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This article is about the type of nutrient in food. For fat in animals, see Adipose tissue. For other uses, see Fat (disambiguation). For chemistry of triglycerides, see triglyceride.

In nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such compounds, most commonly those that occur in living beings or in food.

Idealized representation of a molecule of a typical triglyceride, the main type of fat. Note the three fatty acid chains attached to the central glycerol portion of the molecule.
Composition of fats from various foods, as percentage of their total fat

The term often refers specifically to triglycerides (triple esters of glycerol), that are the main components of vegetable oils and of fatty tissue in animals; or, even more narrowly, to triglycerides that are solid or semisolid at room temperature, thus excluding oils. The term may also be used more broadly as a synonym of lipid—any substance of biological relevance, composed of carbon, hydrogen, or oxygen, that is insoluble in water but soluble in non-polar solvents. In this sense, besides the triglycerides, the term would include several other types of compounds like mono- and diglycerides, phospholipids (such as lecithin), sterols (such as cholesterol), waxes (such as beeswax), and free fatty acids, which are usually present in human diet in smaller amounts.

Fats are one of the three main macronutrient groups in human diet, along with carbohydrates and proteins, and the main components of common food products like milk, butter, tallow, lard, salt pork, and cooking oils. They are a major and dense source of food energy for many animals and play important structural and metabolic functions, in most living beings, including energy storage, waterproofing, and thermal insulation. The human body can produce the fat it requires from other food ingredients, except for a few essential fatty acids that must be included in the diet. Dietary fats are also the carriers of some flavor and aroma ingredients and vitamins that are not water-soluble.

Contents

In humans and many animals, fats serve both as energy sources and as stores for energy in excess of what the body needs immediately. Each gram of fat when burned or metabolized releases about 9 food calories (37 kJ = 8.8 kcal).

Fats are also sources of essential fatty acids, an important dietary requirement. Vitamins A, D, E, and K are fat-soluble, meaning they can only be digested, absorbed, and transported in conjunction with fats.

Fats play a vital role in maintaining healthy skin and hair, insulating body organs against shock, maintaining body temperature, and promoting healthy cell function. Fat also serves as a useful buffer against a host of diseases. When a particular substance, whether chemical or biotic, reaches unsafe levels in the bloodstream, the body can effectively dilute—or at least maintain equilibrium of—the offending substances by storing it in new fat tissue.[citation needed] This helps to protect vital organs, until such time as the offending substances can be metabolized or removed from the body by such means as excretion, urination, accidental or intentional bloodletting, sebum excretion, and hair growth.

Adipose tissue

The obese mouse on the left has large stores of adipose tissue. For comparison, a mouse with a normal amount of adipose tissue is shown on the right.

In animals, adipose tissue, or fatty tissue is the body's means of storing metabolic energy over extended periods of time. Adipocytes (fat cells) store fat derived from the diet and from liver metabolism. Under energy stress these cells may degrade their stored fat to supply fatty acids and also glycerol to the circulation. These metabolic activities are regulated by several hormones (e.g., insulin, glucagon and epinephrine). Adipose tissue also secretes the hormone leptin.

The location of the tissue determines its metabolic profile: visceral fat is located within the abdominal wall (i.e., beneath the wall of abdominal muscle) whereas subcutaneous fat is located beneath the skin (and includes fat that is located in the abdominal area beneath the skin but above the abdominal muscle wall). Visceral fat was recently discovered to be a significant producer of signaling chemicals (i.e., hormones), among which several are involved in inflammatory tissue responses. One of these is resistin which has been linked to obesity, insulin resistance, and Type 2 diabetes. This latter result is currently controversial, and there have been reputable studies supporting all sides on the issue.[citation needed]

A variety of chemical and physical techniques are used for the production and processing of fats, both industrially and in cottage or home settings. They include:

The pancreatic lipase acts at the ester bond, hydrolyzing the bond and "releasing" the fatty acid. In triglyceride form, lipids cannot be absorbed by the duodenum. Fatty acids, monoglycerides (one glycerol, one fatty acid), and some diglycerides are absorbed by the duodenum, once the triglycerides have been broken down.

In the intestine, following the secretion of lipases and bile, triglycerides are split into monoacylglycerol and free fatty acids in a process called lipolysis. They are subsequently moved to absorptive enterocyte cells lining the intestines. The triglycerides are rebuilt in the enterocytes from their fragments and packaged together with cholesterol and proteins to form chylomicrons. These are excreted from the cells and collected by the lymph system and transported to the large vessels near the heart before being mixed into the blood. Various tissues can capture the chylomicrons, releasing the triglycerides to be used as a source of energy. Liver cells can synthesize and store triglycerides. When the body requires fatty acids as an energy source, the hormone glucagon signals the breakdown of the triglycerides by hormone-sensitive lipase to release free fatty acids. As the brain cannot utilize fatty acids as an energy source (unless converted to a ketone), the glycerol component of triglycerides can be converted into glucose, via gluconeogenesis by conversion into dihydroxyacetone phosphate and then into glyceraldehyde 3-phosphate, for brain fuel when it is broken down. Fat cells may also be broken down for that reason if the brain's needs ever outweigh the body's.

Triglycerides cannot pass through cell membranes freely. Special enzymes on the walls of blood vessels called lipoprotein lipases must break down triglycerides into free fatty acids and glycerol. Fatty acids can then be taken up by cells via the fatty acid transporter (FAT).

Triglycerides, as major components of very-low-density lipoprotein (VLDL) and chylomicrons, play an important role in metabolism as energy sources and transporters of dietary fat. They contain more than twice as much energy (approximately 9kcal/g or 38kJ/g) as carbohydrates (approximately 4kcal/g or 17kJ/g).

The most common type of fat, in human diet and most living beings, is a triglyceride, an ester of the triple alcohol glycerolH(–CHOH–)
3
H
and three fatty acids. The molecule of a triglyceride can be described as resulting from a condensation reaction (specifically, esterification) between each of glycerol's –OH groups and the HO– part of the carboxyl groupHO(O=)C− of each fatty acid, forming an ester bridge −O−(O=)C− with elimination of a water moleculeH
2
O
.

Other less common types of fats include diglycerides and monoglycerides, where the esterification is limited to two or just one of glycerol's –OH groups. Other alcohols, such as cetyl alcohol (predominant in spermaceti), may replace glycerol. In the phospholipids, one of the fatty acids is replaced by phosphoric acid or a monoester thereof. The benefits and risks of various amounts and types of dietary fats have been the object of much study, and are still highly controversial topics.

Essential fatty acids

There are two essential fatty acids (EFAs) in human nutrition: alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid). The adult body can synthesize other lipids that it needs from these two.

Properties of vegetable oils
Type Processing
treatment
Saturated
fatty acids
Monounsaturated
fatty acids
Polyunsaturated
fatty acids
Smoke point
Total Oleic
acid
(ω-9)
Total α-Linolenic
acid
(ω-3)
Linoleic
acid
(ω-6)
ω-6:3
ratio
Avocado 11.6 70.6 52–66 13.5 1 12.5 12.5:1 250 °C (482 °F)
Brazil nut 24.8 32.7 31.3 42.0 0.1 41.9 419:1 208 °C (406 °F)
Canola 7.4 63.3 61.8 28.1 9.1 18.6 2:1 238 °C (460 °F)
Coconut 82.5 6.3 6 1.7 175 °C (347 °F)
Corn 12.9 27.6 27.3 54.7 1 58 58:1 232 °C (450 °F)
Cottonseed 25.9 17.8 19 51.9 1 54 54:1 216 °C (420 °F)
Flaxseed/linseed 9.0 18.4 18 67.8 53 13 0.2:1 107 °C (225 °F)
Grape seed 10.5 14.3 14.3 74.7 74.7 very high 216 °C (421 °F)
Hemp seed 7.0 9.0 9.0 82.0 22.0 54.0 2.5:1 166 °C (330 °F)
Olive 13.8 73.0 71.3 10.5 0.7 9.8 14:1 193 °C (380 °F)
Palm 49.3 37.0 40 9.3 0.2 9.1 45.5:1 235 °C (455 °F)
Peanut 16.2 57.1 55.4 19.9 0.318 19.6 very high 232 °C (450 °F)
Rice bran oil 25 38.4 2.2 34.4 15.6 232 °C (450 °F)
High-oleic safflower oil 7.5 75.2 75.2 12.8 0 12.8 very high 212 °C (414 °F)
Sesame ? 14.2 39.7 39.3 41.7 0.3 41.3 138:1
Soybean partially hydrogenated 14.9 43.0 42.5 37.6 2.6 34.9 13.4:1
Soybean 15.6 22.8 22.6 57.7 7 51 7.3:1 238 °C (460 °F)
Walnut oil unrefined 9.1 22.8 22.2 63.3 10.4 52.9 5:1 160 °C (320 °F)
Sunflower 8.99 63.4 62.9 20.7 0.16 20.5 very high 227 °C (440 °F)
Cottonseed hydrogenated 93.6 1.5 0.6 0.2 0.3 1.5:1
Palm hydrogenated 88.2 5.7 0
The nutritional values are expressed as percent (%) by mass of total fat.

Saturated vs. unsaturated fats

Different foods contain different amounts of fat with different proportions of saturated and unsaturated fatty acids. Some animal products, like beef and dairy products made with whole or reduced fat milk like yogurt, ice cream, cheese and butter have mostly saturated fatty acids (and some have significant contents of dietary cholesterol). Other animal products, like pork, poultry, eggs, and seafood have mostly unsaturated fats. Industrialized baked goods may use fats with high unsaturated fat contents as well, especially those containing partially hydrogenated oils, and processed foods that are deep-fried in hydrogenated oil are high in saturated fat content.

Plants and fish oil generally contain a higher proportion of unsaturated acids, although there are exceptions such as coconut oil and palm kernel oil. Foods containing unsaturated fats include avocado, nuts, olive oils, and vegetable oils such as canola.

Many careful studies have found that replacing saturated fats with cis unsaturated fats in the diet reduces risk of cardiovascular diseases, diabetes, or death. These studies prompted many medical organizations and public health departments, including the World Health Organization, to officially issue that advice. Some countries with such recommendations include:

  • United Kingdom
  • United States
  • India
  • Canada
  • Australia
  • Singapore
  • New Zealand
  • Hong Kong

A 2004 review concluded that "no lower safe limit of specific saturated fatty acid intakes has been identified" and recommended that the influence of varying saturated fatty acid intakes against a background of different individual lifestyles and genetic backgrounds should be the focus in future studies.

This advice is often oversimplified by labeling the two kinds of fats as bad fats and good fats, respectively. However, since the fats and oils in most natural and traditionally processed foods contain both unsaturated and saturated fatty acids, the complete exclusion of saturated fat is unrealistic and possibly unwise. For instance, some foods rich in saturated fat, such as coconut and palm oil, are an important source of cheap dietary calories for a large fraction of the population in developing countries.

Concerns were also expressed at a 2010 conference of the American Dietetic Association that a blanket recommendation to avoid saturated fats could drive people to also reduce the amount of polyunsaturated fats, which may have health benefits, and/or replace fats by refined carbohydrates — which carry a high risk of obesity and heart disease.

For these reasons, the United States Food and Drug Administration (FDA), for example, does not advise the complete elimination of saturated fat, but only recommends that it does not exceed 30% of one's daily caloric intake.[citation needed] A 2003 report by the World Health Organization and the Food and Agriculture Organization (FAO) recommends limiting the saturated fatty acids to less than 10% of daily energy intake and less than 7% for high-risk groups. A general 7% limit was recommended also by the American Heart Association in 2006.

The WHO/FAO report also recommended replacing fats so as to reduce the content of myristic and palmitic acids, specifically.

The so-called Mediterranean diet, prevalent in many countries in the Mediterranean Sea area, includes more total fat than the diet of Northern European countries, but most of it is in the form of unsaturated fatty acids (specifically, monounsaturated and omega-3) from olive oil and fish, vegetables, and certain meats like lamb, while consumption of saturated fat is minimal in comparison. A 2017 review found evidence that a Mediterranean-style diet could reduce the risk of cardiovascular diseases, overall cancer incidence, neurodegenerative diseases, diabetes, and mortality rate. A 2018 review showed that a Mediterranean-like diet may improve overall health status, such as reduced risk of non-communicable diseases. It also may reduce the social and economic costs of diet-related illnesses.

A small number of contemporary reviews have challenged this negative view of saturated fats. For example, an evaluation of evidence from 1966 to 1973 of the observed health impact of replacing dietary saturated fat with linoleic acid found that it increased rates of death from all causes, coronary heart disease, and cardiovascular disease. These studies have been disputed by many scientists, and the consensus in the medical community is that saturated fat and cardiovascular disease are closely related. Still, these discordant studies fueled debate over the merits of substituting polyunsaturated fats for saturated fats.

Cardiovascular disease

The effect of saturated fat on cardiovascular disease has been extensively studied. The general consensus is that there is evidence of moderate-quality of a strong, consistent, and graded relationship between saturated fat intake, blood cholesterol levels, and the incidence of cardiovascular disease. The relationships are accepted as causal, including by many government and medical organizations.

A 2017 review by the American Heart Association estimated that replacement of saturated fat with polyunsaturated fat in the American diet could reduce the risk of cardiovascular diseases by 30%.

The consumption of saturated fat is generally considered a risk factor for dyslipidemia — abnormal blood lipid levels, including high total cholesterol, high levels of triglycerides, high levels of low-density lipoprotein (LDL, "bad" cholesterol) or low levels of high-density lipoprotein (HDL, "good" cholesterol). These parameters in turn are believed to be risk indicators for some types of cardiovascular disease. These effects were observed in children too.

Several meta-analyses (reviews and consolidations of multiple previously published experimental studies) have confirmed a significant relationship between saturated fat and high serum cholesterol levels, which in turn have been claimed to have a causal relation with increased risk of cardiovascular disease (the so-called lipid hypothesis). However, high cholesterol may be caused by many factors. Other indicators, such as high LDL/HDL ratio, have proved to be more predictive. In a study of myocardial infarction in 52 countries, the ApoB/ApoA1 (related to LDL and HDL, respectively) ratio was the strongest predictor of CVD among all risk factors. There are other pathways involving obesity, triglyceride levels, insulin sensitivity, endothelial function, and thrombogenicity, among others, that play a role in CVD, although it seems, in the absence of an adverse blood lipid profile, the other known risk factors have only a weak atherogenic effect. Different saturated fatty acids have differing effects on various lipid levels.

Cancer

The evidence for a relation between saturated fat intake and cancer is significantly weaker, and there does not seem to be a clear medical consensus about it.

  • A meta-analysis published in 2003 found a significant positive relationship between saturated fat and breast cancer. However two subsequent reviews have found weak or insignificant relation, and noted the prevalence of confounding factors.
  • Another review found limited evidence for a positive relationship between consuming animal fat and incidence of colorectal cancer.
  • Other meta-analyses found evidence for increased risk of ovarian cancer by high consumption of saturated fat.
  • Some studies have indicated that serum myristic acid and palmitic acid and dietary myristic and palmitic saturated fatty acids and serum palmitic combined with alpha-tocopherol supplementation are associated with increased risk of prostate cancer in a dose-dependent manner. These associations may, however, reflect differences in intake or metabolism of these fatty acids between the precancer cases and controls, rather than being an actual cause.

Bones

Various animal studies have indicated that the intake of saturated fat has a negative effect on effects on the mineral density of bones. One study suggested that men may be particularly vulnerable.

Disposition and overall health

Studies have shown that substituting monounsaturated fatty acids for saturated ones is associated with increased daily physical activity and resting energy expenditure. More physical activity, less anger, and less irritability were associated with a higher-oleic acid diet than one of a palmitic acid diet.

Amounts of fat types in selected foods

Monounsaturated vs. polyunsaturated fat

Schematic diagram of a triglyceride with a saturated fatty acid (top), a monounsaturated one (middle) and a polyunsaturated one (bottom).

Assuming that unsaturated fatty acids (UFAs) are generally healthier than saturated ones (SFAs), another question that has gained attention in recent decades is the risks and benefits of monounsaturated fatty acids (MUFAs, with a single double bond) versus polyunsaturated fatty acids (PUFAs, with two or more double bonds).

The most common fatty acids in human diet are unsaturated or mono-unsaturated. Monounsaturated fats are found in animal flesh such as red meat, whole milk products, nuts, and high fat fruits such as olives and avocados. Olive oil is about 75% monounsaturated fat. The high oleic variety sunflower oil contains at least 70% monounsaturated fat. Canola oil and cashews are both about 58% monounsaturated fat.[citation needed] Tallow (beef fat) is about 50% monounsaturated fat. and lard is about 40% monounsaturated fat.[citation needed] Other sources include hazelnut, avocado oil, macadamia nut oil, grapeseed oil, groundnut oil (peanut oil), sesame oil, corn oil, popcorn, whole grain wheat, cereal, oatmeal, almond oil, sunflower oil, hemp oil, and tea-oil camellia.

Polyunsaturated fatty acids can be found mostly in nuts, seeds, fish, seed oils, and oysters.

Food sources of polyunsaturated fats include:

Food source (100g) Polyunsaturated fat (g)
Walnuts 47
Canola oil 34
Sunflower seeds 33
Sesame seeds 26
Chia seeds 23.7
Unsalted peanuts 16
Peanut butter 14.2
Avocado oil 13.5
Olive oil 11
Safflower oil 12.82
Seaweed 11
Sardines 5
Soybeans 7
Tuna 14
Wild salmon 17.3
Whole grain wheat 9.7

Insulin resistance and sensitivity

MUFAs (especially oleic acid) have been found to lower the incidence of insulin resistance; PUFAs (especially large amounts of arachidonic acid) and SFAs (such as arachidic acid) increased it. These ratios can be indexed in the phospholipids of human skeletal muscle and in other tissues as well. This relationship between dietary fats and insulin resistance is presumed secondary to the relationship between insulin resistance and inflammation, which is partially modulated by dietary fat ratios (Omega-3/6/9) with both omega 3 and 9 thought to be anti-inflammatory, and omega 6 pro-inflammatory (as well as by numerous other dietary components, particularly polyphenols and exercise, with both of these anti-inflammatory). Although both pro- and anti-inflammatory types of fat are biologically necessary, fat dietary ratios in most US diets are skewed towards Omega 6, with subsequent disinhibition of inflammation and potentiation of insulin resistance. This is contrary to the suggestion of more recent studies, in which polyunsaturated fats are shown to be protective against insulin resistance.

The large scale KANWU study found that increasing MUFA and decreasing SFA intake could improve insulin sensitivity, but only when the overall fat intake of the diet was low. However, some MUFAs may promote insulin resistance (like the SFAs), whereas PUFAs may protect against it.[clarification needed]

Cancer

Levels of oleic acid along with other MUFAs in red blood cell membranes were positively associated with breast cancer risk. The saturation index (SI) of the same membranes was inversely associated with breast cancer risk. MUFAs and low SI in erythrocyte membranes are predictors of postmenopausal breast cancer. Both of these variables depend on the activity of the enzyme delta-9 desaturase (Δ9-d).

Results from observational clinical trials on PUFA intake and cancer have been inconsistent and vary by numerous factors of cancer incidence, including gender and genetic risk. Some studies have shown associations between higher intakes and/or blood levels of omega-3 PUFAs and a decreased risk of certain cancers, including breast and colorectal cancer, while other studies found no associations with cancer risk.

Pregnancy disorders

Polyunsaturated fat supplementation was found to have no effect on the incidence of pregnancy-related disorders, such as hypertension or preeclampsia, but may increase the length of gestation slightly and decreased the incidence of early premature births.

Expert panels in the United States and Europe recommend that pregnant and lactating women consume higher amounts of polyunsaturated fats than the general population to enhance the DHA status of the fetus and newborn.

"Cis fat" vs. "trans fat"

In nature, unsaturated fatty acids generally have double bonds in cis configuration (with the adjacent C–C bonds on the same side) as opposed to trans. Nevertheless, trans fatty acids (TFAs) occur in small amounts in meat and milk of ruminants (such as cattle and sheep), typically 2–5% of total fat. Natural TFAs, which include conjugated linoleic acid (CLA) and vaccenic acid, originate in the rumen of these animals. CLA has two double bonds, one in the cis configuration and one in trans, which makes it simultaneously a cis- and a trans-fatty acid.

Trans fat contents in various natural and traditionally processed foods, in g per 100 g
Food type Trans fat content
butter 2g to 7 g
whole milk 0.07g to 0.1 g
animal fat 0g to 5 g
ground beef 1 g
Margarine, a common product that can contain trans fatty acids
Cover of original Crisco cookbook, 1912. Crisco was made by hydrogenating cottonseed oil. The formula was revised in the 2000s and now has only a small amount of trans fat.
Wilhelm Normann patented the hydrogenation of liquid oils in 1902

Concerns about trans fatty acids in human diet were raised when they were found to be an unintentional byproduct of the partial hydrogenation of vegetable and fish oils. While these trans fatty acids (popularly called "trans fats") are edible, they have been implicated in many health problems.

Conversion of cis to trans fatty acids in partial hydrogenation

The hydrogenation process, invented and patented by Wilhelm Normann in 1902, made it possible to turn relatively cheap liquid fats such as whale or fish oil into more solid fats and to extend their shelf-life by preventing rancidification. (The source fat and the process were initially kept secret to avoid consumer distaste.) This process was widely adopted by the food industry already in the early 1900s; first for the production of margarine, a replacement for butter and shortening, and eventually for various other fats used in snack food, packaged baked goods, and deep fried products.

Full hydrogenation of a fat or oil produces a fully saturated fat. However, hydrogenation generally was interrupted before completion, to yield a fat product with specific melting point, hardness, and other properties. Unfortunately, partial hydrogenation turns some of the cis double bonds into trans bonds by an isomerization reaction. The trans configuration is favored[citation needed] because it is the lower energy form.

This side reaction accounts for most of the trans fatty acids consumed today, by far. An analysis of some industrialized foods in 2006 found up to 30% "trans fats" in artificial shortening, 10% in breads and cake products, 8% in cookies and crackers, 4% in salty snacks, 7% in cake frostings and sweets, and 26% in margarine and other processed spreads. Another 2010 analysis however found only 0.2% of trans fats in margarine and other processed spreads. Up to 45% of the total fat in those foods containing man-made trans fats formed by partially hydrogenating plant fats may be trans fat. Baking shortenings, unless reformulated, contain around 30% trans fats compared to their total fats. High-fat dairy products such as butter contain about 4%. Margarines not reformulated to reduce trans fats may contain up to 15% trans fat by weight, but some reformulated ones are less than 1% trans fat.

High levels of TFAs have been recorded in popular "fast food" meals. An analysis of samples of McDonald's French fries collected in 2004 and 2005 found that fries served in New York City contained twice as much trans fat as in Hungary, and 28 times as much as in Denmark, where trans fats are restricted. For Kentucky Fried Chicken products, the pattern was reversed: the Hungarian product containing twice the trans fat of the New York product. Even within the United States, there was variation, with fries in New York containing 30% more trans fat than those from Atlanta.

Cardiovascular disease

Numerous studies have found that consumption of TFAs increases risk of cardiovascular disease. The Harvard School of Public Health advises that replacing TFAs and saturated fats with cis monounsaturated and polyunsaturated fats is beneficial for health.

Consuming trans fats has been shown to increase the risk of coronary artery disease in part by raising levels of low-density lipoprotein (LDL, often termed "bad cholesterol"), lowering levels of high-density lipoprotein (HDL, often termed "good cholesterol"), increasing triglycerides in the bloodstream and promoting systemic inflammation.

The primary health risk identified for trans fat consumption is an elevated risk of coronary artery disease (CAD). A 1994 study estimated that over 30,000 cardiac deaths per year in the United States are attributable to the consumption of trans fats. By 2006 upper estimates of 100,000 deaths were suggested. A comprehensive review of studies of trans fats published in 2006 in the New England Journal of Medicine reports a strong and reliable connection between trans fat consumption and CAD, concluding that "On a per-calorie basis, trans fats appear to increase the risk of CAD more than any other macronutrient, conferring a substantially increased risk at low levels of consumption (1 to 3% of total energy intake)".

The major evidence for the effect of trans fat on CAD comes from the Nurses' Health Study – a cohort study that has been following 120,000 female nurses since its inception in 1976. In this study, Hu and colleagues analyzed data from 900 coronary events from the study's population during 14 years of followup. He determined that a nurse's CAD risk roughly doubled (relative risk of 1.93, CI: 1.43 to 2.61) for each 2% increase in trans fat calories consumed (instead of carbohydrate calories). By contrast, for each 5% increase in saturated fat calories (instead of carbohydrate calories) there was a 17% increase in risk (relative risk of 1.17, CI: 0.97 to 1.41). "The replacement of saturated fat or trans unsaturated fat by cis (unhydrogenated) unsaturated fats was associated with larger reductions in risk than an isocaloric replacement by carbohydrates." Hu also reports on the benefits of reducing trans fat consumption. Replacing 2% of food energy from trans fat with non-trans unsaturated fats more than halves the risk of CAD (53%). By comparison, replacing a larger 5% of food energy from saturated fat with non-trans unsaturated fats reduces the risk of CAD by 43%.

Another study considered deaths due to CAD, with consumption of trans fats being linked to an increase in mortality, and consumption of polyunsaturated fats being linked to a decrease in mortality.

Trans fat has been found to act like saturated in raising the blood level of LDL ("bad cholesterol"); but, unlike saturated fat, it also decreases levels of HDL ("good cholesterol"). The net increase in LDL/HDL ratio with trans fat, a widely accepted indicator of risk for coronary artery, is approximately double that due to saturated fat. One randomized crossover study published in 2003 comparing the effect of eating a meal on blood lipids of (relatively) cis and trans-fat-rich meals showed that cholesteryl ester transfer (CET) was 28% higher after the trans meal than after the cis meal and that lipoprotein concentrations were enriched in apolipoprotein(a) after the trans meals.

The citokyne test is a potentially more reliable indicator of CAD risk, although is still being studied. A study of over 700 nurses showed that those in the highest quartile of trans fat consumption had blood levels of C-reactive protein (CRP) that were 73% higher than those in the lowest quartile.

Breast feeding

It has been established that trans fats in human breast milk fluctuate with maternal consumption of trans fat, and that the amount of trans fats in the bloodstream of breastfed infants fluctuates with the amounts found in their milk. In 1999, reported percentages of trans fats (compared to total fats) in human milk ranged from 1% in Spain, 2% in France, 4% in Germany, and 7% in Canada and the United States.

Other health risks

There are suggestions that the negative consequences of trans fat consumption go beyond the cardiovascular risk. In general, there is much less scientific consensus asserting that eating trans fat specifically increases the risk of other chronic health problems:

  • Alzheimer's disease: A study published in Archives of Neurology in February 2003 suggested that the intake of both trans fats and saturated fats promotes the development of Alzheimer disease, although not confirmed in an animal model. It has been found that trans fats impaired memory and learning in middle-age rats. The brains of rats that ate trans-fats had fewer proteins critical to healthy neurological function. Inflammation in and around the hippocampus, the part of the brain responsible for learning and memory. These are the exact types of changes normally seen at the onset of Alzheimer's, but seen after six weeks, even though the rats were still young.
  • Cancer: There is no scientific consensus that consuming trans fats significantly increases cancer risks across the board. The American Cancer Society states that a relationship between trans fats and cancer "has not been determined." One study has found a positive connection between trans fat and prostate cancer. However, a larger study found a correlation between trans fats and a significant decrease in high-grade prostate cancer. An increased intake of trans fatty acids may raise the risk of breast cancer by 75%, suggest the results from the French part of the European Prospective Investigation into Cancer and Nutrition.
  • Diabetes: There is a growing concern that the risk of type 2 diabetes increases with trans fat consumption. However, consensus has not been reached. For example, one study found that risk is higher for those in the highest quartile of trans fat consumption. Another study has found no diabetes risk once other factors such as total fat intake and BMI were accounted for.
  • Obesity: Research indicates that trans fat may increase weight gain and abdominal fat, despite a similar caloric intake. A 6-year experiment revealed that monkeys fed a trans fat diet gained 7.2% of their body weight, as compared to 1.8% for monkeys on a mono-unsaturated fat diet. Although obesity is frequently linked to trans fat in the popular media, this is generally in the context of eating too many calories; there is not a strong scientific consensus connecting trans fat and obesity, although the 6-year experiment did find such a link, concluding that "under controlled feeding conditions, long-term TFA consumption was an independent factor in weight gain. TFAs enhanced intra-abdominal deposition of fat, even in the absence of caloric excess, and were associated with insulin resistance, with evidence that there is impaired post-insulin receptor binding signal transduction."
  • Infertility in women: One 2007 study found, "Each 2% increase in the intake of energy from trans unsaturated fats, as opposed to that from carbohydrates, was associated with a 73% greater risk of ovulatory infertility...".
  • Major depressive disorder: Spanish researchers analysed the diets of 12,059 people over six years and found that those who ate the most trans fats had a 48 per cent higher risk of depression than those who did not eat trans fats. One mechanism may be trans-fats' substitution for docosahexaenoic acid (DHA) levels in the orbitofrontal cortex (OFC). Very high intake of trans-fatty acids (43% of total fat) in mice from 2 to 16 months of age was associated with lowered DHA levels in the brain (p=0.001). When the brains of 15 major depressive subjects who had committed suicide were examined post-mortem and compared against 27 age-matched controls, the suicidal brains were found to have 16% less (male average) to 32% less (female average) DHA in the OFC. The OFC controls reward, reward expectation, and empathy (all of which are reduced in depressive mood disorders) and regulates the limbic system.
  • Behavioral irritability and aggression: a 2012 observational analysis of subjects of an earlier study found a strong relation between dietary trans fat acids and self-reported behavioral aggression and irritability, suggesting but not establishing causality.
  • Diminished memory: In a 2015 article, researchers re-analyzing results from the 1999-2005 UCSD Statin Study argue that "greater dietary trans fatty acid consumption is linked to worse word memory in adults during years of high productivity, adults age <45".
  • Acne: According to a 2015 study, trans fats are one of several components of Western pattern diets which promote acne, along with carbohydrates with high glycemic load such as refined sugars or refined starches, milk and dairy products, and saturated fats, while omega-3 fatty acids, which reduce acne, are deficient in Western pattern diets.

Biochemical mechanisms

The exact biochemical process by which trans fats produce specific health problems are a topic of continuing research. Intake of dietary trans fat perturbs the body's ability to metabolize essential fatty acids (EFAs, including Omega-3) leading to changes in the phospholipid fatty acid composition of the arterial walls, thereby raising risk of coronary artery disease.

Trans double bonds are claimed to induce a linear conformation to the molecule, favoring its rigid packing as in plaque formation. The geometry of the cis double bond, in contrast, is claimed to create a bend in the molecule, thereby precluding rigid formations.[citation needed].

While the mechanisms through which trans fatty acids contribute to coronary artery disease are fairly well understood, the mechanism for their effects on diabetes is still under investigation. They may impair the metabolism of long-chain polyunsaturated fatty acids (LCPUFAs). However, maternal pregnancy trans fatty acid intake has been inversely associated with LCPUFAs levels in infants at birth thought to underlie the positive association between breastfeeding and intelligence.

Trans fats are processed by the liver differently than other fats. They may cause liver dysfunction by interfering with delta 6 desaturase, an enzyme involved in converting essential fatty acids to arachidonic acid and prostaglandins, both of which are important to the functioning of cells.

Natural "trans fats" in dairy products

Some trans fatty acids occur in natural fats and traditionally processed foods. Vaccenic acid occurs in breast milk, and some isomers of conjugated linoleic acid (CLA) are found in meat and dairy products from ruminants. Butter, for example, contains about 3% trans fat.

The US National Dairy Council has asserted that the trans fats present in animal foods are of a different type than those in partially hydrogenated oils, and do not appear to exhibit the same negative effects. While a recent scientific review agrees with the conclusion (stating that "the sum of the current evidence suggests that the Public health implications of consuming trans fats from ruminant products are relatively limited"), it cautions that this may be due to the low consumption of trans fats from animal sources compared to artificial ones.

More recent inquiry (independent of the dairy industry) has found in a 2008 Dutch meta-analysis that all trans fats, regardless of natural or artificial origin equally raise LDL and lower HDL levels. Other studies though have shown different results when it comes to animal-based trans fats like conjugated linoleic acid (CLA). Although CLA is known for its anticancer properties, researchers have also found that the cis-9, trans-11 form of CLA can reduce the risk for cardiovascular disease and help fight inflammation.

Two Canadian studies have shown that vaccenic acid, a TFA that naturally occurs in dairy products, could be beneficial compared to hydrogenated vegetable shortening, or a mixture of pork lard and soy fat, by lowering total LDL and triglyceride levels. A study by the US Department of Agriculture showed that vaccenic acid raises both HDL and LDL cholesterol, whereas industrial trans fats only raise LDL with no beneficial effect on HDL.

Official recommendations

In light of recognized evidence and scientific agreement, nutritional authorities consider all trans fats equally harmful for health and recommend that their consumption be reduced to trace amounts. The World Health Organization recommended that trans fats make up no more than 0.9% of a person's diet in 2003 and, in 2018, introduced a 6-step guide to eliminate industrially-produced trans-fatty acids from the global food supply.

The National Academy of Sciences (NAS) advises the United States and Canadian governments on nutritional science for use in public policy and product labeling programs. Their 2002 Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids contains their findings and recommendations regarding consumption of trans fat (summary Archived 2007-06-25 at the Wayback Machine).

Their recommendations are based on two key facts. First, "trans fatty acids are not essential and provide no known benefit to human health", whether of animal or plant origin. Second, given their documented effects on the LDL/HDL ratio, the NAS concluded "that dietary trans fatty acids are more deleterious with respect to coronary artery disease than saturated fatty acids". A 2006 review published in the New England Journal of Medicine (NEJM) that states "from a nutritional standpoint, the consumption of trans fatty acids results in considerable potential harm but no apparent benefit."

Because of these facts and concerns, the NAS has concluded there is no safe level of trans fat consumption. There is no adequate level, recommended daily amount or tolerable upper limit for trans fats. This is because any incremental increase in trans fat intake increases the risk of coronary artery disease.

Despite this concern, the NAS dietary recommendations have not included eliminating trans fat from the diet. This is because trans fat is naturally present in many animal foods in trace quantities, and thus its removal from ordinary diets might introduce undesirable side effects and nutritional imbalances. The NAS has, thus, "recommended that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet". Like the NAS, the World Health Organization has tried to balance public health goals with a practical level of trans fat consumption, recommending in 2003 that trans fats be limited to less than 1% of overall energy intake.

Regulatory action

Main article: Trans fat regulation

In the last few decades, there has been substantial amount of regulation in many countries, limiting trans fat contents of industrialized and commercial food products.

Alternatives to hydrogenation

In recent years, the negative public image and strict regulations have driven many fat processing industries to replace partial hydrogenation by fat interesterification, a process that chemically scrambles the fatty acids among a mix of triglycerides. When applied to a suitable bend of oils and saturated fats, possibly followed by separation of unwanted solid or liquid triglycerides, this process can achieve results similar to those of partial hydrogenation without affecting the fatty acids themselves; in particular, without creating any new "trans fat".

Researchers at the United States Department of Agriculture have investigated whether hydrogenation can be achieved without the side effect of trans fat production. They varied the pressure under which the chemical reaction was conducted – applying 1400 kPa (200 psi) of pressure to soybean oil in a 2-liter vessel while heating it to between 140 °C and 170 °C. The standard 140 kPa (20 psi) process of hydrogenation produces a product of about 40% trans fatty acid by weight, compared to about 17% using the high-pressure method. Blended with unhydrogenated liquid soybean oil, the high-pressure-processed oil produced margarine containing 5 to 6% trans fat. Based on current U.S. labeling requirements (see below), the manufacturer could claim the product was free of trans fat. The level of trans fat may also be altered by modification of the temperature and the length of time during hydrogenation.

A University of Guelph research group has found a way to mix oils (such as olive, soybean, and canola), water, monoglycerides, and fatty acids to form a "cooking fat" that acts the same way as trans and saturated fats.

Omega-three and omega-six fatty acids

The ω−3 fatty acids have received substantial attention in recent years.

Among omega-3 fatty acids, neither long-chain nor short-chain forms were consistently associated with breast cancer risk. High levels of docosahexaenoic acid (DHA), however, the most abundant omega-3 polyunsaturated fatty acid in erythrocyte (red blood cell) membranes, were associated with a reduced risk of breast cancer. The DHA obtained through the consumption of polyunsaturated fatty acids is positively associated with cognitive and behavioral performance. In addition DHA is vital for the grey matter structure of the human brain, as well as retinal stimulation and neurotransmission.

Interesterification

Some studies have investigated the health effects of insteresterified (IE) fats, by comparing diets with IE and non-IE fats with the same overall fatty acid composition.

Several experimental studies in humans found no statistical difference on fasting blood lipids between a with large amounts of IE fat, having 25-40% C16:0 or C18:0 on the 2-position, and a similar diet with non-IE fat, having only 3-9% C16:0 or C18:0 on the 2-position. A negative result was obtained also in a study that compared the effects on blood cholesterol levels of an IE fat product mimicking cocoa butter and the real non-IE product.

A 2007 study funded by the Malaysian Palm Oil Board claimed that replacing natural palm oil by other interesterified or partial hydrogenated fats caused adverse health effects, such as higher LDL/HDL ratio and plasma glucose levels. However, these effects could be attributed to the higher percentage of saturated acids in the IE and partially hydrogenated fats, rather than to the IE process itself.

Role in disease

Main article: Hypertriglyceridemia

In the human body, high levels of triglycerides in the bloodstream have been linked to atherosclerosis, heart disease and stroke. However, the relative negative impact of raised levels of triglycerides compared to that of LDL:HDL ratios is as yet unknown. The risk can be partly accounted for by a strong inverse relationship between triglyceride level and HDL-cholesterol level. But the risk is also due to high triglyceride levels increasing the quantity of small, dense LDL particles.

Guidelines

Reference ranges for blood tests, showing usual ranges for triglycerides (increasing with age) in orange at right.

The National Cholesterol Education Program has set guidelines for triglyceride levels:

Level Interpretation
(mg/dL) (mmol/L)
< 150 < 1.70 Normal range – low risk
150–199 1.70–2.25 Slightly above normal
200–499 2.26–5.65 Some risk
500 or higher > 5.65 Very high – high risk

These levels are tested after fasting 8 to 12 hours. Triglyceride levels remain temporarily higher for a period after eating.

The American Heart Association recommends an optimal triglyceride level of 100mg/dL (1.1mmol/L) or lower to improve heart health.

Reducing triglyceride levels

Weight loss and dietary modification are effective first-line lifestyle modification treatments for hypertriglyceridemia. For people with mildly or moderately high levels of triglycerides, lifestyle changes, including weight loss, moderate exercise and dietary modification, are recommended. This may include restriction of carbohydrates (specifically fructose) and fat in the diet and the consumption of omega-3 fatty acids from algae, nuts, fish and seeds. Medications are recommended in those with high levels of triglycerides that are not corrected with the aforementioned lifestyle modifications, with fibrates being recommended first. Omega-3-carboxylic acids is another prescription drug used to treat very high levels of blood triglycerides.

The decision to treat hypertriglyceridemia with medication depends on the levels and on the presence of other risk factors for cardiovascular disease. Very high levels that would increase the risk of pancreatitis is treated with a drug from the fibrate class. Niacin and omega-3 fatty acids as well as drugs from the statin class may be used in conjunction, with statins being the main medication for moderate hypertriglyceridemia when reduction of cardiovascular risk is required.

Main article: Lipid metabolism

Fats are broken down in the healthy body to release their constituents, glycerol and fatty acids. Glycerol itself can be converted to glucose by the liver and so become a source of energy. Fats and other lipids are broken down in the body by enzymes called lipases produced in the pancreas.

Many cell types can use either glucose or fatty acids as a source of energy for metabolism. In particular, heart and skeletal muscle prefer fatty acids.[citation needed] Despite long-standing assertions to the contrary, fatty acids can also be used as a source of fuel for brain cells through mitochondrial oxidation.

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Fat Article Talk Language Watch Edit 160 160 Redirected from Unsaturated fat This article is about the type of nutrient in food For fat in animals see Adipose tissue For other uses see Fat disambiguation For chemistry of triglycerides see triglyceride In nutrition biology and chemistry fat usually means any ester of fatty acids or a mixture of such compounds most commonly those that occur in living beings or in food 1 Idealized representation of a molecule of a typical triglyceride the main type of fat Note the three fatty acid chains attached to the central glycerol portion of the molecule Composition of fats from various foods as percentage of their total fat The term often refers specifically to triglycerides triple esters of glycerol that are the main components of vegetable oils and of fatty tissue in animals 2 or even more narrowly to triglycerides that are solid or semisolid at room temperature thus excluding oils The term may also be used more broadly as a synonym of lipid any substance of biological relevance composed of carbon hydrogen or oxygen that is insoluble in water but soluble in non polar solvents 1 In this sense besides the triglycerides the term would include several other types of compounds like mono and diglycerides phospholipids such as lecithin sterols such as cholesterol waxes such as beeswax 1 and free fatty acids which are usually present in human diet in smaller amounts 2 Fats are one of the three main macronutrient groups in human diet along with carbohydrates and proteins 1 3 and the main components of common food products like milk butter tallow lard salt pork and cooking oils They are a major and dense source of food energy for many animals and play important structural and metabolic functions in most living beings including energy storage waterproofing and thermal insulation 4 The human body can produce the fat it requires from other food ingredients except for a few essential fatty acids that must be included in the diet Dietary fats are also the carriers of some flavor and aroma ingredients and vitamins that are not water soluble 2 Contents 1 Biological importance 1 1 Adipose tissue 2 Production and processing 3 Metabolism 4 Nutritional and health aspects 4 1 Essential fatty acids 5 Dietary sources 5 1 Saturated vs unsaturated fats 5 1 1 Cardiovascular disease 5 1 2 Cancer 5 1 3 Bones 5 1 4 Disposition and overall health 5 2 Monounsaturated vs polyunsaturated fat 5 2 1 Insulin resistance and sensitivity 5 2 2 Cancer 5 2 3 Pregnancy disorders 5 3 Cis fat vs trans fat 5 3 1 Cardiovascular disease 5 3 2 Breast feeding 5 3 3 Other health risks 5 3 4 Biochemical mechanisms 5 3 5 Natural trans fats in dairy products 5 3 6 Official recommendations 5 3 7 Regulatory action 5 3 8 Alternatives to hydrogenation 5 4 Omega three and omega six fatty acids 5 5 Interesterification 5 6 Role in disease 5 7 Guidelines 5 8 Reducing triglyceride levels 6 Fat digestion and metabolism 7 See also 8 ReferencesBiological importanceIn humans and many animals fats serve both as energy sources and as stores for energy in excess of what the body needs immediately Each gram of fat when burned or metabolized releases about 9 food calories 37 kJ 8 8 kcal 5 Fats are also sources of essential fatty acids an important dietary requirement Vitamins A D E and K are fat soluble meaning they can only be digested absorbed and transported in conjunction with fats Fats play a vital role in maintaining healthy skin and hair insulating body organs against shock maintaining body temperature and promoting healthy cell function Fat also serves as a useful buffer against a host of diseases When a particular substance whether chemical or biotic reaches unsafe levels in the bloodstream the body can effectively dilute or at least maintain equilibrium of the offending substances by storing it in new fat tissue citation needed This helps to protect vital organs until such time as the offending substances can be metabolized or removed from the body by such means as excretion urination accidental or intentional bloodletting sebum excretion and hair growth Adipose tissue The obese mouse on the left has large stores of adipose tissue For comparison a mouse with a normal amount of adipose tissue is shown on the right In animals adipose tissue or fatty tissue is the body s means of storing metabolic energy over extended periods of time Adipocytes fat cells store fat derived from the diet and from liver metabolism Under energy stress these cells may degrade their stored fat to supply fatty acids and also glycerol to the circulation These metabolic activities are regulated by several hormones e g insulin glucagon and epinephrine Adipose tissue also secretes the hormone leptin 6 The location of the tissue determines its metabolic profile visceral fat is located within the abdominal wall i e beneath the wall of abdominal muscle whereas subcutaneous fat is located beneath the skin and includes fat that is located in the abdominal area beneath the skin but above the abdominal muscle wall Visceral fat was recently discovered to be a significant producer of signaling chemicals i e hormones among which several are involved in inflammatory tissue responses One of these is resistin which has been linked to obesity insulin resistance and Type 2 diabetes This latter result is currently controversial and there have been reputable studies supporting all sides on the issue citation needed Production and processingA variety of chemical and physical techniques are used for the production and processing of fats both industrially and in cottage or home settings They include Pressing to extract liquid fats from fruits seeds or algae e g olive oil from olives Solvent extraction using solvents like hexane or supercritical carbon dioxide Rendering the melting of fat in adipose tissue e g to produce tallow lard fish oil and whale oil Churning of milk to produce butter Hydrogenation to lower the degree of unsaturation of the fatty acids Interesterification the rearrangement of fatty acids across different triglycerides Winterization to remove oil components with higher melting points Clarification of butter MetabolismSee also Fatty acid metabolism The pancreatic lipase acts at the ester bond hydrolyzing the bond and releasing the fatty acid In triglyceride form lipids cannot be absorbed by the duodenum Fatty acids monoglycerides one glycerol one fatty acid and some diglycerides are absorbed by the duodenum once the triglycerides have been broken down In the intestine following the secretion of lipases and bile triglycerides are split into monoacylglycerol and free fatty acids in a process called lipolysis They are subsequently moved to absorptive enterocyte cells lining the intestines The triglycerides are rebuilt in the enterocytes from their fragments and packaged together with cholesterol and proteins to form chylomicrons These are excreted from the cells and collected by the lymph system and transported to the large vessels near the heart before being mixed into the blood Various tissues can capture the chylomicrons releasing the triglycerides to be used as a source of energy Liver cells can synthesize and store triglycerides When the body requires fatty acids as an energy source the hormone glucagon signals the breakdown of the triglycerides by hormone sensitive lipase to release free fatty acids As the brain cannot utilize fatty acids as an energy source unless converted to a ketone 7 the glycerol component of triglycerides can be converted into glucose via gluconeogenesis by conversion into dihydroxyacetone phosphate and then into glyceraldehyde 3 phosphate for brain fuel when it is broken down Fat cells may also be broken down for that reason if the brain s needs ever outweigh the body s Triglycerides cannot pass through cell membranes freely Special enzymes on the walls of blood vessels called lipoprotein lipases must break down triglycerides into free fatty acids and glycerol Fatty acids can then be taken up by cells via the fatty acid transporter FAT Triglycerides as major components of very low density lipoprotein VLDL and chylomicrons play an important role in metabolism as energy sources and transporters of dietary fat They contain more than twice as much energy approximately 9 kcal g or 38 kJ g as carbohydrates approximately 4 kcal g or 17 kJ g 8 Nutritional and health aspectsThe most common type of fat in human diet and most living beings is a triglyceride an ester of the triple alcohol glycerol H CHOH 3 H and three fatty acids The molecule of a triglyceride can be described as resulting from a condensation reaction specifically esterification between each of glycerol s OH groups and the HO part of the carboxyl group HO O C of each fatty acid forming an ester bridge O O C with elimination of a water molecule H2 O Other less common types of fats include diglycerides and monoglycerides where the esterification is limited to two or just one of glycerol s OH groups Other alcohols such as cetyl alcohol predominant in spermaceti may replace glycerol In the phospholipids one of the fatty acids is replaced by phosphoric acid or a monoester thereof The benefits and risks of various amounts and types of dietary fats have been the object of much study and are still highly controversial topics 9 10 11 12 Essential fatty acids There are two essential fatty acids EFAs in human nutrition alpha linolenic acid an omega 3 fatty acid and linoleic acid an omega 6 fatty acid 13 5 The adult body can synthesize other lipids that it needs from these two Dietary sourcesProperties of vegetable oils 14 15 Type Processing treatment 16 Saturated fatty acids Monounsaturated fatty acids Polyunsaturated fatty acids Smoke pointTotal 14 Oleic acid w 9 Total 14 a Linolenic acid w 3 Linoleic acid w 6 w 6 3 ratioAvocado 17 11 6 70 6 52 66 18 13 5 1 12 5 12 5 1 250 C 482 F 19 Brazil nut 20 24 8 32 7 31 3 42 0 0 1 41 9 419 1 208 C 406 F 21 Canola 22 7 4 63 3 61 8 28 1 9 1 18 6 2 1 238 C 460 F 21 Coconut 23 82 5 6 3 6 1 7 175 C 347 F 21 Corn 24 12 9 27 6 27 3 54 7 1 58 58 1 232 C 450 F 25 Cottonseed 26 25 9 17 8 19 51 9 1 54 54 1 216 C 420 F 25 Flaxseed linseed 27 9 0 18 4 18 67 8 53 13 0 2 1 107 C 225 F Grape seed 10 5 14 3 14 3 74 7 74 7 very high 216 C 421 F 28 Hemp seed 29 7 0 9 0 9 0 82 0 22 0 54 0 2 5 1 166 C 330 F 30 Olive 31 13 8 73 0 71 3 10 5 0 7 9 8 14 1 193 C 380 F 21 Palm 32 49 3 37 0 40 9 3 0 2 9 1 45 5 1 235 C 455 F Peanut 33 16 2 57 1 55 4 19 9 0 318 19 6 very high 232 C 450 F 25 Rice bran oil 25 38 4 2 2 34 4 34 15 6 232 C 450 F 35 High oleic safflower oil 36 7 5 75 2 75 2 12 8 0 12 8 very high 212 C 414 F 21 Sesame 37 14 2 39 7 39 3 41 7 0 3 41 3 138 1Soybean 38 partially hydrogenated 14 9 43 0 42 5 37 6 2 6 34 9 13 4 1Soybean 39 15 6 22 8 22 6 57 7 7 51 7 3 1 238 C 460 F 25 Walnut oil 40 unrefined 9 1 22 8 22 2 63 3 10 4 52 9 5 1 160 C 320 F 41 Sunflower 42 8 99 63 4 62 9 20 7 0 16 20 5 very high 227 C 440 F 25 Cottonseed 43 hydrogenated 93 6 1 5 0 6 0 2 0 3 1 5 1Palm 44 hydrogenated 88 2 5 7 0The nutritional values are expressed as percent by mass of total fat Saturated vs unsaturated fats Different foods contain different amounts of fat with different proportions of saturated and unsaturated fatty acids Some animal products like beef and dairy products made with whole or reduced fat milk like yogurt ice cream cheese and butter have mostly saturated fatty acids and some have significant contents of dietary cholesterol Other animal products like pork poultry eggs and seafood have mostly unsaturated fats Industrialized baked goods may use fats with high unsaturated fat contents as well especially those containing partially hydrogenated oils and processed foods that are deep fried in hydrogenated oil are high in saturated fat content 45 46 47 Plants and fish oil generally contain a higher proportion of unsaturated acids although there are exceptions such as coconut oil and palm kernel oil 48 49 Foods containing unsaturated fats include avocado nuts olive oils and vegetable oils such as canola Many careful studies have found that replacing saturated fats with cis unsaturated fats in the diet reduces risk of cardiovascular diseases 50 51 diabetes or death 52 These studies prompted many medical organizations and public health departments including the World Health Organization 53 54 to officially issue that advice Some countries with such recommendations include United Kingdom 55 56 57 58 59 United States 52 60 61 62 63 India 64 65 Canada 66 Australia 67 Singapore 68 New Zealand 69 Hong Kong 70 A 2004 review concluded that no lower safe limit of specific saturated fatty acid intakes has been identified and recommended that the influence of varying saturated fatty acid intakes against a background of different individual lifestyles and genetic backgrounds should be the focus in future studies 71 This advice is often oversimplified by labeling the two kinds of fats as bad fats and good fats respectively However since the fats and oils in most natural and traditionally processed foods contain both unsaturated and saturated fatty acids 72 the complete exclusion of saturated fat is unrealistic and possibly unwise For instance some foods rich in saturated fat such as coconut and palm oil are an important source of cheap dietary calories for a large fraction of the population in developing countries 73 Concerns were also expressed at a 2010 conference of the American Dietetic Association that a blanket recommendation to avoid saturated fats could drive people to also reduce the amount of polyunsaturated fats which may have health benefits and or replace fats by refined carbohydrates which carry a high risk of obesity and heart disease 74 For these reasons the United States Food and Drug Administration FDA for example does not advise the complete elimination of saturated fat but only recommends that it does not exceed 30 of one s daily caloric intake citation needed A 2003 report by the World Health Organization and the Food and Agriculture Organization FAO recommends limiting the saturated fatty acids to less than 10 of daily energy intake and less than 7 for high risk groups 73 A general 7 limit was recommended also by the American Heart Association in 2006 75 76 The WHO FAO report also recommended replacing fats so as to reduce the content of myristic and palmitic acids specifically 73 The so called Mediterranean diet prevalent in many countries in the Mediterranean Sea area includes more total fat than the diet of Northern European countries but most of it is in the form of unsaturated fatty acids specifically monounsaturated and omega 3 from olive oil and fish vegetables and certain meats like lamb while consumption of saturated fat is minimal in comparison A 2017 review found evidence that a Mediterranean style diet could reduce the risk of cardiovascular diseases overall cancer incidence neurodegenerative diseases diabetes and mortality rate 77 A 2018 review showed that a Mediterranean like diet may improve overall health status such as reduced risk of non communicable diseases It also may reduce the social and economic costs of diet related illnesses 78 A small number of contemporary reviews have challenged this negative view of saturated fats For example an evaluation of evidence from 1966 to 1973 of the observed health impact of replacing dietary saturated fat with linoleic acid found that it increased rates of death from all causes coronary heart disease and cardiovascular disease 79 These studies have been disputed by many scientists 80 and the consensus in the medical community is that saturated fat and cardiovascular disease are closely related 81 82 83 Still these discordant studies fueled debate over the merits of substituting polyunsaturated fats for saturated fats 84 Cardiovascular disease Main article Saturated fat and cardiovascular disease The effect of saturated fat on cardiovascular disease has been extensively studied 85 The general consensus is that there is evidence of moderate quality of a strong consistent and graded relationship between saturated fat intake blood cholesterol levels and the incidence of cardiovascular disease 52 85 The relationships are accepted as causal 86 87 including by many government and medical organizations 73 88 89 52 90 91 92 93 A 2017 review by the American Heart Association estimated that replacement of saturated fat with polyunsaturated fat in the American diet could reduce the risk of cardiovascular diseases by 30 52 The consumption of saturated fat is generally considered a risk factor for dyslipidemia abnormal blood lipid levels including high total cholesterol high levels of triglycerides high levels of low density lipoprotein LDL bad cholesterol or low levels of high density lipoprotein HDL good cholesterol These parameters in turn are believed to be risk indicators for some types of cardiovascular disease 94 95 96 97 98 90 99 100 101 These effects were observed in children too 102 Several meta analyses reviews and consolidations of multiple previously published experimental studies have confirmed a significant relationship between saturated fat and high serum cholesterol levels 52 103 which in turn have been claimed to have a causal relation with increased risk of cardiovascular disease the so called lipid hypothesis 104 105 However high cholesterol may be caused by many factors Other indicators such as high LDL HDL ratio have proved to be more predictive 105 In a study of myocardial infarction in 52 countries the ApoB ApoA1 related to LDL and HDL respectively ratio was the strongest predictor of CVD among all risk factors 106 There are other pathways involving obesity triglyceride levels insulin sensitivity endothelial function and thrombogenicity among others that play a role in CVD although it seems in the absence of an adverse blood lipid profile the other known risk factors have only a weak atherogenic effect 107 Different saturated fatty acids have differing effects on various lipid levels 108 Cancer The evidence for a relation between saturated fat intake and cancer is significantly weaker and there does not seem to be a clear medical consensus about it A meta analysis published in 2003 found a significant positive relationship between saturated fat and breast cancer 109 However two subsequent reviews have found weak or insignificant relation 110 111 and noted the prevalence of confounding factors 110 112 Another review found limited evidence for a positive relationship between consuming animal fat and incidence of colorectal cancer 113 Other meta analyses found evidence for increased risk of ovarian cancer by high consumption of saturated fat 114 Some studies have indicated that serum myristic acid 115 116 and palmitic acid 116 and dietary myristic 117 and palmitic 117 saturated fatty acids and serum palmitic combined with alpha tocopherol supplementation 115 are associated with increased risk of prostate cancer in a dose dependent manner These associations may however reflect differences in intake or metabolism of these fatty acids between the precancer cases and controls rather than being an actual cause 116 Bones Various animal studies have indicated that the intake of saturated fat has a negative effect on effects on the mineral density of bones One study suggested that men may be particularly vulnerable 118 Disposition and overall health Studies have shown that substituting monounsaturated fatty acids for saturated ones is associated with increased daily physical activity and resting energy expenditure More physical activity less anger and less irritability were associated with a higher oleic acid diet than one of a palmitic acid diet 119 Amounts of fat types in selected foods Monounsaturated vs polyunsaturated fat Schematic diagram of a triglyceride with a saturated fatty acid top a monounsaturated one middle and a polyunsaturated one bottom Assuming that unsaturated fatty acids UFAs are generally healthier than saturated ones SFAs another question that has gained attention in recent decades is the risks and benefits of monounsaturated fatty acids MUFAs with a single double bond versus polyunsaturated fatty acids PUFAs with two or more double bonds The most common fatty acids in human diet are unsaturated or mono unsaturated Monounsaturated fats are found in animal flesh such as red meat whole milk products nuts and high fat fruits such as olives and avocados Olive oil is about 75 monounsaturated fat 120 The high oleic variety sunflower oil contains at least 70 monounsaturated fat 121 Canola oil and cashews are both about 58 monounsaturated fat citation needed Tallow beef fat is about 50 monounsaturated fat 122 and lard is about 40 monounsaturated fat citation needed Other sources include hazelnut avocado oil macadamia nut oil grapeseed oil groundnut oil peanut oil sesame oil corn oil popcorn whole grain wheat cereal oatmeal almond oil sunflower oil hemp oil and tea oil camellia 123 Polyunsaturated fatty acids can be found mostly in nuts seeds fish seed oils and oysters 124 Food sources of polyunsaturated fats include 124 125 Food source 100g Polyunsaturated fat g Walnuts 47Canola oil 34Sunflower seeds 33Sesame seeds 26Chia seeds 23 7Unsalted peanuts 16Peanut butter 14 2Avocado oil 13 5 126 Olive oil 11Safflower oil 12 82 127 Seaweed 11Sardines 5Soybeans 7Tuna 14Wild salmon 17 3Whole grain wheat 9 7Insulin resistance and sensitivity MUFAs especially oleic acid have been found to lower the incidence of insulin resistance PUFAs especially large amounts of arachidonic acid and SFAs such as arachidic acid increased it These ratios can be indexed in the phospholipids of human skeletal muscle and in other tissues as well This relationship between dietary fats and insulin resistance is presumed secondary to the relationship between insulin resistance and inflammation which is partially modulated by dietary fat ratios Omega 3 6 9 with both omega 3 and 9 thought to be anti inflammatory and omega 6 pro inflammatory as well as by numerous other dietary components particularly polyphenols and exercise with both of these anti inflammatory Although both pro and anti inflammatory types of fat are biologically necessary fat dietary ratios in most US diets are skewed towards Omega 6 with subsequent disinhibition of inflammation and potentiation of insulin resistance 72 This is contrary to the suggestion of more recent studies in which polyunsaturated fats are shown to be protective against insulin resistance The large scale KANWU study found that increasing MUFA and decreasing SFA intake could improve insulin sensitivity but only when the overall fat intake of the diet was low 128 However some MUFAs may promote insulin resistance like the SFAs whereas PUFAs may protect against it 129 130 clarification needed Cancer Levels of oleic acid along with other MUFAs in red blood cell membranes were positively associated with breast cancer risk The saturation index SI of the same membranes was inversely associated with breast cancer risk MUFAs and low SI in erythrocyte membranes are predictors of postmenopausal breast cancer Both of these variables depend on the activity of the enzyme delta 9 desaturase D9 d 131 Results from observational clinical trials on PUFA intake and cancer have been inconsistent and vary by numerous factors of cancer incidence including gender and genetic risk 132 Some studies have shown associations between higher intakes and or blood levels of omega 3 PUFAs and a decreased risk of certain cancers including breast and colorectal cancer while other studies found no associations with cancer risk 132 133 Pregnancy disorders Polyunsaturated fat supplementation was found to have no effect on the incidence of pregnancy related disorders such as hypertension or preeclampsia but may increase the length of gestation slightly and decreased the incidence of early premature births 124 Expert panels in the United States and Europe recommend that pregnant and lactating women consume higher amounts of polyunsaturated fats than the general population to enhance the DHA status of the fetus and newborn 124 Cis fat vs trans fat In nature unsaturated fatty acids generally have double bonds in cis configuration with the adjacent C C bonds on the same side as opposed to trans 134 Nevertheless trans fatty acids TFAs occur in small amounts in meat and milk of ruminants such as cattle and sheep 135 136 typically 2 5 of total fat 137 Natural TFAs which include conjugated linoleic acid CLA and vaccenic acid originate in the rumen of these animals CLA has two double bonds one in the cis configuration and one in trans which makes it simultaneously a cis and a trans fatty acid 138 Trans fat contents in various natural and traditionally processed foods in g per 100 g 139 Food type Trans fat contentbutter 2g to 7 gwhole milk 0 07g to 0 1 ganimal fat 0g to 5 g 137 ground beef 1 g Margarine a common product that can contain trans fatty acids Cover of original Crisco cookbook 1912 Crisco was made by hydrogenating cottonseed oil The formula was revised in the 2000s and now has only a small amount of trans fat Wilhelm Normann patented the hydrogenation of liquid oils in 1902 Concerns about trans fatty acids in human diet were raised when they were found to be an unintentional byproduct of the partial hydrogenation of vegetable and fish oils While these trans fatty acids popularly called trans fats are edible they have been implicated in many health problems 140 Conversion of cis to trans fatty acids in partial hydrogenation The hydrogenation process invented and patented by Wilhelm Normann in 1902 made it possible to turn relatively cheap liquid fats such as whale or fish oil into more solid fats and to extend their shelf life by preventing rancidification The source fat and the process were initially kept secret to avoid consumer distaste 141 This process was widely adopted by the food industry already in the early 1900s first for the production of margarine a replacement for butter and shortening 142 and eventually for various other fats used in snack food packaged baked goods and deep fried products 143 Full hydrogenation of a fat or oil produces a fully saturated fat However hydrogenation generally was interrupted before completion to yield a fat product with specific melting point hardness and other properties Unfortunately partial hydrogenation turns some of the cis double bonds into trans bonds by an isomerization reaction 143 144 The trans configuration is favored citation needed because it is the lower energy form This side reaction accounts for most of the trans fatty acids consumed today by far 145 146 An analysis of some industrialized foods in 2006 found up to 30 trans fats in artificial shortening 10 in breads and cake products 8 in cookies and crackers 4 in salty snacks 7 in cake frostings and sweets and 26 in margarine and other processed spreads 139 Another 2010 analysis however found only 0 2 of trans fats in margarine and other processed spreads 147 Up to 45 of the total fat in those foods containing man made trans fats formed by partially hydrogenating plant fats may be trans fat 137 Baking shortenings unless reformulated contain around 30 trans fats compared to their total fats High fat dairy products such as butter contain about 4 Margarines not reformulated to reduce trans fats may contain up to 15 trans fat by weight 148 but some reformulated ones are less than 1 trans fat High levels of TFAs have been recorded in popular fast food meals 146 An analysis of samples of McDonald s French fries collected in 2004 and 2005 found that fries served in New York City contained twice as much trans fat as in Hungary and 28 times as much as in Denmark where trans fats are restricted For Kentucky Fried Chicken products the pattern was reversed the Hungarian product containing twice the trans fat of the New York product Even within the United States there was variation with fries in New York containing 30 more trans fat than those from Atlanta 149 Cardiovascular disease Numerous studies have found that consumption of TFAs increases risk of cardiovascular disease 13 5 The Harvard School of Public Health advises that replacing TFAs and saturated fats with cis monounsaturated and polyunsaturated fats is beneficial for health 150 Consuming trans fats has been shown to increase the risk of coronary artery disease in part by raising levels of low density lipoprotein LDL often termed bad cholesterol lowering levels of high density lipoprotein HDL often termed good cholesterol increasing triglycerides in the bloodstream and promoting systemic inflammation 151 152 The primary health risk identified for trans fat consumption is an elevated risk of coronary artery disease CAD 153 A 1994 study estimated that over 30 000 cardiac deaths per year in the United States are attributable to the consumption of trans fats 154 By 2006 upper estimates of 100 000 deaths were suggested 155 A comprehensive review of studies of trans fats published in 2006 in the New England Journal of Medicine reports a strong and reliable connection between trans fat consumption and CAD concluding that On a per calorie basis trans fats appear to increase the risk of CAD more than any other macronutrient conferring a substantially increased risk at low levels of consumption 1 to 3 of total energy intake 156 The major evidence for the effect of trans fat on CAD comes from the Nurses Health Study a cohort study that has been following 120 000 female nurses since its inception in 1976 In this study Hu and colleagues analyzed data from 900 coronary events from the study s population during 14 years of followup He determined that a nurse s CAD risk roughly doubled relative risk of 1 93 CI 1 43 to 2 61 for each 2 increase in trans fat calories consumed instead of carbohydrate calories By contrast for each 5 increase in saturated fat calories instead of carbohydrate calories there was a 17 increase in risk relative risk of 1 17 CI 0 97 to 1 41 The replacement of saturated fat or trans unsaturated fat by cis unhydrogenated unsaturated fats was associated with larger reductions in risk than an isocaloric replacement by carbohydrates 157 Hu also reports on the benefits of reducing trans fat consumption Replacing 2 of food energy from trans fat with non trans unsaturated fats more than halves the risk of CAD 53 By comparison replacing a larger 5 of food energy from saturated fat with non trans unsaturated fats reduces the risk of CAD by 43 157 Another study considered deaths due to CAD with consumption of trans fats being linked to an increase in mortality and consumption of polyunsaturated fats being linked to a decrease in mortality 153 158 Trans fat has been found to act like saturated in raising the blood level of LDL bad cholesterol but unlike saturated fat it also decreases levels of HDL good cholesterol The net increase in LDL HDL ratio with trans fat a widely accepted indicator of risk for coronary artery is approximately double that due to saturated fat 159 160 161 One randomized crossover study published in 2003 comparing the effect of eating a meal on blood lipids of relatively cis and trans fat rich meals showed that cholesteryl ester transfer CET was 28 higher after the trans meal than after the cis meal and that lipoprotein concentrations were enriched in apolipoprotein a after the trans meals 162 The citokyne test is a potentially more reliable indicator of CAD risk although is still being studied 153 A study of over 700 nurses showed that those in the highest quartile of trans fat consumption had blood levels of C reactive protein CRP that were 73 higher than those in the lowest quartile 163 Breast feeding It has been established that trans fats in human breast milk fluctuate with maternal consumption of trans fat and that the amount of trans fats in the bloodstream of breastfed infants fluctuates with the amounts found in their milk In 1999 reported percentages of trans fats compared to total fats in human milk ranged from 1 in Spain 2 in France 4 in Germany and 7 in Canada and the United States 164 Other health risks There are suggestions that the negative consequences of trans fat consumption go beyond the cardiovascular risk In general there is much less scientific consensus asserting that eating trans fat specifically increases the risk of other chronic health problems Alzheimer s disease A study published in Archives of Neurology in February 2003 suggested that the intake of both trans fats and saturated fats promotes the development of Alzheimer disease 165 although not confirmed in an animal model 166 It has been found that trans fats impaired memory and learning in middle age rats The brains of rats that ate trans fats had fewer proteins critical to healthy neurological function Inflammation in and around the hippocampus the part of the brain responsible for learning and memory These are the exact types of changes normally seen at the onset of Alzheimer s but seen after six weeks even though the rats were still young 167 Cancer There is no scientific consensus that consuming trans fats significantly increases cancer risks across the board 153 The American Cancer Society states that a relationship between trans fats and cancer has not been determined 168 One study has found a positive connection between trans fat and prostate cancer 169 However a larger study found a correlation between trans fats and a significant decrease in high grade prostate cancer 170 An increased intake of trans fatty acids may raise the risk of breast cancer by 75 suggest the results from the French part of the European Prospective Investigation into Cancer and Nutrition 171 172 Diabetes There is a growing concern that the risk of type 2 diabetes increases with trans fat consumption 153 173 However consensus has not been reached 156 For example one study found that risk is higher for those in the highest quartile of trans fat consumption 174 Another study has found no diabetes risk once other factors such as total fat intake and BMI were accounted for 175 Obesity Research indicates that trans fat may increase weight gain and abdominal fat despite a similar caloric intake 176 A 6 year experiment revealed that monkeys fed a trans fat diet gained 7 2 of their body weight as compared to 1 8 for monkeys on a mono unsaturated fat diet 177 178 Although obesity is frequently linked to trans fat in the popular media 179 this is generally in the context of eating too many calories there is not a strong scientific consensus connecting trans fat and obesity although the 6 year experiment did find such a link concluding that under controlled feeding conditions long term TFA consumption was an independent factor in weight gain TFAs enhanced intra abdominal deposition of fat even in the absence of caloric excess and were associated with insulin resistance with evidence that there is impaired post insulin receptor binding signal transduction 178 Infertility in women One 2007 study found Each 2 increase in the intake of energy from trans unsaturated fats as opposed to that from carbohydrates was associated with a 73 greater risk of ovulatory infertility 180 Major depressive disorder Spanish researchers analysed the diets of 12 059 people over six years and found that those who ate the most trans fats had a 48 per cent higher risk of depression than those who did not eat trans fats 181 One mechanism may be trans fats substitution for docosahexaenoic acid DHA levels in the orbitofrontal cortex OFC Very high intake of trans fatty acids 43 of total fat in mice from 2 to 16 months of age was associated with lowered DHA levels in the brain p 0 001 166 When the brains of 15 major depressive subjects who had committed suicide were examined post mortem and compared against 27 age matched controls the suicidal brains were found to have 16 less male average to 32 less female average DHA in the OFC The OFC controls reward reward expectation and empathy all of which are reduced in depressive mood disorders and regulates the limbic system 182 Behavioral irritability and aggression a 2012 observational analysis of subjects of an earlier study found a strong relation between dietary trans fat acids and self reported behavioral aggression and irritability suggesting but not establishing causality 183 Diminished memory In a 2015 article researchers re analyzing results from the 1999 2005 UCSD Statin Study argue that greater dietary trans fatty acid consumption is linked to worse word memory in adults during years of high productivity adults age lt 45 184 Acne According to a 2015 study trans fats are one of several components of Western pattern diets which promote acne along with carbohydrates with high glycemic load such as refined sugars or refined starches milk and dairy products and saturated fats while omega 3 fatty acids which reduce acne are deficient in Western pattern diets 185 Biochemical mechanisms The exact biochemical process by which trans fats produce specific health problems are a topic of continuing research Intake of dietary trans fat perturbs the body s ability to metabolize essential fatty acids EFAs including Omega 3 leading to changes in the phospholipid fatty acid composition of the arterial walls thereby raising risk of coronary artery disease 186 Trans double bonds are claimed to induce a linear conformation to the molecule favoring its rigid packing as in plaque formation The geometry of the cis double bond in contrast is claimed to create a bend in the molecule thereby precluding rigid formations citation needed While the mechanisms through which trans fatty acids contribute to coronary artery disease are fairly well understood the mechanism for their effects on diabetes is still under investigation They may impair the metabolism of long chain polyunsaturated fatty acids LCPUFAs 187 However maternal pregnancy trans fatty acid intake has been inversely associated with LCPUFAs levels in infants at birth thought to underlie the positive association between breastfeeding and intelligence 188 Trans fats are processed by the liver differently than other fats They may cause liver dysfunction by interfering with delta 6 desaturase an enzyme involved in converting essential fatty acids to arachidonic acid and prostaglandins both of which are important to the functioning of cells 189 Natural trans fats in dairy products Some trans fatty acids occur in natural fats and traditionally processed foods Vaccenic acid occurs in breast milk and some isomers of conjugated linoleic acid CLA are found in meat and dairy products from ruminants Butter for example contains about 3 trans fat 190 The US National Dairy Council has asserted that the trans fats present in animal foods are of a different type than those in partially hydrogenated oils and do not appear to exhibit the same negative effects 191 While a recent scientific review agrees with the conclusion stating that the sum of the current evidence suggests that the Public health implications of consuming trans fats from ruminant products are relatively limited it cautions that this may be due to the low consumption of trans fats from animal sources compared to artificial ones 156 More recent inquiry independent of the dairy industry has found in a 2008 Dutch meta analysis that all trans fats regardless of natural or artificial origin equally raise LDL and lower HDL levels 192 Other studies though have shown different results when it comes to animal based trans fats like conjugated linoleic acid CLA Although CLA is known for its anticancer properties researchers have also found that the cis 9 trans 11 form of CLA can reduce the risk for cardiovascular disease and help fight inflammation 193 194 Two Canadian studies have shown that vaccenic acid a TFA that naturally occurs in dairy products could be beneficial compared to hydrogenated vegetable shortening or a mixture of pork lard and soy fat by lowering total LDL and triglyceride levels 195 196 197 A study by the US Department of Agriculture showed that vaccenic acid raises both HDL and LDL cholesterol whereas industrial trans fats only raise LDL with no beneficial effect on HDL 198 Official recommendations In light of recognized evidence and scientific agreement nutritional authorities consider all trans fats equally harmful for health and recommend that their consumption be reduced to trace amounts 199 200 201 202 203 The World Health Organization recommended that trans fats make up no more than 0 9 of a person s diet in 2003 137 and in 2018 introduced a 6 step guide to eliminate industrially produced trans fatty acids from the global food supply 204 The National Academy of Sciences NAS advises the United States and Canadian governments on nutritional science for use in public policy and product labeling programs Their 2002 Dietary Reference Intakes for Energy Carbohydrate Fiber Fat Fatty Acids Cholesterol Protein and Amino Acids 205 contains their findings and recommendations regarding consumption of trans fat summary Archived 2007 06 25 at the Wayback Machine Their recommendations are based on two key facts First trans fatty acids are not essential and provide no known benefit to human health 151 whether of animal or plant origin 206 Second given their documented effects on the LDL HDL ratio 152 the NAS concluded that dietary trans fatty acids are more deleterious with respect to coronary artery disease than saturated fatty acids A 2006 review published in the New England Journal of Medicine NEJM that states from a nutritional standpoint the consumption of trans fatty acids results in considerable potential harm but no apparent benefit 156 Because of these facts and concerns the NAS has concluded there is no safe level of trans fat consumption There is no adequate level recommended daily amount or tolerable upper limit for trans fats This is because any incremental increase in trans fat intake increases the risk of coronary artery disease 152 Despite this concern the NAS dietary recommendations have not included eliminating trans fat from the diet This is because trans fat is naturally present in many animal foods in trace quantities and thus its removal from ordinary diets might introduce undesirable side effects and nutritional imbalances The NAS has thus recommended that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet 207 Like the NAS the World Health Organization has tried to balance public health goals with a practical level of trans fat consumption recommending in 2003 that trans fats be limited to less than 1 of overall energy intake 137 Regulatory action Main article Trans fat regulation In the last few decades there has been substantial amount of regulation in many countries limiting trans fat contents of industrialized and commercial food products Alternatives to hydrogenation In recent years the negative public image and strict regulations have driven many fat processing industries to replace partial hydrogenation by fat interesterification a process that chemically scrambles the fatty acids among a mix of triglycerides When applied to a suitable bend of oils and saturated fats possibly followed by separation of unwanted solid or liquid triglycerides this process can achieve results similar to those of partial hydrogenation without affecting the fatty acids themselves in particular without creating any new trans fat Researchers at the United States Department of Agriculture have investigated whether hydrogenation can be achieved without the side effect of trans fat production They varied the pressure under which the chemical reaction was conducted applying 1400 kPa 200 psi of pressure to soybean oil in a 2 liter vessel while heating it to between 140 C and 170 C The standard 140 kPa 20 psi process of hydrogenation produces a product of about 40 trans fatty acid by weight compared to about 17 using the high pressure method Blended with unhydrogenated liquid soybean oil the high pressure processed oil produced margarine containing 5 to 6 trans fat Based on current U S labeling requirements see below the manufacturer could claim the product was free of trans fat 208 The level of trans fat may also be altered by modification of the temperature and the length of time during hydrogenation A University of Guelph research group has found a way to mix oils such as olive soybean and canola water monoglycerides and fatty acids to form a cooking fat that acts the same way as trans and saturated fats 209 210 Omega three and omega six fatty acids Main articles Omega 3 fatty acid and Omega 6 fatty acid The w 3 fatty acids have received substantial attention in recent years Among omega 3 fatty acids neither long chain nor short chain forms were consistently associated with breast cancer risk High levels of docosahexaenoic acid DHA however the most abundant omega 3 polyunsaturated fatty acid in erythrocyte red blood cell membranes were associated with a reduced risk of breast cancer 131 The DHA obtained through the consumption of polyunsaturated fatty acids is positively associated with cognitive and behavioral performance 211 In addition DHA is vital for the grey matter structure of the human brain as well as retinal stimulation and neurotransmission 124 Interesterification Some studies have investigated the health effects of insteresterified IE fats by comparing diets with IE and non IE fats with the same overall fatty acid composition 212 Several experimental studies in humans found no statistical difference on fasting blood lipids between a with large amounts of IE fat having 25 40 C16 0 or C18 0 on the 2 position and a similar diet with non IE fat having only 3 9 C16 0 or C18 0 on the 2 position 213 214 215 A negative result was obtained also in a study that compared the effects on blood cholesterol levels of an IE fat product mimicking cocoa butter and the real non IE product 216 217 218 219 220 221 222 A 2007 study funded by the Malaysian Palm Oil Board 223 claimed that replacing natural palm oil by other interesterified or partial hydrogenated fats caused adverse health effects such as higher LDL HDL ratio and plasma glucose levels However these effects could be attributed to the higher percentage of saturated acids in the IE and partially hydrogenated fats rather than to the IE process itself 224 225 Role in disease Main article Hypertriglyceridemia In the human body high levels of triglycerides in the bloodstream have been linked to atherosclerosis heart disease 226 and stroke 8 However the relative negative impact of raised levels of triglycerides compared to that of LDL HDL ratios is as yet unknown The risk can be partly accounted for by a strong inverse relationship between triglyceride level and HDL cholesterol level But the risk is also due to high triglyceride levels increasing the quantity of small dense LDL particles 227 Guidelines Reference ranges for blood tests showing usual ranges for triglycerides increasing with age in orange at right The National Cholesterol Education Program has set guidelines for triglyceride levels 228 229 Level Interpretation mg dL mmol L lt 150 lt 1 70 Normal range low risk150 199 1 70 2 25 Slightly above normal200 499 2 26 5 65 Some risk500 or higher gt 5 65 Very high high risk These levels are tested after fasting 8 to 12 hours Triglyceride levels remain temporarily higher for a period after eating The American Heart Association recommends an optimal triglyceride level of 100 mg dL 1 1 mmol L or lower to improve heart health 230 Reducing triglyceride levels Weight loss and dietary modification are effective first line lifestyle modification treatments for hypertriglyceridemia 231 For people with mildly or moderately high levels of triglycerides lifestyle changes including weight loss moderate exercise 232 233 and dietary modification are recommended 234 This may include restriction of carbohydrates specifically fructose 231 and fat in the diet and the consumption of omega 3 fatty acids 233 from algae nuts fish and seeds 235 Medications are recommended in those with high levels of triglycerides that are not corrected with the aforementioned lifestyle modifications with fibrates being recommended first 234 236 237 Omega 3 carboxylic acids is another prescription drug used to treat very high levels of blood triglycerides 238 The decision to treat hypertriglyceridemia with medication depends on the levels and on the presence of other risk factors for cardiovascular disease Very high levels that would increase the risk of pancreatitis is treated with a drug from the fibrate class Niacin and omega 3 fatty acids as well as drugs from the statin class may be used in conjunction with statins being the main medication for moderate hypertriglyceridemia when reduction of cardiovascular risk is required 234 Fat digestion and metabolismMain article Lipid metabolism Fats are broken down in the healthy body to release their constituents glycerol and fatty acids Glycerol itself can be converted to glucose by the liver and so become a source of energy Fats and other lipids are broken down in the body by enzymes called lipases produced in the pancreas Many cell types can use either glucose or fatty acids as a source of energy for metabolism In particular heart and skeletal muscle prefer fatty acids citation needed Despite long standing assertions to the contrary fatty acids can also be used as a source of fuel for brain cells through mitochondrial oxidation 239 See alsoAnimal fat Diet and heart disease Fatty acid synthesis Food composition data Western pattern dietReferences a b c d Entry for fat in the online Merriam Webster disctionary sense 3 2 Accessed on 2020 08 09 a b c Thomas A B Sanders 2016 The Role of Fats in Human Diet Pages 1 20 of Functional Dietary Lipids Woodhead Elsevier 332 pages ISBN 978 1 78242 247 1doi 10 1016 B978 1 78242 247 1 00001 6 Macronutrients the Importance of Carbohydrate Protein and Fat McKinley Health Center University of Illinois at Urbana Champaign Retrieved 20 September 2014 Introduction to Energy Storage Khan Academy a b c Government of the United Kingdom 1996 Schedule 7 Nutrition labelling In Food Labelling Regulations 1996 Accessed on 2020 08 09 The human proteome in adipose The Human Protein Atlas www proteinatlas org Retrieved 2017 09 12 White Hayden Venkatesh Balasubramanian 2011 Clinical review Ketones and brain injury Critical Care 15 2 219 doi 10 1186 cc10020 PMC 3219306 PMID 21489321 a b Drummond K E Brefere L M 2014 Nutrition for Foodservice and Culinary Professionals 8th ed John Wiley amp Sons ISBN 978 0 470 05242 6 Rebecca J Donatelle 2005 Health the Basics 6th edition Pearson Education San Francisco ISBN 978 0 13 120687 8 Frank B Hu JoAnn E Manson and Walter C Willett 2001 Types of dietary fat and risk of coronary heart disease A critical review Journal of the American College of Nutrition volume 20 issue 1 pages 5 19 doi 10 1080 07315724 2001 10719008 Lee Hooper Carolyn D Summerbell Julian P T Higgins Rachel L Thompson Nigel E Capps George Davey Smith Rudolph A Riemersma and Shah Ebrahim 2001 Dietary fat intake and prevention of cardiovascular disease systematic review The BMJ volume 322 pages 757 doi 10 1136 bmj 322 7289 757 George A Bray Sahasporn Paeratakul Barry M Popkin 2004 Dietary fat and obesity a review of animal clinical and epidemiological studies Physiology amp Behavior volume 83 issue 4 pages 549 555 doi 10 1016 j physbeh 2004 08 039 a b Dariush Mozaffarian Martijn B Katan Alberto Ascherio Meir J Stampfer and Walter C Willett 2006 Trans fatty acids and cardiovascular disease New England Journal of Medicine volume 354 issue 15 pages 1601 1613 doi 10 1056 NEJMra054035 PMID 16611951 a b c US National Nutrient Database Release 28 United States Department of Agriculture May 2016 All values in this table are from this database unless otherwise cited Fats and fatty acids contents per 100 g click for more details Example Avocado oil user can search for other oils Nutritiondata com Conde Nast for the USDA National Nutrient Database Standard Release 21 2014 Retrieved 7 September 2017 Values from Nutritiondata com SR 21 may need to be reconciled with most recent release from the USDA SR 28 as of Sept 2017 USDA Specifications for Vegetable Oil Margarine Effective August 28 1996 PDF Avocado oil fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 Feramuz Ozdemir Ayhan Topuz May 2003 Changes in dry matter oil content and fatty acids composition of avocado during harvesting time and post harvesting ripening period PDF Elsevier Retrieved 15 January 2020 Marie Wong Cecilia Requejo Jackman Allan Woolf April 2010 What is unrefined extra virgin cold 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Department of Agriculture May 2016 Retrieved 6 September 2017 Palm oil fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 FoodData Central fdc nal usda gov Orthoefer F T 2005 Chapter 10 Rice Bran Oil In Shahidi F ed Bailey s Industrial Oil and Fat Products Vol 2 6 ed John Wiley amp Sons Inc p 465 doi 10 1002 047167849X ISBN 978 0 471 38552 3 Rice bran oil RITO Partnership Retrieved 22 January 2021 Safflower oil salad or cooking high oleic primary commerce fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 Oil sesame salad or cooking FoodData Central fdc nal usda gov Soybean oil salad or cooking partially hydrogenated fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 Soybean oil salad or cooking fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 Walnut oil fat composition 100 g US National Nutrient Database United States Department of Agriculture Smoke Point of Oils Baseline of Health Jonbarron org FoodData Central fdc nal usda gov Cottonseed oil industrial fully hydrogenated fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 Palm oil industrial fully hydrogenated filling fat fat composition 100 g US National Nutrient Database Release 28 United States Department of Agriculture May 2016 Retrieved 6 September 2017 Saturated fats American Heart Association 2014 Retrieved 1 March 2014 Top food sources of saturated fat in the US Harvard University School of Public Health 2014 Retrieved 1 March 2014 Saturated Unsaturated and Trans Fats choosemyplate gov 2020 Reece Jane Campbell Neil 2002 Biology San Francisco Benjamin Cummings pp 69 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challenge 2nd ed Jones and Bartlett Publishers p 277 ISBN 978 0 7637 4689 6 Thijssen MA Mensink RP 2005 Fatty acids and atherosclerotic risk Atherosclerosis Diet and Drugs Handbook of Experimental Pharmacology Vol 170 Springer pp 165 94 doi 10 1007 3 540 27661 0 5 ISBN 978 3 540 22569 0 PMID 16596799 Boyd NF Stone J Vogt KN Connelly BS Martin LJ Minkin S November 2003 Dietary fat and breast cancer risk revisited a meta analysis of the published literature British Journal of Cancer 89 9 1672 1685 doi 10 1038 sj bjc 6601314 PMC 2394401 PMID 14583769 a b Hanf V Gonder U 2005 12 01 Nutrition and primary prevention of breast cancer foods nutrients and breast cancer risk European Journal of Obstetrics Gynecology and Reproductive Biology 123 2 139 149 doi 10 1016 j ejogrb 2005 05 011 PMID 16316809 Lof M Weiderpass E February 2009 Impact of diet on breast cancer risk Current Opinion in Obstetrics and Gynecology 21 1 80 85 doi 10 1097 GCO 0b013e32831d7f22 PMID 19125007 S2CID 9513690 Freedman LS 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Aardestrup IV Johnsen NF Tjonneland A Linseisen J Kaaks R Boeing H Kroger J Trichopoulou A Zavitsanou A Trichopoulos D Sacerdote C Palli D Tumino R Agnoli C Kiemeney LA Bueno de Mesquita HB Chirlaque MD Ardanaz E Larranaga N Quiros JR Sanchez MJ Gonzalez CA Stattin P Hallmans G Bingham S Khaw KT Rinaldi S Slimani N Jenab M Riboli E Key TJ November 2008 Fatty acid composition of plasma phospholipids and risk of prostate cancer in a case control analysis nested within the European Prospective Investigation into Cancer and Nutrition The American Journal of Clinical Nutrition 88 5 1353 63 doi 10 3945 ajcn 2008 26369 PMID 18996872 a b Kurahashi N Inoue M Iwasaki M Sasazuki S Tsugane AS April 2008 Dairy product saturated fatty acid and calcium intake and prostate cancer in a prospective cohort of Japanese men Cancer Epidemiology Biomarkers amp Prevention 17 4 930 7 doi 10 1158 1055 9965 EPI 07 2681 PMID 18398033 S2CID 551427 Corwin RL Hartman TJ Maczuga SA Graubard BI 2006 Dietary saturated fat intake is inversely associated with bone density in humans Analysis of NHANES III The Journal of Nutrition 136 1 159 165 doi 10 1093 jn 136 1 159 PMID 16365076 S2CID 4443420 Kien CL Bunn JY Tompkins CL Dumas JA Crain KI Ebenstein DB Koves TR Muoio DM April 2013 Substituting dietary monounsaturated fat for saturated fat is associated with increased daily physical activity and resting energy expenditure and with changes in mood The American Journal of Clinical Nutrition 97 4 689 97 doi 10 3945 ajcn 112 051730 PMC 3607650 PMID 23446891 Abdullah MM Jew S Jones PJ February 2017 Health benefits and evaluation of healthcare cost savings if oils rich in monounsaturated fatty acids were substituted for conventional dietary oils in the United States Nutrition Reviews 75 3 163 174 doi 10 1093 nutrit nuw062 PMC 5914363 PMID 28158733 Huth PJ Fulgoni VL Larson BT November 2015 A systematic review of high oleic vegetable oil substitutions for other fats and oils on cardiovascular disease risk 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OR May 2014 Retrieved 24 May 2017 National nutrient database for standard reference release 23 United States Department of Agriculture Agricultural Research Service 2011 Archived from the original on 2015 03 03 Retrieved 2009 02 22 Vegetable oil avocado Nutrition Facts amp Calories nutritiondata self com United States Department of Agriculture National Nutrient Database 8 September 2015 Vessby B Uusitupa M Hermansen K Riccardi G Rivellese AA Tapsell LC Nalsen C Berglund L Louheranta A Rasmussen BM Calvert GD Maffetone A Pedersen E Gustafsson IB Storlien LH March 2001 Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women The KANWU Study Diabetologia 44 3 312 9 doi 10 1007 s001250051620 PMID 11317662 Lovejoy JC October 2002 The influence of dietary fat on insulin resistance Current Diabetes Reports 2 5 435 40 doi 10 1007 s11892 002 0098 y PMID 12643169 S2CID 31329463 Fukuchi S Hamaguchi K Seike M Himeno K Sakata T Yoshimatsu H June 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transfer The American Journal of Clinical Nutrition 77 5 1119 24 doi 10 1093 ajcn 77 5 1119 PMID 12716661 Lopez Garcia E Schulze MB Meigs JB Manson JE Rifai N Stampfer MJ et al March 2005 Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction The Journal of Nutrition 135 3 562 6 doi 10 1093 jn 135 3 562 PMID 15735094 Innis SM King DJ September 1999 trans Fatty acids in human milk are inversely associated with concentrations of essential all cis n 6 and n 3 fatty acids and determine trans but not n 6 and n 3 fatty acids in plasma lipids of breast fed infants The American Journal of Clinical Nutrition 70 3 383 90 doi 10 1093 ajcn 70 3 383 PMID 10479201 Morris MC Evans DA Bienias JL Tangney CC Bennett DA Aggarwal N et al February 2003 Dietary fats and the risk of incident Alzheimer disease Archives of Neurology 60 2 194 200 doi 10 1001 archneur 60 2 194 PMID 12580703 a b Phivilay A Julien C Tremblay C Berthiaume L Julien P Giguere Y Calon F March 2009 High dietary consumption of trans fatty acids decreases brain docosahexaenoic acid but does not alter amyloid beta and tau pathologies in the 3xTg AD model of Alzheimer s disease Neuroscience 159 1 296 307 doi 10 1016 j neuroscience 2008 12 006 PMID 19135506 S2CID 35748183 Granholm AC Bimonte Nelson HA Moore AB Nelson ME Freeman LR Sambamurti K June 2008 Effects of a saturated fat and high cholesterol diet on memory and hippocampal morphology in the middle aged rat Journal of Alzheimer s Disease 14 2 133 45 doi 10 3233 JAD 2008 14202 PMC 2670571 PMID 18560126 American Cancer Society Common questions about diet and cancer Retrieved 9 January 2007 Chavarro J Stampfer M Campos H Kurth T Willett W Ma J 1 April 2006 A prospective study of blood trans fatty acid levels and risk of prostate cancer Proc Amer Assoc Cancer Res 47 1 943 Retrieved 9 January 2007 Brasky TM Till C White E Neuhouser ML Song X Goodman P et al June 2011 Serum phospholipid fatty acids and prostate 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Herald Retrieved 8 February 2011 McNamara RK Hahn CG Jandacek R Rider T Tso P Stanford KE Richtand NM July 2007 Selective deficits in the omega 3 fatty acid docosahexaenoic acid in the postmortem orbitofrontal cortex of patients with major depressive disorder Biological Psychiatry 62 1 17 24 doi 10 1016 j biopsych 2006 08 026 PMID 17188654 S2CID 32898004 Golomb BA Evans MA White HL Dimsdale JE 2012 Trans fat consumption and aggression PLOS ONE 7 3 e32175 Bibcode 2012PLoSO 732175G doi 10 1371 journal pone 0032175 PMC 3293881 PMID 22403632 Golomb BA Bui AK 2015 A Fat to Forget Trans Fat Consumption and Memory PLOS ONE 10 6 e0128129 Bibcode 2015PLoSO 1028129G doi 10 1371 journal pone 0128129 PMC 4470692 PMID 26083739 Melnik BC 15 July 2015 Weinberg J ed Linking diet to acne metabolomics inflammation and comedogenesis an update Clinical Cosmetic and Investigational Dermatology 8 371 88 doi 10 2147 CCID S69135 PMC 4507494 PMID 26203267 Kummerow FA Zhou Q Mahfouz MM Smiricky MR Grieshop CM 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Jokipii K Kallio H Schwab U et al 2001 Effects of palm oil and transesterified palm oil on chylomicron and VLDL triacylglycerol structures and postprandial lipid response PDF J Lipid Res vol 42 no 10 pp 1618 25 PMID 11590218 Berry SE Woodward R Yeoh C Miller GJ Sanders TA 2007 Effect of interesterification of palmitic acid rich tryacylglycerol on postprandial lipid and factor VII response Lipids 42 4 315 323 doi 10 1007 s11745 007 3024 x PMID 17406926 S2CID 3986807 Summers LK Fielding BA Herd SL et al 1999 Use of structured triacylglycerols containing predominantly stearic and oleic acids to probe early events in metabolic processing of dietary fat PDF J Lipid Res vol 40 no 10 pp 1890 98 PMID 10508209 Christophe AB De Greyt WF Delanghe JR Huyghebaert AD 2000 Substituting enzymically interesterified butter for native butter has no effect on lipemia or lipoproteinemia in man Annals of Nutrition and Metabolism 44 2 61 67 doi 10 1159 000012822 PMID 10970994 S2CID 22276158 Sundram K Karupaiah T Hayes K 2007 Stearic acid rich interesterified fat and trans rich fat raise the LDL HDL ratio and plasma glucose relative to palm olein in humans PDF Nutr Metab 4 3 doi 10 1186 1743 7075 4 3 PMC 1783656 PMID 17224066 Retrieved 2007 01 19 Destaillats F Moulin J Bezelgues JB 2007 Letter to the editor healthy alternatives to trans fats Nutr Metab vol 4 p 10 doi 10 1186 1743 7075 4 10 PMC 1867814 PMID 17462099 Mensink RP Zock PL Kester AD Katan MB 2003 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 PDF Am J Clin Nutr vol 77 no 5 pp 1146 1155 doi 10 1093 ajcn 77 5 1146 PMID 12716665 Boston scientists say triglycerides play key role in heart health The Boston Globe Retrieved 2014 06 18 Ivanova EA Myasoedova VA Melnichenko AA Grechko AV Orekhov AN 2017 Small Dense Low Density Lipoprotein as Biomarker for Atherosclerotic Diseases Oxidative Medicine and Cellular Longevity 2017 1273042 doi 10 1155 2017 1273042 PMC 5441126 PMID 28572872 Triglycerides MedlinePlus Archived from the original on 28 February 2014 Retrieved 2015 04 23 Crawford H Micheal Current Diagnosis amp Treatment Cardiology 3rd ed McGraw Hill Medical 2009 p19 What s considered normal Triglycerides Why do they matter Mayo Clinic 28 September 2012 a b Nordestgaard BG Varbo A August 2014 Triglycerides and cardiovascular disease The Lancet 384 9943 626 35 doi 10 1016 S0140 6736 14 61177 6 PMID 25131982 S2CID 33149001 GILL Jason Sara HERD Natassa TSETSONIS Adrianne HARDMAN Feb 2002 Are the reductions in triacylglycerol and insulin levels after exercise related Clinical Science 102 2 223 231 doi 10 1042 cs20010204 PMID 11834142 Retrieved 2 March 2013 a b Crawford H Micheal Current Diagnosis amp Treatment Cardiology 3rd ed McGraw Hill Medical 2009 p21 a b c Berglund L Brunzell JD Goldberg AC et al September 2012 Evaluation and treatment of hypertriglyceridemia an endocrine society clinical practice guideline J Clin Endocrinol Metab 97 9 2969 89 doi 10 1210 jc 2011 3213 PMC 3431581 PMID 22962670 Davidson Michael H 28 January 2008 Pharmacological Therapy for Cardiovascular Disease In Davidson Michael H Toth Peter P Maki Kevin C eds Therapeutic Lipidology Contemporary Cardiology Cannon Christopher P Armani Annemarie M Totowa New Jersey Humana Press Inc pp 141 142 ISBN 978 1 58829 551 4 Abourbih S Filion KB Joseph L Schiffrin EL Rinfret S Poirier P Pilote L Genest J Eisenberg MJ 2009 Effect of fibrates on lipid profiles and cardiovascular outcomes a systematic review Am J Med 122 10 962 e1 962 e8 doi 10 1016 j amjmed 2009 03 030 PMID 19698935 Jun M Foote C Lv J et al 2010 Effects of fibrates on cardiovascular outcomes a systematic review and meta analysis Lancet 375 9729 1875 1884 doi 10 1016 S0140 6736 10 60656 3 PMID 20462635 S2CID 15570639 Blair HA Dhillon S Oct 2014 Omega 3 carboxylic acids a review of its use in patients with severe hypertriglyceridemia Am J Cardiovasc Drugs 14 5 393 400 doi 10 1007 s40256 014 0090 3 PMID 25234378 S2CID 23706094 Panov Alexander Orynbayeva Zulfiya Vavilin Valentin Lyakhovich Vyacheslav 2014 Baranova Ancha ed Fatty Acids in Energy Metabolism of the Central Nervous System BioMed Research International Hindawa 2014 The Roads to Mitochondrial Dysfunction 472459 doi 10 1155 2014 472459 PMC 4026875 PMID 24883315 Wikibooks Cookbook has a recipe module on Oil and fatLook up Fat in Wiktionary the free dictionary Retrieved from https en wikipedia org w index php title Fat amp oldid 1093573059 Unsaturated fat, wikipedia, wiki, book,

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