Effect of trans fatty acid intake on abdominal and liver fat deposition and blood lipids: a randomized trial in overweight postmenopausal women

N T Bendsen, E Chabanova, H S Thomsen, T M Larsen, J W Newman, S Stender, J Dyerberg, S B Haugaard, A Astrup, N T Bendsen, E Chabanova, H S Thomsen, T M Larsen, J W Newman, S Stender, J Dyerberg, S B Haugaard, A Astrup

Abstract

Background: Intake of industrially produced trans fatty acids (TFAs) is, according to observational studies, associated with an increased risk of cardiovascular disease, but the causal mechanisms have not been fully elucidated. Besides inducing dyslipidemia, TFA intake is suspected to promote abdominal and liver fat deposition.

Objective: We examined the effect of a high intake of TFA as part of an isocaloric diet on whole-body, abdominal and hepatic fat deposition, and blood lipids in postmenopausal women.

Methods: In a 16-week double-blind parallel intervention study, 52 healthy overweight postmenopausal women were randomized to receive either partially hydrogenated soybean oil providing 15.7 g day(-1) of TFA or a control oil with mainly oleic and palmitic acid. Before and after the intervention, body composition was assessed by dual-energy X-ray absorptiometry, abdominal fat by magnetic resonance (MR) imaging, and liver fat by (1)H MR spectroscopy.

Results: Compared with the control fat, TFA intake decreased plasma high-density lipoprotein (HDL)-cholesterol by 10%, increased low-density lipoprotein (LDL)-cholesterol by 18% and resulted in an increased LDL/HDL-cholesterol ratio (baseline adjusted mean (95% CI) difference between diet groups 0.41 (0.22; 0.60); P<0.001). TFA tended to increase the body fat (0.46 (-0.20; 1.17) kg; P=0.16) and waist circumference (1.1 (-0.1; 2.4) cm; P=0.08) more than the control fat, whereas neither abdominal nor liver fat deposition was affected by TFA.

Conclusion: The adverse effect of dietary TFA on cardiovascular disease risk involves induction of dyslipidemia, and perhaps body fat, whereas weight gain-independent accumulation of ectopic fat could not be identified as a contributory factor during short-term intake.

Figures

Figure 1
Figure 1
CONSORT flow diagram displaying subjects recruited into the dietary intervention. Subjects were randomly assigned into two diet groups: a trans fatty acid (TFA) group and a control (CTR) group.
Figure 2
Figure 2
Semi-quantitative assessment of trans fatty acids (TFAs) in red blood cell (RBC) phospholipids assessed by gas chromatography. Based on semi-quantitative assessments of RBC trans18:1 profiles, including the scores 0, 0.5, 1, 1.5 and 2 (where 2 signifies full enrichment) (Supplementary Figure 1), maximal TFA enrichment was observed by week 8 and was generally sustained at week 16 in the TFA group (n=24), whereas the subjects in the control group experienced no TFA enrichment (n=25). Changes from baseline TFA profiles were assessed by repeated-measures ANOVA. Owing to the non-normal distribution of the semi-quantitative data, the analyses were performed on ranked data. aSignificantly different from the baseline value (P<0.001). bSignificantly different from the control group (P<0.001).
Figure 3
Figure 3
Development in mean (±s.e.m.) body weight (a) and waist circumference (b) in the trans fat (TFA; n=24) and control (CTR; n=25) groups during the 16-week dietary intervention. Baseline values were not significantly different (unpaired t-test, P>0.05). Note that the y-axes have been truncated. In spite of the isocaloric study design, body weight increased significantly in both diet groups (P=0.002 for effect of time in repeated-measures analysis of covariance testing for interaction between diet group and time (weeks 4, 8, 12, 16) with week 0 as a covariate; there was no significant interaction between diet and time, nor effect on diet). Waist circumference tended to increase more in the TFA group (P=0.08 for effect of diet; there was no significant interaction between diet and time, nor effect of time).
Figure 4
Figure 4
Liver fat percentage in the trans fat group (TFA; n=23) and in the control group (CTR; n=23) before and after 16 weeks of dietary intervention and in lean references (n=19) obtained by 1H MR spectroscopy. Bars show geometric means (95% confidence intervals). There was no significant effect of diet, P=0.87 for differences between diet groups at week 16 with week 0 as a covariate, by analysis of covariance performed on log-transformed data. The liver fat % in lean references was significantly lower than in overweight intervention subjects (diet groups combined) by Kruskal–Wallis test for skewed data; P<0.01.

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