Coronary Heart Disease

• 'Convincing evidence that TFA from commercial partially hydrogenated vegetable oils (PHVO) increase CHD risk factors and CHD events'.
• 'probable evidence of an increased risk of fatal CHD and sudden cardiac death…'  from commercial partially hydrogenated vegetable oils (PHVO).

• 'Prospective cohort studies show a consistent relationship between higher intakes of TFA and increased risk of CHD. The available evidence is insufficient to establish whether there is a difference between equivalent amounts of ruminant and industrially produced TFA on the risk of CHD'.
• 'Under iso-energetic conditions, the most favourable lipoprotein profile to lower atherosclerotic risk is achieved when a mixture of SFA and TFA is replaced by a mixture of oleic acid, linoleic acid and n-3 LCPUFA. These effects are dose-dependent'.

• 'probable evidence that an increased intake of trans fatty acids also increases risk of CHD'
• Insufficient evidence that 'trans fatty acids from processed plant fats and fats from ruminants have different effects on risk of CHD'.

• 'large numbers of CHD events and deaths may be prevented with the elimination of partially hydrogenated oils (PHO)'.
• 'In replacing PHOs containing industrially produced TFA, a more significant reduction in CHD risk is estimated by replacement with vegetable oils containing higher amounts of cis-unsaturated fatty acids than with those high in saturated fatty acids, but we expect a risk reduction even if iTFA is replaced with fats and oils high in saturated fatty acids'.

• 'Any incremental increases in […] trans fatty acid intakes increase CHD risk'.
• 'positive linear trend between trans fatty acid intake and LDL cholesterol concentration and therefore an increased risk of coronary heart diseases'.

Blood pressure

• With the exception of n-3 LCPUFA (see Table 5.3d), there is no convincing evidence that other fatty acids affect blood pressure.

• Insufficient evidence for an association between TFA intake and risk of hypertension.

• Limited evidence (no conclusion) for 'an effect of any modification of the quality of dietary fat on blood pressure'.

Serum lipids

• 'Consumption of diets containing trans-MUFA […], increases blood total and LDL cholesterol concentrations in a dose-dependent manner, compared with consumption of diets containing cis-MUFA or cis-PUFA'.
• 'Consumption of diets containing trans-MUFA also results in reduced blood HDL cholesterol concentrations and increases the total cholesterol to HDL cholesterol ratio. The available evidence indicates that TFA from ruminant sources have adverse effects on blood lipids and lipoproteins similar to those from industrial sources'.

• convincing evidence that an increased intake of trans fatty acids 1) increases the risk of dyslipoproteinaemia 2)  increases plasma concentrations of triglycerides, total and LDL cholesterol, as well as the ratio of total-to-HDL cholesterol and 3) reduces plasma HDL cholesterol concentration.
• insufficient evidence of 'an influence of trans fatty acids on the ratio of LDL to HDL cholesterol' and 'a different effect of industrial and natural trans fatty acids from ruminants'.

• Consumption of trans fat raises the level of LDL cholesterol in the blood, which  increases risk of developing heart disease.

• Moderate evidence that 'in controlled feeding trials among adults, for every 1% of energy from TFA replaced by 1% of energy from MUFA, or PUFA, LDL cholesterol is lowered by 1.5 and 2.0 mg/dL respectively', HDL cholesterol is increased by an 0.4 and 0.5 mg/dL respectively, while triglycerides are decreased by an estimated 1.2 and 1.3 mg/dL.

• 'positive linear trend between trans fatty acid intake and LDL cholesterol concentration and therefore an increased risk of coronary heart diseases'.
• 'Recent data have shown a dose-dependent relationship between trans fatty acid intake and the LDL:HDL ratio. The combined results of numerous studies have indicated that the magnitude of this effect is greater for trans fatty acids, compared with saturated fatty acids'.

Stroke

• Insufficient evidence for an association between TFA intake and risk of stroke.

Metabolic syndrome

• 'Probable evidence of an increased risk […] of metabolic syndrome components' from iTFA (PHVO).

• Insufficient evidence for an association between TFA intake and the occurrence of metabolic syndrome.

• 'Epidemiological prospective cohort studies have not found consistent relationships between […] the intake of specific fatty acids […] with the risk to develop type 2 diabetes mellitus'.

• 'Probable evidence of an increased risk […] of diabetes ' from iTFA (PHVO).

• Insufficient evidence for an association between TFA intake and T2DM risk.

• 'For many specific fatty acids, results from prospective cohort studies are still too limited, and sometimes contradictory, to conclude on clear associations between their intakes and the risk of a particular type of cancer'.
• 'Evidence is not sufficient to define a DRV for […] specific fatty acids based on cancer outcome'.

• 'scientific requirements for judging the strength of the evidence regarding trans fatty acids and risk of cancer are not fulfilled. Accordingly, no judgement was made'.

• 'there is no evidence that, at habitual intakes […] TFA […] have a discernible impact on energy balance'.

• Based on studies with energy adjustment, there is possible evidence for a 'primary prevention of obesity through a diet with a reduced proportion of trans fatty acids'.
• Based on studies without energy adjustment, there is insufficient evidence for 'primary prevention of obesity through a diet with a reduced proportion of trans fatty acids'.

• 'no evidence that the quality of fat has any effect on body weight'.

• 'TFA from hydrogenated sources may have adverse effects on the inflammatory profile. Clear dose-response relationships have, however, not been established'.