fao (lipid and lipid acid)

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Fats and fatty acids in human nutrition Report of an expert consultationISSN 0254-4725FAOFOOD ANDNUTRITIONPAPER91Food andAgricultureOrganization oftheUnited NationsFats and fatty acids in human nutrition Report of an expert consultationFAOFOODANDNUTRITION PAPER9110 14 November 2008GenevaFOODANDAGRICULTUREORGANIATIONOFT!EUNITEDNATION" Rom#$ %&1&The designations employedandthepresentation of materialin this informationproductdonotimply theexpressionof any opinionwhatsoeveronthepartof theFood andAgriculture Organizationof theUnitedNations(FAO) concerningthelegal or development statusof any country territory city or areaor of its authorities or concerningthedelimitationof its frontiersor !oundaries" The mentionof specificcompaniesor productsof manufacturers whetheror notthesehave!eenpatented doesnotimply thatthesehave!eenendorsed or recommended !y FAO in preferencetoothersof a similar naturethatare notmentioned"#$%N &'()&*)+),-.'//)(All rightsreserved" FAO encourages reproduction anddisseminationof materialin this informationproduct"Non)commercialuseswill !eauthorizedfree of charge upon re0uest"1eproductionfor resaleor othercommercialpurposes includingeducational purposes may incur fees" Applicationsfor permissiontoreproduce or disseminateFAO copyrightmaterials andall other0ueriesconcerningrightsandlicences should !e addressed !y e)mail toc o p yright2fa o "o rgor tothe3hief 4u!lishing4olicy and $upport %ranch Office of 5nowledge 6xchange 1esearch and6xtension FAO7iale delle Terme di 3aracalla --,+/ 1ome #taly"8 FAO *-,-In eoria4rofessor9ohn3":aterlow diedpeacefullyon,&Octo!er *-,- attheageof&;atthe 3helsea and :estminster ing in?uyana Trinidadand To!agoand 9amaica where he esta!lished theTropical@eta!olism 1esearch Unitatthe Universityofthe :est #ndiesin5ingston9amaicaandcarriedouthiscutting)edgewor>onthepathophysiologyandtreatmentofmalnutrition"Atrademar>ofhiswor> was to transform complex scientificandtechnicalissues intosimple practicalmessagessuchas his A,-easy)to)remem!er stepsBtreatment guidelinesforhospitalstaffin treating malnutritionandits relateddiseases":hen4rofessor:aterlowreturned totheU5 and!eganhis longtenureas4rofessorofines andtheiractivities3yto>ine 4rincipal producingcells @ain target cells Function?@)3$FTh cells 4rogenitorcells ?rowthanddifferentiationofmonocytesandF3#=),EN #=), @onocytesNmacrophagesN % Th cells 3o)stimulation cellsN F3%cells @aturation andproliferationN5cellsActivation7arious #nflammationacutephaseresponsefever#=)*Th, cells ActivatedTand%cells ActivationgrowthandproliferationN5 cells#=)/Th cells N5cells$temcells ?rowthanddifferentiation@astcells ?rowthandhistaminerelease#=); Th* cells Activated%cells4roliferationanddifferentiationN#g?,and#g6synthesis@acrophages@einflammatoryprocesses"3onsumption of$FAin humansimpairs theanti)inflammatoryproperties ofes of n)/=34UFA"6videnceofa!enefit isstrong inrheumatoidarthritis!utwea>er inotherconditions" es for preventionand to some extenttreatmentofinflammatory processes are rather similarto those that are appliedfortheoptimization andmaintenanceofother aspects ofhuman health (controlof!odyweight cardiovascularfunction prevention ofcancers)"#nta>esofaround /gn)/=34UFAOdayarerecommendedforsomechronicdiseasesespeciallyrheumatoidarthritis" 1ecommendationsshould !e tailored to individualson the !asis of theassessment oftheirFAstatusandgeneralsituation"RE*EREN"ES:aCan2NB9B *--'"Omega)/fattyacidspro)inflammatory signalingandneuroprotection"Curr> 1pin>Clin> ;utr>Metab>Care ,-H,/.),;,":ur-.e29B"B J "al-er2PB"B *--."Fietary F)linolenic acidandhealth)related outcomesH a meta!olicperspective";utr>.es> .ev",&H*.)+/""al-er2 PB"B*--."N)/ polyunsaturated fatty acids inflammationand inflammatorydiseases"#m>?> Clin> ;utr"(/($uppl")H ,+-+$),+,&$""al-er2PB"B*--&a"4olyunsaturatedfattyacidsandinflammatory processesHnewtwistsin anoldtale"-iochimie&,H'&,)'&+""al-er2PB"B *--&!"Fattyacidsandimmune functionH relevancetoinflammatory !oweldiseases")nt>.ev>)mmunol" *(H+-.)+/;""al-er2PB"B*--&c"4olyunsaturatedfattyacidsandinflammationHtherapeuticpotentialin rheumatoid arthritis"Curr> .heumatol> .ev"+*,;)**+"*aroo1ui2 ABAB2#orroc6s2 +BABJ*aroo1ui2 TB*--'" @odulation ofinflammation in!rainHamatter offat"?> ;eurochem> ,-,-H+'')+&&"#o-.e2 +B2 Saloe2 "B(B2 #u./es2 LB(B et al.,&&("6ffects ofdietaryinta>eof omega)/andomega). fattyacidsonseverity ofasthmain children"%ur> .espir> ?" ,,H/.,)/.+">in.2;BRB2 #uan.2DB+B2 &0all2DB+B2 "urran2 OBEB2 Priestl02LB;B J (ic/aelTitus2ABTB*--." Omega /fatty acidsimprove recoverywhereas omega .fatty acidsworsenoutcome afterspinalcordinDury in theadultrat"?> ;eurosci"*.H;.'*);.(-"Na.a6ura2 TB2(atsu-a2SB2S/ic/iE0o2 >B2Su.ioto2#BJ#ata2 >B*---" Fietarysupplementation withfish oil rich in omega)/ polyunsaturated fattyacids in childrenwith!ronchialasthma" %ur> .espir> ?" ,.H(.,)(.+"Sc/ac/ter2 #B2Reisan2 LB2 Tran2>B et al.*--;" eandcancerhas!eeninvestigated extensivelyformorethan twodecades"sforcolorectal cancer(313) endometrial cancerandpostmenopausal !reastcancerZFoes totalfatcontri!utetoo!esityandif soinwhat wayZThe6xpert3onsultationaffirmedthat there is nodirectrelationship!etween totalfatando!esityandthatitis energyim!alancethenutrients contri!uting toitandlife styles thatareresponsi!leforo!esity"Fofattyacidsplayaspecificroleincancerdevelopment !eyondtheircontri!utiontoprovidingenergyZThis 0uestion is particularlyrelevantto4UFAespecially n)/andtransFAnotonly !ecausetheircontri!ution toenergyinta>eis low!ut!ecausetheyareendowed withspecific functionalproperties"eof theseFAprovidespecial characteristicsin theirownright"For examplethesourceofn)/=34UFAis essentiallyfishandfishis alsoasourceofvitaminF andselenium!oth!eingcreditedwithapossi!leprotectiveeffectagainstsomecancers"Thusif areduction inris> associated withfishconsumptionis o!served itcould!eentirelyorpartlyduetothese othernutrients" @oreoverif fishsu!stitutesformeatwhichisrecognized asaris>factorforcolorectalcancer anyo!served reduction inris> may!eerroneouslyattri!uted tofishanditsnutrients" 2rans FAwhichareoftenfoundinprocessed andenergy)densefoods!eingpartofthe:estern dietpatternaresuspectedto!earis> factorassociated withseveralcancers(3haDesetal"*--(N=iuetal" *--'N3havarroetal" *--()"Thus o!servationalepidemiologyalonemay !euna!letoprovidesufficientevidencetoconclude withcertaintywhetherornotthe0uantityortypeoffatinthediethasanyeffect on the ris>ofdeveloping anytypeofcancer" 6xperimentalstudies and!iologicalplausi!ilitymaycontri!utecomplementarylinesofevidenceand rationaleand couldhelptoreach aconclusioninsome situations" Therefore aportfolio(ormosaic)approachhas !een used to estimate the strengthofthe evidence !asedonstudiesselected onmethodologicalcriteriastarting frompreviousexpertreports(AF$$A*--/N:31FOA#31*--')andupdated to$eptem!er *--("Onecanalsoas>ifisityetpossi!letogivefiguresonfattyacidinta>e aimedat reducing cancer ris>followingathoroughliterature reviewofthe evidence forassociationof fattyacid inta>eandris> of cancerincidence"$ince it has!eenproposedtouse diseaseoutcome as an indicatorof ade0uacyor optimalinta>erecommendationswill !eproposed" Theserecommendationsare0uantitative whenever Dudgedpossi!le"This exerciseis constrained !y severallimitations"@anyofthestudiesdonot0uantifytheFAassociated withcancerris>N afoodfre0uency0uestionnairewhichis themaintoolforexposureassessmentis su!Decttomeasurementerror(%inghametal"*--/N5ipnis andFreedman *--()andhencetheexposure valuesaresupposedtoclassify4ats andfattyacids in human nutrition0.eportofane=pertconsultation $00thecasesrelatively tocontrols andcannot !econsidered a!solute" es inhigh)incomecountries where mostoftherelevantstudieshave!een conducted(Astorget al"*--;) energy mayconfoundanyeffect oftotal fat" Thisisshown intwocase)control studiesoncolorectalcancer(?er!er*--&)where adDustmentofenergyusingtheresidualmethod negatedtheincreased ris> associated withtotalfatinta>e(Theodoratou etal"*--')whereas theincreasedris> persistedwhenanadDustmentwasmade fortotalenergy(ingintoaccount thisevidence theconsultationconcludedthatit is very li>ely thattotalfatconfounds theeffectof energyandthattotalfatpersedoesnotcontri!ute to313 ris>":reastcancerNotall studyresultsarein agreement ontherelationship!etween totalfatinta>eand!reastcancer(%3)"A suggestive!utlimitedrelationshipwasreported !y the:31FOA#31 (*--')" (O1R,"-/N3#H ,"-*),"-;foranincrement of*-gOdayoftotalfat)andthat ofsevencase)control studiesshowed anoverallO1 of,",,(3#H ,"-/),"-.)"#n additionthe:omenCs eN*)hormoneconcentrations decreasedintheexperimental group!utwerenotmodifiedinthecontrolgroup" This change inhormoneconcentrationiso!served inwomen treatedwith anti)aromataseand adipose tissue aromataseis!elievedto!eresponsi!le forextragonadalhormonesynthesisN/)sex)hormone)!inding)glo!uline ($ 0uestionnaire" 11H;"( (,"/),(",)andTH-"-(in premenopausal women"*3ohortof+,*patients with%3" edwithcolon)rectumendometrialandovariancancers"Forthesethreecancersgiventhatanimalfatis mostoftenacomponent ofenergy)densefood itseffect can!econfounded!yenergy" #naddition forcolorectal cancer itmight!econfounded !ysomecharacteristicsofthemeat (Theodoratou etal" *--()"Fataaretooscarcetoreachaconclusionforovarianandendometrial cancer!utthe:31FOA#31(*--')concludedthatthereis limited!utsuggestiveevidencethatfoodscontaininganimalfatwhichareenergy)dense increasetheris> of313"SATURATE&*ATThereisnorelationship !etween313 and$FA" $FA especiallymyristic andpalmiticacidshave!een reportedtoincrease the ris>ofprostatecancer 43(5urahashietal"*--()andof43 progression ($trometal"*--()"eand!odyweightdia!etesandthemeta!olicsyndromeBN /) thecontextofthe@editerraneandietpatternmighteithercontri!utetoorconfoundtheeffect"Againsimilar o!servationsarereported in Atherelationship!e

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