Abstract
BackgroundTrans-fatty acids (TFAs) occur in small amounts in nature but became widely produced by the food industry. The hazardous effects of different TFA subtypes to human health are controversial. We aimed to evaluate the association of plasma TFAs levels (elaidic acid, vaccenic acid, palmitelaidic acid, and linoelaidic acid) with mortality.MethodsUtilizing 1999–2000 Nutrition Examination Survey (NHANES) and linked mortality data, we performed a cohort study with 1456 participants and used Cox proportional hazards models and penalized smoothing spline plots to elucidate the relationships between TFAs and all-cause, cardiovascular diseases (CVD) and cancer mortality.ResultsDuring 16,034 person-years of follow-up, a total of 221 deaths occurred. In the multivariate model, including mutual adjustment for the 4 TFA subtypes, elaidic acid associated with higher all-cause mortality (hazard ratio (HR) = 2.00, 95% confidence interval (CI) = 1.18 to 3.40, fourth quartiles versus second quartiles) and CVD mortality (HR = 1.64, 95% CI = 1.07 to 2.50, per 10 units increase). Higher palmitelaidic acid levels were associated with increased cancer mortality (HR = 2.91, 95% CI = 1.09 to 7.81, fourth quartiles versus second quartiles). A J-shaped pattern was observed in the regression curve of elaidic acid and all-cause mortality, as well palmitelaidic acid and cancer mortality.ConclusionsPlasma elaidic acid levels are associated with higher risk of all-cause and CVD mortality, and palmitelaidic acid levels are associated with higher cancer mortality in later life. Further studies are needed to investigate current inconsistent results in this field and the possible underlying mechanisms.
Highlights
Trans-fatty acids (TFAs) occur in small amounts in nature but became widely produced by the food industry
* Correspondence: yfwmanu@sina.com †Equal contributors 1School of Public Health, Wannan Medical College, No 22 Western Wenchang Road, Wuhu 241002, China Full list of author information is available at the end of the article (IP-TFAs), a portion of cis-isomers are converted into trans-isomers during hydrogenation
TFAs, industrially-produced TFAs (IP-TFAs), consistently increases the risk for diseases associated with the modern Western lifestyle such as cardiovascular diseases (CVD) [2,3,4], stroke [5], diabetes [6], Alzheimer’s disease [7], and certain cancers [8]
Summary
Trans-fatty acids (TFAs) occur in small amounts in nature but became widely produced by the food industry. Industrial production of TFAs from vegetable fats since the 1950s was widely increased for use in processed foods, margarine, frying fast foods and commercial baked goods [1]. In industrially-produced TFAs (IP-TFAs), a portion of cis-isomers are converted into trans-isomers during hydrogenation. This conversion stabilizes polyunsaturated oils, protects them against rancidification and keeps them solid at room temperature. Many measures have been adopted to reduce the general population’s intake of TFAs. The Food and Drug Administration announced a final rule that requires food manufacturers to list TFAs on nutrition facts labels in 2003 [9].
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