Serum cholesterol predictive equations with special emphasis on trans and saturated fatty acids.: An analysis from designed controlled studies

The effects of dietary trans fatty acids on serum total and low density lipoprotein (LDL) cholesterol have been evaluated by incorporating trans fatty acids into predictive equations and comparing their effects with the effects of the individual saturated fatty acids 12:0, 14:0, and 16:0. Trans fatty acids from partially hydrogenated soybean oil (TRANS V) and fish oil (TRANS F) were included in previously published equations by constrained regression analysis, allowing slight adjustments of existing coefficients. Prior knowledge about the signs and ordering of the regression coefficients was explicitly incorporated into the regression modeling by adding lower and upper bounds to the coefficients. The amounts of oleic acid (18:1) and polyunsaturated fatty acids (18:2, 18:3) were not sufficiently varied in the studies, and the respective regression coefficients were therefore set equal to those found by Yu et al. [Yu, S., Derr, J., Etherton, T.D., and Kris-Etherton, P.M. (1995) Plasma Cholesterol-Predictive Equations Demonstrate That Stearic Acid Is Neutral and Monounsaturated Fatty Acids Are Hypocholesterolemic, Am. J. Clin. Nutr. 61, 1129-1139]. Stearic acid (18:0), considered to be neutral, was not included in the equations. The regression analyses were based on results from four controlled dietary studies with a total of 95 participants and including 10 diets differing in fatty acid composition and with 30-38% of energy (E%) as fat. The analyses resulted in the following equations, where the change in cholesterol is expressed in mmol/L and the change in intake of fatty acids is expressed in E%: A Total cholesterol = 0.01 Delta (12:0) + 0.12 Delta (14:0) + 0.05 7 Delta (16:0) + 0.039 Delta (TRANS F) + 0.031 Delta (TRANS V) - 0.0044 Delta (18:1) - 0.017 Delta (18:2,18:3) and Delta LDL cholesterol = 0.01 Delta (12:0) + 0.071 Delta (14:0) + 0.047 Delta (16:0) + 0.043 Delta (TRANS F) + 0.025 Delta (TRANS V) - 0.0044 Delta (18:1) - 0.017 Delta (18:2,18:3). The regression analyses confirm previous findings that 14:0 is the most hypercholesterolemic fatty acid and indicate that trans fatty acids are less hypercholesterolemic than the saturated fatty acids 14:0 and 16:0. TRANS F may be slightly more hypercholesterolemic than TRANS V or there may be other hypercholesterolemic fatty acids in partially hydrogenated fish oil than those included in the equations. The test set used for validation consisted of 22 data points from seven recently published dietary studies. The equation for total cholesterol showed good prediction ability with a correlation coefficient of 0.981 between observed and predicted values. The equation has been used by the Norwegian food industry in reformulating margarines into more healthful products with reduced content of cholesterol-raising fatty acids.