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The Great Fat Debate: Reducing Cholesterol
Editor's note: On November 8, 2010, Walter C. Willett, MD, DrPH; Lewis H. Kuller, MD, DrPH; Dariush Mozaffarian, MD, DrPH; and Alice H. Lichtenstein, DSc, participated in “The Great Fat Debate” as part of the Member Showcase at the American Dietetic Association's 93rd Food & Nutrition Conference & Expo in Boston, MA. The following is an edited transcript of Kuller's presentation. An audio recording of the entire debate is available at www.eatright.org/fnce.The Great Fat Debate: Total Fat and Health
Editor's note: On November 8, 2010, Walter C. Willett, MD, DrPH; Lewis H. Kuller, MD, DrPH; Dariush Mozaffarian, MD, DrPH; and Alice H. Lichtenstein, DSc, participated in “The Great Fat Debate” as part of the Member Showcase at the American Dietetic Association's 93rd Food & Nutrition Conference & Expo in Boston, MA. The following is an edited transcript of Willett's presentation. An audio recording of the entire debate is available at www.eatright.org/fnce.The Great Fat Debate: Taking the Focus Off of Saturated Fat
Editor's note: On November 8, 2010, Walter C. Willett, MD, DrPH; Lewis H. Kuller, MD, DrPH; Dariush Mozaffarian, MD, DrPH; and Alice H. Lichtenstein, DSc, participated in “The Great Fat Debate” as part of the Member Showcase at the American Dietetic Association's 93rd Food & Nutrition Conference & Expo in Boston, MA. The following is an edited transcript of Mozaffarian's presentation. An audio recording of the entire debate is available at www.eatright.org/fnce.The Great Fat Debate: Q & A
Editor's note: On November 8, 2010, Walter C. Willett, MD, DrPH; Lewis H. Kuller, MD, DrPH; Dariush Mozaffarian, MD, DrPH; and Alice H. Lichtenstein, DSc, participated in “The Great Fat Debate” as part of the Member Showcase at the American Dietetic Association's 93rd Food & Nutrition Conference & Expo in Boston, MA. At the conclusion of the debate, members of the audience were given the opportunity to pose questions to the panel. The following is an edited transcript of those questions and the panelists' answers.Validation of a Food Frequency Questionnaire to Assess Intake of n-3 Polyunsaturated Fatty Acids in Subjects with and without Major Depressive Disorder
The role of n-3 polyunsaturated fatty acids (PUFAs) in psychiatric illness is a topic of public health importance. This report describes development and biomarker validation of a 21-item, self-report food frequency questionnaire (FFQ) intended for use in psychiatric research to assess intake of α-linolenic acid (18:3n-3 [ALA]), docosahexaenoic acid (22:6n-3 [DHA]), and eicosapentaenoic acid (20:5n-3 [EPA]). In a cross-sectional study conducted from September 2006 to September 2008, sixty-one ethnically diverse adult participants with (n=34) and without (n=27) major depressive disorder completed this n-3 PUFA FFQ and provided a plasma sample.Dietary Intake of Vitamin B-6, Plasma Pyridoxal 5′-Phosphate, and Homocysteine in Puerto Rican Adults
Vitamin B-6 is an important cofactor in many metabolic processes. However, vitamin B-6 intake and plasma status have not been well studied in the Puerto Rican population, a group with documented health disparities.n-3 Fatty Acid Intake and Periodontal Disease
Gingivitis and periodontitis are inflammatory diseases characterized by bleeding gums, gum recession, formation of deep pockets between the gum and tooth, and loss of the periodontal ligaments and alveolar bone structure that support the teeth in the jaw. The prevalence and severity of the different forms of periodontal disease vary considerably in the US adult population. Gingival bleeding, the mildest and most readily reversible form, is found in 54% of men and 46% of women age 30 years and older (1).Intake of Fish and n-3 Fatty Acids and Future Risk of Metabolic Syndrome
Whether or not fish and n-3 fatty acid intake is associated with the metabolic syndrome risk has not been carefully evaluated. This study investigated the effect of fish and n-3 fatty acid intake on the incidence of metabolic syndrome and on the individual risk factors for the syndrome.n-3s from Fish and the Risk of Metabolic Syndrome
Fish and seafood are not like oranges and berries, foods which most people love. With fish, individuals have strong responses to the taste and texture, as well as religious or cultural associations, but these foods, along with algae, are the sole source of two nutrients essential in human nutrition: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) n-3. In this issue, Baik and colleagues (1) present findings of a prospective study of a population-based Korean cohort.Knowledge of Dietary Fats among US Consumers
Dietary advice emphasizes that some dietary fats increase the risk of heart disease, whereas other dietary fats decrease risk if they are substituted for more risk-increasing fats. Thus, it is important that consumers understand the differences between dietary fats. Existing evidence in the United States suggests troublesome consumer misunderstanding. As part of its continuing effort to promote public health, the US Food and Drug Administration measured consumer awareness and understanding of dietary fats in its Health and Diet Survey− 2004 Supplement.Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation
Trans fatty acids have long been used in food manufacturing due in part to their melting point at room temperature between saturated and unsaturated fats. However, increasing epidemiologic and biochemical evidence suggest that excessive trans fats in the diet are a significant risk factor for cardiovascular events. A 2% absolute increase in energy intake from trans fat has been associated with a 23% increase in cardiovascular risk. Although Denmark has shown it is possible to all but eliminate commercial sources of trans fats from the diet, total elimination is not possible in a balanced diet due to their natural presence in dairy and meat products.The Debate about n-6 Polyunsaturated Fatty Acid Recommendations for Cardiovascular Health
The dietetics profession has been guided by advances in science that are translated to clinical practice guidelines. Inherent to advancing practice is the ongoing scientific dialogue. Progress made in clinical practice reflects the evolution of ideas and opinions that are subjected to additional scientific experimentation to advance our understanding and resolve “debates.” A good example of ongoing dialogue is the discussion about n-6 polyunsaturated fatty acids (PUFAs) and heart health. The National Academies and the Dietary Guidelines Advisory Committee 2005 have recommended that PUFAs provide 5% to 10% of energy (1,2).Enhanced Absorption of n-3 Fatty Acids from Emulsified Compared with Encapsulated Fish Oil
Health benefits of n-3 fatty acids are well-established. However, consumption of adequate dietary sources of these fatty acids is inadequate. Oral fish oil supplements are an alternative means of consuming adequate long-chain n-3 fatty acids in individuals who do not consume sufficient dietary sources. However, palatability can present a problem with compliance. Emulsifying fish oil allows for production of a pleasant-tasting supplement and can enhance digestion and absorption of the fatty acids.A Systemic Review of the Roles of n-3 Fatty Acids in Health and Disease
Attention to the role of n-3 long-chain fatty acids in human health and disease has been continuously increased during recent decades. Many clinical and epidemiologic studies have shown positive roles for n-3 fatty acids in infant development; cancer; cardiovascular diseases; and more recently, in various mental illnesses, including depression, attention-deficit hyperactivity disorder, and dementia. These fatty acids are known to have pleiotropic effects, including effects against inflammation, platelet aggregation, hypertension, and hyperlipidemia.Docosahexaenoic Acid (DHA) Supplementation of Orange Juice Increases Plasma Phospholipid DHA Content of Children
The major dietary source of docosahexaenoic acid (DHA) is fish, which is not widely consumed by children. There is concern, therefore, that children may not receive adequate DHA and so might benefit from dietary supplementation. The aim of the present study was to evaluate the effects of providing a supplement of microencapsulated algal DHA in juice. We assessed the effects of two levels of DHA supplementation on the plasma phospholipid DHA content of healthy 4- to 6-year-old and 7- to 12-year-old children who were randomly assigned to consume 180 mL juice containing either 50 mg (lower dose) or 100 mg (higher dose) DHA daily for 6 weeks.Achieving Adequate DHA in Maternal and Infant Diets
Thank you for the Commentary by Makrides in the October 2008 issue of the Journal (1). This commentary highlights the important role of the long-chain n-3 fatty acid, docosahexaenoic acid (DHA; 22:6 n-3), in maternal and infant diets. This important commentary also calls attention to the limited ability to produce DHA de novo from the short-chain n-3 precursor α-linolenic acid (ALA; 18:3 n-3) (2,3) and the challenge associated with achieving adequate DHA in the diet particularly during pregnancy, nursing, and early postnatal life (4) but overestimates the DHA content of a few key foods.Concerning PUFA in Fish
It was surprising to read in the Journal that certain n-6 polyunsaturated fatty acids (PUFAs), long considered essential nutrients, were deemed unfavorable (1). For years, Americans have been urged to substitute unsaturated fatty acids, including polyunsaturated ones, for saturated ones, with the result that the US consumption of PUFAs is about 7% of energy or more, most of which comes from linoleic acid (2). This increase has been associated with decreased mortality from coronary heart disease and lower incidence of myocardial infarction (3).Outcomes for Mothers and Their Babies: Do n-3 Long-Chain Polyunsaturated Fatty Acids and Seafoods Make a Difference?
The last few years have witnessed the emergence of a multitude of supplements for pregnant and lactating women with n-3 fatty acids, predominantly as marine or fish oil. These marine oils have been added to prenatal vitamins and minerals as well as to food products specifically designed for women in the perinatal period. The main motivation behind these supplements appears to be the suggestion that an increased supply of docosahexaenoic acid (DHA, 22:6n-3), a key n-3 long-chain polyunsaturated fatty acid, during the last trimester of pregnancy and early postnatal life may enhance development of the fetal and infant brain, clearly building on the extensive body of work relating to long-chain polyunsaturated fatty acid supplementation of infant formulas for term and preterm infants (1).Low Docosahexaenoic Acid in the Diet and Milk of Women in New Mexico
Because docosahexaenoic acid (DHA) is critical for the development of the nervous system, especially during the first year of life, the content of DHA in human milk is important for the well-being of exclusively breastfed infants. The aim of this study was to determine the fatty acid composition, including DHA, of the breast milk fat and serum phospholipids of women in New Mexico, and to correlate these data with dietary fatty acid content. Samples of blood and breast milk, 3-day diet records, and information on dietary supplement use were obtained from 29 women.Regarding Favorable and Unfavorable PUFA in Fish
We would like to thank Dr Harris for his thoughtful comments regarding our paper on favorable and unfavorable polyunsaturated fatty acids found in commonly eaten fish in the July 2008 issue of the Journal (1). Harris is a world-recognized and respected nutritionist, and his thoughts in the form of a Research Editorial (2) are greatly appreciated.Algal-Oil Capsules and Cooked Salmon: Nutritionally Equivalent Sources of Docosahexaenoic Acid
Food and nutrition professionals question whether supplement-sourced nutrients appear to be equivalent to those derived from natural food sources. We compared the nutritional availability of docosahexaenoic acid (DHA) from algal-oil capsules to that from assayed cooked salmon in 32 healthy men and women, ages 20 to 65 years, in a randomized, open-label, parallel-group study. In this 2-week study comparing 600 mg DHA/day from algal-oil capsules to that from assayed portions of cooked salmon, mean change from baseline in plasma phospholipids and erythrocyte DHA levels was analyzed and DHA levels were compared by Student's t tests.The Content of Favorable and Unfavorable Polyunsaturated Fatty Acids Found in Commonly Eaten Fish
Changes in diet during the past century have caused a marked increase in consumption of saturated fatty acids and n-6 polyunsaturated fatty acids (PUFAs) with a concomitant decrease in the intake of n-3 PUFAs. Increased fish consumption has been shown to be the only realistic way to increase dietary quantities of beneficial long-chain n-3 PUFAs such as eicosapentaenoic acid and docosahexaenoic acid and re-establish more balanced n-6:n-3 ratios in the diets of human beings. Our objective in this research was to characterize some of the relevant fatty acid chemistry of commonly consumed fish, with a particular focus on the four most commonly consumed farmed fish.You Are What You Eat Applies to Fish, Too
The health benefits of fish have long been touted based on their low fat content, excellent protein quality, and available micronutrients. Recently, calls for increased “oily fish” intake have been on the rise. Several large epidemiological investigations, as well as randomized clinical trials (1,2), have underscored the cardiovascular benefits of n-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]), nutrients found almost exclusively in seafood. The 2007 recommendations from the American Dietetic Association (ADA) and the Dietitians of Canada (DC) are the latest to join in a growing international chorus (3) specifying a healthful intake of EPA and DHA, now set at 500 mg/day.Dietary Modeling Shows that the Substitution of Canola Oil for Fats Commonly Used in the United States Would Increase Compliance with Dietary Recommendations for Fatty Acids
To examine the effect of substituting canola oil for selected vegetable oils and canola oil–based margarine for other spreads on energy, fatty acid, and cholesterol intakes among US adults.Position of the American Dietetic Association and Dietitians of Canada: Dietary Fatty Acids
It is the position of the American Dietetic Association (ADA) and Dietitians of Canada (DC) that dietary fat for the adult population should provide 20% to 35% of energy and emphasize a reduction in saturated fatty acids and trans-fatty acids and an increase in n-3 polyunsaturated fatty acids. ADA and DC recommend a food-based approach for achieving these fatty acid recommendations; that is, a dietary pattern high in fruits and vegetables, whole grains, legumes, nuts and seeds, lean protein (ie, lean meats, poultry, and low-fat dairy products), fish (especially fatty fish high in n-3 fatty acids), and use of nonhydrogenated margarines and oils.
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