Dr. Arikawa 11/06/2016 Dietary Fat and Contributors to Cardiovascular Disease In a position stated by the Academy of Nutrition and Dietetics in 2014, it is in the general populations best interest for 20%-35% of energy be provided by dietary fat; emphasizing an increased recommendation for n-3 and n-6 polyunsaturated fatty acids (PUFA) and decrease in trans fatty acids(TFA) and saturated fatty acids (SFA) with a diet approach that includes consistent consumption of fish, nuts, seeds, lean meat, poultry, low fat dairy, vegetables, fruits, whole grains, and legumes. How recommendations and intakes align with consumption patterns are what can be learned from the Academys stance, one that shows chronic disease prevalence from abiding by these recommendations over time. It is shown that among the Academys stance the majority of organizations support the above mentioned target range. It is also emphasized and recommended that sustainable health status can be aligned with adjusting saturated and unsaturated fat consumption rather than lowering both all-together. So many differing health implications come from the first double bond position correlating to n-3 versus n-6 fatty acids. The academy states one must first understand the benefits of both before adjusting intake levels while understanding the need for Trans and saturated fatty acids to be lowered. Research suggests that inadequacy of n-3 fatty acids is associated with cardiac death and not balancing the proper ratio can result in an increase disease risk in healthy individuals (this stance is based on this population) [1]. Due to human inability to synthesize these fatty acids obtaining them through the diet is very important as they are used for a multitude of things. Recommendations have since 2005 changed drastically to show research that includes 11 cohort studies from multiple countries that took years to conduct. The research findings were noted to inform individuals that a focus needs to be made that replaces trans-fatty acids (TFA) and saturated fatty acids (SFA) and promotes an increased n-3/n-6 PUFA consumption. With recommendations showing such a drastic intake increase of PUFA results show exactly why qualitative data associated directly supports cardiac health and a decreasing risk of Cardiovascular heart disease. Vannice and Rasmussens research indicates how these fatty acids contribute a high amount of functional properties towards homeostatic regulation that are associated with the following; activation and inhibition of inflammation, platelet formation, cell growth, cell membrane production, cognitive function, bone metabolism, and organ muscle contraction that largely equates to vasoconstrictive as well vasodilating factors [1]. While a-linolenic acid (ALA) and linoleic acid (LA; most highly consumed PUFA) are of big emphasis due to their precursor selectivity the importance of balance can regulate so many long term benefits or issues. A newer diagnosis of chronic low-grade inflammation brings more of a long term analysis to the equation, many of the subjects that took place in this research participated over a long period of time. With fatty acid recognition being of much more importance now than just a few years ago, supplements have entered the market with everything from flax and chia seeds to fish oils and much more. A combination of studies completed in 2011 revealed fish or fish oil consumption was consistent with a thirty six percent decrease in fatal heart disease [1]. In a stance similar to the academys the Journal of Biochemical Nutrition stands firm on the idea of high circulation of SFA being a direct contributor to CVD. Also, with their not being a RDA they too believe these fatty acids should be lowered or removed from the diet all together and in comparison show a decrease in CVD risk when replaced with PUFA [1,2]. The research findings are associated with systemic low-grade inflammation, insulin resistance, and metabolic syndrome that can eventually lead to the development of CVD are consistent with the academys. The Journal of Biochemical Nutrition states that a high intake of SFA can directly be distinguished by a high circulating level of LDLs and lower concentration of HDLs [2]. Both of their stances align with American intakes floating around 10 percent and state that optimal range is consistently around five percent. All the evidence supporting this range is inconclusive however due to both stating that SFA intake cant be specifically connected to cardiovascular problems but otherwise a contributor. The hesitancy to directly connect the types of SFA to cardiovascular health is summarized by the variety of food consumed throughout the diet and complexity of ingredients amongst the majority of dishes. Most importantly the western diet, and more specifically the consumption of red meat and fatty dairy products. The Academy and Biochemical Journal of Nutrition both agree that red meat has a SFA content that can be a contributor to increases in disease risk but the moderations appear to be the question. A more general statement to make from this information is how much is too much, their emphasis on percentage totals on what they should be is the more important question. While CVD has shown high LDL circulation research appears to only put light on an increase CVD risks. The question of other components comes into play as well for example, sodium and iron are two other things commonly found in conjunction with red meat that are contributors according to Vannice and Rasmussen. In a research topic conducted by the American Journal of Clinical Nutrition the focus was on the outcome of saturated fat effects on diets of men and women aged twenty-one to sixty with moderate CVD risk. The results included little to no effect on flow-mediated dilation, fasting serum lipids, microvascular reactivity, arterial stiffness, ambulatory blood pressure, markers of insulin resistance, inflammation, and endothelial activation [3]. Among the results, replacing these SFA with MUFA and PUFA showed promising results with a conclusion stating a seventeen to twenty percent decrease in CVD risk. Similar to the other two sources listed however there results were inconclusive enough to say that fat replacement is still unclear. The types of diets that were included in this research were isoenergetic that targeted lowering circulating LDLs and increasing HDLs. Another interesting result showed that nighttime systolic blood pressure decreased which correlates to the Academys stance on chronic low grade inflammation. Their position also aligns with the benefits of not replacing diets with carbohydrates as that can have adverse effects on circulating cholesterol inadvertently. In conclusion, it can be stated that since updated recommendations were established a few years ago a tighter window has been created. As research shows that SFA contribute a high amount of LDLs, an emphasis on their replacement with PUFA or MUFA (more specifically n- 3) being beneficial is fact. Lower CVD risk has been aligned with this but the question of chronic low grade inflammation draws the most interest. When establishing target ranges of SFA the major point of the academy is to slowly eliminate them from the diet with replacing them with healthier PUFA that contribute many more healthy benefits. The second and third references listed below support the academys stance with recommendations on what adequate intakes should be. All three have inconclusive evidence however, genetics and other lifestyle factors appear to play a bigger role in relation to CVD than what has been previously known especially in the last few years. References 1. Vannice G, Rasmussen H. From the Academy: Position of the Academy of Nutrition and Dietetics: Dietary Fatty Acids for Healthy Adults. Journal Of The Academy Of Nutrition And Dietetics [serial online]. January 1, 2014;114:136-153. Available from: ScienceDirect, Ipswich, MA. Accessed November 2, 2016. 2. Ruiz-Nez B, Dijck-Brouwer D, Muskiet F. The relation of saturated fatty acids with low-grade inflammation and cardiovascular disease. Journal Of Nutritional Biochemistry [serial online]. October 2016;36:1-20. Available from: Environment Complete, Ipswich, MA. Accessed November 4, 2016. 3. Katerina Vafeiadou, Michelle Weech, Hana Altowaijri, Susan Todd, Parveen Yaqoob, Kim G Jackson, Julie A Lovegrove. Replacement of saturated with unsaturated fats had no impact on vascular function but beneficial effects on lipid biomarkers, E-selectin, and blood pressure. American Journal of Clinical Nutrition . 2015;102(1):40-48.