Contribution of Trans-Fatty Acid Intake to Coronary Heart Disease Burden in Australia: A Modelling Study.

Jason Wu,Jan Barendregt,Lennert Veerman,Elise Catterall,Shauna Downs,Miaobing Zheng,Beth Thomas

doi:10.3390/nu9010077

Abstract

Trans-fatty acids (TFAs) intake has been consistently associated with a higher risk of coronary heart disease (CHD) mortality. We provided an updated assessment of TFA intake in Australian adults in 2010 and conducted modeling to estimate CHD mortality attributable to TFA intake. Data of the 2011–2012 National Nutrition and Physical Activity Survey was used to assess TFA intake. The CHD burden attributable to TFA was calculated by comparing the current level of TFA intake to a counterfactual setting where consumption was lowered to a theoretical minimum distribution of 0.5% energy. The average TFA intake among adults was 0.59% energy, and overall 10% of adults exceeded the World Health Organization (WHO) recommended limit of 1% energy. Education and income were moderately and inversely associated with TFA intake (p-value ≤ 0.001), with one in seven adults in the lowest income and education quintile having >1% energy from TFA. Australia had 487 CHD deaths (95% uncertainty interval, 367–615) due to TFA exposure, equivalent to 1.52% (95% uncertainty limits: 1.15%–1.92%) of all CHD mortality. The relative impact of TFA exposure on CHD mortality in Australia is limited, but, in absolute terms, still substantial. Policies aimed at reducing industrial TFA exposure can reduce socioeconomic inequalities in health and may therefore be desirable.

Highlights

Trans-fatty acids (TFAs) are unsaturated fatty acids that contain at least one double bond in the trans configuration
Diverse levels of TFA intake have been observed, both due to different dietary habits and varying quantities of iTFA added to processed foods [1]
In Australia, 0.5%E from TFA appears to be a reasonable theoretical minimum distribution level—taking the mean of 0.6%E from total TFA currently based on the NNPAS, and the estimates by Food Standard Australia New Zealand (FSANZ) that rTFA contribute up to 75% of total TFA intake in Australia, elimination of iTFA would leave mean rTFA intake of 0.6% × 75% = ~0.5%E

Summary

Introduction

Trans-fatty acids (TFAs) are unsaturated fatty acids that contain at least one double bond in the trans configuration. TFAs are manufactured via industrial processes (iTFA) including partial hydrogenation and deodorization of vegetable oils, and heating oils at very high temperatures [1]. Low levels of naturally occurring TFAs are obtained from the meat and milk of ruminant animals (rTFA, e.g., cattle and sheep) [2]. TFAs cause lipid and other metabolic disturbances in experimental studies, and are consistently associated with a higher risk of coronary heart disease (CHD) mortality [3,4]. Diverse levels of TFA intake have been observed, both due to different dietary habits and varying quantities of iTFA added to processed foods [1]. Limited data from some countries suggest that TFA intakes vary within populations, and could contribute

Objectives

Methods

Discussion

Conclusion