Saturated and cis- and trans-unsaturated fatty acids intake in rural and urban Costa Rican adolescents

Abstract

Coronary heart disease (CHD) is the main cause of death in most Latin American countries, including Costa Rica [1]. Adolescents make up a significant proportion— on average 21%—of the general population in these countries. Also, the extent of atherosclcrotic change in early years is correlated with the presence of CHD factors in adults [2,3]. Eating habits associated with CHD risk are acquired early in life and may accelerate the development of this pathology [2,3]. Therefore, developing a healthy diet in adolescents may contribute to reducing the risk of CHD in adulthood [4]. The fatty acid composition of the diet is associated with CHD risk. Some prospective cohort studies [5,6], but not all [7,8] have found a significant positive association between saturated fat intake and risk of CHD. In the Nurses’ Health Study [9], replacing five percent of energy from saturated fat with CTj-unsaturated fats was associated with a 42 percent reduction in CHD. Similarly, trans fatty acid intake is associated with increased risk of CHD, and replacing two percent of the energy from trans fatty acids with non-hydrogenated unsaturated fats reduced the risk of CHD by 53 percent [9]. As expected, no association between trans fatty acid intake and CHD has been found in European countries were intake of trans fatty acids is low [10,11]. Using adipose biomarkers of intake, 18:2 trans fatty acids showed the highest association with CHD in population based case-control study in Costa Rica [12,13]. In contrast, both cis n-6 fatty acids (primarily linoleic acid, 18:2n-6) and cis n-3 fatty acids reduce the risk of CHD [14]. A synergistic relation between linoleic acid and alphalinolenic acid intake has been suggested by Djousse et al. [ 15], showing that the combined intake of these fatty acids may be associated with a greater reduction in the prevalence of CHD.