nutritional and health attributes of palm...

Nutritional and Health Attributes of Nutritional and Health Attributes of Palm OilPalm OilPalm OilPalm Oil

Pramod Khosla, PhD

Associate Professor,Dept. of Nutrition & Food Science,

Wayne State University,Detroit, MI 48202

Cardiovasculardisease

Cancer

ExerciseFat Quality

Low calories: More fiber,

Cognitive dec Mostly unknown

Chronic Disease

Cancer

Diabetes

Hypertension

grains, vegs. More fruits

Lower sodium

Control CHO &energy intake

Osteoporosis Increased calcium

Diet and Lifestyle changesDiet and Lifestyle changes Fat quality Protein quality Fiber OIL

PALM

No smoking

Antioxidants Phytochemicals Carbohydrate type Alcohol

PALM

Maintain a healthy body weight Low to moderate intensity exercise 30-45 mins/day

Per Capita Fat Consumption Per Capita Fat Consumption -- g/dayg/day

8090

100

IRAN 67 /d

203040506070 IRAN ~67g/day

WHO recommendationWHO recommendation

010

Africa

Asia

CAmer

ica

SAmer

ica

REurope

Ocean

ia

NAmer

icaEU15

Source : FAO websiteSource : FAO website

5.0

10.0

15.0

20.0

25.0

30.0

35.033.3 33.5

16.0

9.7

23.3

7.0

16.6

millio

n to

nn

es

Soybean40%

Palm 4%

C t

Others30%

Total Area

Palm 29%

Rapeseed14%

Sunflower8%

Total Vegetable Oil Output

0.0Soybean

oilPalm oil Rapeseed

oilSunflower

oilAnimal Fats

Laurics Others

Rapeseed12%Sunflower

10%

Coconut4%

Soybean29%

Laurics6%

Others14%

3

4Tonnes/hectare/year

Soybean oil18%

Palm oilOthers

4%

Global ExportsGlobal Exports

Iran

Pakistan

N Africa

India

EU-27

China PR

Net Importers

Iran

0

1

2

SBO SunflO RapSO Palm

Palm oil52%

Rapeseed oil3%

Sunflower oil8%

Animal Fats7%

Laurics8%

4%

Others

Taiwan

Nigeria

Russia

South Korea

South Africa

Turkey

Japan

Mexico

Bangladesh

(x 1000 ton

Malaysia

Net Exporters

RISK FACTORS FOR CHD RISK FACTORS FOR CHD

Gender Increasing age

G ti F il hi t f CHD Genetics: Family history of CHD

High TC, LDL-C Low HDL-C Smoking

DIET

Fat quality Protein quality Fiber Antioxidants

h h lg

Diabetes Obesity

Phytochemicals Carbohydrate type Alcohol

Dietary fat composition: by fatty acid classesDietary fat composition: by fatty acid classes

90

100

Fatty Acid Classes ,%

PUFA

20

30

40

50

60

70

80

SFA

TFA

MUFA

PUFA

0

10

20

AAD34%en15:12:7P/S 0.4

Coco PKO MilkF CoButt Tallow Pstear Palm POlein Lard Chick Olive hiOsun Canola Soyb Corn Saff

MUFA

SFA

..we also have trans fatty acids..we also have trans fatty acids

•Unsaturated fatty acids - at least one trans double bond

•Partial hydrogenation of polyunsaturated oils - isomerization and migration of double bonds - distribution of cis and transdouble bonds (margarines shortenings salad & cooking oils)double bonds (margarines, shortenings, salad & cooking oils)

•Partial hydrogenationtFA. Full hydrogenation SFA•Major tFA - elaidic acid (t9 - 18:1)•Dairy and meats have t9 - 16:1 and t11 - 18:1 (vaccenic acid)

-0.020

0.020.04

ScMPtM

So what are the effects of fatty acids classes on lipoprotein cholesterol? So what are the effects of fatty acids classes on lipoprotein cholesterol?

0.02LDL tM

0

0.02

0.04

HDL

ScMPtM

0.04S

MUFA & PUFA best.MUFA & PUFA best.Trans worse than SFATrans worse than SFA

-0.04-0.02

00.02

TC/HDL

ScMPtM

Changes shown in Changes shown in mmolmmol/L for LDL and HDL. Adapted from /L for LDL and HDL. Adapted from MensinkMensink et al Am J et al Am J ClinClin NutrNutr(2003) 77: 1146(2003) 77: 1146--11551155

0 02

0

0.02

Effects on the TC/HDLEffects on the TC/HDL--C ratioC ratio

-0.04

-0.02

-0.02

0

CHO CHO FAFA

-0.06S cM P

-0.04S cM P tFAS cM P tFA

tFA tFA FAFAAm J Clin Nutr (2003) 77: 1146Am J Clin Nutr (2003) 77: 1146--11551155 N Engl J Med (2006) 344: 1601N Engl J Med (2006) 344: 1601--16131613

Ascherio et al, (1999 N Engl J Med 340: 1994-1998 55

TC/HDLTC/HDL--C was adversely affected by the C was adversely affected by the transtrans dietdiet

a

140

trans lowered HDLtrans lowered HDL--CC

40

60

80

100

120

10

20

f. c

ontr

ol)

trans increased TC/ HDLtrans increased TC/ HDL--C ratioC ratio

Diet

1 2 3 4 5 6 7 8 9 10 11

TransPalmitate

0

20

-20

-10

0

% t

ran

sfer

(c.

f

16:0 Trans

p = 0.03

Khosla et al, (1997)trans increased CETPtrans increased CETP

Dietary Fat intake and Risk of CHD and Type II Dietary Fat intake and Risk of CHD and Type II Diabetes (TIID) in WomenDiabetes (TIID) in Women

Effects of replacing 2%en from carbohydrates with trans fatty acidsEffects of replacing 2%en from carbohydrates with trans fatty acids

CHD data - Hu et al, (1997) N Engl J Med, 337: 1491-1499

Type II Diabetes data - Salmeron et al, (2001) Am J Clin Nutr 73: 1019-1026

Effects of replacing 5%en from carbohydrates with specific fatty acidsEffects of replacing 5%en from carbohydrates with specific fatty acids

40

50

601.6 to 2.8% en4.1 to 7.4% en12 to 18% en

Relative risk of CHD based on quintiles of dietary fatty acid intake Relative risk of CHD based on quintiles of dietary fatty acid intake (Multivariate analyses) (Multivariate analyses) 20 year follow20 year follow--up data from the Nurses Health Studyup data from the Nurses Health Study

-10

0

10

20

30

40

12345

Beneficial effects with PUFABeneficial effects with PUFA

Adverse effects with tFAAdverse effects with tFA

-30

-20

SFA MUFA PUFA tFA

from Oh et al (2005) Am J Epidemiol, 161: 672-679

SkeaffSkeaff and Miller , (2009) Ann. and Miller , (2009) Ann. NutrNutr. . MetabMetab. 55: 173. 55: 173--201201

A meta-analysis of 28 cohort studies – 6,600 CHD deaths, 280,000 participants, approx. 3.7 million person-years of follow-up. Duration of follow-up: 4 to 25 years. Most studies were from North America and Europe. Nineteen of the 28 cohorts included ponly men. The age at recruitment varied from 40 to 65 years.

When comparing low SFA intakes (7-11% total calories) to high SFA intakes (14-18% total calories), SFA intake was not associated with CHD mortality (RR – 1.14; p=0.43) or CHD events (RR – 0.93; p=0.27)

Additionally, with 5% energy increments from SFA there was no association with CHD mortality (RR – 1.11; p=0.59) or CHD events (RR – 1.03; p=0.72)

• Pooled analysis of 11 studies. 4-10 year follow-up

• Pooled RR evaluated in 344, 696 bj t (5 249 t

1.2

1.4

Replacing SFA with different fatty acids or carbohydratesReplacing SFA with different fatty acids or carbohydrates

subjects (5, 249 coronary events, 2155 coronary deaths)

• Effect of 5% lower energy intake from SFA with a simultaneous higher energy intake from PUFA, carbs or MUFA is shown for coronory 0.4

0.6

0.8

1

yevents and coronory deaths

Jakobsen et al , (2009) Am J Clin Nutr 89: 1425 - 1432

0

0.2

PUFA Carbs MUFA

• Overall , significant inverse association between substitution of PUFA and risk of coronary events and coronary deaths.

• Overall, indication of a direct association between


substitution of MUFA and risk of coronary events – but not coronary deaths

Overall, significant direct association between substitution of carbohydrates and risk of coronary events – but not coronary deaths

Using substitution models the results suggest that l i SFA ith PUFA t b h d t MUFA replacing SFA with PUFA – not carbohydrates or MUFA -

would be beneficial

• Prospective cohort study. Median 12 year follow-up

• Hazard Ratio evaluated in 53, 644 subjects [1 943 cases of

Exchanging 5% calories from SFA with Exchanging 5% calories from SFA with carbscarbs of different GI valuesof different GI values

644 subjects [1, 943 cases of incident myocardial infarction (MI)]

• For a 5% lower energy intake from SFA with a simultaneous higher energy intake from carbs with d ff ldifferent GI values

• Singificant association with high GI carbs


Predicted effects are based on changes in the TC:HDL-C ratio

Evidence from a meta analysis of eight

Effects on CHD risk of consuming PUFA, carbs , or MUFA in place of SFA

Evidence from a meta-analysis of eight randomized controlled trials

Evidence for observed relationships of usual dietary habits with CHD events comes from a pooled analysis of 11 prospective cohort studies.

MichaMicha and and MozaffarianMozaffarian, (2010) Lipids. 45: 893, (2010) Lipids. 45: 893--905905

MetaMeta--analysis of 21 prospective epidemiologic studies showed no analysis of 21 prospective epidemiologic studies showed no significant evidence for concluding SFA are associated with increased significant evidence for concluding SFA are associated with increased CHD riskCHD risk

• 5-23 year follow-up• Pooled RR evaluated in 347 747 subjects (11 006 developed CHD • Pooled RR evaluated in 347, 747 subjects (11, 006 developed CHD

or stroke)• SFA intake was not associated with

CHD (Pooled RR – 1.07; 95% CI 0.96 – 1.19, p=0.22) Stroke (Pooled RR - 0.81; 95% CI 0.62 – 1.05, p=0.11) CVD – (Pooled RR - 1.00; 95% CI 0.89 – 1.11, p=0.95)

Siri-Tarino et al , (2010 ) Am J Clin Nutr 91: 535 – 546

Dietary fats comprised of individual fatty acids Dietary fats comprised of individual fatty acids –– especially important for SFAespecially important for SFA

90

100

Fatty Acid Classes

18:2

18:3

20

30

40

50

60

70

80

16:0

18:0

C18:1 t18:1

12:0

14:0

16:1

0

10

20

AAD34%en15:12:7P/S 0.4

Coco PKO MilkF CoaBut Tallow Pstear Palm pOle Lard Chick Olive hiOsun Canola Soyb Corn Saff

10:06:0+ 8:0

10/2510/25

Effects of individual SFA on lipoprotein cholesterolEffects of individual SFA on lipoprotein cholesterol

-0.020

0.020.040.06

LMPS0.02

LDL S

0

0.020.04

0.06

HDL

LMPS 0.02

L

14:0, 16:0 no effect14:0, 16:0 no effect18:0, 12:0 beneficial18:0, 12:0 beneficial

-0.04

-0.020

TC/HDL

LMPS

Changes shown in mmol/L for LDL and HDL. Adapted from Mensink et al Am J Clin Nutr Changes shown in mmol/L for LDL and HDL. Adapted from Mensink et al Am J Clin Nutr (2003) 77: 1146(2003) 77: 1146--11551155

conservative conservative ---- based on current recommendations for SFAbased on current recommendations for SFA----can calculate the amount of palm oil in a can calculate the amount of palm oil in a prudentprudent diet that diet that satisfies various dietary guidelinessatisfies various dietary guidelines

Khosla (2006) J Agro Food Ind. 17: 21-23 Hayes and Khosla, Eur J Lipid Sci Tech (2007) 109: 453-464

Palm Palm OleinOlein and MUFAand MUFA--rich Oils exert similar effects on the ratio of rich Oils exert similar effects on the ratio of Total cholesterol to HDL cholesterol (TC/HDLTotal cholesterol to HDL cholesterol (TC/HDL--C) in human subjectsC) in human subjects

IransIrans’ Imports of Malaysian Palm Oil (’ Imports of Malaysian Palm Oil (x 1000 x 1000 tonnestonnes) )

** Jan ** Jan –– Nov 2013Nov 2013

……. ……. practical aspectspractical aspects

SFA vs tFA– not a realistic comparison

Look at specific fats/oils replacing PHVO containing tFAPHVO containing tFA

CHD risk based not just on changes in plasma lipoproteins.

Report of Mozaffarian and Clarke (2009) is of interest

Also risk assessment papers (Barraj et al 2008, Mente et al 2009)

Fatty acids in Iranian foodsFatty acids in Iranian foods

Fatty acids in fast-foods Sausage, calbas, hamburgers,

pizza

Fatty acids in edible oils PHVO, cooking oils

(unhydrogenated), frying oils Stearic acid 14% to 21% Palmitic acid 2% to 14% Trans FA ~24% to 31%

PHVO CO FOSFA 28.4 9.4 18.9TFA 35.2 0.9 2.6C-unsat 34.9 83.4 72.3

Asgary et al. (2009)Asia Pac J Clin Nutr 18 (2187-192

Elaidic acid most common tFA Elaidic acid most common tFA

Asgary et al. (2009) J Res Med Sci 14 ( 211-215

Home consumption 2001-2003 2636 kcal consumed 25% calories from fat (73g)

Reductions in CHD by replacing TFA from PHVO with Reductions in CHD by replacing TFA from PHVO with ciscis MUFA or SFAMUFA or SFA

( g) 14g/1000 kcal of PH cooking oils 37 g PH cooking oils total (12.5%

total calories) Typical tFA content of cooking

oils ~ 33% tFA consumption ~4 2% of total tFA consumption 4.2% of total

calories (~12.3 g/day at home)

MozafarriaMozafarrian et al (2007) Eur. J. n et al (2007) Eur. J. ClinClin. . NutrNutr. . 6161, 1004, 1004--10101010

Effect of Fatty Effect of Fatty A id CVDA id CVD

Fish n-3 PUFAPlant n-3 PUFAPlant n-6 PUFA

Benefit

Acids on CVD:Acids on CVD:Weight of the Weight of the

EvidenceEvidence

Plant n 6 PUFAMUFA

Saturated Fat

Refined CHO

Trans Fat -

D. Mozaffarian, MD, DrPH10/14/10

Trans Fat Industrial

Harm

Fatal CHD CHD eventsTotal Fat C-NR C-NR

TFA P CSFA/CHO P NR P NR

Skeaff and Miller , (2009) Ann. Nutr. Metab. 55: 173Skeaff and Miller , (2009) Ann. Nutr. Metab. 55: 173--201201

SFA/CHO P-NR P-NRMUFA/SFA

PUFA/SFA C CLinoleic acid

Alpha Linolenic

Dietary Fatty Acids and CHD: Summary of the EvidenceDietary Fatty Acids and CHD: Summary of the Evidence

C = Convincing evidence; P = Probable evidence; NR C = Convincing evidence; P = Probable evidence; NR –– no relation; no relation; RedRed denotes denotes increased risk while increased risk while GreenGreen denotes decreased riskdenotes decreased risk

n3 LCPUFA P C

Diet and Lifestyle changesDiet and Lifestyle changes Fat quality Protein quality Fiber OIL

PALM

No smoking

Antioxidants Phytochemicals Carbohydrate type Alcohol

PALM

Maintain a healthy body weight Low to moderate intensity exercise 30-45 mins/day

“Vitamin A” activity of red palm oil“Vitamin A” activity of red palm oilRE

Per 100 g

Relative quality

(Times <red palm oil

Phytoene 2.0%

Phytofluene 1.2%

Cis-β- Carotene 0.8%Red Palm Oil

30,000 -

Carrots 2,000 15

Leafy Vegetables

685 44

Apricots 250 120

β

β – Carotene 47.4%

α- Carotene 37.0%

Cis- α- Carotene 6.9%

ζ- Carotene 1.3%

δ - Carotene 0.6%

γ - Carotene 0.5%Tomatoes 100 300

Bananas 30 1000

Orange Juice

8 3,750

γ

Neurosporene Tr

β - Zeacarotene 0.5%

α - Zeacarotene 0.3%

Lycopene 1.5%

Numerous human studies showing efficacy Numerous human studies showing efficacy of red palm oil of red palm oil in fighting Vitamin A deficiencyin fighting Vitamin A deficiency

…studies have adopted different methods to provide Vitamin A naturally…studies have adopted different methods to provide Vitamin A naturally

Children fed traditional Indian sweets made with redPO School children fed biscuits baked with redPO School children fed biscuits baked with redPO School children given 5 – 10 mL redPO daily Cooking green leafy vegetables in redPO

Also Vitamin A status improved by feeding redPO to pregnant mothers at various stages of pregnancy.

Also lactating mothers

Numerous human studies showing efficacy of Numerous human studies showing efficacy of red palm oil red palm oil in fighting Vitamin A deficiencyin fighting Vitamin A deficiency

• Variety of carotenoids (Vitamin A)• Vitamin E (tocopherols and tocotrienols)

Nutritional attributes of PNutritional attributes of Palm Oil & Palm alm Oil & Palm OleinOlein

Oil Tocopherols(ppm) Tocotrienols(ppm) Ppmp (pp )αT βT γT δT

(pp )αT3 βT3 γT3 δT3

pT+T3

Red Palm Oil 152 - - - 205 - 439 94 890

Soyabean 101 - 593 264 985

Cornoil 112 50 602 18 782

Groundnut 130 - 216 21 367

Safflower 387 - 174 240 801

Sunflower 487 - 51 8 546

Numerous in vitro studies showing efficacy of Numerous in vitro studies showing efficacy of tocotrienolstocotrienols in inhibiting in inhibiting cancer cellcancer cell proliferation proliferation and decreasingand decreasing neurodegenerationneurodegeneration. .

A pilot human breast cancer clinical trial was A pilot human breast cancer clinical trial was not definitivenot definitivepp ff

A series of studies show efficacy A series of studies show efficacy against lung cancer against lung cancer and Phase I and Phase I human studies are the next logical stephuman studies are the next logical step

Ongoing human Ongoing human stroke prevention stroke prevention trial is recruiting subjects. An earlier trial is recruiting subjects. An earlier study from our lab helped establish the dosestudy from our lab helped establish the dose

Evidence that Evidence that tooctrienolstooctrienols may lower blood lipids may lower blood lipids –– and possible and possible synergy with synergy with statinstatin drugs has been suggested??drugs has been suggested??

Recent study in dialysis patients from Recent study in dialysis patients from our laboratoryour laboratory

SummarySummary

In Iran – even though total fat intake is within WHO parameters, trans fatty acid consumption is substantially higher .

With high imports of palm oil, Iran can eliminate trans with appropriate labeling and policy decisions

Palm Oil can serves a multitude of nutritional needs Supply of palm oil makes it the important player globallyFatty acid profile of palm eliminates need for hydrogenation Minor components (antioxidant/phytochemicals) help alleviate Minor components (antioxidant/phytochemicals) help alleviate

micronutrient deficiencies using food-based approach AND show promise for preventative route in certain chronic disease

Additional details: J. Am. Coll. Nutr. (2010), 29 (3S) 237-340

nutritional and health attributes of palm...

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