Sunday, March 28, 2010

A Brief Essay on The History and Dangers of Trans Fats.


Author: Clint Slaughter, M.D., March 19, 2009

Rather than an infectious or outright chemical additive to food, our industrial food process has developed many ways to modify what we eat into other forms with occasionally unanticipated and disastrous results. The introduction of chemically modified trans-fats, formerly known as "partially hydrogenated" fats, into our diets over the course of the 20th century is one example of industrial food manipulation gone wrong. Vegetable oil comes in many natural and unnatural forms, the four main types in our diet being saturated fat, monounsaturated fat, polyunsaturated fat, and trans fats, all of which affect the body slightly differently (Fats 101, 2009). Saturated fats and trans fats are considered the "bad fats", which have been found to increase Low Density Lipoproteins (LDLs), or "bad cholesterol", when consumed regularly (de Roos, Bots, Katan, 2001), saturated fats also being more calorically dense than unsaturated fats. Since 1990, however, many studies have shown that the artificially modified trans fats have many more deleterious health effects, significantly contributing to vascular and coronary artery disease in various ways (Mozaffarian, Katan, Ascherio, Stampfer, Willett, 2006).


Partially hydrogenated oils were first introduced to the American Public in the form of Crisco in 1911 (A History of Trans Fats, 2008). A chemical reaction causes the natural cis, or same-side bond in a fatty acid chain to be converted to a trans, or opposite side bond. This actually straightens the molecule so that it becomes a more solid substance which allows for longer shelf life, longer use in fryers, and forms solid shortenings and margerine from liquid oil. Since the 1990's, more and more studies have demonstrated that trans fats have many more health effects than natural fats, even the more caloric saturated fats. An excellent review of the current literature was published in the New England Journal of Medicine in 2006, discussed these many health issues, including elevated LDLs, and triglycerides, decreased
High Density Lipoproteins (HDLs), or "good cholesterol", increased systemic inflammation, and impaired endothelial cell dysfunction, all of which contribute to atherosclerosis, vascular disease, and coronary artery disease (Mozaffarian, et al, 2006). Another study looked at the effects of trans fats on flow-mediated vasodilation (FMD), another risk marker for vascular disease, and found that in comparison with saturated fats, trans fats decreased normal FMD, presumably further increasing cardiac risk (de Roos, et al, 2001).

Cardiovascular disease is the number one cause of death in the United States, leading to nearly 8 million heart attacks a year and 6.5 million strokes (Cardiovascular Disease Statistics, 2009). The American Heart Association notes that in 2005, this translates to 864,480 deaths, or 35.3% of U.S. deaths, in comparison to 559,312 deaths from cancer, and 117,809 deaths from accidents. Unfortunately, trans fats have become a part of every American's diet through margarine, fried foods, trans fats added to foods, it is ubiquitous in our industrial food supply, effecting all of us. As cardiovascular disease has increased over the last century, the addition of trans fats into the American diet has undoubedtly been a factor in the rise of our number one killer. As a testament to the public health system, the healthcare system, and the scientific community, over the last few years, trans fats have become a source of national attention. Through grass-roots activism and public health efforts, trans fats are being discouraged and even outlawed in New York City in 2006 and in California in 2007. More education is needed for consumers to be able to distinguish between types of fats and look for trans fats in labels where they are still available.


References

American Heart Association (2008). A History of Trans Fats. Retrieved on March 19, 2009 from: http://www.americanheart.org/presenter.jhtml?identifier=3048193

American Heart Association (2009). Cardiovascular Disease Statistics. Retrieved on March 19, 2009 from: http://www.americanheart.org/presenter.jhtml?identifier=4478

American Heart Association (2009). Fats 101. Retrieved on March 19, 2009 from:
http://www.americanheart.org/presenter.jhtml?identifier=3045789

American Heart Association (2009). Trans Fats. Retrieved on March 19, 2009 from: http://www.americanheart.org/presenter.jhtml?identifier=3045792

de Roos, M., Bots, L., Katan, M. (2001). Replacement of Dietary Saturated Fatty Acids by Trans Fatty Acids Lowers Serum HDL Cholesterol and Impairs Endothelial Function in Healthy Men and Women
Arteriosclerosis, Thrombosis, and Vascular Biology. 21: 1233 - 1237. Retrieved on March 19, 2009 from:
http://atvb.ahajournals.org/cgi/content/full/21/7/1233

Mozaffarian, D., Katan, M., Ascherio, A., Stampfer, M., Willett W. (2006).
Trans fatty acids and cardiovascular disease. New England Journal of Medicine. 354:15. 1601-13. Retrieved on March 19, 2009 from http://content.nejm.org/cgi/content/full/354/15/1601?ijkey=/Ulbtkh3itKkQ&keytype=ref&siteid=nejm

Tuesday, March 16, 2010

The S.E.E.P. is Back in School - Master's of Public Health from Walden University


I apologize to any regular readers for the paucity of posts over the past year, I am now just over halfway through a Master's of Public Health Degree from Walden University online while continuing to work as an ER physician and helping with our now 8 month old son Orion. My wife Laura is back in school as well for a Master's of Nursing Education, so we've been very busy while enjoying our new family at home.

I'm concentrating on environmental health and will begin posting relevant essays from classes with citations, shifting some of the writing on theseep.com from my generally well-informed, standard rants to articles with reliable sources and citations so that readers can look further into issues and see the basic research behind the rants.

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