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Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3978 (Published 12 August 2015) Cite this as: BMJ 2015;351:h3978

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Re: Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies

Trans fats consumption associated with low intake vitamins, antioxidants and minerals and their effect on health.
We have read the article by Dr de Souza RJ and colleagues in your recent issue of the journal which shows that increased consumption of trans fats is associated with increased risk of mortality and coronary artery disease(1). A decrease in fruit and vegetable consumption is associated with poor health and increased risk of non communicable diseases (NCDs). Low intake of fruits and vegetables is seen in families with low socioeconomic status and this is often due to the increase in cost of fruits and vegetables (2). Vegetables contain generally 90-96% water and fruits water content is between 80 and 90% (3). When food is cooked, cooking medium and the duration of heating can decrease the vitamin (fat-soluble and water-soluble vitamins) content of foods as vitamins are susceptible to heat. Cooking method that can result in the loss of minerals. This generates undesirable compounds (like nitrosamines) during frying, baking, grilling, smoking and roasting . Cooking can also increase the formation and bio-availability of some antioxidants, such as lycopene. (2) and decrease water content (4). Increased consumption of trans fats decreases plasma high-density lipoprotein (HDL) and increases low-density lipoprotein (LDL)-cholesterol. Trans fat intake can increase the body fat (5).
Increase in trans fat consumption leads to impairment of memory behavioral irritability and aggression in adults (6.7). In India the fat content of vegetable oils from street vendors has high levels of saturated fat and trans fat. People are consuming snacks having increased content of trans fat as part of daily diets. Trans fat consumption in India exceeds WHO recommendations for transfat intake (8). Trans fats intake is also associated with breast cancer, shortening of pregnancy period, risks of preeclampsia, disorders of nervous system, colon cancer, diabetes, obesity and allergy(9). A recent study shows that eating while walking leads to overeating compared to eating during other forms of distraction such as watching TV or during a conversation with a friend(10).The distraction, including eating at our desks also can lead to weight gain (10). People eat more often commercially prepared foods while walking, watching TV , and working at desk.
Consumption of snacks with trans fat is more often associated with low intake of dietary fibre, vegetables and fruits leading to low intake of vitamins, antioxidants and minerals. The deficiency of these can also contribute to metabolic disorders and cardiovascular disease .

References
1.de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies.
BMJ. 2015 Aug 11;351:h3978. doi: 10.1136/bmj.h3978.
2. Increasing fruit and vegetable consumption to reduce the risk of non communicable diseases
http://www.who.int/elena/titles/bbc/fruit_vegetables_ncds/en/
3. Bastin S , Henken K Water Content of Fruits and Vegetables. University of Kentucky - Cooperative Extension Service - December 1997. https://www2.ca.uky.edu/enri/pubs/enri129.pdf
4. The Why, How and Consequences of cooking our food. EUFIC REVIEW 11/2010
http://www.eufic.org/article/en/expid/cooking-review-eufic/
5. Bendsen NT, Chabanova E, Thomsen HS, Larsen TM, Newman JW, Stender S, Dyerberg J, Haugaard SB, Astrup A. Effect of trans fatty acid intake on abdominal and liver fat deposition and blood lipids: a randomized trial in overweight postmenopausal women.
Nutr Diabetes. 2011 Jan 31;1:e4. doi: 10.1038/nutd.2010.4.
6. Golomb BA, Bui AK A Fat to Forget: Trans Fat Consumption and Memory
PLoS One. 2015 Jun 17;10(6):e0128129. doi: 10.1371/journal.pone.0128129. eCollection 2015.
7.Golomb BA1, Evans MA, White HL, Dimsdale JE. Trans fat consumption and aggression PLoS One. 2012;7(3):e32175. doi: 10.1371/journal.pone.0032175. Epub 2012 Mar 5.
8. Downs SM1, Singh A2, Gupta V3, Lock K4, Ghosh-Jerath S. The need for multisectoral food chain approaches to reduce trans fat consumption in India
BMC Public Health. 2015 Jul 22;15(1):693. doi: 10.1186/s12889-015-1988-7.
9. Dhaka V, Gulia N, Ahlawat KS, Khatkar BS. Trans fats—sources, health risks and alternative approach - A review. Journal of food science and technology. 2011;48(5):534-541. doi:10.1007/s13197-010-0225-8.
10. Jane Ogden J , Oikonomou E and Alemany G. Distraction, restrained eating and disinhibition: An experimental study of food intake and the impact of ‘eating on the go’ Journal of Health Psychology Ogden, August 2015 DOI:10.1177/1359105315595119

Competing interests: No competing interests

23 August 2015
Mahantayya V Math
Associate Professor in Physiology
Dr Yashoda Ravindra Kattimani Assistant Professor in Physiology
MGM Medical College, Kamothe ,Navi Mumbai
Kamothe, Navi Mumbai 410209, Maharashtra State, India