Effects of ruminant trans fatty acids on cardiovascular disease and cancer: a comprehensive review of epidemiological, clinical, and mechanistic studies

Dietary fatty acids and lipoprotein metabolism: new insights and updates

PURPOSE OF REVIEW

Dyslipidemia is a powerful risk factor for cardiovascular disease (CVD). Dietary fatty acid composition regulates lipids and lipoprotein metabolism and may confer CVD benefit. This review updates understanding of the effect of dietary fatty acids on lipoprotein metabolism in humans.

RECENT FINDINGS

High dietary fish-derived n-3 polyunsaturated fatty acid (PUFA) consumption diminished hepatic triglyceride-rich lipoprotein (TRL) secretion and enhanced TRL to LDL conversion. n-3 PUFA also decreased TRL-apoB-48 concentration by decreasing TRL-apoB-48 secretion. High n-6 PUFA intake decreased liver fat, and plasma proprotein convertase subtilisin/kexin type 9, triglycerides, total-cholesterol and LDL-cholesterol concentrations. Intake of saturated fatty acids with increased palmitic acid at the sn-2 position was associated with decreased postprandial lipemia, which might be due to decreased triglyceride absorption. Replacing carbohydrate with monounsaturated fatty acids increased TRL catabolism. Ruminant trans-fatty acid decreased HDL cholesterol, but the mechanisms are unknown. A new role for APOE genotype in regulating lipid responses was also described.

SUMMARY

The major advances in understanding the effect of dietary fatty acids on lipoprotein metabolism have focused on n-3 PUFA. This knowledge provides insights into the importance of regulating lipoprotein metabolism as a mode to improve plasma lipids and potential CVD risk. Further studies are required to better understand the cardiometabolic effects of other dietary fatty acids.

Role of fatty acid-based functional lipidomics in the development of molecular diagnostic tools

Lipids are molecules with different structures which have the feature of water insolubility in common. They have very important biological roles within structural, functional and signaling activities that have recently received renewed attention from life science research. Lipidomics considers the structural and functional roles played by lipids, but also their in vivo changes due to metabolic or degradation pathways, as well as their biological consequences. In this context, the dynamic vision of phospholipid metabolism and, in particular, fatty acid transformations combine with nutritional aspects and health consequences, providing important information for molecular medicine. Fatty acid-based functional lipidomics can be successfully applied to the follow-up of human lipid profiles under normal and pathological conditions, and this review provides several examples of this powerful molecular diagnostic tool, which is expected to have a strong influence on biomedical research in the 21st century.

Current issues surrounding the definition of trans-fatty acids: implications for health, industry and food labels

The definition of trans-fatty acids (TFA) was established by the Codex Alimentarius to guide nutritional and legislative regulations to reduce TFA consumption. Currently, conjugated linoleic acid (CLA) is excluded from the TFA definition based on evidence (primarily preclinical studies) implying health benefits on weight management and cancer prevention. While the efficacy of CLA supplements remains inconsistent in randomised clinical trials, evidence has emerged to associate supplemental CLA with negative health outcomes, including increased subclinical inflammation and oxidative stress (particularly at high doses). This has resulted in concerns regarding the correctness of excluding CLA from the TFA definition. Here we review recent clinical and preclinical literature on health implications of CLA and ruminant TFA, and highlight several issues surrounding the current Codex definition of TFA and how it may influence interpretation for public health. We find that CLA derived from ruminant foods differ from commercial CLA supplements in their isomer composition/distribution, consumption level and bioactivity. We conclude that health concerns associated with the use of supplemental CLA do not repudiate the exclusion of all forms of CLA from the Codex TFA definition, particularly when using the definition for food-related purposes. Given the emerging differential bioactivity of TFA from industrial v. ruminant sources, we advocate that regional nutrition guidelines/policies should focus on eliminating industrial forms of trans-fat from processed foods as opposed to all TFA per se.

Plasma phospholipid trans fatty acids and risk of heart failure

BACKGROUND

Although trans fatty acids (TFAs) may increase the risk of dyslipidemia and coronary artery disease (CAD), limited data are available on their association with heart failure (HF).

OBJECTIVE

Our goal was to assess associations of plasma and dietary TFAs with HF and CAD.

DESIGN

We used a prospective, nested case-control design to select 788 incident HF cases and 788 matched controls from the Physicians' Health Study for biomarker analyses and a prospective cohort for the dietary analyses. Plasma fatty acids were assessed by using gas chromatography, and dietary intake was estimated by using a food-frequency questionnaire. Self-reported HF was ascertained by using annual follow-up questionnaires with validation in a subsample. We used conditional logistic (or Cox) regression to estimate multivariable-adjusted ORs (or HRs) for HF and CAD.

RESULTS

Multivariable-adjusted ORs (95% CIs) for HF across consecutive quintiles of plasma trans 18:2 (linoleic acid) fatty acids were 1.0 (reference), 1.10 (0.79, 1.54), 0.88 (0.62, 1.25), 0.71 (0.49, 1.02), and 0.67 (0.45, 0.98) (P-trend = 0.01). Each SD of plasma trans 18:2 was associated with a 22% lower risk of HF (95% CI: 6%, 36%). Plasma trans 16:1 and 18:1 were not associated with risk of HF (P > 0.05). Dietary trans fats were not associated with incident HF or CAD.

CONCLUSIONS

Our data are consistent with a lower risk of HF with higher concentrations of plasma trans 18:2 but not with trans 16:1 or trans 18:1 fatty acids in male physicians. Dietary TFAs were not related to incident HF or CAD.

Separation of cis-fatty acids from saturated and trans-fatty acids by nanoporous polydicyclopentadiene membranes

This article describes the separation of mixtures of fatty acid salts using a new organic solvent nanofiltration membrane based on polydicyclopentadiene (PDCPD). Mixtures of free fatty acids could not be separated by the membranes because they permeated at similar rates. When triisobutylamine was added to the fatty acids, the cis-fatty acid salts (oleic, petroselinic, vaccenic, linoleic, and linolenic acid) had slower permeation though the membranes than saturated (stearic acid) and trans-fatty acid (elaidic acid) salts. The reason for the difference in permeation was due to the formation of stable salt pairs between the amine and fatty acids that increased their cross-sectional areas. The fatty acid salts derived from saturated and trans-fatty acids were smaller than the critical area cutoff for the PDCPD membranes, so they readily permeated. In contrast, the fatty acid salts derived from the cis-fatty acids had critical areas larger than critical area cutoff of the PDPCD membranes and had slowed permeation. The partitioning coefficients of fatty acids and fatty acid salts were investigated to demonstrate that they were not responsible for the difference in permeation. The use of pressure was investigated to greatly accelerate the permeation through the membranes. For a solvent mixture of 35/65 (v/v) toluene/hexanes, the permeation of solvent was approximately 39 L m(-2) h(-1). This value is similar to values reported for permeation through membranes used in industry. The separation of a mixture of fatty acids based on the composition of soybean oil was investigated using pressure. The saturated fatty acid salts were almost completely removed from the cis-fatty acid salts when iBu(3)N was used as the amine to form the salt pairs. The separation of the cis-fatty acids found in soybean oil was investigated with Pr(3)N as the amine. The oleic acid salt (oleic acid has one cis double bond) preferentially permeated the membrane while the linoleic (two cis double bonds) and linolenic (three cis double bonds) salts were partly retained. The separation of fatty acids using membranes may have real applications in industry to purify fatty acids on a large scale.

Effect of the inclusion of quebracho tannins in a diet rich in linoleic acid on milk fatty acid composition in dairy ewes

Despite controversy surrounding the ability of tannins to modulate the fatty acid (FA) profile of ruminant-derived products, reports on this issue are still very limited for dairy sheep. This study was conducted to examine the effect of the inclusion of quebracho tannins in a diet rich in linoleic acid on ewe performance and milk FA composition. Thirty-six lactating ewes were distributed into 6 lots and allocated to 2 treatments (3 lots/treatment): control or quebracho. All sheep received a total mixed ration based on alfalfa hay and a concentrate (forage:concentrate ratio of 40:60) supplemented with 20 g of sunflower oil/kg of dry matter plus 0 (control diet) or 20 g of an extract of quebracho tannins/kg of dry matter (QUE diet). Milk production and composition were analyzed on d 0, 3, 6, 9, 12, 15, 18, 21, 24, and 27 on treatments, and milk FA profile on d 0, 3, 6, 12, 18, and 27. On d 27, samples of rumen fluid were collected for pH, and lactate, ammonia, and volatile FA concentration analysis. Feeding the QUE diet had no apparent effect on animal performance and hardly modified ruminal fermentation characteristics, except for a reduction in the molar proportions of minor volatile FA. Dietary tannins increased the milk concentration of several 18:1 and 18:2 isomers and decreased that of branched-chain FA. Some of these changes were relatively constant throughout the experiment (e.g., cis-12 18:1 and trans-9,cis-12 18:2), whereas others varied over time (e.g., trans-10 18:1, which increased gradually with the QUE diet). Significant differences between treatments in trans-11 18:1 and cis-9,trans-11 conjugated linoleic acid were only observed on d 3. Overall, addition of quebracho tannins to a diet rich in linoleic acid did not prove useful to beneficially modify milk FA composition, especially over the long term.

Milk fat depression induced by dietary marine algae in dairy ewes: persistency of milk fatty acid composition and animal performance responses

Addition of marine algae (MA) to the diet of dairy ruminants has proven to be an effective strategy to enhance the milk content of some bioactive lipids, but it has also been associated with the syndrome of milk fat depression. Little is known, however, about the persistency of the response to dietary MA in sheep. Based on previous experiments with dairy ewes fed sunflower oil plus MA, it was hypothesized that the response might be mediated by time-dependent adaptations of the rumen microbiota, which could be evaluated indirectly through milk fatty acid (FA) profiles. Animal performance and milk FA composition in response to MA in the diet were studied using 36 Assaf ewes distributed in 6 lots and allocated to 2 treatments (3 lots/treatment) consisting of a total mixed ration (40:60 forage:concentrate ratio) supplemented with 25 g of sunflower oil (SO)/kg of dry matter plus 0 (SO; control diet) or 8 g of MA/kg of dry matter (SOMA diet). Milk production and composition, including FA profile, were analyzed on d 0, 6, 12, 18, 24, 34, 44, and 54 of treatment. Diet supplementation with MA did not affect milk yield but did decrease milk fat content. Differences in the latter were detected from d 18 onward and reached -17% at the end of the experiment (i.e., on d 54). Compared with the control diet, the SOMA diet caused a reduction in milk 18:0 and its desaturation product (cis-9 18:1) that lasted for the whole experimental period. This decrease, together with the progressive increase in some putative fat synthesis inhibitors, especially trans-10 18:1, was related to the persistency of milk fat depression in lactating ewes fed MA. Additionally, inclusion of MA in the diet enhanced the milk content of trans-11 18:1, cis-9,trans-11 18:2, and C20-22 n-3 polyunsaturated FA, mainly 22:6 n-3. Overall, the persistency of the responses observed suggests that the ruminal microbiota did not adapt to the dietary supply of very long chain n-3 polyunsaturated fatty acids.

Intake of ruminant trans fatty acids and changes in body weight and waist circumference

BACKGROUND/OBJECTIVES

Follow-up studies have suggested that total intake of trans fatty acids (TFA) is a risk factor for gain in body weight and waist circumference (WC). However, in a cross-sectional study individual TFA isomers in adipose tissue had divergent associations with anthropometry. Our objective was to investigate the association between intake of TFA from ruminant dairy and meat products and subsequent changes in weight and WC. Furthermore, potential effect modification by sex, age, body mass index and WC at baseline was investigated.

SUBJECTS/METHODS

Data on weight, WC, habitual diet and lifestyle were collected at baseline in a Danish cohort of 30,851 men and women aged 50-64 years. Follow-up information on weight and WC was collected 5 years after enrolment. The associations between intake of ruminant TFA (R-TFA) and changes in weight and WC were analysed using multiple linear regression with cubic spline modelling.

RESULTS

Intake of R-TFA, both absolute and energy-adjusted intake, was significantly associated with weight change. Inverse associations were observed at lower intakes with a levelling-off at intakes >1.2 g/day and 0.4 energy percentage (E %). Absolute, but not energy-adjusted, intake of R-TFA was significantly associated with WC change. An inverse association was observed at lower intakes with a plateau above an intake of 1.2 g/day.

CONCLUSIONS

The present study suggests that intake of R-TFA is weakly inversely associated with changes in weight, whereas no substantial association with changes in WC was found.

Autophagy regulates trans fatty acid-mediated apoptosis in primary cardiac myofibroblasts

Trans fats are not a homogeneous group of molecules and less is known about the cellular effects of individual members of the group. Vaccenic acid (VA) and elaidic acid (EA) are the predominant trans monoenes in ruminant fats and vegetable oil, respectively. Here, we investigated the mechanism of cell death induced by VA and EA on primary rat ventricular myofibroblasts (rVF). The MTT assay demonstrated that both VA and EA (200μM, 0-72 h) reduced cell viability in rVF (P<0.001). The FACS assay confirmed that both VA and EA induced apoptosis in rVF, and this was concomitant with elevation in cleaved caspase-9, -3 and -7, but not caspase-8. VA and EA decreased the expression ratio of Bcl2:Bax, induced Bax translocation to mitochondria and decrease in mitochondrial membrane potential (Δψ). BAX and BAX/BAK silencing in mouse embryonic fibroblasts (MEF) inhibited VA and EA-induced cell death compared to the corresponding wild type cells. Transmission electron microscopy revealed that VA and EA also induced macroautophagosome formation in rVF, and immunoblot analysis confirmed the induction of several autophagy markers: LC3-β lipidation, Atg5-12 accumulation, and increased beclin-1. Finally, deletion of autophagy genes, ATG3 and ATG5 significantly inhibited VA and EA-induced cell death (P<0.001). Our findings show for the first time that trans fat acid (TFA) induces simultaneous apoptosis and autophagy in rVF. Furthermore, TFA-induced autophagy is required for this pro-apoptotic effect. Further studies to address the effect of TFA on the heart may reveal significant translational value for prevention of TFA-linked heart disease.

Ruminant-produced trans-fatty acids raise plasma HDL particle concentrations in intact and ovariectomized female Hartley guinea pigs

Cardiovascular disease (CVD) is the leading cause of death among women worldwide, and risk for developing CVD increases postmenopause. Consumption of trans-fatty acids (tFA) has been positively associated with CVD incidence and mortality. The current study was designed to assess the effects of diets high in industrially produced (IP)-tFA, from partially hydrogenated vegetable oils (PHVO), and ruminant-produced (RP)-tFA, from butter oil (BO), on risk factors for CVD. Thirty-two female Hartley guinea pigs, one-half of which were ovariectomized (OVX) to mimic the postmenopausal condition, were fed hypercholesterolemic diets containing 9% by weight PHVO or BO (n = 8/diet and ovariectomy) for 8 wk. The plasma and hepatic lipids did not differ between IP- and RP-tFA groups or between intact and OVX guinea pigs. The BO diet resulted in higher concentrations of plasma total and small HDL particle subclass concentrations than the PHVO diet regardless of ovariectomy status. The intact BO group had higher concentrations of large HDL particles than the intact PHVO group. HDL mean particle size tended to be larger (P = 0.07) in the PHVO groups compared with the BO groups regardless of ovariectomy status. There was a trend toward an interaction between diet and ovariectomy status for LDL mean particle size, which tended to be larger in OVX guinea pigs fed PHVO (P = 0.07). In summary, consumption of IP- and RP-tFA resulted in differential effects on HDL particle subclass profiles in female guinea pigs. The effect of tFA consumption and hormonal status on HDL particle subclass metabolism and the subsequent impact on CVD in females warrants further investigation.

Modulation of oxidative stress by γ-glutamylcysteine (GGC) and conjugated linoleic acid (CLA) isomer mixture in human umbilical vein endothelial cells

Individually, γ-glutamylcysteine (GGC), a dipeptide and precursor of glutathione (GSH), and conjugated linoleic acid (CLA), a trans-fatty acid, exhibit antioxidant properties. The objective of this study was to compare effects of co-administration of GGC and CLA to treatment with GGC alone on oxidative stress and GSH synthesis in human endothelial cells. Changes in levels of 8-epi-PGF2α, thiobarbituric acid reactive substances (TBARS), GSH, total antioxidants, GSH synthetase (GSS) expression, and transcription factor DNA binding were assessed in human umbilical vein endothelial cells (HUVEC) treated with GGC alone (100 μmol/L) or combined with CLA isomer mixture (10, 50, 100 μmol/L) for 24h. Significantly higher levels of TBARS, 8-epi-PGF2α, GSH, and GSS protein were found in cells treated with GGC and 10 μmol/L CLA, compared to cells treated with GGC alone, indicative of prooxidant effects of CLA. Approximately 40% cell death was microscopically observed in cells incubated with GGC and 100 μmol/L CLA. Despite lower levels of GSH, treatment with GGC and 50 μmol/L CLA appeared to be protective from oxidative stress similar to treatment with GGC alone, as indicated by lower levels of TBARS, compared to control cells not treated with GGC and CLA.