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^DIETARY FAT AND HUMAN HEALTH A Report of the FOOD AND NUTRITION BOARD * National Academy of Sciences National Research Council NAS-NRC JUL 12 1966 LIBRARY Publication 1147 National Academy of Sciences National Research Council Washington, D.C. 1966
' Available from Printing and Publishing Office National Academy of Sciences 2101 Constitution Avenue Washington, D.C. 20418 Price: $1.50 Library of Congress Card Catalog Number 63-65471
FOREWORD The American public has been made widely conscious that satu- rated fat and cholesterol may have something to do with mor- tality rates from heart disease. Dietary fat has economic as well as nutritional and medical importance. Much emphasis has been placed upon the possible ill effects of excess fat per se, or of excess intake of certain types of fat. Some investigations have implicated dietary fats or faulty fat metabolism as factors in elevated concentration of cho- lesterol and other lipids in blood plasma and in the development of atherosclerosis and its complications, and have suggested that the American people should reduce their consumption of fat, particularly the proportion of saturated fat. Such changes in fat consumption alter the relative distribution of the other major food componentsâcarbohydrate and proteinâwithin the diet and can be justified only on sound evidence that the net results are likely to be beneficial to the population as a whole. Fats are valuable food substances in their own right, and are usually by-products of protein resources and, to a large extent, determine the economy of protein production. Agriculture and the fat-processing industries are looking to nutrition scientists, biochemists, and physicians for the answer to the question, "How much and what kind of fat is compatible with human health ?" Agriculture and the food industry can adapt their production to the best interests of the public if they know what those interests are. A report, The Role of Dietary Fat in Human Health, was first published in 1958 by the Food and Nutrition Board as NAS-NRC Publication 575, based on a report submitted by a Committee on Fats established in 1956. A new committee was appointed in 1961 to consider revision of Publication 575 in the light of new information on blood lipids, tissue fats, and changes in dietary patterns. The report was reprinted with minor changes in 1962 and a new revision is issued herewith. The committee comprised Drs. C. S. Davidson, Chairman, E. H. Ahrens, Jr., D. S. Fredrickson, W. S. Hartroft, R. T. Holman, C. S. Lieber,
J. F. Mead, O. N. Miller, and T. B. Van Itallie. Dr. Fred Mattson and Dr. M. K. Horwitt aided the committee. The Board is grateful for the committee's efforts in a very difficult assignment. Partial support for travel and secretarial services involved in the preparation of this publication was derived from Grant No. AM-05296 from the National Institutes of Health, U.S. Public Health Service.
CONTENTS 1 FAT IN THE NATIONAL DIET 4 CHEMISTRY OF FOOD FATS 4 Fatty Acid and Glyceride Structures 5 Fatty Acid Composition of Fats 7 Monoglycerides and Diglycerides 7 Phospholipids 8 Unsaponifiable Constituents 8 Hydrogenation 10 Cooking 11 FAT METABOLISM 11 Digestion and Absorption 12 Plasma Lipids and Their Transport 13 Free Fatty Acids 13 Lipoproteins 13 a-Lipoproteins 14 /3 - and Pre-j3-lipoproteins 15 Particles (Chylomicrons) 16 Lipid Synthesis and Utilization 16 Fatty Acids and Glycerides 17 Phospholipids 18 Fat Storage 18 Cholesterol Metabolism 20 Lipotropic Factors 21 NUTRITIONAL ROLE OF FOOD FATS 21 Energy and Storage 21 Payability of Diets 21 Nutrient Carriers 22 Essential Fatty Acids
23 ATHEROSCLEROSIS (ARTERIOSCLEROSIS) 23 The Nature of Atherosclerosis 25 Experimental Production of Atherosclerosis 26 Relation of Lipids in Normal and Atherosclerotic Arteries to Plasma Lipids 27 Plasma Triglycerides, Obesity, Diabetes, and Atherosclerosis 29 Vitamin E and Lipid Metabolism 29 Effects of Fats on Blood Coagulation and Thrombosis 30 Alcohol, Blood Lipids, and Atherosclerosis 32 PLASMA CHOLESTEROL LEVELS AS RELATED TO DIET AND HEART DISEASE 33 Effect of Dietary Cholesterol on Plasma Cholesterol Level 34 Effect of Kind of Dietary Fat on Plasma Cholesterol Level 35 Effect of Dietary Carbohydrate on Plasma Cholesterol Level 36 Pharmacological Control of Plasma Cholesterol 37 Epidemiologic and Other Population Studies of Diet, Plasma Lipids, and Heart Disease 42 SUMMATION AND RECOMMENDATIONS 44 REFERENCES
DIETARY FAT AND HUMAN HEALTH