The effect of dietary trans alpha-linolenic acid on plasma lipids and platelet fatty acid composition: the TransLinE study

A 24-year prospective study of dietary α-linolenic acid and lethal prostate cancer

Several meta-analyses have attempted to determine the relationships between intake of α-linolenic acid (ALA) and prostate cancer, but results were inconclusive. 47,885 men aged 40-75 years without prior cancer in the Health Professionals Follow-Up Study were prospectively followed from 1986 to 2010. Intake of ALA was determined from validated food frequency questionnaires every 4 years. We used multivariate Cox proportional hazards models to estimate hazard ratios (HR) with 95% confidence intervals (CIs) for lethal prostate cancer (distant metastasis or prostate cancer death). 386 lethal prostate cancers were diagnosed in the pre-PSA era (before February, 1994) and 403 cancers in the PSA era. Intake of ALA was associated with increased risk of lethal prostate cancer in the pre-PSA era (comparing top to bottom quintile of intake, multivariate-adjusted HR = 1.78; 95% CI = 1.22-2.06; p_trend  = 0.003), but not in the PSA era (HR = 0.81; 95% CI = 0.56-1.17; p_trend  = 0.53), and the difference in associations was statistically significant (p for interaction = 0.02). Mayonnaise, a primary food source of ALA intake in our cohort, was likewise only significantly associated with lethal prostate cancer in the pre-PSA era. Among many other fatty acids that are correlated with ALA due to shared food sources, none was associated with lethal prostate cancer in the pre-PSA era. In conclusion, higher intake of ALA was associated with an increased risk of lethal prostate cancer in the pre-PSA era, but not in the PSA era. Potential reasons for the differential associations warrant further investigation.

Dietary intake of α-linolenic acid and risk of age-related macular degeneration

Background: The relation between α-linolenic acid (ALA), a plant-derived omega-3 (n-3) fatty acid, and age-related macular degeneration (AMD) is unclear. European researchers reported that ≤40% of ALA can be present as trans forms.Objective: We aimed to evaluate the associations between intake of ALA and intermediate and advanced AMD.Design: Seventy-five thousand eight hundred eighty-nine women from the Nurses' Health Study and 38,961 men from Health Professionals Follow-Up Study were followed up from 1984 to 2012 and from 1986 to 2010, respectively. We assessed dietary intake by a validated food-frequency questionnaire at baseline and every 4 y thereafter. One thousand five hundred eighty-nine incident intermediate and 1356 advanced AMD cases (primarily neovascular AMD) were confirmed by medical record review.Results: The multivariable-adjusted HR for intermediate AMD comparing ALA intake at the top quintile to the bottom quintile was 1.28 (95% CI: 1.05, 1.56; P-trend = 0.01) in the analyses combining 2 cohorts. The HR in each cohort was in the positive direction but reached statistical significance only in the women. However, the positive association was apparent only in the pre-2002 era in each cohort and not afterward (P-time interaction = 0.003). ALA intake was not associated with advanced AMD in either time period. Using gas-liquid chromatography, we identified both cis ALA (mean ± SD: 0.13% ± 0.04%) and trans ALA isomers (0.05% ± 0.01%) in 395 erythrocyte samples collected in 1989-1990. In stepwise regression models, mayonnaise was the leading predictor of erythrocyte concentrations of cis ALA and one isomer of trans ALA. We also found trans ALA in mayonnaise samples.Conclusions: A high intake of ALA was associated with an increased risk of intermediate AMD before 2002 but not afterward. The period before 2002 coincides with the same time period when trans ALA was found in food and participants' blood; this finding deserves further study.

Plasma phospholipid trans-fatty acids levels, cardiovascular diseases, and total mortality: the cardiovascular health study

BACKGROUND

While self-reported trans-fatty acid (TFA) consumption is linked to coronary heart disease (CHD), relationships between objective biomarkers of TFA subtypes (t-16:1n9, total t-18:1, and cis/trans-(c/t-), t/c- and t/t-18:2) and cardiovascular disease (CVD) or total mortality are not well established.

METHODS AND RESULTS

We evaluated 2742 adults in the Cardiovascular Health Study, aged 74±5 years and free of prevalent CVD, with plasma phospholipid TFA measures in 1992. Incident fatal and nonfatal CHD events, CVD and non-CVD mortality, and total mortality were centrally adjudicated through 2010. Risks were assessed using Cox proportional hazards. During 31 494 person-years, 1735 total deaths and 639 total CHD events occurred. In the multivariate model including mutual adjustment for the 5 TFA subtypes, circulating t/t-18:2 was associated with higher total mortality (extreme quintile hazard ratio (HR)=1.23, 95% CI=1.04 to 1.44, P-trend=0.01), CVD mortality (HR=1.40, 95% CI=1.05 to 1.86, P-trend=0.02), and total CHD (HR=1.39, 95% CI=1.06 to 1.83, P-trend=0.01). t/c-18:2 was positively related to total mortality (HR=1.19, P-trend=0.05), total CHD (HR=1.67, P-trend=0.002), and nonfatal CHD (HR=2.06, P-trend=0.002) after mutual adjustment; these associations were insignificant without mutual adjustment. Neither t-16:1n9 nor t-18:1 was significantly associated with total mortality or CVD, nor was c/t-18:2 if we excluded early cases.

CONCLUSIONS

Among circulating TFAs, t/t-18:2 was most adversely associated with total mortality, mainly due to the increased risk of CVD. t/c-18:2 was also positively associated with total mortality and CHD, but only after adjustment for other TFAs. These results highlight the need for further investigation of dietary sources, nondietary determinants, and health effects of specific TFA subtypes, especially t-18:2 isomers.

Trans fatty acids in diets act as a precipitating factor for gut inflammation?

Fatty acids in our daily diet are broadly classified into cis and trans fatty acids (TFAs). TFAs are formed during the manufacturing process of hydrogenated vegetable oils such as margarine. Modern diets such as deep-fried products, frozen foods, and packaged snacks commonly include large quantities of margarine containing TFAs. Although an increased report in the effects of the diet containing TFAs on a risk factor of metabolic syndrome, diabetes mellitus, and coronary heart disease has been observed in the recent years, influence on intestinal inflammation remains unknown. This review describes pro-inflammatory effects of TFAs in our diary diet on various systemic disorders and also discusses a possible role of TFAs on gut inflammation.

Content of trans fatty acids in human cheek epithelium: comparison with serum and adipose tissue

Studies pertaining to trans fatty acids (TFA), which have been implicated in development of chronic diseases, are more relevant in developing countries where nutrition transition is changing traditional habits and practices. Measuring TFA is an arduous task because of the need for fat biopsies. This study identifies a tissue, which can be easily accessed for analytical measurement of trans fatty acid. In this cross-sectional study, fatty acid in adipose tissue, cheek epithelium, and blood samples were assessed by gas chromatography. Spearman correlation coefficient was computed to study the correlation of fatty acid distribution among the three tissues. The correlation coefficient of total trans fatty acid between cheek epithelium and serum was 0.30 (P < 0.02) and between cheek epithelium and adipose tissue was 0.33 (P < 0.019). This study is the first to report trans fatty acid profile in cheek epithelium giving scope for utilizing the cheek epithelium as a tissue for objective assessment of trans fatty acid intake.

Trans fat involvement in cardiovascular disease

Coronary heart disease is becoming a worldwide epidemic and diet and lifestyle are well known contributing factors. Identifying the kinds of foods that may have a cardioprotective or cardiotoxic effect and understanding their molecular mechanisms of action has become of increasing importance. Through largely epidemiological evidence, trans fatty acid (TFA) intake has been associated with a variety of cardiovascular complications including atherosclerosis. Traditionally, industrial TFAs (iTFAs) have been associated with these deleterious cardiovascular effects. However, there is a current body of research that suggests that ruminant trans fats (rTFAs) may have a cardioprotective role within the heart. The molecular mechanisms whereby TFAs are delivering their effects are largely unknown. In the following review, we discuss recent in vitro, animal and epidemiological research to better understand the effect of TFAs in the diet on cardiovascular disease, particularly atherosclerosis.

Oxidative risk for atherothrombotic cardiovascular disease

In the vasculature, reactive oxidant species, including reactive oxygen, nitrogen, or halogenating species, and thiyl, tyrosyl, or protein radicals may oxidatively modify lipids and proteins with deleterious consequences for vascular function. These biologically active free radical and nonradical species may be produced by increased activation of oxidant-generating sources and/or decreased cellular antioxidant capacity. Once formed, these species may engage in reactions to yield more potent oxidants that promote transition of the homeostatic vascular phenotype to a pathobiological state that is permissive for atherothrombogenesis. This dysfunctional vasculature is characterized by lipid peroxidation and aberrant lipid deposition, inflammation, immune cell activation, platelet activation, thrombus formation, and disturbed hemodynamic flow. Each of these pathobiological states is associated with an increase in the vascular burden of free radical species-derived oxidation products and, thereby, implicates increased oxidant stress in the pathogenesis of atherothrombotic vascular disease.

Membrane lipidomics and the geometry of unsaturated fatty acids from biomimetic models to biological consequences

In the last decades, free radical processes delineated an interdisciplinary field linking chemistry to biology and medicine. Free radical mechanisms became of importance as molecular basis of physiological and pathological conditions. Lipids, in particular, unsaturated fatty acids, are susceptible of free radical attack. The reactivity of the double bond toward free radicals is well known, in particular the reversible addition of radical species to this functionality determines the cis-trans double bond isomerization. Since the prevalent geometry displayed by unsaturated fatty acids in eukaryotes is cis, the occurrence of the cis-trans isomerization by free radicals corresponds to the loss of an important structural information linked to biological activity. The formation of trans isomers can have important meaning and consequences connected to radical stress. Free radical isomerization of membrane fatty acids has been the subject of research coupling the top-down approach by model studies, such as biomimetic chemistry in liposomes, with the bottom-up approach dealing with the examination of cell membrane lipidome in living systems under several physiopathological conditions. Methodologies and molecular libraries have been settled, for both liposome experiments and the examination of the radical stress in biological membranes. This chapter will give an overview of the current procedures used for liposome models and the cis-trans isomerization experiments, in order to build-up a library of trans geometrical fatty acid isomers.

Trans Fatty Acids in Membranes: The Free Radical Path

The double bond geometry of most of the naturally occurring unsaturated fatty acid residues is cis. Due to the relevance of fatty acids as structural components of cell membranes and as biologically active molecules, the change of the cis geometry means a change of the associated functions and activities. The finding that the cis to trans isomerization is effective in phospholipids by the intervention of radical species led to the discovery that there can indeed occur an endogenous formation of trans fatty acids, whose significance in biological systems started to be addressed with in vitro and in vivo studies. Studies of liposome models simulating the formation of isomerizing species and evaluating their ability to interact with the hydrophobic part of the membrane bilayer has contributed to the gain in knowledge of the fundamental features of the lipid isomerization in membranes. Further work is in progress for the identification of the real culprits of the in vivo lipid isomerization, and recent results are shown on oleic acid micelles, where *NO2 radicals are not able to induce double bond isomerization in comparison with amphiphilic thiol, such as 2-mercaptoethanol. H2S and sulfur-containing amino acid residues are two of the possible species involved in this process at a biological level. An update of the scenario of the geometrical isomerization in membranes by free radicals is provided, together with applications and perspectives in life sciences.

Dietary trans fatty acids: Review of recent human studies and food industry responses

Dietary trans FA at sufficiently high levels have been found to increase low density lipoprotein (LDL)-cholesterol and decrease high density lipoprotein (HDL)-cholesterol (and thus to increase the ratio of LDL-cholesterol/HDL-cholesterol) compared with diets high in cis monounsaturated FA or PUFA. The dietary levels of trans FA at which these effects are easily measured are around 4% of energy or higher to increase LDL-cholesterol and around 5 to 6% of energy or higher to decrease HDL-cholesterol, compared with essentially trans-free control diets. Very limited data at lower levels of intake (less than 4% of energy) are available. Most health professional organizations and some governments now recommend reduced consumption of foods containing trans FA, and effective January 1, 2006, the U.S. Food and Drug Administration requires the labeling of the amounts of trans FA per serving in packaged foods. In response, the food industry is working on ways to eliminate or greatly reduce trans FA in food products. Current efforts focus on four technological options: (i) modification of the hydrogenation process, (ii) use of interesterification, (iii) use of fractions high in solids from natural oils, and (iv) use of trait-enhanced oils. Challenges to the food industry in replacing trans FA in foods are to develop formulation options that provide equivalent functionality, are economically feasible, and do not greatly increase saturated FA content.

Cis-9, trans- 11 and trans-10, cis-12 conjugated linoleic acid (CLA) do not affect the plasma lipoprotein profile in moderately overweight subjects with LDL phenotype B

BACKGROUND

Results of a pilot study suggested that cis-9, trans-11 conjugated linoleic acid (CLA) improved LDL phenotype in moderately overweight subjects with LDL phenotype B.

OBJECTIVE

Initiated by the results of this pilot study, we have specifically designed a study to test the hypothesis that cis-9, trans-11 conjugated linoleic acid improves LDL phenotype in moderately overweight subjects with LDL phenotype B. Effects on the serum lipid profile, on plasma glucose and insulin concentrations, and on clinical parameters were also examined.

DESIGN

Volunteers with LDL phenotype B were divided into three groups consuming daily a drinkable dairy product not enriched with CLA (placebo, n = 34), the same dairy product enriched with 3g c9, t11 CLA (n = 34), or the dairy product enriched with 3g t10, c12 CLA (n = 19) for 13 weeks.

RESULTS

Median changes in the proportions of plasma small dense LDL were -2.0% in the control group and -0.1% in the c9, t11 CLA and t10, c12 CLA groups (p = 0.981 for the differences between the groups). c9, t11 CLA or t10, c12 CLA did also not affect serum concentrations of LDL and HDL cholesterol, and of triacylglycerol, and plasma concentrations of glucose and insulin.

CONCLUSIONS

In humans with LDL phenotype B, c9, t11 CLA and t10, c12 CLA do not beneficially change risk factors for cardiovascular disease or diabetes.

Occurrence of trans fatty acids in rats fed a trans-free diet: a free radical-mediated formation?

Trans isomers of unsaturated fatty acids are absorbed from the diet, due to their presence in diary fat and hydrogenated vegetable oils, and health concern has risen due to their effects on lipid risk factors in cardiovascular diseases. On the basis of the efficiency of the thiyl-radical-catalyzed cis/trans isomerization in vitro and the presence of many sulfur-containing compounds in the cell, the aim of this study was to demonstrate that trans geometry of lipid double bonds can be endogenously generated within membrane phospholipids. The study reports trans fatty acids occurrence in tissue and erythrocyte phospholipids of young adult rats fed a diet completely free of trans isomers. Results show that tissues are differently prone to the endogenous isomerization and that, following a free radical attack, trans fatty acids can reach very high amounts. The effectiveness of this process is considerably inhibited in the presence of all-trans retinol, confirming previous data in model membranes. Our results suggest that geometrical isomerization of unsaturated fatty acids, which causes a structural modification of membrane lipids and may influence basic membrane properties and vital biochemical functions, can occur under radical stress conditions and could be efficiently prevented by vitamin A.

Trans fatty acids and atopic eczema/dermatitis syndrome: the relationship with a free radical cis-trans isomerization of membrane lipids

The formation of trans FA residues in membrane phospholipids may be due to a free radical-catalyzed isomerization process occurring to the cis unsaturated FA moieties. Radical stress is well documented in inflammatory processes of atopic diseases, but no data are yet available about a possible association with trans FA detected in these patients. We investigated the presence of trans lipid isomers in the erythrocyte and T-lymphocyte membranes of 26 children affected by atopic eczema/dermatitis syndrome (AEDS). Trans lipid isomers were found in both cell membranes, up to a total content of 2.7 and 4.9% of the FA composition, respectively. By using the geometrical trans lipid library derived from in vitro models of thiyl radical-catalyzed isomerization, oleic and arachidonic acid isomers were detected. The statistical significance was evaluated by comparison with an age-matched control group. These results suggest the role of an endogenous free radical isomerization path occurring to membrane unsaturated lipids, complementary to the dietary contribution, which can be involved in the lipid impairment in AEDS. This study contributes to lipidomic research regarding the double bond structure and the influence of a geometrical change of membrane lipids in physiology and diseases.

Comparison of Phosphatidylcholine Vesicle Properties Related to Geometrical Isomerism†

Glycerophosphatidylcholine containing trans-unsaturated fatty acid residues was prepared by reaction of the corresponding naturally occurring cis lipid with photochemically generated thiyl radicals. This modified lipid was chosen as the simplest model for gaining some insights of the complex scenario of membrane formation, in connection with the role of lipid geometry and the predominance of cis lipids in eukaryotic cells. The critical aggregation concentration for the spontaneous formation of vesicles was determined for cis and trans isomers with cis-parinaric acid used as a fluorescent probe and it was found to be similar for both lipids. Vesicle dimensions were investigated by light scattering and electron microscopy, and the type of fatty acid residues influenced the vesicle diameter, with a decrease along the series cis > trans > saturated. Fluorescence measurement of dye release from trans and cis vesicles showed also a different permeability. A picture emerged of the geometrical isomer preference in cells as a process driven by natural selection during the life evolution of different organisms, both in terms of compartment dimensions and membrane functionality.

Geometrical trans Lipid Isomers: A New Target for Lipidomics

Evidence that lipids play different roles in the biological environment, particularly in dealing with metabolic regulation and cell signaling, has led to a growing interest in these molecules, and nowadays the research field of lipid structures and functions is called lipidomics. The term describes diverse research areas, from mapping the entire spectrum of lipids in organisms to describing the function and metabolism of individual lipids. Recent investigations on geometrical trans isomers of fatty acid derivatives, which have the double bonds in the same position as the natural compounds but with the trans instead of the naturally occurring cis geometry, highlighted these compounds as a new target for lipidomics. In addition to the identification of their structures and functions, research in a multidisciplinary context aims at understanding the biochemical significance of cis and trans lipid geometry, and a chemical biology approach can be envisaged to explore the role of the geometry change as either an alteration or a signal that can perturb a biological system and induce a cellular response.

Synthesis of all-trans arachidonic acid and its effect on rabbit platelet aggregation

A simple and high-yielding method to convert natural all-cis PUFA derivatives to the corresponding all-trans geometrical isomers is described. The method is based on the thiyl radical-catalyzed cis-trans isomerization. The all-trans isomer of arachidonic acid was found to cause rabbit platelet aggregation at concentrations higher than 0.1 mM and inhibition of PAF-induced platelet aggregation in a concentration dependent manner with an IC(50) in the micromolar range.

Test-retest reliability of Yale Physical Activity Survey among older Mexican American adults: a pilot investigation

The objective of the work reported in this paper is to assess test-retest reliability of Yale Physical Activity Survey Total Time, Estimated Energy Expenditure, Activity Dimension Indices, and Activities Check-list in older Mexican American men and women. A convenience-based healthy sample of 49 (42 women and 7 men) older Mexican American adults recruited from senior recreation centers aged 68 to 80 years volunteered to participate in this pilot study. Forty-nine older Mexican American adults filled out the Yale Physical Activity Survey for this study. Fifteen (12 women and 3 men) of the 49 volunteers responded twice to the Yale Physical Activity Survey after a 2-week period, and helped assess the test-retest reliability of the Yale Physical Activity Survey. Results indicate that based on a 2-week test-retest administration, the Yale Physical Activity Survey was found to have moderate (rhoI= .424, p < .05) to good reliability (rs = .789, p < .01) for physical activity assessment in older Mexican American adults who responded.

Regioselective cis-trans isomerization of arachidonic double bonds by thiyl radicals: the influence of phospholipid supramolecular organization

Trans unsaturated fatty acids in humans may be originated by two different contributions. The exogenous track is due to dietary supplementation of trans fats and the endogenous path deals with free-radical-catalyzed cis-trans isomerization of fatty acids. Arachidonic acid residue (5c,8c,11c,14c-20:4), which has only two out of the four double bonds deriving from the diet, was used to differentiate the two paths and to assess the importance of a radical reaction. A detailed study on the formation of trans phospholipids catalyzed by the HOCH2CH2S* radical was carried out on L-alpha-phosphatidylcholine from egg lecithin and 1-stearoyl-2-arachidonoyl-L-alpha-phosphatidylcholine (SAPC) in homogeneous solution or in large unilamellar vesicles (LUVET). Thiyl radicals were generated from the corresponding thiol by either gamma-irradiation or UV photolysis, and the reaction course was followed by GC, Ag/TLC, and 13C NMR analyses. The isomerization was found to be independent of cis double bond location (random process) in i-PrOH solution. In the case of vesicles, the supramolecular organization of lipids produced a dramatic change of the isomerization outcome: (i) in egg lecithin, the reactivity of arachidonate moieties is higher than that of oleate and linoleate residues, (ii) in the linoleate residues of egg lecithin, the 9t,12c-18:2 isomer prevailed on the 9c,12t-18:2 isomer (3:1 ratio), and (iii) a regioselective isomerization of SAPC arachidonate residues occurred in the 5 and 8 positions. This effect of "positional preference" indicates that thiyl radicals entering the hydrophobic region of the membrane bilayer start to isomerize polyunsaturated fatty acid residues having the double bonds nearest to the membrane surfaces. We propose that arachidonic acid and its trans isomers can function as biomarkers in membranes for distinguishing the two trans fatty acid-forming pathways.

Dietary trans fatty acids and composition of human atheromatous plaques

Dietary fatty acids are incorporated into atheromatous plaques mainly in the form of cholesterol esters. Physicochemical properties of the plaque (e. g. mechanical strength) depend on its fatty acid composition. Trans isomers of unsaturated fatty acids (TFA) are known to reduce the availability of fatty acid precursors for the synthesis of anticoagulant PG(1) and PG(3) prostaglandins. The present study was undertaken to determine the content of trans isomers in atheromatous plaques and to search for correlations between trans isomers in the plaque and adipose tissue. Atheromatous plaques were obtained from 31 patients who underwent surgery due to atherosclerotic stenosis of the abdominal aorta, iliac or femoral arteries. Fatty acids were extracted and separated as methyl esters using gas chromatography (GC) with an internal standard. Correlations were searched for with statistical methods, taking the level of significance as p < 0.05. We found spatial and positional isomers of sixteen- and eighteen-carbon fatty acids in plaques and adipose tissue, with elaidic acid (C18:1 trans-9) being the most abundant. Every plaque and adipose tissue sample contained linolelaidic acid (C18:2 trans-9 trans-12) which is derived exclusively from linoleic acid, as well as conjugated dienes of linoleic acid (CLA) produced during oxidative processes. The presence of trans isomers of fatty acids in the atheromatous plaque seems to be of relevance to plaque formation. Of much concern is the detection of elaidic and linolelaidic acids which adversely affect the physiologically important metabolism of eicosanoids. The TFA pool in adipose tissue has little effect on the amount of these acids in the atheromatous plaque. Apparently, the presence of TFA in atheromatous plaques is the result of processes taking place during plaque formation and maturation.

Arachidonate geometrical isomers generated by thiyl radicals: the relationship with trans lipids detected in biological samples

The presence of trans fatty acids in mammalians is attributed to exogenous sources; nevertheless, trans isomers could be easily formed by free radical-catalyzed isomerization processes in vivo. The isomerization of methyl arachidonate (all-cis isomer) catalyzed by thiyl radical is proposed as a methodology applicable in biochemical laboratories, which produces mono- and di-trans isomers. Carbon-13 nuclear magnetic resonance spectroscopy shows that the carbon atom in position 15 is characteristic for each mono- and di-trans isomer. Antioxidants, such as alpha-tocopherol and all-trans-retinol acetate, inhibited the isomerization process. Trans phospholipids are formed in erythrocyte membranes by exposing blood to gamma-irradiation in the presence of thiols, which is in contradiction with the known role of these compounds as radioprotectors. Trans isomers are also analyzed in tissues harvested from breast cancer patients and compared to the adipose breast tissue taken a few centimeters from the edge of the tumor from the same patient. This work is generally aimed at contributing to the debate on trans fatty acids and stimulating a reconsideration of the current view on the exclusive presence of cis double bonds in cell membranes by studying radical processes that could affect or protect this natural configuration.

Dietary trans alpha-linolenic acid from deodorised rapeseed oil and plasma lipids and lipoproteins in healthy men: the TransLinE Study

TRANS: isomers of alpha-linolenic acid, which are formed by deodorization of refined vegetable oils, can be found in significant amounts in edible oils. Effects of trans alpha-linolenic acid on plasma lipoproteins are unknown. We therefore investigated the effects of trans alpha-linolenic acid on plasma lipids and lipoproteins in healthy European men. Eighty-eight healthy men from three European countries (France, Scotland, UK and the Netherlands) first consumed for 6 weeks a diet with experimental oils 'free' of trans fatty acids (run-in period). For the next 6 weeks, they were randomly allocated to a diet with experimental oils 'high' or 'low' in trans alpha-linolenic acid. Daily total trans alpha-linolenic acid intake in the high trans group was 1410 (range 583-2642) mg. Experimental oils were provided as such, or incorporated into margarines, cheeses, muffins and biscuits. The high trans alpha-linolenic acid diet significantly increased the plasma LDL-:HDL-cholesterol ratio by 8.1 % (95 % CI 1.4, 15.3; and the total cholesterol:HDL-cholesterol ratio by 5.1 % (95 % CI 0.4, 9.9; compared with the low-trans diet. This was largely explained by an increase in LDL-cholesterol on the high-trans diet, while no change was observed in the low-trans group (mean treatment effect of 4.7 % (95 % CI -0.8, 10.5; No effects were found on total cholesterol and HDL-cholesterol, triacylglycerols, apolipoprotein B and A-1, and lipoprotein(a) concentrations. In conclusion, trans alpha-linolenic acid may increase plasma LDL-:HDL-cholesterol and total cholesterol:HDL-cholesterol ratios. Whether diet-induced changes in these ratios truly affects the risk for CHD remains to be established.

No effect of dietary trans isomers of alpha-linolenic acid on platelet aggregation and haemostatic factors in european healthy men. The TRANSLinE study

The aim of this study was to investigate the effect of trans alpha-linolenic acid on platelet aggregation and blood haemostasis. A randomized, double blind dietary intervention trial was carried out with healthy male volunteers (n=88) in three European centers. After a 6-week washout period where subjects avoided foods containing all trans fats, subjects either continued for 6 weeks with a low trans diet or a diet where trans alpha-linolenic acid provided 0.6% of energy (supplied as oil, margarine, cheese, muffins, and biscuits). At the end of the washout period the intake of trans polyunsaturated fats was 58+/-115 mg/day; this increased in patients on the high trans diet by +1344+/-328 mg/day, compared with +10+/-67 mg/day in patients on the low trans diet (p<0.01). The change in trans alpha-linolenic acid in plasma cholesteryl esters was 0.26+/-0. 20 on the high trans and 0.00+/-0.07% of fatty acids on the low trans diet (p<0.001). No effect of the high trans diet was observed on platelet aggregation: collagen EC(50) high trans 157+/-100, low trans 152+/-90 ng/mL (NS); U44619 EC(50) high trans 81+/-61, low trans 59+/-27 nM (NS). The high trans diet did not affect platelet thromboxane production, fibrinogen levels, factor VII, activated factor VIIa, or plasminogen activator inhibitor activity. There were no center-specific differences in response to the high trans diet. A relatively high amount of trans alpha-linolenic acid for 6 weeks does not increase the risk of coronary heart disease by promoting platelet aggregation and blood coagulation.