Elim­i­nat­ing trans fats de­creases chances of early death

The Sentinel-Record - - VIEWPOINTS - Copy­right 2017, Univer­sal UClick for UFS Robert Ash­ley, M.D., is an in­ternist and as­sis­tant pro­fes­sor of medicine at the Univer­sity of Cal­i­for­nia, Los An­ge­les.

Dear Doc­tor: How bad are trans fats re­ally? Seems hard to be­lieve that sim­ply ban­ning them in restau­rants could cut heart at­tacks and strokes, as a re­cent study sug­gests.

Dear Reader: First, let’s start with hy­dro­gena­tion, a process that adds hy­dro­gen to the fats found in veg­etable oils in or­der to make them solid. A par­tial hy­dro­gena­tion process cre­ates trans fats. Trans fats have a long shelf life, are more sta­ble when fried and can make baked goods taste more palat­able. That sounds good, doesn’t it?

The re­al­ity is less so. For starters, trans fats neg­a­tively im­pact choles­terol lev­els by in­creas­ing LDL choles­terol (the bad choles­terol linked to heart dis­ease) and de­creas­ing HDL choles­terol (the good choles­terol that pro­tects against heart dis­ease). If that weren’t enough, trans fats also in­crease triglyc­erides, lipopro­tein(a) and small par­ti­cles of low-den­sity lipopro­tein (LDL), all of which in­crease the risk of heart dis­ease.

Fur­ther, trans fats in­crease in­flam­ma­tion through­out the body, rais­ing lev­els of in­flam­ma­tory mark­ers, such as tu­mor necro­sis fac­tor (TNF), in­ter­leuken-6 and C-re­ac­tive pro­tein. That’s im­por­tant be­cause in­creased in­flam­ma­tion is a risk fac­tor for di­a­betes, ath­er­o­scle­ro­sis, heart fail­ure and sud­den car­diac death. What’s more, trans fats have a di­rect ef­fect on the in­ner lin­ing of blood ves­sels, which may fur­ther in­crease the risk of heart at­tacks and strokes.

The ev­i­dence as to trans fats’ neg­a­tive im­pact is grow­ing. A com- bined New

Eng­land Jour­nal of Medicine anal­y­sis of four stud­ies, based on nearly 140,000 sub­jects’ di­etary habits, found a clear link be­tween con­sump­tion of trans fats and coro­nary heart dis­ease. The re­searchers found that a 2 per­cent in­crease in daily caloric in­take from trans fats led to a 23 per­cent risk in coro­nary heart dis­ease.

Sim­i­larly, an 11-year study pub­lished in the jour­nal Cir­cu­la­tion eval­u­ated blood sam­ples of peo­ple who had ex­pe­ri­enced sud­den car­diac ar­rest and com­pared them to blood sam­ples of peo­ple in the com­mu­nity. Those pa­tients who had el­e­vated trans fats in the mem­branes of red blood cells had a 47 per­cent greater risk of sud­den car­diac ar­rest. Most of this in­creased risk was seen in peo­ple with el­e­vated li­noleic trans fatty acids, mean­ing that some ar­ti­fi­cial trans fats are worse than oth­ers. Note that some trans fats are pro­duced nat­u­rally in the stom­ach of cows and some end up in small amounts in cow milk; th­ese types of trans fats have not been as­so­ci­ated with heart dis­ease.

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