Trans Fatty Acids

Trans fatty acids (TFAs) are associated with increased LDL and lipoprotein-a (Lp[a]) levels, decreased HDL cholesterol levels, increased inflammatory markers levels, and impaired endothelial function (Mozaffarian et al. 2006). Meta-analyses have reported a positive association between the intake of TFA and CHD morbidity and mortality (Mente et al. 2009; Mozaffarian and Clarke 2009). It is therefore suggested that TFA intake should be limited to less than 1% of total daily calories (Perk et al. 2012).

n-6 Polyunsaturated Fatty Acids

The n-6 PUFAs most often studied include linoleic acid (LA) and arachidonic acid (AA). A large body of evidence suggests that higher intakes of n-6 PUFAs may result in a reduced risk of CHD (Harris et al. 2009). Findings from the Nurses’ Health Study suggested that n-6 PUFAs have a beneficial effect on cardiac death risk (Chiuve et al. 2012b). A meta-analysis of 8 RCTs indicated that for every 5% energy substitution of SFA with n-6 PUFA, there was a 10% reduction in CHD risk (Mozaffarian et al. 2010). In 2009, the AHA Science Advisory after combining data from RCTs, observational studies, and animal experiments suggested that the consumption of at least 5%-10% of energy from n-6 PUFAs results in a reduced risk of CHD compared with lower intakes, while higher intakes seem to remain safe and may also enhance the beneficial effect (Harris et al. 2009).

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