Science Behind the 2010 Dietary Guidelines Recommendations: Dietary Fats

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1 Science Behind the 2010 Dietary Guidelines Recommendations: Dietary Fats Roger Clemens, DrPH IFT President-elect Chief Scientific Officer E.T. Horn TM

2 Objectives Review the evidence Saturated Fatty Acids (modeling exercise) Role of Stearic Acid (implications in labeling) Achievable Dietary Cholesterol (modeling exercise) Potential in MUFAs and PUFAs (risks and benefits) Differences in trans-fatty acids (industrial vs ruminant) Impact of n-6 PUFA on health (risks and benefits) Role of specific foods (nuts, chocolate) and health (risk and benefits) 2

3 Saturated Fatty Acids Question: What is the effect of saturated fat intake on increased risk of CVD or T2D, including effects on intermediate markers, such as serum lipid and lipoprotein levels? Evidence: 12 studies since 2004; 8 studies strong Conclusion Committee: Strong evidence indicates that intake of dietary SFA is positively associated with intermediate markers and end point health outcomes for Increased serum total and LDL cholesterol and increased risk of CVD Increased markers of insulin resistance and increased risk of T2D Policy: A strong body of evidence indicates that higher intake of most dietary SFA is associated with higher levels of blood total cholesterol and LDL cholesterol risk factors for CVD T2D is not discussed in this section 3

4 Saturated Fatty Acids CHO substitution CHD risk Sat Carbo (5%en) Mono Carbo (5%en) Poly Carbo (5%en) Sat Mono (5%en) Sat Poly (5%en) Sat Unsat (5%en) Trans Mono (2%en) These data suggest a higher intake of PUFA reduces the risk of CHD. 95% CI Trans Poly (2%en) Trans Unsat (2%en) isocaloric substitution Change in CHD Risk (%) 4 Hu FB et al., J Am CollNutr2001;20:5-19

5 Saturated Fatty Acids Summary Limit SFA intake to < 7%en, replacing these calories with MUFA or PUFA rather than CHO to reduce risk of CVD and T2D (adults and children) Goal: Take steps to < 7%en by consuming < 10%en Decrease major sources of SFA 5 Percent of total SFA intake* 10% 8% 6% 4% 2% 0% Regular cheese Pizza Grain-based desserts Dairy-based desserts * Sources of dietary SFA in U.S. population > 2 yo, NHANES Sausage, franks, bacon, ribs

6 Stearic Acid Question What are the effects of dietary stearic acid on LDL cholesterol? Evidence: Since 2000, review of 20 RCTs + IOM report (2002) Conclusion Committee: Moderate evidence from a systematic review indicates that when stearic acid is substituted for other SFA or trans fatty acids, plasma LDL cholesterol levels are decreased; when substitute for CHO, LDL cholesterol levels are unchanged; when substituted for MUFA or PUFA, LDL cholesterol levels are increased; the impact of stearic acid replacement of other energy sources is variable regarding LDL cholesterol, and the potential impact of changes in stearic acid intake on CVD risk remains unclear. Policy: No comment 6

7 Top Dietary Sources of Stearic Acid among U.S. Population ( NHANES) 10% Contributio on to Intake 8% 6% 4% 2% 8.3% 6.1% 6.0% 5.7% 5.7% 5.1% 4.8% 4.4% 4.3% 4.2% These 18 food sources of stearic acid represent 76.7% of the total intake. 3.3% 3.2% 3.2% 3.0% 2.6% 2.5% 2.2% 2.2% 0% 7

8 Stearic Acid Functional Alternatives Stearic Acid (18:0) Health Impact Clinical study: Stearic acid reduced LDL-C, did not affect the ratio of LDL to HDL cholesterol (Aro A et al., Am J Clin Nutr 1997;65: ) Institute of Medicine: Stearic acid considered neutral effect on LDL cholesterol (IOM, 2002; not part of 2010 NEL review) Metabolic review: Based on the available evidence about the biological effects of stearic acid, we propose that it is a viable candidate as a replacement for tfa. (Kris-Etherton PM et al., Lipids 2005;40: ) Meta-analysis: Four studies that assessed substitution of stearic acid (7-9%en) for tfa (7-8%en) showed not adverse effects on CVD risk. (Hunter JE et al., Am J Clin Nutr doi: /ajcn ) Regulatory Implications Unknown What if SFA omitted stearic acid (18:0) from the nutrition facts panel? 8

9 Stearic Acid Implications Stearic acid not known to raise LDL cholesterol Stearic acid should not be categorized with known cholesterol-raising fats Stearic acid in foods, such as dark chocolate and shea nut oil, need not be considered as problematic 9

10 Dietary Cholesterol Question What is the effect of dietary cholesterol intake on risk of CVD, including effects on intermediate markers such as serum lipid and lipoprotein levels and inflammation? Evidence Identified 16 studies since meta-analysis (17 studies), 2 systematic reviews, 1 pooled analysis, 8 prospective cohort studies on cholesterol, 6 prospective studies on eggs 10

11 Dietary Cholesterol Modeling < 200 mg/d < 2 eggs/wk and 20% of meat, chicken + substitution with nuts and soy + limit solid fats at 10 g/d + isocaloric substitution with oils Potential unintended consequences Conclusion Committee: Moderate evidence from epidemiological studies relates dietary cholesterol to clinical CVD endpoints RCTs suggest 1 egg/d is not associated with risk of CHD Among those with T2D, increased dietary cholesterol associated with CVD risk Policy One egg/d does not increase risk of CVD in healthy people Consuming < 300 mg/d can help maintain normal blood cholesterol levels Consuming < 200 mg/d can help individuals at high risk of CVD 11

12 Unintended Consequences Example: What about choline? Food mg/100 kcal kcal/serving(g) Eggs, whole, fresh (56 g) Liver, chicken, raw (100 g) Non-fat milk 46 86(247 g) Wheat bran (100 g) Nuts (almonds, blanched) (28 g) 12

13 Potential for MUFA Question What is the effect of dietary intake of MUFA when substituted for SFA on increased risk of CVD and T2D, including intermediate markers such as lipid and lipoprotein levels and inflammation? What is the effect of replacing high CHO diet with a high MUFA diet in persons with T2D? 13

14 Potential for MUFA Evidence: 13 studies (including meta-analysis, prospective cohort, RCTs) since 2004 Conclusion Committee Strong evidence indicates that dietary MUFA are associated with improved blood lipids related to both CVD and T2D Policy No comment (see glossary) 14

15 Seafood n-3 Fatty Acids Question What is the relationship between consumption of seafood n-3 fatty acids and risk of CVD? Evidence: Total of 25 studies since

16 Seafood n-3 Fatty Acids Mozaffarian and Rimm, JAMA A 2006;296: Compared with little or no fish intake, modest consumption ( mg/d EPA+DHA) is associated with lower risk of CHD death. 16

17 Seafood n-3 Fatty Acids Conclusion Committee Moderate evidence shows that consumption of two servings of seafood per week (4 oz/serving), which provide an average of 250 mg/d of long-chain n-3 fatty acids, is associated with reduced cardiac mortality from CHD or sudden death in persons with and without CVD. Policy No comment (see glossary) relative to CHD Recommend increased seafood consumption (protein food) Pregnant and breastfeeding women: Consume 8 to12 oz of seafood per week from a variety of seafood types 17

18 Ruminant trans-fatty Acids Question What effect does consuming natural (ruminant) versus synthetic (industrially hydrogenated) trans fatty acids have on LDL-, HDL- and non HDL cholesterol levels? Evidence: Two strong randomized controlled cross-over trials and one methodologically neutral review since Conclusion Committee: Limited evidence is available to support a substantial biological difference in the detrimental effects of industrial trans fatty acids (itfa) and ruminant trans fatty acids (rtfa) on health when rtfa is consumed at 7-10 times the normal level of consumption. Policy: There is limited evidence to conclude whether synthetic and natural trans fatty acids differ in their metabolic effects and health outcomes. Because natural trans fatty acids are present in meat, milk, and milk products, their elimination is not recommended because this could have potential implications for nutrient adequacy. 18

19 Ruminant trans-fatty Acids Definition: unsaturated fatty acids that contain one or more isolated (i.e., nonconjugated) double bonds in a trans configuration produced by chemical hydrogenation, e.g., Elaidic acid (t9- C18:1) (Federal Register Vol. 68, No. 133, p , July 11, 2003) Risk: CVD risk associated with dietary trans fatty acids (itfa) is due, in part, their effects on LDL and HDL cholesterol, inflammatory processes, as well as interference with fat metabolism. (Hunter JE. Lipids 2006;41(11):967-92) 19

20 Ruminant trans-fatty Acids Natural Sources (rtfa) Meat, milk and other dairy products; mostly as vaccenic acid (18:1;t11) and CLA (18:2;t9,11) Background (Chardigny J-M et al., Am J Clin Nutr 2008;87(3): (TRANSFACT project)) [n=40; 27.6± yo; normolipemic; g xtfa/d for 3wks; 5% energy] rtfa increased HDL and LDL in women, not men Unable draw a conclusion about the effect of TFAs from either source on absolute CVD risk Meta-Analysis (Nestel PJ, J Am Coll Nutr 2008;27(6):735S- 40S) Ruminant TFA neutral (too little in the diet) 20

21 n-6 PUFA and Health Question What is the effect of dietary intake of n-6 PUFA on risks of CVD and T2D, including intermediate markers, such as lipid and lipoprotein levels and inflammation? Evidence 10 studies since

22 n-6 PUFA and Health Conclusion Committee Strong and consistent evidence indicates that dietary PUFA are associated with improved blood lipids related to CVD, in particular when PUFA is a replacement for dietary SFA or trans fatty acids. Policy No comment (see glossary) 22

23 Role of Specific Foods Question What are the health effects related to consumption of nuts? Evidence 17 studies (e.g., tree nuts, peanuts) identified since

24 Role of Specific Foods Estimated mean daily intakes of tree nuts and peanuts 1 by adults 20 years and over, US Gender Sample size Mean 2 intake of nuts (grams) Mean 2 energy from nuts (kcal) Mean energy from nuts (%) Men ± ± Women ± ± All adults ± ± Includes tree nuts and peanuts eaten out of hand, either alone or in nuts mixtures containing dried fruits and/or seeds, and peanut butter eaten alone or in sandwiches. Nuts in baked products, such as muffins and cakes, and nuts in candies are not included. 2 Mean±standard error. 24

25 Role of Specific Foods Frequency of nut consumption and coronary heart disease risk reduction in a dose-response manner. Relative Risk Adventist Health Study Iowa Women's Health Study Nurses' Health Study Physicians' Health Study 0.4 < 1/month 1-4/month 1-4/week >5/week Times per Week 25 Sabaté J, Ang Y. Am J Clin Nutr 2009;89:1643S-1648S

26 Role of Specific Foods Conclusion Committee There is moderate evidence that consumption of unsalted peanuts and tree nuts, specifically walnuts, almonds, and pistachios, in the context of a nutritionally adequate diet and when total calorie intake is held constant, has a favorable impact on CVD risk factors, particularly serum lipids. Policy Nuts are among nutrient-dense foods to be increased Nuts are part of protein foods to be increased Nuts are sources of MUFA and PUFA as well as SFA Moderate evidence indicates that eating peanuts and certain tree nuts (i.e., walnuts, almonds, and pistachios) reduces risk factors for cardiovascular disease when consumed as part of a diet that is nutritionally adequate and within calorie needs. 26

27 Role of Specific Foods Question What are the health effects related to consumption of chocolate? Evidence 13 studies identified since 2000 Conclusion

28 Future Research Risk / benefits of isocaloric substitution for SFA of MUFA vs PUFA Cholesterol feeding studies by non-industry sponsors; assessment of genetic polymorphisms Mechanisms of MUFA and PUFA improve blood lipid profiles Impact of stearic acid on inflammation and coagulation Assess synergies of plant n-3 fatty acids vs marine n-3 fatty acids Continue to evaluate EPA & DHA vs MetHg in women and infants relative to neurological development and cognitive function Compare types of nuts on markers of CVD and inflammation Examine polyphenolic compounds, such as those in chocolate and fruit, on health benefits 28

29 Institute of Food Technologists Headquarters 525 W. Van Buren Street Suite 1000 Chicago, IL ift.org Washington, D.C. Office 1025 Connecticut Avenue, NW Suite 503 Washington, D.C ift.org TM

30 The Expanding Toolbox of Fats and Oils for the Food Industry Robert Collette President Institute of Shortening and Edible Oils TM

Time for an Oil Change 2002, Institute of Medicine Trans fatty acid (TFA) consumption should be as low as possible while consuming a nutritionally adequate diet.

31 Time for an Oil Change 2002, Institute of Medicine Trans fatty acid (TFA) consumption should be as low as possible while consuming a nutritionally adequate diet. 2006, Food and Drug Administration Mandates TFA labeling on pre-packaged foods 2007, New York City Bans use of TFA-containing food ingredients (> 0.5 gram TFA per serving in spreads, cooking oil, shortening) in restaurants

32 What are the trends in reformulation? Develop products with zero trans as quickly as possible Develop products with zero trans but with improved functionality Develop products with zero trans but with lower saturates

33 Early stages develop products with zero trans as quickly as possible Naturally stable oils or fats, including trait enhanced oils Palm Palm kernel Coconut Cottonseed Corn Peanut Rice Bran High oleic sunflower 4

34 Develop products with zero trans but with improved performance and functionality More blends that use and combine stable oils emerge e.g. blending palm oil fractions and other vegetable oils (canola, soy, sunflower) New trait enhanced oils are emerging to expand on the existing trait enhanced oils

35 Interesterified Products Liquid Oil Liquid oils are low in trans fatty acids and sources of MUFAs&PUFA s Liquid Oil Fully Hydro Veg. Oil Blend Tank Rearrangement Hard Stock Baking Fat or Margarine Base

36 Palm Fruit Palm Oil Palm kernel Superstearine Midstearine Stearine Olein Soft PMF Superolein Hard PMF Mid Olein Mid Olein Top Olein

37 New tools for the tool box Trait Enhanced Oilseed Varieties Plenish, High Oleic Soybean Oil Vistive Gold Low Saturate/High Oleic/Low Linolenic Soybeans

9 Plenish TM High Oleic Soy: Silencing of oleic acid desaturase genes Reduces amount of unstable 18:2 and 18:3 acids Increases level of 18:1 oleic acid Eliminates need for hydrogenation = no trans

38 9 Plenish TM High Oleic Soy: Silencing of oleic acid desaturase genes Reduces amount of unstable 18:2 and 18:3 acids Increases level of 18:1 oleic acid Eliminates need for hydrogenation = no trans formation Fatty acid profile similar to heart healthy olive oil Commodity Soybean Oil LowLin Soybean Oil Palmitic Acid C16:0 Saturated Monounsaturated Polyunsaturated <3 Stearic Acid C18:0 Oleic Acid C18:1 Oleic acid desaturase C18:2 fad2 Linoleic Acid Linolenic Acid C18:3 Plenish TM High Oleic* *Target fatty acid composition

39 10 Plenish TM High Oleic Soy: Functionality & Performance the Food Industry Needs Higher stability than other natural oils and within the range of hydrogenated products OSI Hours (110 C) High Oleic Canola High Oleic Sun Low Lin Soy 6-8 Corn Partially Hydrogenated Soy Plenish(TM) High Oleic Soy > 25

Better Flavor Over a longer period of time Consumer Benefits 0g trans fat 20% less saturated fat than commodity soybean

40 11 Plenish TM High Oleic Soy Oil Benefits Longer Fry Life 2 to 3X longer than conventional soy Reduced Polymer Build-up on Equipment Lower maintenance and cleaning costs Extended Shelf Life For food products prepared with Plenish high oleic soy Better Flavor Over a longer period of time Consumer Benefits 0g trans fat 20% less saturated fat than commodity soybean oil Plenish Conventional Soy Fry Life* Days Reduced Polymer Build-up Conventional Soy Plenish High Oleic Soy

41 Vistive Gold Low Saturate/High Oleic/Low Linolenic Soybeans Development Phase: Phase 4 (prelaunch) Market Focus: Food Fatty Acid Composition: C16:0 Palmitic C18:0 Stearic C18:1 Oleic C18:2 Linoleic C18:3 Linolenic Commodity Soybean Low Linolenic Soybean <3 Low SaturateHigh Oleic Soybean <3 Reduced Saturates Improved Stability Nutritional Benefits 0g transfats Lowest sat fat of soybean oils Functional Benefits Excellent flavor High stability Eliminates polymer buildup Targeted Use Frying Spray for crackers/snacks Baking blends

42 Improved Stability Results in Increased Fry Life Vistive Gold (Low Saturate High Oleic) 90 Hrs High Oleic Low Lin Canola 85 Hrs Fry Shortening 85 Hrs Vistive Low Lin 67.5 Hrs Based on time to reach 24% total polar material, at which time the oil is replaced Monsanto/Merlin Development French Fry Study, 2009

43 Vistive Gold Benefits: Nutrition Significant Reduction in Transand Saturated Fat 40 French Fries Fried Chicken - White Fried Chicken - Dark % Reduction Trans + SAFA % Reduction 3.1 Trans + SAFA 29% Reduction Trans + SAFA Fry Shortening Vistive Gold Fry Shortening Vistive Gold Fry Shortening Vistive Gold % Saturates % trans Analytical Results. Pre Cooked Values: Fries: 28.5% SAFA 0.6% trans White Chicken: 23.9% SAFA 0.4% trans Dark Chicken: 28.9% SAFA 0.5% trans Monsanto Data Source: Monsanto

Stearidonic Acid (SDA) Omega-3 Soybeans Collaborative Partner: Solae, LLC Development Phase: Phase 4 Market Focus: Food Fatty Acid Composition: C16:0 C18:0 C18:1 C18:2 C18:3n6 C18:3 C18:4n3 Palmitic

44 Stearidonic Acid (SDA) Omega-3 Soybeans Collaborative Partner: Solae, LLC Development Phase: Phase 4 Market Focus: Food Fatty Acid Composition: C16:0 C18:0 C18:1 C18:2 C18:3n6 C18:3 C18:4n3 Palmitic Stearic Oleic Linoleic γ-linolenic Linolenic Stearidonic Commodity Soybean SDA Omega- 3 Soybean Key Benefits: Optimal omega-3 for food Readily converts to EPA Excellent taste and stability Can be added to a broad range of food products Provides consumers with desirable heart healthy foods

SDA Omega-3: Product Benefits Potential Broad Range of Applications Beverages Soy Milk/Smoothies Fruit Juices/Drinks Vegetable Juices/Drinks Enhanced Waters Dairy Products Dairy Drinks Yogurt/Yogurt

45 SDA Omega-3: Product Benefits Potential Broad Range of Applications Beverages Soy Milk/Smoothies Fruit Juices/Drinks Vegetable Juices/Drinks Enhanced Waters Dairy Products Dairy Drinks Yogurt/Yogurt Drinks Cheese Products Sour Cream/Dips Ice Cream/Frozen Desserts Non Dairy Creamers Oil Based Foods Margarine/Spreads Shortenings Mayonnaise Salad Dressings Peanut Butter Baking Breads Muffins Cookies/Crackers Pastries/Cakes Baked Cereal Bars Snack Foods Granola/Cereal Bars Nutritional Bars Snacks Confectionery Prepared Foods Processed Meats Processed Fish Entrees/Sides Soups/Sauces Pet Foods Conventional soybean processing Clean, neutral oil taste Oil stability improved vs. other omega- 3 oils Broad range of food applications Maintain traditional flavor and shelf life 16

46 Sources and Acknowledgements Dave Tegeder, Pioneer a DuPont Business david.tegeder@pioneer.com Richard Wilkes, Monsanto Company richard.s.wilkes@monsanto.com Tom Tiffany, ADM Oils and Fats tiffany@adm.com

47 Institute of Food Technologists Headquarters 525 W. Van Buren Street Suite 1000 Chicago, IL ift.org Washington, D.C. Office 1025 Connecticut Avenue, NW Suite 503 Washington, D.C ift.org TM

48 The Fats & Oils Portfolio of Tomorrow - Addressing 2010 Dietary Guidelines and Beyond Connie Diekman, M.Ed, RD, LD, FADA Director of University Nutrition Washington University in St Louis American Dietetic Assoc. Past President TM

49 Objectives Discuss how the 2010 Dietary Guidelines will impact consumer food choices Review impact of emerging oils on the consumer Communicating a healthy oils message to the consumer

50 2010 Dietary Guidelines on Fat Guidelines provide information based on - Foods and Food Components to Reduce - Foods and Nutrients to Increase - Building Healthy patterns Identify nutrients of concern Fat Focus is decrease Solid fats and Use oils

51 Food Sources of Saturated Fats

52 2010 Dietary Guidelines Shift the focus to Type of fat - Reduce saturated or solids to <10% - Trans fats as low as possible - Replace solid fats with oils

53 2010 Dietary Guidelines on Fat

54 Food Sources of Saturated Fats

55 Shifting Fat Intake Choose oils in place of solids - Canola - Olive - Peanut - Corn - Safflower - Soybean - Sunflower Choose plant fats like nuts and avocadoes Boost seafood intake to maximize Omega 3 intake

56 Consumers Knowledge of Fat I don t know which fats have which benefits for my health Agree % Neither agree/disagree % Disagree % Global average Developed average Emerging average United States Greece Spain Belgium United Kingdom Poland Netherlands Germany Sweden Czech Republic France Indonesia Turkey Mexico South Africa Brazil Statements about fats (GOM) Q -How strongly do you agree or disagree with these statements about fats?

57 RESULTS: Fat is mentioned by few people as needed for a balanced diet What is needed for a healthy balanced diet Global average % Developed average % Emerging average % Vitamins Proteins Fibre Minerals Carbohydrates Salt Fat Sugar Alcohol Foods that are needed for a balanced diet (GOM) Q -Thinking about the different things that foods contains, which of these do you think people need for a healthy balanced diet?

58 RESULTS: Fat has stronger association with a negative contribution to the body Global Average Any negative contribution % Any positive contribution % Fat Saturated fats Essential fats Omega 3 and Negative Cause weight gain, Clog up your arteries, Raise cholesterol, Cause cancer Positive Provide vitamins, Help with optimal cell growth and renewal, Help keep your heart healthy, Keep you feeling full for longer, Help keep your skin and hair healthy, Help brain and nerve cells function well, What fat does to the body (GOM) Q -Which of these things do you think fat/saturated fats/essential fats/omega 3 and 6 can do to the body?

59 Healthy Oil Usage Consumers will need - - Simple tips for use - Recipe ideas - Products that fit what they do New oils in high fat foods might not be accepted - Peace of mind with technology for new products

60 Focus on Oils Educate consumer on - Role and benefit of fat - Types of fats needed to promote health - How new oils can fit into a healthy pattern - Technology behind new products - Achieving a balanced approach to healthy eating Collaboration with be key

61 Institute of Food Technologists Headquarters 525 W. Van Buren Street Suite 1000 Chicago, IL ift.org Washington, D.C. Office 1025 Connecticut Avenue, NW Suite 503 Washington, D.C ift.org TM

Perception and insights on fats and fatty acids: knowledge of fat quality of the diet

Perception and insights on fats and fatty acids: knowledge of fat quality of the diet Background Research indicates that consumers nowadays are very aware of their health and the major role nutrition plays