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Premature coronary deaths in Asians

BMJ 1996; 312 doi: (Published 24 February 1996) Cite this as: BMJ 1996;312:508
  1. Alberto Ascherio,
  2. Eunyoung Cho,
  3. Kathleen Walsh,
  4. Frank M Sacks,
  5. Walter C Willett,
  6. Azhar Faruqui
  1. Assistant professor of nutrition and epidemiology Research associate Research associate Associate professor of nutrition Professor of nutrition and epidemiology Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
  2. Professor of cardiology National Institute of Cardiovascular Diseases, Karachi-75510, Pakistan

    EDITOR,—Sandeep Gupta and colleagues discuss ways in which premature coronary deaths in Asians in Britain might be avoided.1 When cooking, many people in India and Pakistan use a semisolid fat obtained by partially hydrogenating vegetable oils. This product, called vanaspathi or vegetable ghee, contains high levels of trans-fatty acids, which adversely affect blood lipid concentrations and are thus likely to increase the risk of coronary heart disease.2

    As part of a pilot investigation conducted at the National Institute of Cardiovascular Diseases in Karachi to assess the feasibility of a case-control study we collected specimens of subcutaneous fat from 48 subjects. The samples were collected by a modification of the technique described by Beynen and Katan,3 stored at 70°C, and transported to the United States on dry ice. Fatty acids were extracted and analysed by capillary gas chromatography with a 100 m column. We found that the 14 subjects who used vegetable ghee for both cooking and frying had significantly higher percentages of trans-fatty acids and lower percentages of linoleic and linolenic acid in adipose tissue than the 21 subjects who used only non-hydrogenated vegetable oils (table 1). The adipose tissue of the remaining 13 subjects, who used a combination of different fats, had an intermediate composition.

    Table 1

    Comparison of content of adipose tissue (expressed as percentages) in 48 subjects according to type of fat used for cooking and frying.* Figures are means (SD)

    View this table:

    These data indicate that consumption of vegetable ghee is associated with changes in the fatty acid composition of body fat that are likely to increase the risk of coronary heart disease. Vegetable ghee is also consumed by south Asians who have settled overseas, and this may help explain their higher mortality from coronary heart disease.1 4 5


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