Correspondence

Trans-Fatty-Acid Content of Common Foods

N Engl J Med 1993; 329:1969-1970December 23, 1993

Article

To the Editor:

Trans fatty acids, which are created by the partial hydrogenation of liquid vegetable oils in the manufacturing of margarine and vegetable shortening, increase serum levels of low-density lipoprotein cholesterol and decrease those of high-density lipoprotein cholesterol1-3. The adverse effects of the trans fatty acids on the ratio of total cholesterol to high-density lipoprotein cholesterol is twice that of saturated fatty acids. Higher consumption of trans fatty acids was associated with an increased incidence of coronary heart disease among 85,000 nurses during eight years of follow-up4.

Information on the trans-fatty-acid content of foods is limited because of a lack of compositional data from the U.S. Department of Agriculture and changes in food manufacturing over time. The fast-food industry has responded to consumer demands by switching to vegetable oils in place of beef tallow for deep-fat frying. Such foods are often marketed as containing no cholesterol or as made with 100 percent vegetable shortening, with the implication that they are healthy choices. Currently, there are no federal regulations regarding the nutritional labeling of the trans-isomer content of foods.

In updating our existing data base on food composition in 1991, we collected food samples for fatty-acid analysis. The foods were analyzed by gas-liquid chromatography for trans isomers of 16:1, 18:1, and 18:2 fatty acids5. Absolute trans-fatty-acid content was calculated by multiplying the proportion of trans fatty acids in the specimen analyzed by the total fat content (Table 1Table 1Trans-Fatty-Acid Content of Foods Analyzed by Gas-Liquid Chromatography.).

The intake of trans fatty acids from an average diet can be high enough to have a detrimental effect on the dietary treatment of hypercholesterolemia. For example, a person eating a doughnut with breakfast (3.19 g of trans fatty acids), a small order of french fries with lunch (3.43 g), two teaspoons of stick margarine on bread with dinner (1.24 g), and two cookies for a snack (1.72 g) would ingest a total of 9.58 g of trans fatty acids, nearly 5 percent of the total energy intake of an 1800-calorie diet. This intake of trans fatty acids would be predicted1 to negate the serum cholesterol-lowering effect of a decrease in saturated fat of 10 percent of total energy intake. Given the recently available studies of the effects of trans fatty acids on serum lipids, as well as their relation to coronary heart disease, patients and physicians may want to consider important sources of these artificial fatty acids when making their food choices.

Lisa Litin, R.D.
Frank Sacks, M.D.
Harvard School of Public Health, Boston, MA 02115

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    Cara B Ebbeling, Dorota B Pawlak, David S Ludwig. (2002) Childhood obesity: public-health crisis, common sense cure. The Lancet 360:9331, 473-482
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    Jason B. Dictenberg, Andrzej Pronczuk, K.C. Hayes. (1995) Hyperlipidemic effects of trans fatty acids are accentuated by dietary cholesterol in gerbils. The Journal of Nutritional Biochemistry 6:7, 353-361
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