Validity and reproducibility of the intake of trans-fatty acids estimated using a FFQ and characteristics of trans-fatty acid intake of the Japanese population: the JPHC FFQ Validation Study.

We aimed to validate a method for assessing trans-fatty acid (TFA) intake in the Japanese population using the FFQ developed in the 1990s from a prospective study that was based on the Japan Public Health Center-based Prospective Cohort Study. For FFQ validation, we included 565 participants (Cohort I: n 215, Cohort II: n 350) aged 40-69 years. We used a 28-d dietary record (DR) over 1 year and two FFQ administered before and after DR assessment. We calculated total TFA intake, TFA from industrial oils (i-TFA) and TFA from ruminants (r-TFA) considering a database of measurements obtained mainly from Japan. Spearman's rank correlation coefficients (CC) were computed for validity and reproducibility. Energy adjustments were applied using two methods considering the TFA measurement: density method for TFA % of total energy and residual method for TFA g/d. The total TFA intake (% of the total energy intake) was 0·08-0·76 % (median, 0·27-0·37 %) in DR of both cohorts and was 0·00-1·13 % (median, 0·30-0·40 %) in FFQ. The i-TFA accounted for approximately 50 % of the total TFA intake in DR and approximately 40 % in FFQ. For total TFA (% of the total energy intake), CC were 0·54-0·69, and weighted κ coefficients were 0·88-0·92 for both cohorts. The de-attenuated CC was 0·46-0·62 for i-TFA (g/d) and 0·57-0·68 for r-TFA (g/d). Our study showed that the validity and reproducibility of TFA intake estimation using the FFQ were reasonable, suggesting its suitability among the Japanese population with low-TFA intake.

Butter-Derived Ruminant Trans Fatty Acids Do Not Alleviate Atherosclerotic Lesions in High-Fat Diet-Fed ApoE-/- Mice.

Atherosclerosis (AS) is the most common cardiovascular disease (CVD). Currently, it is widely believed that R-TFA and I-TFA may cause different biological effects. In the present study, we aim to elucidate the effect of mixed R-TFA derived from butter on the development of AS in high-fat diet-fed ApoE-/- mice and find the possible mechanism. It was shown that butter-derived R-TFA promoted dyslipidemia, reduced thoracic and abdominal aorta diameters, and induced aortic lipid deposition and atherosclerotic lesions in high-fat diet-fed ApoE-/- mice. Meanwhile, butter-derived R-TFA affected the serum lipid profile of high-fat diet-fed ApoE-/- mice and the lipid metabolism of human umbilical vein endothelial cells (HUVECs). Through lipidomic techniques, we found that butter-derived R-TFA had a significant effect on the glycerophospholipid metabolic pathway. In conclusion, our results demonstrated that butter-derived R-TFA does not alleviate but promotes atherosclerotic lesions in high-fat diet-fed ApoE-/- mice and that the glycerophospholipid metabolic pathway plays a major role in this pro-atherosclerotic effect.

Ruminant fat intake improves gut microbiota, serum inflammatory parameter and fatty acid profile in tissues of Wistar rats.

This study tested the hypothesis that naturally and industrially produced trans-fatty acids can exert distinct effects on metabolic parameters and on gut microbiota of rats. Wistar rats were randomized into three groups according to the diet: CONT-control, with 5% soybean oil and normal amount of fat; HVF-20% of hydrogenated vegetable fat (industrial); and RUM-20% of ruminant fat (natural). After 53 days of treatment, serum biochemical markers, fatty acid composition of liver, heart and adipose tissue, histology and hepatic oxidative parameters, as well as gut microbiota composition were evaluated. HVF diet intake reduced triglycerides (≈ 39.39%) and VLDL levels (≈ 39.49%). Trans-fatty acids levels in all tissue were higher in HVF group. However, RUM diet intake elevated amounts of anti-inflammatory cytokine IL-10 (≈ 14.7%) compared to CONT, but not to HVF. Furthermore, RUM intake led to higher concentrations of stearic acid and conjugated linoleic acid in all tissue; this particular diet was associated with a hepatoprotective effect. The microbial gut communities were significantly different among the groups. Our results show that ruminant fat reversed the hepatic steatosis normally caused by high fat diets, which may be related to the remodelling of the gut microbiota and its anti-inflammatory potential.

Development and validation of a food frequency questionnaire for assessing nutrient intake during childhood in Jordan.

INTRODUCTION: Introduction: assessing the relationship between childhood diseases and nutrient intake is a crucial issue that requires valid and reliable dietary assessment tools in this period of physical and physiological development. Objective: the present study aimed to develop and validate a food frequency questionnaire (FFQ) to assess nutrient intake in Jordanian children. Methods: in this validation study, nutrient intake as obtained from a culturally sensitive quantitative FFQ was compared to nutrient intake as assessed by four 24-hour dietary recalls (24-HRs) between September 2017 and May 2018. One hundred and thirty-six children aged 6-18 years were enrolled from selected schools in Amman, Jordan. Children or their caregivers were asked to complete the FFQ during an initial face-to-face interview. Four 24-HRs were collected weekly over one month. Of these children, 50 also took part in the reproducibility phase, which involved a repeat completion of the FFQ within 1 month. Results: the intraclass correlation coefficients between the two FFQs ranged from 0.5 for trans-fats to 0.96 for calcium. Correlation coefficients between dietary intake estimates derived from the FFQ and 24-HRs were significant at p < 0.05. The highest correlation was detected for energy (0.8) while the lowest was identified for trans-fatty acids (0.04). For all nutrients, over 60 % of participants were classified into the same or adjacent quartile of crude and adjusted intake. Bland-Altman plots showed a satisfactory agreement between the two methods for energy and proteins. Conclusion: the FFQ showed a good reproducibility and a reasonable relative validity for most nutrients.

INTRODUCCIÓN: Introducción: evaluar la relación entre las enfermedades infantiles y la ingesta de nutrientes es un tema crucial que requiere herramientas de evaluación dietética válidas y confiables en este período de desarrollo físico y fisiológico. Objetivo: el presente estudio tuvo como objetivo desarrollar y validar un cuestionario de frecuencia de alimentos (FFQ) para evaluar la ingesta de nutrientes de los niños jordanos. Métodos: en este estudio de validación, la ingesta de nutrientes de un FFQ cuantitativo culturalmente sensible se comparó con la ingesta de nutrientes de cuatro recordatorios dietéticos de 24 horas (24-HR) entre septiembre de 2017 y mayo de 2018. Se reclutaron ciento treinta y seis niños y adolescentes de 6 a 18 años en escuelas seleccionadas de Amán, Jordania. Se pidió a los niños o sus cuidadores que completaran el FFQ en una entrevista inicial presencial. Se recogieron cuatro 24-HR semanalmente durante un mes. De estos niños, 50 también participaron en la fase de reproducibilidad, que involucró la repetición del FFQ en un plazo de 1 mes. Resultados: los coeficientes de correlación intraclase entre los dos FFQ oscilaron entre 0,5 para las grasas trans y 0,96 para el calcio. Los coeficientes de correlación entre las estimaciones de la ingesta alimentaria derivadas del FFQ y los 24-HR fueron significativas, con un valor p < 0,05. La correlación más alta se detectó para la energía (0,8) mientras que la más baja fue para los ácidos grasos trans (0,04). Para todos los nutrientes, más del 60 % de los participantes se clasificaron en el mismo cuartil o el adyacente de ingesta cruda y ajustada. Las gráficas de Bland-Altman mostraron un acuerdo satisfactorio entre los dos métodos en términos de energía y proteínas. Conclusión: el FFQ mostró una buena reproducibilidad y una validez relativa razonable para la mayoría de los nutrientes.

Added sugar and trans fatty acid intake and sedentary behavior were associated with excess total-body and central adiposity in children and adolescents with congenital heart disease.

BACKGROUND: Over the past three decades, the prevalence rate of overweight and obesity has increased in survivors with congenital heart disease, and little is known about the body composition and its association with clinical characteristics and lifestyle factors. OBJECTIVES: To evaluate excess total-body adiposity and central adiposity and, to describe associated factors. METHODS: Cross-sectional study with children and adolescents who underwent procedure to treat congenital heart disease, from January to July 2017. Sociodemographic and clinical characteristics, and lifestyle factors (dietary intake, physical activity, and sedentary behavior) were assessed. Adiposity was assessed using air-displacement plethysmography and waist circumference. Factors associated with excess total-body adiposity and central adiposity were analyzed using logistic regression models. RESULTS: Of 232 patients, 22.4% were identified with excess total-body adiposity and 24.6% with central adiposity. Significant factors positively associated with excess total-body adiposity were intake of added sugar and trans fatty acids, adjusted for confounding factors. Similarly, lifestyle factors were positively associated with central adiposity: intake of added sugar and trans fatty acids, sedentary behavior, and family history of obesity. CONCLUSIONS: Lifestyle factors were associated with excess total-body adiposity and central adiposity. Assessment of body composition and healthy-lifestyle counseling into outpatient care may be the key point to prevent obesity in children and adolescents with congenital heart disease.

A trans-fatty acid-rich diet promotes liver tumorigenesis in HCV core gene transgenic mice.

Excess consumption of trans-fatty acid (TFA), an unsaturated fatty acid containing trans double bonds, is a major risk factor for cardiovascular disease and metabolic syndrome. However, little is known about the link between TFA and hepatocellular carcinoma (HCC) despite it being a frequent form of cancer in humans. In this study, the impact of excessive dietary TFA on hepatic tumorigenesis was assessed using hepatitis C virus (HCV) core gene transgenic mice that spontaneously developed HCC. Male transgenic mice were treated for 5 months with either a control diet or an isocaloric TFA-rich diet that replaced the majority of soybean oil with shortening. The prevalence of liver tumors was significantly higher in TFA-rich diet-fed transgenic mice compared with control diet-fed transgenic mice. The TFA-rich diet significantly increased the expression of pro-inflammatory cytokines, as well as oxidative and endoplasmic reticulum stress, and activated nuclear factor-kappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (NRF2), leading to high p62/sequestosome 1 (SQSTM1) expression. Furthermore, the TFA diet activated extracellular signal-regulated kinase (ERK) and stimulated the Wnt/ß-catenin signaling pathway, synergistically upregulating cyclin D1 and c-Myc, driving cell proliferation. Excess TFA intake also promoted fibrogenesis and ductular reaction, presumably contributing to accelerated liver tumorigenesis. In conclusion, these results demonstrate that a TFA-rich diet promotes hepatic tumorigenesis, mainly due to persistent activation of NF-κB and NRF2-p62/SQSTM1 signaling, ERK and Wnt/ß-catenin pathways and fibrogenesis. Therefore, HCV-infected patients should avoid a TFA-rich diet to prevent liver tumor development.

Dietary intake and serum levels of trans fatty acids and risk of breast cancer: A systematic review and dose-response meta-analysis of prospective studies.

BACKGROUND & AIMS: Although the relationship between dietary intake and serum levels of trans fatty acids and risk of breast cancer has been investigated extensively, findings are inconsistent. To summarize earlier findings on the association of dietary intake and serum levels of trans fatty acids with risk of breast cancer through a dose-response meta-analysis. METHODS: The online databases of PubMed, ISI Web of Science, Scopus, ProQuest, Science Direct and Embase were searched for relevant publications up to June 2018, using MeSH and non-MeSH keywords. In total, 7 prospective studies [6 cohort studies and one nested case-control study] were included on total dietary trans fat intake, and five studies [1 cohort study and 4 nested case-control studies] were included about serum trans fatty acids. Assessment of study quality was conducted using the Newcastle-Ottawa scale. Study-specific RRs were combined via fixed-effects model to compute overall RRs. RESULTS: Participants were apparently healthy aged 26 years or older. We observed no significant relationship between dietary intake of total trans fatty acids and risk of breast cancer (pooled effect size: 1.02, 95% CI: 0.95-1.10, P = 0.403). Combining 3 effect sizes from 2 prospective and one nested case-control study, no significant relation was seen between dietary intake of CLA and risk of breast cancer (pooled effect size: 1.05, 95% CI: 0.95-1.17, P = 0.513). Based on 5 effect sizes, each additional 1 g/day dietary intake of total trans fats was not significantly associated with risk of breast cancer (RR = 1.00; 95% CI = 0.99-1.01). In addition, it seems that serum levels of trans fats might be associated with an increased risk of breast cancer only among postmenopausal women (Pooled effect size: 1.37, 95% CI: 1.04-1.81, P = 0.02). CONCLUSIONS: In conclusion, dietary intake of trans fatty acids was not associated with risk of breast cancer; however, a significant positive association was seen between serum trans fats and risk of breast cancer in postmenopausal women.

Trans-palmitoleic acid (trans-9-C16:1, or trans-C16:1 n-7): Nutritional impacts, metabolism, origin, compositional data, analytical methods and chemical synthesis. A review.

Since the early 2010s, dietary trans-palmitoleic acid (trans-9-hexadecenoic acid, trans-9-C16:1 in the Δ-nomenclature, trans-C16:1 n-7 in the Ω-nomenclature, TPA) has been epidemiologically associated with a lower risk of type 2 diabetes in humans. Thanks to these findings, TPA has become a nutrient of interest. However, there is a lot of unresolved crucial questions about this dietary fatty acid. Is TPA a natural trans fatty acid? What kind of foods ensures intakes in TPA? What about its metabolism? How does dietary TPA act to prevent type 2 diabetes? What are the biological mechanisms involved in this physiological effect? Clearly, it is high time to answer all these questions with the very first review specifically dedicated to this intriguing fatty acid. Aiming at getting an overview, we shall try to give an answer to all these questions, relying on appropriate and accurate scientific results. Briefly, this review underlines that TPA is indeed a natural trans fatty acid which is metabolically linked to other well-known natural trans fatty acids. Knowledge on physiological impacts of dietary TPA is limited so far to epidemiological data, awaiting for supplementation studies. In this multidisciplinary review, we also emphasize on methodological topics related to TPA, particularly when it comes to the quantification of TPA in foods and human plasma. As a conclusion, we highlight promising health benefits of dietary TPA; however, there is a strong lack in well-designed studies in both the nutritional and the analytical area.

Plasma and Dietary Linoleic Acid and 3-Year Risk of Type 2 Diabetes After Myocardial Infarction: A Prospective Analysis in the Alpha Omega Cohort.

OBJECTIVE: To study plasma and dietary linoleic acid (LA) in relation to type 2 diabetes risk in post-myocardial infarction (MI) patients. RESEARCH DESIGN AND METHODS: We included 3,257 patients aged 60-80 years (80% male) with a median time since MI of 3.5 years from the Alpha Omega Cohort and who were initially free of type 2 diabetes. At baseline (2002-2006), plasma LA was measured in cholesteryl esters, and dietary LA was estimated with a 203-item food-frequency questionnaire. Incident type 2 diabetes was ascertained through self-reported physician diagnosis and medication use. Hazard ratios (with 95% CIs) were calculated by Cox regressions, in which dietary LA isocalorically replaced the sum of saturated (SFA) and trans fatty acids (TFA). RESULTS: Mean ± SD circulating and dietary LA was 50.1 ± 4.9% and 5.9 ± 2.1% energy, respectively. Plasma and dietary LA were weakly correlated (Spearman r = 0.13, P < 0.001). During a median follow-up of 41 months, 171 patients developed type 2 diabetes. Plasma LA was inversely associated with type 2 diabetes risk (quintile [Q]5 vs. Q1: 0.44 [0.26, 0.75]; per 5%: 0.73 [0.62, 0.86]). Substitution of dietary LA for SFA+TFA showed no association with type 2 diabetes risk (Q5 vs. Q1: 0.78 [0.36, 1.72]; per 5% energy: 1.18 [0.59, 2.35]). Adjustment for markers of de novo lipogenesis attenuated plasma LA associations. CONCLUSIONS: In our cohort of post-MI patients, plasma LA was inversely related to type 2 diabetes risk, whereas dietary LA was not related. Further research is needed to assess whether plasma LA indicates metabolic state rather than dietary LA in these patients.

Parallel declines in erythrocyte trans fatty acids and US fatal ischemic heart disease rates.

Ischemic heart disease (IHD) is a leading cause of mortality in the United States. There is substantial evidence that a sustained intake of industrially-produced trans fatty acids (IP-TFA) is associated with increased risk of fatal IHD. This has led many regulatory agencies to pressure dietary oil producers to remove IP-TFA from their products. That this has resulted in lower blood levels of IP-TFA in the United States is clear, but whether this has been accompanied by a reduction in the incidence of fatal IHD is unknown. To test the hypothesis that declining IP-TFA levels are associated with declining rates of fatal IHD, we compared the IP-TFA levels in red blood cells (RBC) analyzed in our laboratory between 2009 and 2016 (n = 53 194) with yearly US-specific IHD mortality rates. We found that decreasing RBC IP-TFA levels were strongly correlated with decreasing rates of fatal IHD (R2 = 0.9552, P < .0001). Recognizing the limitations of observational studies in addressing causation questions, our findings nevertheless support our hypothesis and suggest that efforts to remove IP-TFA from the food supply in the United States may be having the desired effect.

Global Surveillance of trans-Fatty Acids.

Trans-fatty acid (TFA) intake can increase the risk of coronary heart disease (CHD) morbidity and mortality and all-cause mortality. Industrially produced TFAs and ruminant TFAs are the major sources in foods. TFA intake and TFA-attributed CHD mortality vary widely worldwide. Excessive TFA intake is a health threat in high-income countries; however, it is also a threat in low- and middle-income countries (LMICs). Data on TFA intake are scarce in many LMICs and an urgent need exists to monitor TFAs globally. We reviewed global TFA intake and TFA-attributed CHD mortality and current progress toward policy or regulation on elimination of industrially produced TFAs in foods worldwide. Human biological tissues can be used as biomarkers of TFAs because they reflect actual intake from various foods. Measuring blood TFA levels is a direct and reliable method to quantify TFA intake.

Fatty acids, epigenetic mechanisms and chronic diseases: a systematic review.

BACKGROUND: Chronic illnesses like obesity, type 2 diabetes (T2D) and cardiovascular diseases, are worldwide major causes of morbidity and mortality. These pathological conditions involve interactions between environmental, genetic, and epigenetic factors. Recent advances in nutriepigenomics are contributing to clarify the role of some nutritional factors, including dietary fatty acids in gene expression regulation. This systematic review assesses currently available information concerning the role of the different fatty acids on epigenetic mechanisms that affect the development of chronic diseases or induce protective effects on metabolic alterations. METHODS: A targeted search was conducted in the PubMed/Medline databases using the keywords "fatty acids and epigenetic". The data were analyzed according to the PRISMA-P guidelines. RESULTS: Consumption fatty acids like n-3 PUFA: EPA and DHA, and MUFA: oleic and palmitoleic acid was associated with an improvement of metabolic alterations. On the other hand, fatty acids that have been associated with the presence or development of obesity, T2D, pro-inflammatory profile, atherosclerosis and IR were n-6 PUFA, saturated fatty acids (stearic and palmitic), and trans fatty acids (elaidic), have been also linked with epigenetic changes. CONCLUSIONS: Fatty acids can regulate gene expression by modifying epigenetic mechanisms and consequently result in positive or negative impacts on metabolic outcomes.

Association between trans fatty acid intake and overweight including obesity in 4 to 5-year-old children from the INMA study.

BACKGROUND: Trans fatty acid (TFA) intake has been positively associated with obesity in adults, although the evidence in children is scarce. There is growing evidence that TFA of industrial or natural origin may have different effects. OBJECTIVES: We aimed to explore the association between total, industrial, and natural TFA intake and overweight including obesity in 4 to 5-year-old Spanish children. METHODS: We cross-sectionally analyzed data of 1744 children aged 4 to 5 from the INMA study, a prospective mother-child cohort study in Spain. We estimated the intake of total, industrial, and natural TFA in grams per day (g/day) using a validated food frequency questionnaire and expressed it as quartiles. Overweight including obesity was defined according to the International Obesity Task Force criteria. We used multiple logistic regression to estimate adjusted odds ratios (OR) and confidence intervals (95%CI). RESULTS: After adjusting for major risk factors, the highest quartile of industrial TFA intake (>0.7 g/day) was positively associated with overweight including obesity (OR 1.57, 95%CI 1.13-2.21, P trend for quartiles 0.01). No significant associations were observed between natural TFA intake and overweight including obesity. CONCLUSIONS: In 4 to 5-year-old Spanish children, higher intake of industrial but not natural TFA was positively associated with overweight including obesity.

Regional and traffic-related air pollutants are associated with higher consumption of fast food and trans fat among adolescents.

Background: Air pollution exposures are novel contributors to the growing childhood obesity epidemic. One possible mechanism linking air pollution exposures and obesity is through changes in food consumption patterns. Objective: The aim of this study was to examine the longitudinal association between childhood exposure to air pollutants and changes in diet among adolescents. Design: School-age children were enrolled in the Southern California Children's Health Study during 1993-1994 (n = 3100) and were followed for 4-8 y. Community-level regional air pollutants [e.g., nitrogen dioxide (NO2), elemental carbon (EC), and fine particles with aerodynamic diameter <2.5 µm (PM2.5)] were measured at central monitoring stations. Line dispersion modeling was used to estimate concentrations of traffic-related air pollutants based on nitrogen oxides (NOx) at participants' residential addresses. In addition, self-reported diet information was collected annually using a structured youth/adolescent food-frequency questionnaire during 1997-2001. Generalized linear mixed-effects models were used in the association analyses. Results: Higher exposures to regional and traffic-related air pollutants were associated with intake of a high-trans-fat diet, after adjusting for confounders including socioeconomic status and access to fast food in the community. A 2-SD (12.2 parts per billion) increase in regional NO2 exposure was associated with a 34% increased risk of consuming a high-trans-fat diet compared with a low-trans-fat diet (OR: 1.34; 95% CI: 1.05, 1.72). In addition, higher exposures to acid vapor, EC, PM2.5, and non-freeway NOx were all associated with higher consumption of dietary trans fat (all P < 0.04). Notably, higher exposures to regional NO2, acid vapor, and EC were also associated with a higher consumption of fast food (all P < 0.05). Conclusions: Childhood exposures to regional and traffic-related air pollutants were associated with increased consumption by adolescents of trans fat and fast foods. Our results indicate that air pollution exposures may contribute to obesogenic behaviors. This study was registered at clinicaltrials.gov as NCT03379298.

Dietary Fats in Relation to Total and Cause-Specific Mortality in a Prospective Cohort of 521 120 Individuals With 16 Years of Follow-Up.

RATIONALE: Evidence linking saturated fat intake with cardiovascular health is controversial. The associations of unsaturated fats with total and cardiovascular disease (CVD) mortality remain inconsistent, and data about non-CVD mortality are limited. OBJECTIVE: To assess dietary fat intake in relation to total and cause-specific mortality. METHODS AND RESULTS: We analyzed data of 521 120 participants aged 50 to 71 years from the National Institutes of Health-American Association of Retired Persons Diet and Health Study with 16 years of follow-up. Intakes of saturated fatty acids (SFAs), trans-fatty acids, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) were assessed via food frequency questionnaires. Hazard ratios and 95%CIs were estimated using the Cox proportional hazards model. Overall, 129 328 deaths were documented during 7.3 million person-years of follow-up. In the replacement of carbohydrates, multivariable-adjusted hazard ratios of total mortality comparing extreme quintiles were 1.29 (95% CI, 1.25-1.33) for SFAs, 1.03 (1.00-1.05) for trans-fatty acids, 0.98 (0.94-1.02) for MUFAs, 1.09 (1.06-1.13) for animal MUFAs, 0.94 (0.91-0.97) for plant MUFAs, 0.93 (0.91-0.95) for PUFAs, 0.92 (0.90-0.94) for marine omega-3 PUFAs, 1.06 (1.03-1.09) for α-linolenic acid, 0.88 (0.86-0.91) for linoleic acid, and 1.10 (1.08-1.13) for arachidonic acid. CVD mortality was inversely associated with marine omega-3 PUFA intake ( P trend <0.0001), whereas it was positively associated with SFA, trans-fatty acid, and arachidonic acid intake. Isocalorically replacing 5% of the energy from SFAs with plant MUFAs was associated with 15%, 10%, 11%, and 30% lower total mortality, CVD, cancer, and respiratory disease mortality, respectively. Isocaloric replacement of SFA with linoleic acid (2%) was associated with lower total (8%), CVD (6%), cancer (8%), respiratory disease (11%), and diabetes mellitus (9%) mortality. CONCLUSIONS: Intakes of SFAs, trans-fatty acids, animal MUFAs, α-linolenic acid, and arachidonic acid were associated with higher mortality. Dietary intake of marine omega-3 PUFAs and replacing SFAs with plant MUFAs or linoleic acid were associated with lower total, CVD, and certain cause-specific mortality. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00340015.

Obesity, dynapenia and high cardiovascular risk co-exist in post-liver transplant setting: results of a cross-sectional study.

BACKGROUND: Cardiovascular disease is a major cause of death in post-liver transplantation (LT). The aim of this study was to evaluate LT patients as to the carotid intima-media thickness (CIMT) and its association with nutritional status, dietary intake, metabolic profile and cardiovascular risk factors. METHODS: In this cross-sectional study, adult patients with more than 12 months of post-transplant follow-up underwent clinical, laboratory, functional and nutritional evaluation by 3-day-diet-record, anthropometry and dynamometry. CIMT was evaluated by Doppler ultrasonography. RESULTS: Sixty-nine post-LT patients [males 61%, median of age 59 (51-64) years were included; median time post-liver transplantation 2.8 (1.4-6.3) years]. High prevalence of malnutrition was found (45% of arm muscle area < p15 and 71% of handgrip strength < p30). Excess weight was present in 72% of patients, body mass index ≥ 30 kg/m2 in 35% and metabolic syndrome in 51%. Abnormal CIMT was found in 54% of the sample. Patients with abnormal CIMT presented higher cardiovascular risk Score, LDL cholesterol, higher prevalence of high-sensitive C-reactive protein ≥ 1 mg/L and higher intake of saturated and trans fatty acids (P < 0.05 for all). CONCLUSIONS: Abnormal IMT was commonly found in LT patients presenting at the same time with overweight and dynapemia. These results were associated with higher LDL-cholesterol levels, high-sensitive C-reactive protein ≥ 1 mg/L and higher intake of saturated and trans fatty acids. Preventive measures, including dietary advice, are required for all post-liver transplantation patients to minimize cardiovascular risk.

Effect of industrial trans-fatty acids-enriched diet on gut microbiota of C57BL/6 mice.

PURPOSE: Previous studies have shown that industrially originated trans-fatty acids (iTFAs) are associated with several chronic diseases, but the underlying mechanisms remain unknown. Because gut microbiota play a critical role in human health, diet competent induced gut microbiota dysbiosis may contributing to disease pathogenesis. Therefore, the present study examined the impact of iTFA on gut microbiota, help understanding the underling mechanism of iTFA-associated chronic diseases. METHODS: Forty male 8-week-old mice were divided into 4 groups and randomly assigned to diets containing soybean oil (non-iTFA) or partially hydrogenated soybean oil (iTFA). The intervention groups were: (1) low soybean oil (LS); (2) high soybean oil (HS); (3) low partially hydrogenated oil (LH) and (4) high partially hydrogenated oil (HH). The gut microbiota profiles were determined by 16S rRNA gene sequencing. Physiological parameters and the inflammatory status of the small intestine and other tissues were analyzed. Short-chain fatty acid levels in feces were measured using gas chromatography. RESULTS: The intake of iTFA increased the abundance of well-documented 'harmful' bacteria, such as Proteobacteria and Desulfovibrionaceae (P < 0.05), whereas it decreased relative abundance of 'beneficial' bacteria, such as Bacteroidetes, Lachnospiraceae, Bacteroidales S24-7 (P < 0.05). Surprisingly, the intake of iTFA increased the abundance of the probiotic Lactobacillaceae (P < 0.05). Additionally, the intake of iTFA induced increase of inflammatory parameters, as well as a numerical decrease of fecal butyric acid and valeric acid. CONCLUSIONS: This study, to our knowledge, is the first to demonstrate that the consumption of iTFA resulted in a significant dysbiosis of gut microbiota, which may contribute to the development of chronic diseases associated with iTFA.

Trans-fatty Acids and Survival in Renal Transplantation.

OBJECTIVE: High consumption of trans-fatty acids (TFAs) is associated with increased mortality. DESIGN AND METHODS: Observational cohort study of 1.988 Norwegian renal transplant recipients with a median follow-up time of 9.6 years. We assessed multivariable adjusted associations between plasma levels of industrial and ruminant TFAs with patient and graft survival. Plasma phospholipid fatty acid levels were determined by gas chromatography at 10 weeks after transplantation. RESULTS: During follow-up, there were 595 deaths, and 805 grafts were lost. Plasma industrial TFA levels dropped from 0.3 wt% in years 1999-2004 to reach a plateau of 0.2 wt% from year 2005 and beyond, whereas plasma levels of ruminant TFAs remained stable throughout the study period. In the former era (years 1999 to 2004, n = 902), we found multivariable adjusted associations between plasma industrial TFA levels and mortality (hazard ratio 4.44, P = .02) and graft loss (hazard ratio 4.22, P = .01). In the latter era (years 2005 to 2011, n = 1,086), there were no associations between plasma industrial TFA levels and patient or graft survival. Plasma ruminant TFAs were not associated with mortality or graft loss in either eras. CONCLUSION: In this Norwegian transplant cohort, plasma industrial TFA levels dropped from around 0.3 wt% in the former era to 0.2 wt% in the latter era. While plasma industrial TFA was significantly associated with survival in the former era, no associations were found with survival in the latter era. This finding suggests that lowering industrial TFA consumption from modest to low levels could possibly influence health beneficially after renal transplantation.

Street food in Maputo, Mozambique: Availability and nutritional value of homemade foods.

BACKGROUND:: A nutrition transition is occurring in the urban areas of developing countries, where street food makes an important contribution to daily food intake. AIM:: We aimed to characterise street food offer in Maputo, Mozambique, and to evaluate the nutritional composition of the most common homemade foods. METHODS:: A cross-sectional study was conducted in 2014. Streets in the surroundings (500 m buffer) of randomly selected public transport stops in KaMpfumu district, Maputo, were canvassed to identify all street food vending sites ( n = 968). Information regarding vending site characteristics and the food offered was gathered through interview and observation. Samples ( n = 80) of the most common homemade foods were collected for laboratorial analysis. RESULTS:: Most street food vending sites identified were stationary (77.4%) and sold exclusively industrial food (51.9%). Frequency of fruit, beverages and food other than fruit was 24.5%, 32.5% and 73.9%, respectively. Fried cakes were the most energy-dense (430 kcal/100 g), and richest in fats (21.0g/100 g) and carbohydrates (53.4 g/100 g). The richest sources of protein were the stewed meat/fish/liver dishes (10.7-11.6 g/100 g). Fried cakes showed the lowest sodium and potassium content (90 mg/100 g and 81 mg/100 g, respectively) whereas hamburgers exhibited the highest content of those micronutrients (455 mg/100 g and 183 mg/100 g, respectively). Stewed liver dishes presented the highest sodium/potassium ratio (11.95). Fried snacks presented the highest trans-fatty acid content (0.20 g/100 g). CONCLUSIONS:: Street food in Maputo is abundant and scattered throughout the urban district, exhibiting high variability in the nutritional composition of homemade foods. Public health policies should be targeted to improve the street food offer, promoting nutrient-dense foods and the reduction of added salt.