce the risk of
heart attack by 50%
– eating fish is more effective than taking oil pills, are
other factors involved?
• Whole grains
• Fruits and vegetables
• Nuts
• Soy
• Garlic
• Onions, berries, tea (flavonoids and other anti-oxidants)
• Red wine (1 or 2 drinks a day only)
Lipids in Foods

– Peanuts 48% other nuts are also high

– Cheese ~ 35%
– Beef 16 to 25% depending on the cut
– Poultry 12 to 15%
– Eggs 12% all from the yolk
– Milk (whole) 3.2%
– Corn 1.0%
– Broccoli 0.3%
– Potatoes 0.1%
 Physical Properties and Functions
of Lipids in Foods:

1. Flavour (desirable and undesirable:

volatiles, flavour carriers)
• “Pure” triglycerides have no taste or odour
• SCFA’s – volatile
• Fat soluble flavour compounds – many!
• Defects
• Oxidative rancidity
– autoxidation: double bonds
– painty, cardboardy flavours
– Control oxygen
– antioxidants: BHA, BHT
• Lipolytic rancidity
– enzymes producing free fatty acids
 Physical Properties and Functions
of Lipids in Foods:

2. Lubricant to the palate

3. Satisfaction / satietation
4. Texture: from melting characteristics
• melting point increases with increasing
chain length of saturated fatty acids
(butyric – oil; stearic – fat)
• melting point decreases with unsaturation
(unsaturates–oils; saturates–fats;
hydrogenation converts an oil to a fat)
• trans double bonds produce harder fats
• Food fats generally contain numerous
triglycerides, therefore exhibit a wide
melting range
• e.g., butter vs. cocoa fat
• crystal size and morphology:
polymorphism
• e.g., melted and recrystallizd fats
5. Cooking medium – frying oils
– smoke point

6. Shortening power, more later re doughs

7. Emulsification (mono- and di-glycerides)
8. Structural agent – fat droplet or crystal
networks
Sources of Food Fats and Oils
• Lauric - palmitic group (12:0-16:0, coconut, palm)
• highly saturated, therefore very stable at room
temperature
• melting point in the range of 25 to 45O C
• “Tropical fats” (Malaysia) - somewhat controversial
• Oleic-linoleic group (18:1, 18:2, corn, safflower,
sunflower, olive, peanut)
• liquid at room temperature due to high levels of
unsaturated FA s
• Linolenic group (18:3, soy, canola, flaxseed)
• highly unsaturated due to the 3 double bonds and
therefore easily oxidized
Canola oil is #1 used oil in foods in Canada
– makes up ~75% of all lipids used in our foods
– canola is a newer plant variety, developed from rapeseed
• Cocoa butter
• melts at 32-35OC, a sharp texture transition from solid to liquid
(body temperature is 37OC)
• gives a melt in your mouth character
• Marine oils
• highly unsaturated oils
• fatty acids are mainly long chains (C 18 or longer)
• good source of n-3 fatty acids
• chemically unstable due to many double bonds
• rancidity is high and a problem (strong odours)
• Animal fats
• highly saturated, also contain cholesterol
• from animal fats left over from meat packing operations
• produced by rendering operations (high heat used to the melt fat
and recover it as a liquid)
• used in lards, some shortening and soaps
Fatty acid composition of various lipid sources:
Source Saturated Unsaturated n-3 n-6 n-9
(linolenic) (linoleic) (oleic)
1. Canola 7% 93% 11% 21% 61%
2. Safflower 10 90 trace 76 14
3. Sunflower 12 88 1 71 16
4. Corn 13 87 1 57 29
5. Olive 15 85 1 9 75
6. Soy 15 85 8 54 23
7. Peanut 19 81 trace 33 48
8. Cottonseed 27 73 trace 54 19
9. Lard 43 57 1 9 47
10. Beef fat 48 52 1 2 49
11. Palm 51 49 trace 10 39
12. Butterfat 68 32 1 3 28
13. Coconut 91 9 0 2 7
• only animal fats will contain cholesterol
Processing of Fats and Oils
- Cooking/frying/ingredient fats and oils
processing:
extraction (pressing, centrifugation, solvent)
degumming (remove phospholipid)
refining (remove free fatty acids)
bleaching (remove chlorophyll)
deodourization
modification:
hydrogenation
interesterification
fractionation, e.g., winterization
Hydrogenation and Trans Fatty Acids (t-FAs)
• In food processing, hydrogenated fats make it possible
to use oils for applications where fats are required
• Mainly used in deep fat frying (they are quite stable to
heat), harder margarines and cookies or crackers (for
textural effects)
• Partial hydrogenation produces both saturated fats
and trans unsaturated fats; full hydrogenation
produces only saturated fats
• Alternative oils (more stable ones) are becoming
available in commercial quantities – much current
work
Figure 5.12. Hydrogenation yields both saturated and trans fatty acids.
Trans Fatty Acids (t-FAs)
• In nutrition, the t-FAs raise the LDLs and lower the
HDLs (double negative for risk of CVD)
• much research information from Dr. Bruce Holub (U
of Guelph) and Dr. David Jenkins (U of Toronto) -
both world leaders in this area
• Jan 2006 - Canada was the first country in the world to
require t-FA labeling on a food product and to begin
voluntary reductions (see next)
• By Jan. 2010, we were meeting target goals
Health Canada Trans Fat Monitoring Program
http://www.hc-sc.gc.ca/fn-an/nutrition/gras-trans-fats/index-eng.php
In 2006, the Trans Fat Task Force recommended a trans
fat limit of 2% of the total fat content for all vegetable
oils and soft, spreadable margarines, and a limit of 5% of
the total fat content for all other foods, including
ingredients sold to restaurants. In June 2007, Health
Canada adopted these recommendations
and gave industry two years to
demonstrate progress in meeting the
recommended targets. Health Canada
monitored two-year progress through the
Trans Fat Monitoring Program and the
results are available on its website.
• Cow’s milk and human milk both contain t-FAs,,
making the message more complicated
– In cow’s milk fat (5% of total fat) – two sources –
rumen hydrogenation (~4%, mostly vaccenic acid,
C18:1, trans -11) and naturally synthesized (CLA,
C18:2, cis -9, trans -11, ~1%)
– In human milk – two sources – from the diet (declining
steadily) and CLA (~1% of total fat)
– CLA has been shown to have very beneficial health
effects
– Vaccenic acid may be more neutral, not the same
effects as industrially hydrogenated trans
Lipid Products and Processing
1)Cooking/frying/ingredient fats and oils

2) Shortening / lard

3) Emulsions
– Continuous and discrete phases and an interface
(emulsifier)
– Thermodynamically unstable, stabilized kinetically
– Water in oil, e.g., spreads: butter, margarine (80%
fat)
– Oil in water, e.g., mayonnaise (80% fat), peanut
butter, milk, cream, salad dressings
An oil-in-water emulsion