Heart disease is a problem that effects as many as 20% of Americans. This indicates that 1 in 5 adults will develop heart disease during their lifetime, (Tokede, et al., 2013). To reduce these risks, researchers continue study the relationship between diet and heart health. They encourage lifestyle and dietary changes to promote the health of the general public. This includes reducing intake of trans-fatty acids and other diet restrictions to limit incidents of stroke and heart attack. Preliminary research suggests a strong relationship between fatty acids and heart disease. However, a research conducted by Tokede, Petrone, Hanson, Tsai, Weir, Glynn, Gaziano and Djousse suggests that the relationship between fatty acids and heart failure is limited, complex, and unclear. To improve public health and awareness of the issue it is important to gain a better understanding of how fatty acids can be a predictor of heart health.
Heart disease is global problem affecting millions of people around the world. It “describes a range of conditions that affect the heart”, (Mayo Clinic, 2015). It can occur in many different forms including heart attack, arrhythmias, and congestive heart failure. Many associate heart disease with cardiovascular disease which are the blood vessels going to and from the heart- the cause of stroke and coronary artery disease. Studies show it is the primary cause of death for both women and men across the United States. It is often associated with one’s lifestyles and habits. This is attributed to smoking, high cholesterol, high blood pressure, and obesity. It also includes unhealthy diets and lack of exercise, (Mayo Clinic, 2015). All of these causes are correctable and associated with habits and lifestyles. Research continues to study the different ways in which heart disease can be better controlled such as the relationship between fatty acids and heart failure.
Fatty acids are found in different foods and range in variety and type. In addition to trans-fatty acids, there are saturated fats, polyunsaturated fats, and monounsaturated fats. These fats come from food sources that are labeled both healthy and unhealthy. For instance, “naturally occurring trans-fat is found in small amounts of the fatty parts of meat and dairy”, (CDC, 2014). Fatty-acids are not just unhealthy foods deep fried and saturated in grease like french fries and cheese burgers. Unsaturated fats are recognized for their healthy qualities because of the natural oils produced. This includes oil found in corn, peanuts, olives, soybeans, and even sunflowers. Trans-fatty acid, on the other head is most recognized as processed oil made for consumption, (CDC, 2014). This includes oil found in butter and margarine. These types of foods are commonly associated with saturated fats which are known to raise blood pressure and cholesterol. “Consuming trans-fat increases low-density lipoprotein or bad cholesterol… this risk factor contributes to the leading cause of death in the U.S.- coronary heart disease”, (CDC, 2014).
All fatty acids are not bad fatty acids. Good fatty acids are observed in healthy foods such as vegetables that grow from the earth. It can be found in meat such as fish. The oil found in fish fits into the category of unsaturated fats, otherwise known as omega-3 fatty acids. According to the Mayo Clinic, “omega-3 fatty acids in fish are good for your heart”, (2015). It has the ability to reduce heart disease and lower cholesterol. This is because it is full of heart healthy nutrients. Omega-3 can reduce inflammation associated with heart disease. Inflammation around the heart can cause damage to blood vessels causing heart attack. Furthermore, Omega-3 fatty acids can reduce risks of blood clotting, triglycerides, blood pressure, stroke, and even arrhythmia (MayoClinic, 2015). Research by the Mayo clinic encourages people to eat fish regularly, as many as 2 servings a week. By eating foods such as salmon, tuna, trout, and sardines, people can gain a healthy heart.
To better understand the relationship between fatty acids and heart failure, researchers Tokede and colleagues conducted a control study of 788 cases of heart failure who matched the dietary needs for analysis. The group was “randomized, double-blind, and placebo-controlled”, (Tokede et al., 2013, p.699). This group was paired to a control group with no symptoms of heart failure of the same likeness by race, age, and blood. Blood samples were collected by all participating members including self-reporting information such as medical information, symptoms, treatment regimes, diet, excetra.
Data was collected over the course of 4 years, from 1997-2001. Blood samples from the control group and those with heart failure were compared by likeness. Participants gave blood samples to measure fatty acids. This was done by measuring fatty acid profiles extracted by lipids found in plasma, “with a mixture of chloroform and methanol”, (Tokede et al., 2013, p. 699). Once the fatty acid was extracted from the plasma, it could be accurately measured by percentage.
Assessments were completed regarding participants diet and health choices. Health choices include the use and rate of smoking, alcohol intake, and exercise, (Tokede, et al., 2013). This was rated using a base line to determine the how much or how often participants perform these behaviors. Smoking was rated asking never, past, and present use. Participants where weighed to determine their Body Mass Index as well as other comorbid issues. Dietary consumption was monitored and documented using the Food Frequency Questionnaire (FFQ). The data entered was compared “using the food composition database from the Harvard School of Public health”, (Tokede, et al., 2013, p. 699). With the use of statistical analysis, the researchers compared the fatty acid percentage of the control group against those with heart failure. Participants in the control group were compared for cholesterol levels, hypertension levels, heart failure, and percentage factors of fatty acid.
The results of this study are mixed. While high percentage of some fatty acids showed low indication heart failure, other forms of fatty acid showed adverse effects. Additionally, a third form of fatty acid, trans 18:2, also resulted in lower risk of heart failure by 22%, (Tokede, et al., 2013). Most significant, the study found that no meaningful association between trans-fat percentages and “additional adjustments for Coronary Artery Disease and hypertension had minimal effect on the original results”, (Tokede, et al., 2013, p. 700). Furthermore, no meaningful association was found between trans fatty acids observed in the dietary evaluation and coronary artery disease.
Although much research has found the benefits of unsaturated fatty acids, Tokede and colleagues determined the relationship between heart disease and fatty acids to be unclear. Over the years, many argued that trans-fatty acids increases the risks of heart failure including coronary artery disease, and additional health risks such as type 2 diabetes, obesity, dyslipidemia, and hypertension, (Tokede, 2013). Although trans-fatty acids may be linked to negative health, it does not suggest an increase of heart disease, failure, and complications. Studies conducted by the American Journal of Clinical Nutrition attempts to determine the relationship between fatty acids and heart disease to better answer this question. To do this, researchers studied the plasma found in fatty acids to examine the difference between biology and food consumption. Their study found that, “higher concentrations of plasma phospholipids trans linoleic acids were significantly associated with lower risk of heart failure”, (Tokede,et al., 2013, p. 698). This is confirmed by the Mayo Clinic and others. These studies found a positive link between omega-3 and heart disease. However, when looking into the relationship between dietary consumptions of trans-fatty acids and heart failure there was no significant relationships. This was especially seen in those who consumed average levels of fatty acids over the course of 4 years. It suggests that additional research is needed to better determine a significant relationship between the two.
Tokede and colleagues rationalize the results of this finding. They cite that mixed results are due to individual diet. “A diet high in fat and low in carbohydrate prevented the development and progression of heart failure compared with low-fat/high-chrbohydrate diets”, (Tokede et al., 2013, p. 702). It suggests that the relationship between the type of fatty acids consumed is more intricate and complicated than once perceived. Although many studies have found negative associations with saturated fatty acids, other studies also show mixed results as well. Unsaturated fat found in meat and dairy is made by the process of bacterial metabolism. This process may help better determine the effects it has on the heart. However, there are additional factors that can how fatty acids work for or against the heart. This includes individual “metabolism, endogenous synthesis, and sample handling/storage, and diseases (diabetes, malabsorption)”, (Tokede, et al., 2013, p. 703). The results found when comparing the dietary questionnaire to trans fats further substantiates the disassociation with heart failure. This indicates a strong need for continued research.
Centers for Disease Control and Prevention, (2014).Nutrition for everyone: Trans fat. Retrieved from CDC website: http://www.cdc.gov/nutrition/everyone/basics/fat/transfat.html
Mayo Clinic, (2015). Heart disease: Omega-3 in fish. Retrieved from Mayo Clinic website: http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/omega-3/art-20045614
Tokede, O., Petrone, A., Hanson, N., Tsai, M., Weir, N., Glynn, R., Gaziano, J., & Djousse, L. (2013). Plasma phospholipd trans fatty acids and risk of heart failure. The American Journal of Clinical Nutrition, 97(4), 698-705. Retrieved from http://ajcn.nutrition.org/content/97/4/698.full