Skip to main content
Log in

Dietary Trans Fatty Acids and Cardiovascular Disease Risk: Past and Present

  • Nutrition (JP Foreyt, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Dietary trans double bond containing fatty acids have been associated with increased risk of cardiovascular disease. There are two main sources of dietary trans fatty acids: meat and dairy fats, and partially hydrogenated fats. Because of a number of factors, including changes in federal labeling requirements for packaged foods, and local bans and grassroots pressure on the use of partially hydrogenated fat, trans fat intake has declined in recent years. Similar to saturated fatty acids, trans fatty acids increase plasma low density lipoprotein (LDL)-cholesterol concentrations. In contrast to saturated fatty acids, trans fatty acids do not increase high density lipoprotein (HDL)-cholesterol concentrations. These differences have been attributed to lipoprotein catabolic rate rather than production rate. When reported, effects of partially hydrogenated fat on glucose homeostasis, C-reactive protein, blood pressure, and LDL oxidation are modest. Although at this time some issues remain unresolved regarding trans fatty acids and CVD risk factors other than plasma lipoprotein concentrations, they should not affect the final dietary recommendation to limit intake.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Finking G, Hanke H. Nikolaj Nikolajewitsch Anitschkow (1885-1964) established the cholesterol-fed rabbit as a model for atherosclerosis research. Atherosclerosis. 1997;135(1):1–7.

    Article  CAS  PubMed  Google Scholar 

  2. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114:82–96.

    Article  PubMed  Google Scholar 

  3. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010;91:502–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010;7:e1000252.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Baum SJ, Kris-Etherton P, Willett WC, Lichtenstein AH, Rudel LL, Maki KC, et al. Fatty acids in acrdiovascular health and disease: a comprehensive update. J Clin Lipidol. 2012;6:216–34.

    Article  PubMed  Google Scholar 

  6. Matthan NR, Welty FK, Barrett PH, Harausz C, Dolnikowski GG, Parks JS, et al. Dietary hydrogenated fat increases high-density lipoprotein apoA-I catabolism and decreases low-density lipoprotein apoB-100 catabolism in hypercholesterolemic women. Arterioscler Thromb Vasc Biol. 2004;24(6):1092–7. doi:10.1161/01.ATV.0000128410.23161.be.

    Article  PubMed  Google Scholar 

  7. Eckel RH, Borra S, Lichtenstein AH, Yin-Piazza SY. Understanding the complexity of trans fatty acid reduction in the American diet. Circulation. 2007;115:2231–46.

    Article  CAS  PubMed  Google Scholar 

  8. Gebauer SK, Chardigny JM, Jakobsen MU, Lamarche B, Lock AL, Proctor SD, et al. Effects of ruminant trans fatty acids on cardiovascular disease and cancer: a comprehensive review of epidemiological, clinical, and mechanistic studies. Adv Nutr. 2011;2:332–54.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med. 2006;354(15):1601–13.

    Article  CAS  PubMed  Google Scholar 

  10. Lefevre M, Mensink RP, Kris-Etherton PM, Petersen B, Smith K, Flickinger BD. Predicted changes in fatty acid intakes, plasma lipids, and cardiovascular disease risk following replacement of trans fatty acid-containing soybean oil with application-appropriate alternatives. Lipids. 2012;47(10):951–62. doi:10.1007/s11745-012-3705-y.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Remig V, Franklin B, Margolis S, Kostas G, Nece T, Street JC. Trans fats in America: a review of their use, consumption, health implications, and regulation. J Am Diet Assoc. 2010;110(4):585–92. doi:10.1016/j.jada.2009.12.024.

    Article  CAS  PubMed  Google Scholar 

  12. Doell D, Folmer H, Lee HR, Honigfort M, Carberry S. Updated esimtate of trans fat intake by the US population. Food Addit Contam. 2012;29:861–74.

    Article  CAS  Google Scholar 

  13. Food and Drug Administration. Food labeling: trans fatty acids in nutrition labeling, nutrient content claims, and health claims. Final rule. Fed Regist. 2003;133:41433–14506.

    Google Scholar 

  14. Rahkovsky I, Martinez S, Kuchler F. New food choices free of trans fats better align U.S. diets with health recommendations. Economic Information Bulletin Number 95, USDA. 2012.

  15. Otite FO, Jacobson MF, Dahmubed A, Mozaffarian D. Trends in trans fatty acids reformulations of US supermarket and brand-name foods from 2007 through 2011. Prev Chronic Dis. 2013;10:E85. doi:10.5888/pcd10.120198.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Angell SY, Cobb LK, Curis CJ, Konty KJ, Silver LD. Change in trans fatty acid content of fast food purchases associated with New York City's restaurant regulation. Annal of Internal Medicine. 2012. This study demonstrated that restricting the use of partially-hydrogenated fat in New York City dramatically decreased the mean trans fatty acid content of food purchased from fast-food restaurants.

  17. Food and Drug Administration. FDA takes step to further reduce trans fats in processed foods. 2013.

  18. Vesper HW, Kuiper HC, Mirel LB, Johnson CL, Pirkle JL. Levels of plasma trans-fatty acids in non-hispanic white adults in the United States in 2000 and 2009. JAMA. 2012;307:562. The findings of this study demonstrate that secular changes in the use of partially-hydrogenated fat in the food supply has an effect on a measurable biomarker, plasma trans fatty acid concentration.

    Article  PubMed  Google Scholar 

  19. Harris WS, Pottala JV, Lacey SM, Vasan RS, Larson MG, Robins SJ. Clinical correlates and heritability of erythrocyte eicosapentaenoic and docosahexaenoic acid content in the Framingham Heart Study. Atherosclerosis. 2012;225(2):425–31. doi:10.1016/j.atherosclerosis.2012.05.030.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Aronis KN, Khan SM, Mantzoros CS. Effects of trans fatty acids on glucose homeostasis: a meta-analysis of randomized, placebo-controlled clinical trials. Am J Clin Nutr. 2012;96(5):1093–9. doi:10.3945/ajcn.112.040576.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Schwenke DC, Foreyt JP, Miller 3rd ER, Reeves RS, Vitolins MZ. Plasma concentrations of trans fatty acids in persons with type 2 diabetes between September 2002 and April 2004. Am J Clin Nutr. 2013;97(4):862–71. doi:10.3945/ajcn.112.046508.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Temme EH, Millenaar IL, Van Donkersgoed G, Westenbrink S. Impact of fatty acid food reformulations on intake of Dutch young adults. Acta Cardiol. 2011;66:721–8.

    PubMed  Google Scholar 

  23. Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77(5):1146–55.

    CAS  PubMed  Google Scholar 

  24. Ascherio A, Katan MB, Zock PL, Stampfer MJ, Willett WC. Trans fatty acids and coronary heart disease. N Engl J Med. 1999;340(25):1994–8.

    Article  CAS  PubMed  Google Scholar 

  25. Lichtenstein AH, Ausman LA, Jalbert SM, Schaefer EJ. Comparison of different forms of hydrogenated fats on serum lipid levels in moderately hypercholesterolemic female and male subjects. N Engl J Med. 1999;340:1933–40.

    Article  CAS  PubMed  Google Scholar 

  26. Han SN, Leka LS, Lichtenstein AH, Ausman LM, Schaefer EJ, Meydani SN. Effect of hydrogenated and saturated, relative to polyunsaturated, fat on immune and inflammatory responses of adults with moderate hypercholesterolemia. J Lipid Res. 2002;43(3):445–52.

    CAS  PubMed  Google Scholar 

  27. Smit LA, Katan MB, Wanders AJ, Basu S, Brouwer IA. A high intake of trans fatty acids has little effect on markers of inflammation and oxidative stress in humans. J Nutr. 2011;141(9):1673–8. doi:10.3945/jn.110.134668.

    Article  CAS  PubMed  Google Scholar 

  28. Aronis KN, Joseph RJ, Blackburn GL, Mantzoros C. Trans-fatty acids, insulin resistance/diabetes, and cardiovascular disease risk: should policy decisions be based on observational cohort studies, or should we be waiting for results from randomized placebo-controlled trials? Metab Clin Exp. 2011;60(7):901–5. doi:10.1016/j.metabol.2011.04.003.

    Article  CAS  PubMed  Google Scholar 

  29. Bendsen NT, Christensen R, Bartels EM, Astrup A. Consumption of industrial and ruminant trans fatty acids and risk of coronary heart disease: a systematic review and meta-analysis of cohort studies. Eur J Clin Nutr. 2011;65:773–83.

    Article  CAS  PubMed  Google Scholar 

  30. Micha R, Mozaffarian D. Trans fatty acids: effects on metabolic syndrome, heart disease and diabetes. Nat Rev Endocrinol. 2009;5(6):335–44. doi:10.1038/nrendo.2009.79.

    Article  CAS  PubMed  Google Scholar 

  31. Matthan NR, Ausman LM, Lichtenstein AH, Jones PJ. Hydrogenated fat consumption affects cholesterol synthesis in moderately hypercholesterolemic women. J Lipid Res. 2000;41(5):834–9.

    CAS  PubMed  Google Scholar 

  32. Cuchel M, Schwab US, Jones PJ, Vogel S, Lammi-Keefe C, Li Z, et al. Impact of hydrogenated fat consumption on endogenous cholesterol synthesis and susceptibility of low-density lipoprotein to oxidation in moderately hypercholesterolemic individuals. Metab Clin Exp. 1996;45(2):241–7.

    Article  CAS  PubMed  Google Scholar 

  33. Lichtenstein AH, Jauhiainen M, McGladdery S, Ausman LM, Jalbert SM, Vilella-Bach M, et al. Impact of hydrogenated fat on high density lipoprotein subfractions and metabolism. J Lipid Res. 2001;42(4):597–604.

    CAS  PubMed  Google Scholar 

  34. Krauss RM. Lipoprotein subfractions and cardiovascular disease risk. Curr Opin Lipidol. 2010;21(4):305–11. doi:10.1097/MOL.0b013e32833b7756.

    Article  CAS  PubMed  Google Scholar 

  35. Mauger JF, Lichtenstein AH, Ausman LM, Jalbert SM, Jauhiainen M, Ehnholm C, et al. Effect of different forms of dietary hydrogenated fats on LDL particle size. Am J Clin Nutr. 2003;78(3):370–5.

    CAS  PubMed  Google Scholar 

  36. Lichtenstein AH, Erkkila AT, Lamarche B, Schwab US, Jalbert SM, Ausman LM. Influence of hydrogenated fat and butter on CVD risk factors: remnant-like particles, glucose and insulin, blood pressure and C-reactive protein. Atherosclerosis. 2003;171(1):97–107.

    Article  CAS  PubMed  Google Scholar 

  37. Brouwer IA, Wanders AJ, Katan MB. Trans fatty acids and cardiovascular health: research completed? Eur J Clin Nutr. 2013;67(5):541–7. doi:10.1038/ejcn.2013.43.

    Article  CAS  PubMed  Google Scholar 

  38. Matthan NR, Cianflone K, Lichtenstein AH, Ausman LM, Jauhiainen M, Jones PJ. Hydrogenated fat consumption affects acylation-stimulating protein levels and cholesterol esterification rates in moderately hypercholesterolemic women. J Lipid Res. 2001;42(11):1841–8.

    CAS  PubMed  Google Scholar 

  39. Booth SL, Davidson KW, Lichtenstein AH, Sadowski JA. Plasma concentrations of dihydro-vitamin K1 following dietary intake of a hydrogenated vitamin K1-rich vegetable oil. Lipids. 1996;31(7):709–13.

    Article  CAS  PubMed  Google Scholar 

  40. Erkkila AT, Booth SL, Hu FB, Jacques PF, Manson JE, Rexrode KM, et al. Phylloquinone intake as a marker for coronary heart disease risk but not stroke in women. Eur J Clin Nutr. 2005;59:196–204.

    Article  CAS  PubMed  Google Scholar 

  41. Erkkila AT, Lichtenstein AH, Jacques PF, Hu FB, Wilson PW, Booth SL. Determinants of plasma dihydrophylloquinone in men and women. Br J Nutr. 2005;93(5):701–8.

    Article  PubMed  Google Scholar 

  42. de Roos B, Wanders AJ, Wood S, Horgan G, Rucklige G, Reid M, et al. A high intake of industrial or ruminant trans fatty acids does not affect the plasma proteome in healthy men. Proteomics. 2011;11(19):3928–34. doi:10.1002/pmic.201100163.

    Article  PubMed  Google Scholar 

  43. Krogager TP, Nielsen LV, Bak S, Young C, Ferreri C, Jensen ON, et al. Identification of a potential biomarker panel for the intake of the common dietary trans fat elaidic acid (trans9-C18:1). J Proteomics. 2012;75(9):2685–96. doi:10.1016/j.jprot.2012.03.023.

    Article  CAS  PubMed  Google Scholar 

  44. Mensink RP, Katan MB. Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects. N Engl J Med. 1990;323(7):439–45.

    Article  CAS  PubMed  Google Scholar 

  45. Soares-Miranda L, Stein PK, Imamura F, Sattelmair J, Lemaitre RN, Siscovick DS, et al. Trans-fatty acid consumption and heart rate variability in 2 separate cohorts of older and younger adults. Circ Arrhythm Electrophysiol. 2012;5(4):728–38. doi:10.1161/CIRCEP.111.966259.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Yu DX, Sun Q, Ye XW, Pan A, Zong G, Zhou YH, et al. Erythrocyte trans-fatty acids, type 2 diabetes and cardiovascular risk factors in middle-aged and older Chinese individuals. Diabetologia. 2012;55(11):2954–62. doi:10.1007/s00125-012-2674-2.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  47. Chiuve SE, Rimm EB, Manson JE, Whang W, Mozaffarian D, Stampfer MJ, et al. Intake of total trans, trans-18:1, and trans-18:2 fatty acids and risk of sudden cardiac death in women. Am Heart J. 2009;158(5):761–7. doi:10.1016/j.ahj.2009.08.015.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  48. Imamura F, Lemaitre RN, King IB, Song X, Lichtenstein AH, Matthan NR, et al. Novel circulating fatty acid patterns and risk of cardiovascular disease: the Cardiovascular Health Study. Am J Clin Nutr. 2012;96(6):1252–61. doi:10.3945/ajcn.112.039990.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  49. Kiage JN, Merrill PD, Robinson CJ, Cao Y, Malik TA, Hundley BC, et al. Intake of trans fat and all-cause mortality in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) cohort. Am J Clin Nutr. 2013;97(5):1121–8. doi:10.3945/ajcn.112.049064. The data from this study indicated that in a racially and ethnically diverse group of individuals living in the U.S. higher trans fat intake was associated with an increased risk of all-cause mortality.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Brouwer IA, Wanders AJ, Katan BM. Effect of animal and industrial trans fatty acids on HDL and LDL cholesterol levels in humans–a quantitative review. PLoS One. 2010;5:e9434.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Laake I, Pedersen JI, Selmer R, Kirkhus B, Lindman AS, Tverdal A, et al. A prospective study of intake of trans-fatty acids from ruminant fat, partially hydrogenated vegetable oils, and marine oils and mortality from CVD. Br J Nutr. 2012;108(4):743–54. doi:10.1017/S0007114511005897.

    Article  CAS  PubMed  Google Scholar 

  52. Wanders AJ, Brouwer IA, Siebelink E, Katan MB. Effect of a high intake of conjugated linoleic acid on lipoprotein levels in healthy human subjects. PLoS One. 2010;5(2):e9000. doi:10.1371/journal.pone.0009000.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Eckel RH, Jakicic JM, Ard JD, Hubbard VS, de Jesus JM, Lee IM, et al. AHA/acc guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013. doi:10.1161/01.cir.0000437740.48606.d1.

    Google Scholar 

  54. Lichtenstein AH. New York City trans fat ban: improving the default option when purchasing foods prepared outside of the home. Annal Intern Med. 2012;157:144–5.

    Article  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Alice H. Lichtenstein declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alice H. Lichtenstein.

Additional information

This article is part of the Topical Collection on Nutrition

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lichtenstein, A.H. Dietary Trans Fatty Acids and Cardiovascular Disease Risk: Past and Present. Curr Atheroscler Rep 16, 433 (2014). https://doi.org/10.1007/s11883-014-0433-1

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11883-014-0433-1

Keywords

Navigation