Metabolic aspects of trans fatty acids

  • B. Koletzko
    Correspondence to B. K., Professor of Paediatrics, Kinderpoliklinik, Klinikum Innenstadt der Ludwig-Maximilians-Universität, Pettenkoferstr. 8a, D-80336 München, Germany
    Kinderpoliklinik, Ludwig-Maximilians University, Munich, Germany
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  • T. Decsi
    Department of Paediatrics, University MedicalSchool of Pécs, Pécs, Hungary
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      The consumption of trans isomers of unsaturated fatty acids has been associated withuntoward metabolic effects. Several clinical investigations demonstrated that trans fatty acids increase plasma LDL-cholesterol and lipoprotein (a) and reduce HDL-cholesterol concentrations. These alterations of plasma lipid profiles indicate an atherogenic effect of trans fatty acids. Both in preterm infants and in healthy children aged 1–15 years, we found blood plasma arachidonic acid (C20:4ω-6) levels and the product/substrate ratios of arachidonic acid synthesis (C20:4ω-6/C18:2ω-6) inversely correlated to the level of the principal trans fatty acid, trans octadecaenoic acid (C18:1ω-9/7, trans), which is compatible with a dose-dependent inhibition of arachidonic acid synthesis by trans fatty acids. Moreover, in premature infants trans fatty acids in blood plasma correlated inversely with birth weight in an observational study, indicating that trans fatty acids may impair early human growth. It appears desirable to limit the dietary intake of trans fatty acids. The major dietary sources of trans fatty acids are partially hydrogenated vegetable and fish oils. Refinement of the industrial technology of partial hydrogenation and appropriate food labelling may lead to a considerably decrease of human exposure to trans fatty acids.
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        • Koletzko B.
        Zufuhr, Stoffwechsel und biologische Wirkungen trans-isomerer Fettsauren bei Säuglingen.
        Die Nahrungi. 1991; 35: 229-283
        • Brühl L.
        Determination of trans fatty acids in cold pressed oils.
        European Journal of Medical Research. 1995; 1: 89-93
        • Steinhart H.
        • Pfalzgraf A.
        Consumption and metabolism of dietary trans fatty acids.
        European Journal of Medical Research. 1995; 1: 84-85
        • Demmelmair H.
        • Festl B.
        • Wolfram G.
        • Koletzko B.
        Trans fatty acid contents in spreads and cold cuts usually consumed by children.
        Z Ernährungswiss. 1996; 35: 235-240
        • Hunter J.E.
        • Applewhite T.H.
        Reassessment of trans-fatty acid availability in the US diet.
        Am J Clin Nutr. 1991; 54: 363-369
        • Enig M.G.
        • Atal S.
        • Keeny M.
        • Sampugna J.
        Isomeric trans fatty acids in the US diet.
        J Am Coll Nutr. 1990; 9: 471-486
        • Danish Nutrition Council
        The influence of trans fatty acids on health.
        Clin Sci. 1995; 88: 375-392
        • Senti F.R.
        Health aspects of dietary trans fatty acids.
        in: Report prepared for Center for Food Safety and Applied Nutrition, Food and Drug Administration,Department of Health and Human Services, Washington, DC. 20204. Fed Am Soc Exp Biol. Life Sciences Research Office, Bethesda, MD1985
        • Koletzko B.
        • Müller L.
        Cis- and trans-isomeric fatty acids in plasma lipids of newborn infants and their mothers.
        Biol Neonate. 1990; 57: 172-178
        • Koletzko B.
        • Bremer H.J.
        Fat content and fatty acid composition of infant formulas.
        Acta Pediatr Scand. 1989; 78: 513-521
        • Genzel-Boroviczeny O.
        • Wahle J.
        • Koletzko B.
        Fatty acid composition of human milk during the first month after term and preterm delivery.
        Eur J Pediatr. 1997; 156: 142-147
        • Craig-Schmidt M.C.
        • Weete J.D.
        • Faircloth S.A.
        • Wickwire M.A.
        • Livant E.J.
        The effect of hydrogenated fat in the diet of nursing mothers on lipid composition and prostaglandin content of human milk.
        Am J Clin Nutr. 1984; 39: 778-786
        • Koletzko B.
        • Thiel I.
        • Abiodun P.O.
        Fatty acid composition of mature human milk in Nigeria.
        Z Emährungwiss. 1991; 30: 289-297
        • Decsi T.
        • Behrendt E.
        • Koletzko B.
        Fatty acid composition of Hungarian infant formulae revisited.
        Acta Paediatr Hung. 1994; 34: 107-116
        • Decsi T.
        • Thiel I.
        • Koletzko B.
        Essential fatty acid status in full term infants fed breast milk or formula.
        Arch Dis Child. 1995; 72: F23-F28
        • Koletzko B.
        • Edenhofer S.
        • Lipowsky G.
        • Reinhardt D.
        Effects of a low birthweight infant formula containing docosahexaenoic and arachidonic acids at human milk levels.
        J Pediatr Gastroenterol Nutr. 1995; 21: 200-208
        • Koletzko B.
        Trans fatty acids.
        Ann Nestle. 1997; (in press)
        • Tato J.
        Trans-fatty acids in the diet: a coronary risk factor?.
        European Journal of Medical Research. 1995; 1: 118-122
        • Ascherio A.
        • Hennekens C.H.
        • Buring J.E.
        • Master C.
        • Stampfer M.J.
        • Willett W.C.
        Trans-fatty acid intake and risk of myocardial infraction.
        Circulation. 1994; 89: 94-101
        • Vergroesen A.J.
        • Gottenbos J.J.
        The role of fats in human nutrition: an introduction.
        in: Vergroesen A.J. The Role of Fats in Human Nutrition. Academic Press, New York1975: 1-41
        • Mensink R.P.
        • Katan M.B.
        Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects.
        N Engl J Med. 1990; 323: 439-445
        • Nestel P.
        • Noakes M.
        • Belling B.
        • et al.
        Plasma lipoprotein lipid and Lp[a] changes with substitution of elaidic acid for oleic in the diet.
        J Lipid Res. 1992; 33: 1029-1036
        • Judd J.T.
        • Clevidence A.
        • Muesing R.A.
        • Wittes J.
        • Sunkin M.E.
        • Podczasy J.J.
        Dietary trans-fatty acids: effects on plasma lipids and lipoproteins of healthy men and women.
        Am J Clin Nutr. 1994; 59: 861-868
        • Lagrost L.
        Differential effects of cis- and trans-fatty acid isomers, oleic and elaidic acids, on the cholesteryl ester transfer protein activity.
        Biochim Biophys Acta. 1992; 1124: 159-162
        • Koletzko B.
        Classification and therapy of hyperlipidaemias.
        Int Seminars in Paediatric Gastroenterology and Nutrition. 1996; 5: 10-15
        • Abbey M.
        • Nestel P.
        Plasma cholesteryl ester transfer protein activity is increased when trans-elaidic acid is substituted for cis-oleic acid in the diet.
        Atherosclerosis. 1994; 106: 99-107
        • Zock P.L.
        • Katan M.B.
        • Mensink R.P.
        Dietary trans fatty acids and lipoprotein cholesterol.
        Am J Clin Nutrl. 1995; 61: 617
        • Kostner G.
        • Avogaro P.
        • Cazzolazo G.
        • Marth E.
        • Bittolo-Bon G.
        • Quinci G.B.
        Lipoprotein (a) and the risk for myocardial infarction.
        Atherosclerosis. 1981; 38: 51-61
        • Mensink R.P.
        • Zock P.L.
        • Katan M.B.
        • Hornstra G.
        Effect of dietary cisand trans-fatty acids on serum lipoprotein(a) levels in humans.
        J Lipid Res. 1992; 33: 1493-1501
        • Lichtenstein A.H.
        • Austrian A.M.
        • Carrasco W.
        • Jenner J.L.
        • Ordovas J.M.
        • Schaefer E.J.
        Hydrogenation impairs the hypolipidemic effect of corn oil in humans. Hydrogenation, trans- fatty acids, and plasma lipids.
        Arterioscler Thromb Vasc Biol. 1993; 13: 154-161
        • Almendingen K.
        • Jordal O.
        • Kierulf P.
        • Sandstad B.
        • Pedersen J.I.
        Effects of partially hydrogenated fish oil, partially hydrogenated soybean oil and butter on serum lipoproteins and LP(a) in men.
        J Lipid Res. 1995; 36: 1370-1384
      1. (Abstract)
        • Mutanen M.
        • Jauhiainen M.
        • Aro A.
        Lipids, lipoproteins and lipoprotein(a) in healthy subjects having high stearic and trans-fatty acid diets.
        in: Seventh European Nutrition Conference. 1995
        • Sauerwald T.
        • Hachey D.L.
        • Jensen C.L.
        • Chen H.
        • Anderson R.E.
        • Heird W.C.
        Intermediates in endogenous synthesis of C22:6ω3 and C20:4ω6 by term and preterm infants.
        Pediatr Res. 1997; 41: 183-187
        • Demmelmair H.
        • von Schenck U.
        • Behrendt E.
        • Sauerwald T.
        • Koletzko B.
        Estimation of arachidonic acid synthesis in full-term neonates using natural variation of 13C-abundance.
        J Pediatr Gastroenterol Nutr. 1995; 36: 31-36
        • Decsi T.
        • Koletzko B.
        Growth, fatty acid composition of plasma lipid classes, and plasma retinol and tocopherol concentrations in full-term infants fed formula enriched with long-chain polyunsaturated fatty acids.
        Acta Paediatr. 1995; 84: 725-732
        • Mahfouz M.M.
        • Smith T.L.
        • Kummerow F.A.
        Effect of dietary fats on desaturase activities and the biosynthesis of fatty acids in rat-liver microsomes.
        Lipids. 1984; 19: 214-222
        • Rosenthal M.D.
        • Doloresco M.A.
        The effects of trans fatty acids on fatty acyl delta 5 desaturation by human skin fibroblasts.
        Lipids. 1984; 19: 869-874
        • Anderson R.L.
        • Fullmer C.S.
        • Hollenbach E.J.
        Effects of the trans isomers of linoleic acid on the metabolism of linoleic acid in rats.
        J Nutr. 1975; 105: 393-400
        • Lawson L.D.
        • Hill E.G.
        • Holman R.T.
        Suppression of arachidonic acid in lipids of rat tissues by dietary mixed isomeric cis and trans octadecenoates.
        J Nutr. 1983; 113: 1827-1835
        • Hwang D.H.
        • Chanmugam P.
        • Anding R.
        Effects of dietary 9-trans-12trans linoleate on arachidonic acid metabolism in rat platelets.
        Lipids. 1982; 17: 307-313
        • Bruckner G.
        • Goswami S.
        • Kinsella J.E.
        Dietary trilinolelaidate: effects on organ fatty acid composition, prostanoid biosynthesis and platelet function in rats.
        J Nutr. 1984; 114: 58-67
        • Koletzko B.
        Trans fatty acids may impair biosynthesis of long-chain polyunsaturates and growth in man.
        Acta Paediatrica Scandinavia. 1992; 81: 302-306
        • Decsi T.
        • Koletzko B.
        Polyunsaturated fatty acids and infant nutrition.
        Acta Paediatr Suppl. 1994; 395: 1-7
        • Demmelmair H.
        • v.Schenck U.
        • Behrendt E.
        • Sauerwald T.
        • Koletzko B.
        Estimation of arachidonic acid synthesis in full term neonates using natural variation of 13-C content.
        J Pediatr Gastroenterol Nutr. 1995; 21: 31-36
        • Koletzko B.
        • Mrotzek M.
        • Bremer H.J.
        Fatty acid composition of mature human milk in Germany.
        Am J Clin Nutr. 1988; 47: 954-959
        • Koletzko B.
        • Mrotzek M.
        • Bremer H.J.
        Trans fatty acids in human milk and infant plasma and tissue.
        in: Goldman A.S. Atkinson S. Hanson L.A. Human Lactation, Vol. 3. Effect of human milk on the recipient infant. Plenum Publishing Corporation, New York1987: 323-333
        • Koletzko B.
        • Braun M.
        Arachidonic acid and early human growth: is there a relation?.
        Ann Nutr Metab. 1991; 35: 128-131
        • Decsi T.
        • Koletzko B.
        Do trans fatty acids impair linoleic acid metabolism in healthy children?.
        Ann Nutr Metab. 1995; 39: 36-41
        • Voss A.
        • Reinhart M.
        • Sankarappa S.
        • Sprecher H.
        The metabolism of 7,10,13,16,19- docosapentaenoic acid to 4,7,10,13,16,19-docosahexaenoic acid in rat liver is independent of a 4-desaturase.
        J Biol Chem. 1991; 266: 19995-20000
        • Rosenthal M.D.
        • Garcia M.C.
        • Jones M.R.
        • Sprecher H.
        Retroconversion and delta4 desaturation of docosatetraenoate (22: 4(n-6)) and docosapentaenoate (22:5(n-3)) by human cells in culture.
        Biochim Biophys Acta. 1991; 1083: 29-36
        • Koletzko B.
        Trans fatty acids and the human infant.
        in: Galli C. Simopoulos A.P. Tremoli E. Fatty acids and lipids: biological aspects. Karger, Basel1994: 82-85
        • Koletzko B.
        • Decsi T.
        Adipose tissue trans fatty acids and coronary heart disease.
        Lancet. 1995; 345: 1107-1108