Diabetes Clinical Trial
Official title:
The Effects of Natural Versus Man-Made Trans Fatty Acids on Lipoprotein Profiles: A Pilot Study
The purpose of this study is to test the effects of natural vs. man-made trans fatty acids (trans fats) on blood cholesterol.
Since the purpose of the study is to determine the statistical power required for a
definitive study testing and comparing the effects of two trans fatty acids, vaccenic and
elaidic acid, on lipoprotein profiles, no hypotheses will be specified.
Specific Aims:
1. To determine the variability in the lipid and lipoprotein response to diets enriched in
natural versus man-made trans fats in order to appropriately power a larger scale
clinical study
2. To optimize the delivery of trans fat-enriched diets through the development of
supplemental food items
The adverse health effects of trans fatty acids (TFA) on cardiovascular disease (CVD) risk
have been established in a number of metabolic and epidemiological studies [Willett 1993, Hu
1997, Ascherio 1996, Pietinen 1997, Oomen 2001]. Trans fats are fatty acids with 18 carbon
chains and one or more double bond(s). The hydrogen atoms of the double bond(s) are in a
configuration (trans rather than cis) that results in the straightening of a normally kinked
unsaturated fatty acid chain. Trans fats occur naturally in low quantities in dairy and beef
products, but have also been artificially introduced to the food supply by the process of
the hydrogenation of vegetable oils [Mann 1994]. Only two studies linking the consumption of
trans fatty acids with an increased risk of CVD have distinguished between the effects of
man-made versus naturally occurring trans fatty acids [Willett 1993, Oomen 2001].
It has been suggested that the relationship between trans fatty acids and coronary heart
disease is specifically attributable to man-made trans fatty acids. In fact, some of the
trans fats that occur naturally in animal products, in particular, conjugated linoleic acid
(CLA), may have beneficial health effects. CLA has been shown to be anti-carcinogenic [Ip
2003], anti-atherogenic [McLeod 2004] and anti-diabetic [Rainer 2004]; it has also been
shown to enhance the immune response and have positive effects on growth and energy
partitioning. As a precursor to CLA, vaccenic acid (VA), another trans fatty acid found in
dairy and beef products, may also provide health benefits. Bioconversion of VA to CLA has
been recently demonstrated [Turpeinen 2002]. The effects of diet supplementation with VA on
health parameters have yet to be defined.
The objective of the overall research project will be to test the hypothesis that the
ingestion of high doses of naturally occurring VA does not cause the adverse lipid and
lipoprotein effects known to occur with the consumption of man made trans fatty acids, in
particular, elaidic acid (EA). The latter is the primary trans fatty acid found in products
such as margarines, cakes, cookies, crackers and other baked and processed foods [Steinhart
2003]. The primary outcome measure will be the ratio of total to high density lipoprotein
(HDL) cholesterol. Related secondary outcome measures include concentrations of low density
lipoprotein (LDL) cholesterol, HDL cholesterol, triglyceride (TG) and Lp(a). The present
proposal is designed to test the feasibility of, and determine the power for, a definitive
study.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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