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Fats and Lipids in

Nutrition
http://www.cwu.edu/~geed/fcsn245.htm
Dr. David L. Gee
FCSN 245 - Basic Nutrition
Fats and Lipids
Definition
Classes of Fats
Triglycerides
Phospholipids
Cholesterol and other Sterols
Functions of Triglycerides
Energy storage
Physical & thermal
insulator
Carrier of fat soluble
vitamins
Triglyceride Chemistry
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Phospholipid Chemistry
Very similar to triglycerides
Glycerol
TWO fatty acids
Phosphate + nitrogen-containing
compound
Structure with two distinct parts
Fat soluble part (FAs)
Water soluble part (phosphate + N-
compound)
Functions of Phospholipids

Cell membrane
structure
Emulsifier
fat digestion
fat transport in blood
Cholesterol Chemistry
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Functions of Cholesterol
Cellmembrane structure
Precurser for:
Bile acids
Steroid hormones
Vitamin D
Sources:
Animal fats only
Made in liver (non-dietary essential)
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Triglycerides
Structure
Mono- & Di- glycerides
Fatty Acids
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Fatty Acids
Chain length
Long chain ( C12 - C22 )
most vegetable fats
most animal fats
Medium chain ( C6 - C10 )
butter fat
coconut oil
liquids/very soft at room T
Fatty Acids
Degree of saturation
Saturatedfatty acids (SFA)
Monounsaturated (MUFA)
Polyunsaturated (PUFA)
2002 Wadsworth Publishing / Thomson Learning
The problem with
Saturated Fatty Acids
Raises blood cholesterol
Raises LDL-cholesterol (bad)
Lowers activity of LDL-receptor
What are lipoproteins?
Particles in the blood for
transporting fat.
Structure
Outer coat
Phospholipids, cholesterol,
proteins
Core
Fats: triglycerides, cholesterol-FA
esters
Types of lipoproteins
Triglyceride carriers
Chylomicrons (dietary TGs)
Very Low Density lipoproteins (VLDL,
TGs made in the body)
Cholesterol carriers
LDL ( delivers cholesterol to tissues )
HDL ( removes cholesterol from tissues for
excretion in liver)
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
2002 Wadsworth Publishing / Thomson Learning
Saturated Fatty Acids
Raises blood cholesterol
Raises LDL-cholesterol (bad)
Solid at room temperature
High in animal fats
Tropical plant fats
coconut oil, palm oil, cocoa oil
Mono Unsaturated Fats
Lowers blood cholesterol
Lowers LDL - cholesterol
No effect on HDL - cholesterol
Liquid at room temperature
Olive oil, canola oil, peanut oil
Major Types of Human
Nutrition Research
Anecdotal & Case Studies
Individual or small # subjects
Not controlled
Not considered reliable research
Epidemiological
Research
Randomized Controlled Trials
Nutritional Epidemiological
Studies
Studies:
Prevalence of disease/disorder in a population
Association with nutritional factors
Observational
Time
cross-sectional studies
Retrospective studies
Prospective studies
Nutritional Epidemiological
Studies
Strengths
Significant endpoints
mortality
morbidity
Free living populations
Prospective studies over long periods of
time
Magnesium Intake and Reduced
Risk of Colon Cancer in a
Prospective Study of Women
American Journal of Epidemiology 2006 163(3):232-235

http://aje.oxfordjournals.org/cgi/content/abstract/163/3/232?maxtoshow=&HITS=10&hits=10
&RESULTFORMAT=1&title=magnesium+colon+cancer&andorexacttitle=and&andorexacttitl
eabs=and&andorexactfulltext=and&searchid=1138822446001_2635&FIRSTINDEX=0&sorts
pec=relevance&journalcode=amjepid
Nutritional Epidemiological
Studies
Does not prove cause and effect
Suggests possible relationships
between nutrition and disease
Well known epidemiological studies
Framingham Studies
Physicians Health Studies
Nurses Health Studies
Randomized Controlled Trials
(RCT)
Experimental
Groups assigned randomly
All other factors (other than
experimental factor) controlled
Single and double blind experiments
Strongest evidence proving cause and
effect
Modification of lymphocyte DNA
damage by carotenoid supplementation
in postmenopausal women.
American Journal of Clinical Nutrition, Vol. 83, No. 1, 163-
169, January 2006

http://www.ajcn.org/cgi/content/abstract/83/1/163
Randomized Controlled Trials
Limitations
Short period of time
Clinical trials can be longer, but more
difficult to control
Subjects not free-living
# subjects small
Endpoints measured related to, but
does not measure morbidity or
mortality
Mono Unsaturated Fats
Lowers blood cholesterol
Lowers LDL - cholesterol
No effect on HDL - cholesterol
Liquid at room temperature
Olive oil, canola oil, peanut oil
Mediterranean Diet
Protection Against Heart Disease?
High in Olive Oil (MUFA)
French Paradox
Northern vs Southern France
But other possible contributing factors:
High Red Wine consumption
Rich in fiber, fruits, vegetables
More active lifestyle
Recent changes in diet and lifestyle
Polyunsaturated Fats
Lowers LDL-cholesterol
But also lowers HDL-
cholesterol
Dietary Sources
Vegetable oils
Fish oils
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Essential Fatty Acids
PUFAs required in diet
Two classes of EFAs
Omega-6 PUFAs
Linoleic acid
Omega-3 PUFAs
Linolenic acid
3-6 g/day (1 tsp veg. oil)
2002 Wadsworth Publishing / Thomson Learning
Essential Fatty Acids
Deficiency Syndrome
Rare
fat malabsorption in infants
Dermatitis, hair loss, poor wound
healing
Bigger
concerns of relative
amounts of w-3 & w-6 in US diet
Essential Fatty Acids
Functions
Component of phospholipids in cell
membranes
Synthesis of Eicosanoids
Potent hormone-like chemicals
Prostaglandins
Leukotrienes
Eicosanoid Functions:
role in heart disease
Regulates
smooth muscle contractions
blood pressure
Omega-3 eicosanoids tend to lower BP
Omega-6 tend to increase BP

blood clotting
Omega-3 eicosanoids tend to inhibit blood
clotting
Omega-6 tend to increase blood clotting
Intake of Fish and Omega-3 Fatty
Acids and Risk of Stroke in
Women
JAMA, Jan. 2001
Nurses Health Study
Prospective epidemiological study
14 year follow up on 79,839 women
574 strokes
Relative Risk related to fish consumption
Risk of Stroke on Fish
Consumption
1
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
<1/mo 1-3/mo 1/wk 2-4/wk >4/wk
Stroke and Fish Intake (cont.)
Risk of ischemic stroke 49% in
women consuming fish > 2/wk
Risk related to intake of omega-3
PUFA
No association between fish intake
or omega-3 intake with
hemorrhagic stroke
Dietary Effects on Eicosanoids
Omega-6 PUFA (Veg Oils)
Produce eicosanoids that tend to:
increase blood clotting
increase blood pressure
May tend to increase risk of
heart disease
Dietary Effects on Eicosanoids
Omega -3 PUFAs (fish oils,
canola)
Produce eicosanoids that tend to:
decreases blood clotting
decreases blood pressure
decreases blood viscosity
decreases risk of heart disease
Essential Fatty Acids and
Inflammation
Inflammation: injury that results in
increased immune system activity and
blood flow
Inflammation may play a role in heart
disease and cancer
Omega-3 PUFA may reduce
inflammatory response
Hydrogenation of UFA
Conversion of PUFA to MUFA &
SFA
Process
Purposes:
Produce solid fats from oils
Produce more chemically stable fats
(resists oxidation, rancidity)
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Hydrogenation of UFA
cisand trans UFA
trans formed as a side/reverse
reaction of hydrogenation
Trans fats mainly found in foods
with partially hydrogenated fats
Trace amounts in milk fat & tallow
Current average intake ~2.6% of calories
2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning is a trademark used herein under license.
Health Concerns of Trans Fatty Acids
Epidemiological Studies
Several show association between consumption of
trans fats and risk of coronary heart disease
Randomized Controlled Trials
Several show that increased consumption of trans
fats increase LDL-C, possibly by decreasing LDL
receptor activity
FDA requires Trans fat labeling containing >
0.5g/serving (Jan. 2006)
Currently, trans fats are included with all
unsaturated fats
Diet and Heart Disease
Incidence
Leading cause of death
1,250,000 myocardial
infarctions/yr
750,000 MI deaths/yr
Diet and Heart Disease
Incidence of early heart disease
(under age 65)
Males:
300/100,000 fatal MI
80/1,000 MI
Female:
125/100,000 fatal MI
45/1,000 MI
History of a Heart Attack
Initiation
Fatty Streaks
Initiated by:
hypertension
cigarette smoke
Inflammation
C-reactive Protein: a marker for
chronic inflammation (CRP)
other causes?
Low-grade Systemic
Inflammation in Overweight
Children
Pediatrics, Jan. 2001
cross-sectional epidemiological study
3,561 children, 8-16 yrs old
C-reactive protein
Associated with inflammation
linked with development of heart disease in
overweight adults
C-reactive Protein in Overweight
Children
History of a Heart Attack
Atherosclerotic Plaque Development

Macrophages attach
LDL-cholesterol accumulates
Fibrous cells grow
Calcification
2002 Wadsworth Publishing / Thomson Learning
History of a Heart Attack:
End-Stage: Symptoms Appear
Myocardial Infarction
Heart attack
Angina
Chest pain
Thrombosis:
growth of stationary clot
Embolism:
sudden closure by loose clot
Ischemia
Lack of blood flow and oxygen delivery to tissue
History of a Heart Attack
Warning signs
Angina & shortness of breath
Often no warning!
Treatment
Angiogram
Angioplasty
Coronary bypass surgery
Treatment of late-stage CHD
Secondary Prevention of CHD
Testing
Stress test
Angiogram
Angioplasty
Balloon angioplasty
stents
Coronary Bypass Surgery
Grafting of healthy veins around diseased
coronary arteries
Primary Prevention of CHD
Know your risk factors
Make dietary changes
Start/continue exercise
Stop smoking
Stress reduction
Use medication if necessary
CHD Risk Factors
( * modifiable)
High LDL-cholesterol *
Low HDL-cholesterol *
High blood pressure *
Family history of early CHD
Current cigarette smoking *
Diabetes *
(Obesity *)
Risk Factors for CHD
High Total Blood Cholesterol
>200 mg/dl: borderline high risk
>240 mg/dl: high risk
High LDL-C
>130 mg/dl: borderline high
>160 mg/dl: high risk
Lowering your LDL-C
Decrease dietary saturated fat
< 10% calories (Step 1)
< 7% calories (Step 2)
Decrease dietary cholesterol
< 300 mg/day (Step 1)
< 200 mg/day (Step 2)
Lowering your LDL-C
Replacing dietary SFA with
MUFA
Canola oil, olive oil
Increase dietary fiber
Whole grains, oats, fruits,
vegetables
Lowering your LDL-C
Decrease dietary Trans-FA
hydrogenated fats
Medication
Plant stanols/sterols
Statin drugs
Bile acid binding resins
Niacin (pharmacological doses)
Risk Factors for CHD
Low HDL-C
< 40mg/dl : high risk
> 65mg/dl : protective
Increasing your HDL-C
Exercise
Alcohol
1-2 servings/d males
1 serving/d females
2nd Exam
Tuesday, Feb 13, 2005

The Lipids: Fats and Oils


Chapter 5
Nutrition and Disease Prevention
Chapter 11
Cardiovascular Disease
Hypertension and Stroke
Nutrition and Cancer Prevention
Nutrition Research
Chap 1: 11-14
Risk Factors for CHD
Hypertension
Cigarette smoking
quit/dont start
Diabetes
lose weight if overweight (type 2)
control blood sugar
Non-modifiable Risk Factors
Age
males over 45
female post-menopause
Family History
premature CHD
males under 55
females under 65
Risk Reduction
100

80
smoke, hiBP, hiTC
60
hiBP, hiTC
hiTC
40
none
20

0
Reversal of Heart Disease ?
HeartDisease Reversal Program
Dean Ornish, MD
Semi-vegetarian
NF dairy
egg whites
<10% cal from fat
Reversal of Heart Disease ?
JAMA 1998
5 year study - mod-severe CHD
20 patients on Ornish diet
15 patients on AHA Step 2 diet
Average % stenosis
Ornish - 8% improved
AHA - 28% worse
Reversal of Heart Disease ?
Cardiac Events
heart attacks
angioplasty
coronary bypass surgery
Ornish - 25 events in 5 years
AHA - 45 events in 5 years
More CHD regression, half the number
of cardiac events