Article

Fatty acids in cardiovascular health and disease: a comprehensive update.

Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Journal of Clinical Lipidology (Impact Factor: 3.59). 05/2012; 6(3):216-34. DOI: 10.1016/j.jacl.2012.04.077
Source: PubMed

ABSTRACT Research dating back to the 1950s reported an association between the consumption of saturated fatty acids (SFAs) and risk of coronary heart disease. Recent epidemiological evidence, however, challenges these findings. It is well accepted that the consumption of SFAs increases low-density lipoprotein cholesterol (LDL-C), whereas carbohydrates, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) do not. High-density lipoprotein (HDL)-C increases with SFA intake. Among individuals who are insulin resistant, a low-fat, high-carbohydrate diet typically has an adverse effect on lipid profiles (in addition to decreasing HDL-C, it also increases triglyceride and LDL particle concentrations). Consequently, a moderate fat diet in which unsaturated fatty acids replace SFAs and carbohydrates are not augmented is advised to lower LDL-C; compared with a low-fat diet, a moderate-fat diet will lower triglycerides and increase HDL-C. Now, there is some new evidence that is questioning the health benefits of even MUFAs and PUFAs. In addition, in a few recent studies investigators have also failed to demonstrate expected cardiovascular benefits of marine-derived omega-3 fatty acids. To clarify the clinical pros and cons of dietary fats, the National Lipid Association held a fatty acid symposium at the 2011 National Lipid Association Scientific Sessions. During these sessions, the science regarding the effects of different fatty acid classes on coronary heart disease risk was reviewed.

0 Bookmarks
 · 
194 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explain why epidemiological studies have reached such diverse views as to whether apolipoprotein B (apoB) and/or low-density lipoprotein particle number (LDL-P) are more accurate markers of the risk of cardiovascular disease than LDL-C or non-high-density lipoprotein cholesterol (HDL-C) and to review the treatment options to lower LDL. The Emerging Risk Factor Collaboration, a large prospective participant level analysis, a meta-analysis of statin clinical trials, and the Heart Protection Study have each reported that apoB does not add significantly to the cholesterol markers as indices of cardiovascular risk. By contrast, a meta-analysis of published prospective studies demonstrated that non-HDL-C was superior to LDL-C, and apoB was superior to non-HDL-C. As well, three studies using discordance analysis each demonstrated that apoB and LDL-P were superior to the cholesterol markers. Two approaches to resolve these differences are brought to bear in this article: first, which results are credible and second, how does taking the known differences in LDL composition into account, help resolve them. The best identification of individuals at risk of coronary artery disease or with coronary artery disease allows the most efficacious treatment of elevated LDL-P and will permit a more extensive use of some of the more novel LDL-lowering agents. Much of the controversy vanishes once the physiologically driven differences in the composition of the apoB lipoprotein particles are taken into account, illustrating that epidemiology, not directed by physiology, is like shooting without aiming.
    Current opinion in endocrinology, diabetes, and obesity 04/2013; 20(2):140-7. · 3.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: For over a century, catalytic hydrogenation of vegetable oils has been an important process in the food industry, but today, they have lost much of their former popularity, because of the detrimental trans fatty acids as side products. However, the design of novel hydrogenation catalysts and the development of new strategies to remove trans isomers enable the production of trans-free hydrogenated fat products with desirable functionality.
    Angewandte Chemie International Edition 04/2013; · 11.34 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Low-density lipoprotein cholesterol has been positively associated to an increase of cardiovascular risk by a large number of epidemiological studies. On the contrary, high-density lipoprotein cholesterol results inversely related to cardiovascular risk. In this contest plasma total cholesterol and low-density lipoprotein cholesterol concentration, and the total cholesterol - high-density lipoprotein cholesterol ratio seems to be able to predict cardiovascular risk. Diet and its composition affects various plasma cholesterol concentration and their ratios. Particularly, a reduction of saturated fat acids dietary intake is strictly related to both improve of blood lipid profile and reduction of cardiovascular events incidence. On the other hand, the evidences from epidemiologic and clinical studies are consistent in finding that the reduction of cardiovascular risk depends by nutrients used for replacing saturated fat acids. Specifically it has been demonstrated that replacement of saturated fat acids with unsaturated fat acids, either monounsaturated or polyunsaturated ones, is effective in improving cardiovascular risk. On the contrary, saturated fat acids replacement with high glycemic index refined carbohydrate actually increases cardiovascular risk. Despite that, many dietary guidelines do not give any tips about nutrients to use in replacement of saturated fat acids, underestimating the significance. In this perspective Mediterranean diet, represents an attractive dietary pattern for the improvement of blood lipid profile and the reduction of the cardiovascular risk.
    Journal of Basic and Applied Sciences. 01/2014;

Full-text (2 Sources)

View
183 Downloads
Available from
May 20, 2014