Jennifer Wihlborg

N00936334

HUN 3230

Fatty acids, the major form of dietary fat, are classified into several different groups: total

fat, n-3 and n-6 polyunsaturated fatty acids (PUFAs), monounsaturated fatty acids (MUFAs),

saturated fatty acids (SFAs) and trans-fatty acids (TFAs). Each has its own biological effects and

structural differences. SFAs have no double bonds, while MUFAs have one double bond and

PUFAs have more than one double bond (as well as the variety of cis or trans configurations).

Furthermore, n-3 PUFAs have a double bond occurring at the third carbon of the fatty acid chain

from the methyl end, while n-6 PUFAs have a double bond occurring at the sixth carbon. Each

fatty acid has its own biological effect. Due to the extensive nature of fats, the Academy of

Nutrition and Dietetics (AND) has created a position statement in regards to dietary fatty acids

for healthy adults:

It is the position of the Academy of Nutrition and Dietetics that dietary fat for the

healthy adult population should provide 20% to 35% of energy, with an increased

consumption of n-3 polyunsaturated fatty acids and limited intake of saturated and trans

fats. The Academy recommends a food-based approach through a diet that includes

regular consumption of fatty fish, nuts and seeds, lean meats and poultry, low-fat dairy

products, vegetables, fruits, whole grains, and legumes.1

 Although the Academy recommends 20% to 35% of daily calories from fat, the quality of

fat is of tantamount importance. PUFAs, which are liquid at room temperature, are most

commonly known for the n-3 and n-6 versions. Both are essential fatty acids, for humans are

unable to synthesize them. Each has its own benefits. Alpha-linolenic acid (ALA) is the most

abundant n-3 PUFA, many of which are strongly correlated with heart health. Specific n-3

PUFAs associated with cardiovascular benefits are ALA, EPA, and DHA. Diets rich in ALA

have been found to lower lipid levels, reduce vascular inflammation, and reduce blood pressure,

while there have been positive associations between EPA and DHA (commonly found in fatty

fish) and decreased risk of cognitive decline.1 More general studies have found a link between

inadequate intake of n-3 has been linked with depression and an increased risk of sudden cardiac

death.1 It is recommended that n-3 intake should be 0.6% to 1.2% of daily caloric intake. In

reverence to n-6 PUFAs, LA is the most highly consumed PUFA in the Western diet, as well as

the metabolic precursor of arachidonic acid (ARA). ARA can contribute to overproduction of

eicosanoids, which have been linked with negative effects such as inflammation,

vasoconstriction, and platelet aggregation. Due to this, n-6 PUFA intake should be limited to 5%

to 10% of daily caloric intake.

MUFA supplementation is not common practice since it is abundant in various foods and

oils. MUFA intake has been linked to alteration in markers of health and disease, such as

reducing LDL cholesterol, triglycerides, total cholesterol to HDL ratio, and increasing HDL

cholesterol.1 Although there have been positive correlations, there have also been negative ones.

Over a 30 year assessment, MUFA levels were positively associated with coronary death.1

Current recommendations for MUFA intake are consuming no more than 12% of energy. SFA

intake should not exceed 7% of energy intake; according to the AHAs Diet and Lifestyle
Recommendations (2006).1 This limited intake of SFAs is recommended due to its negative

effects including increased LDL cholesterol levels. An exception for SFA supplements are

medium chain fatty acids (MCTs). MCT supplements, derived from coconut oil, are used for

medical nutrition therapy (MNT) in patients who lack the ability to properly metabolize long-

chain fatty acids (LCFAs).1 Lastly, trans-fatty acid intake should be as low as possible. It has

been concluded that absolutely any TFA intake increases risk of developing CHD, metabolic

syndrome and diabetes.1 Although TFA intake has been declining over the years, it is important

to keep the decline continuous.

As discussed, fat is an important, even necessary, macronutrient. Additional studies have

been conducted since the publication of the Academys statement that further supports its

conclusions. Although there have been multiple studies published in relation to the beneficial

health effects of fatty acids, several have specifically focused on the negative health effects of

certain types of fatty acids. A study conducted by Cen et al has results suggestive of long-chain

free fatty acids (FFAs) having an enhancing effect on insulin secretion (even at low glucose

concentrations), with MUFAs (palmitoleate or oleate) being more potent than SFAs (palmitate or

stearate). These results were primarily due to mitochondrial respiration and increased glycolytic

flux. There are implications that there are stimulatory effects of fatty acids on insulin secretion at

fasting glucose concentrations. This may contribute to hyperinsulinemia (often linked with

insulin resistance, and eventually the diagnosis of type 2 diabetes) in subjects with elevated

levels of FFAs.2

One 20-week animal study conducted research on the effects of trans-fatty acids on

obesity, insulin resistance (IR) and hepatic steatosis. Six male mice were fed four different diets

for 20 weeks: normal diet (ND, 25% kcal from fat), high fat diet (HFD, 50% kcal from fat), low
trans-fatty acids diet (LTD, 25% kcal from fat) and high trans-fatty acid diet (HTD, 50% kcal

from fat). Results concluded that the HTD diet produced the highest body weights and further

impaired glucose tolerance (with HFD as second). The HTD group also showed more severe

liver steatosis in comparison to the other groups. It was concluded that ...consumption of a diet

high in trans-fatty acids induces higher rates of obesity, IR and hepatic steatosis3 The

importance of this study is great, as overconsumption of fatty acids leads to deposition directly to

the liver. This can eventually lead to steatohepatitis, hepatic fibrosis, and further liver damage.

This studys results prove that trans-fatty acids are a risk factor for obesity, IR, and metabolic

syndrome. Specifically, mice on the HTD diet in comparison to the HFD diet suffered glucose

intolerance more severely. Animal studies are not necessarily reliable for drawing concrete

conclusions for human subjects, yet this study gives great insight to the consequences of

consumption of trans-fatty acids such as the promotion of lipid accumulation in the liver and

induction of more severe insulin resistance.

As discussed in the Academy of Nutrition and Dietetics position paper, each fatty acid

has its own beneficial and/or negative biological effect on the body. Due to this, each fatty acid

has an intake recommendation from the Academy. As supported through Xiaona et als study,

trans-fatty acid intake should be as minimal as possible, as the effects are detrimental. MUFAs,

which tend to be higher in the Mediterranean diet due to the abundance in olive oil, have positive

effects on over secretion of insulin. Although optimal intake of MUFA in still to be determined,

the key is to make MUFA intake balanced. Replacement of SFAs with n-3 and n-6 PUFAs have

been encouraged for the inverse association between PUFA levels and sudden cardiac death. The

Academy's position statement has certainly been supported throughout a range of research

studies, although clarification must be made that findings from animal studies cannot always be
applicable to human subjects. Therefore, it is the job of registered dietitian nutritionists (RDNs)

to help the general public understand the impacts of fatty acids as a whole. Effects of fatty acids

need to be understood in order to eat a healthy balance of them. With their knowledge, RDNs are

experts in the area of making realistic goals in regards to fat intake - nutrition education

(specifically in regards to fat) through RDNs can influence lifelong health and longevity.
 References

1. Vannice G, Rasmussen H. From the Academy: Position of the Academy of Nutrition and

Dietetics: Dietary Fatty Acids for Healthy Adults. Journal Of The Academy Of Nutrition

And Dietetics. January 1, 2014;114:136-153.

2. Jing C, Sargsyan E, Bergsten P. Fatty acids stimulate insulin secretion from human

pancreatic islets at fasting glucose concentrations via mitochondria-dependent and -

independent mechanisms. Nutrition & Metabolism. August 30, 2016;13:1-9.

3. Xiaona Z, Cheng S, Junbo G, et al. Trans-Fatty Acids Aggravate Obesity, Insulin

Resistance and Hepatic Steatosis in C57BL/6 Mice, Possibly by Suppressing the IRS1

Dependent Pathway. Molecules. June 2016;21(6):1-11.