High consumption of trans fat, found mainly in partially hydrogenated vegetable oils and widely used by the food industry, has been linked to an increased risk of coronary heart disease (CHD). Many cities are considering bans to eliminate its use in restaurants.
A recent study from the Harvard School of Public Health (HSPH) provides the strongest association to date between trans fat and heart disease. It found that women in the U.S. with the highest levels of trans fat in their blood had three times the risk of CHD as those with the lowest levels. The study appeared in the Circulation: Journal of the American Heart Association.
“The strength of this study is that the amount of trans fatty acid levels was measured in blood samples from the study population. Because humans cannot synthesize trans fatty acids, the amount of trans fat in red blood cells is an excellent biomarker of trans fat intake,” said senior author Frank Hu, associate professor of nutrition and epidemiology at HSPH.
Clinical trials have shown that trans fatty acids increase LDL “bad” cholesterol and lower HDL “good” cholesterol, making them the only class of fatty acids, which includes saturated fat, to have this dual effect.
The researchers, led by Hu and lead author Qi Sun, a graduate research assistant at HSPH, set out to test the assumption that higher trans fatty acid levels in red blood cells were associated with a higher risk of heart disease among U.S. women.
Blood samples collected from 32,826 participants were examined. During six years of follow-up, 166 cases of CHD were diagnosed in participants with a low level of trans fatty acids in red blood cells compared to 327 cases of CHD in participants with a high level of trans fatty acids.
After adjusting for age, smoking status and other dietary and lifestyle cardiovascular risk factors, the researchers found that a higher level of trans fatty acids in red blood cells was associated with an elevated risk of CHD. The risk among women in the top quarter of trans fat levels was triple that of the lowest quarter.
“Positive associations have been shown in earlier studies based on dietary data provided by the participants, but the use of red blood cell biomarkers of trans fatty acids is believed to be more reliable than self-reports. This is probably the reason why we see an even stronger association between blood levels of trans fat and risk of CHD in this study,” said Sun.
“These data provide further justifications for current efforts to remove trans fat from foods and restaurant meals,” said Hu. “Trans fat intake in the U.S. is still high. Reducing trans fat intake should remain an important public health priority.”
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