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Learning Outcomes
1. Distinguish various lipids and identify at least
Fats and Other Lipids one physiological role of each type of lipid.
2. Identify major food sources of lipids, including
trans fatty acids.
Insert photo of
fries and dip 3. Explain the process of atherosclerosis and list at
from chapter least 6 risk factors of cardiovascular disease.
opener 4. Distinguish HDL cholesterol from LDL
cholesterol.
5. Identify major dietary sources of omega-
omega -3 fatty
acids.
6. List dietary and other lifestyle actions that can
reduce the risk of cardiovascular disease.

Fats in Food Understanding Lipids

• Provide essential fatty acids (EFA) Lipids include:
• Provide concentrated food energy - Fatty acids
- Triglycerides
• Carry fat soluble vitamins
- Phospholipids
• Provide raw materials for synthesis - Cholesterol
• Stimulate appetite, provide satiety • Lipids are
– insoluble in water
– less dense than water

Fatty Acids
Fatty acids contain a hydrocarbon chain (carbon and
“Oil and hydrogen atoms) with a methyl group (CH3) at one end
and an acid group (COOH
COOH)) at the other.
Water Don’t
Mix”
• Insert bottle of oil
and vinegar from Insert Figure 6.1
page 145

Since oil is less

dense than water,
Fatty acids vary in their number of carbons:
carbons:
it floats on top. Short chain fatty acids — 2 to 4 carbons
Medium chain fatty acids — 6 to 12 carbons
Long chain fatty acids –- 14 to 24 carbons

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Dietary fatty acid

• Capric 10:0 • Arachidonic 20:4
• Lauric 12:0 • EPA 20:5
• Myristic 14:0 • DHA 22:6
• Palmitic 16:0
• Stearic 18:0
• Oleic 18:1
• Linoleic 18:2
• Alpha-linolenic 18:3

Saturation
Fatty acids also vary by saturation. Unsaturated Fatty acids
• Saturated – each carbon atom within the chain
holds 2 hydrogen atoms.
• Unsaturated – one or more carbon atoms within Insert figure 6.1
the chain lack 2 hydrogen atoms, and as a result,
the molecule has 1 or more double bonds.
bonds.

Insert figure 6.1

Essential Fatty Acids

Benefits of Essential Fatty Acids

Insert figure 6.2 • Precursors of prostaglandins

Hormone--like substances formed from
Hormone
EPA, DHA, and arachidonic acid

• Effects of prostaglandins:
– Stimulate uterine contractions
The 2 essential fatty acids are:
– Regulate blood pressure
1) Alpha
Alpha--linolenic acid 2) Linoleic acid
– Promote immune system response

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Essential fatty acids

• Human beings lost the ability to make
enzymes that catalyze the introduction • Rare in man
of double bonds as present in Alpha-LA
and linoleic acids • Children given fat free diets /
• Deficiency: dermatosis and skin patients
becomes ‘leaky’ to water
• Growth retardation
• Impaired reproduction
• Degeneration / impairment of functions
in many organs

Eicosanoids
• Arachidonic acid (20:4 n-6) and other C20,
22 PUFA are metabolised
• Ability to contract smooth muscles
• Adhesion of platelets
• Constriction / dilation of blood vessels
• Immune response and inflammatory
reactions
• Prostacyclins (inhibit platelet aggregation),
thromboxenes (stimulate platelet
aggregation), prostaglandins, leucotrines
• Balance of n6 and n3

Trans Fats
Hydrogenation
What are trans fats?
fats?
Unsaturated fats with at least 1 trans Hydrogenation::
Hydrogenation
double bond rather than the more Process that adds hydrogen atoms to liquid
vegetable oils
common cis bond
Partial hydrogenation:
hydrogenation:
– Not all double bonds are hydrogenated.
Insert figure 6.3 a from page 148 – Natural cis double bonds convert to the
unhealthy trans form.

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Trans Fats and Health

• Used in many processed foods

• High amounts of trans fats in diet
increase heart disease risk by raising
blood cholesterol levels.
• FDA requires amount of trans fat
displayed on Nutrition Facts panel.

Triglycerides Functions of Triglyceride

• Composed of 3 fatty 1. Energy: 9kcal/gram
acids attached to a
Insert figure 6.4
glycerol “backbone”
2. Main stored form of energy; stored in
• ~ 95% of lipids in the adipose cells.
body and foods is in
the form of 3. Protects the organs and insulates the
triglycerides.
body.

Approximate Percentages of Saturated Phospholipids

Insert figure 6.5
and Unsaturated Fatty Acids in  Chemically similar to a
Common Fats and Oils triglyceride, except 1 fatty
acid is replaced by a
Insert Table 6.1 compound containing
phosphorus and nitrogen
groups

Lecithin - The main

phospholipid in foods such
as egg yolks, liver, wheat
germ, peanut butter, and soy

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Hydrophobic/
Hydrophilic Emulsification
Phospholipids act as
emulsifiers,, because
emulsifiers
they have Insert Figure 6.6
hydrophobic and
hydrophilic regions. Insert figure 6.5

• Hydrophobic region
– Attracts lipids and
avoids water
• Hydrophilic region
– Attracts water and
avoids lipids

The Sterols Cholesterol

• Contain a multi-ring structure and a hydroxyl group Cholesterol: sterol containing carbon,
(-OH). hydrogen, and oxygen atoms arranged in a
complex ring-
ring-like structure
• Are derived from both plants and animals.
• Cholesterol comes from animal sources.
• Phytosterol – β sitosterol; stigmasterol,
campesterol Insert figure 6.7
• The group of sterols includes: bile acids,
testosterone, vitamin D, cortisol, etc.

Cholesterol Content of Some

Functions of Cholesterol Common Foods

The body uses cholesterol to make

various substances, including:
Insert Table 6.2
– Vitamin D
– Steroid hormones
• Estrogen
• Testosterone
– Bile

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Digesting Triglycerides Bile

In the duodenum,
pancreatic lipase Bile — made in the
digests triglycerides, liver and stored in
the gallbladder
Insert figure 6.8 forming primarily: – Bile contains bile Insert Figure 6.9
- Monoglycerides salts.
- Free fatty acids
Emulsification occurs in
the small intestine, as
fat droplets are
coated with bile salts.

Journey Into General Overview of Lipid Digestion

Circulation 1. Stomach — minor fat
digestion occurs
Insert figure 6.11
2. Liver — produces bile that
Insert figure 6.10 helps emulsify fat (bile is
stored in gallbladder)
3. Pancreas — secretes
lipase into small intestine
4. Small intestine — main
site for lipid digestion and
absorption
5. Anus — less than 5% of
undigested fat is
excreted in feces

Recycling Bile Salts

Enterohepatic
Circulation
Insert Figure 6.12 Lipoproteins
Liver: uses cholesterol to
make bile salts • Transport lipids
Gallbladder: stores
• mixture of protein and lipids
bile before release into – Pro & phospholipids are water soluble
small intestine
• packaged so water soluble cpds on outside
Small intestine: site
where bile emulsifies and insoluble cpds on inside
fat.
– like homogenized milk
Portal vein: returns bile
salts to liver
liver,, where the • LP have different forms, functions, &
compounds are effects on CVD risk
recycled

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Chylomicron Formation
Lipoproteins:
Insert figure 6.9
Transport vehicles for fat in the lymph and
blood systems.

1. Chylomicrons
2. Very Low Density Lipoprotein (VLDL)
3. Low Density Lipoprotein (LDL)
4. High Density Lipoprotein (HDL)

Fat and lipoprotein metabolism

Free FA Chylomicron: travels via
Chylomicrons
TAG
LPL the Lymphatic System
LIVER
VLDL
Hydrophilic head
CM-remnants
Cholesterol

VLDL
Intestine

VLDL LPL
HDL2
HL
IDL
LPL

HDL3
LDL Hydrophobic tail
Small dense LDL

Very Low-
Low-density Lipoproteins
Chylomicrons (CM)
High levels may
• Made in small intestine
contribute to
• Carries dietary lipids & FSV to body tissues
atherosclerosis
• Dumped into lymph (bypasses liver)
• CM shrinks as tissues pull off lipids (TG Insert Figure 6.18
VLDL primarily
mostly stored) & then…
carries
• Liver clears remnant from blood
triglycerides
• Normally, only see high blood levels after a
meal

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Low--density Lipoproteins
Low
Very Low Density LP (VLDL) LDL commonly
called “bad
bad”
• Made in Liver cholesterol
• Carries lipids to body tissues • Conveys
• Lipids are those left over from CM or cholesterol to
made by liver from xs CHO & Protein tissues Insert Figure 6.18
• High in TG • May become
• TG used for energy or stored in adipose oxidized LDL and
contribute to
atherosclerotic
plaque

High--density Lipoproteins
High
Low Density LP (LDL)
• remnant of VLDL after most TG removed HDL commonly
• very HIGH in Cholesterol
called “good
good”
cholesterol
– major component of total blood cholesterol
• not always effectively cleared by liver so other • Transports
tissues remove including artery walls Insert Figure 6.18
cholesterol away
– esp when cholesterol has been modified from tissues and
• risk of “high blood cholesterol” is from LDL, i.e., to the liver where
increases risk of CVD it can be
eliminated

Using Triglycerides for Energy

High Density LP (HDL) Adipose cell — stores a large Insert Figure 6.13
triglyceride droplet
• made by Liver & intestine & then altered
Adipose cells can break down
in blood triglycerides into fatty acid and
glycerol molecules, and release them
• carries cholesterol from tissues into blood stream.
(including arteries) & other LP to Liver Other cells remove fatty acids from
circulation and use them for energy.
• Reduces risk of CVD Liver can convert glycerol to glucose—
glucose—
another energy source.
• Ratio of LDL/HDL may be better
Triglycerides provide 9 kcal/g
predictor of CVD risk than any single LP (carbohydrate and protein provide 4
or total blood cholesterol level kcal/g)

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Understanding Nutritional
Labeling: Lipids
Cardiovascular Disease (CVD)

Lipid information required • Diseases of the heart and blood vessels

on Nutrition Facts panel:
- Total kilocalories from fat – Heart disease (“coronary artery disease”)
- Total fat (g) – Stroke
- Saturated fat (g) Insert Fig. 6.14
- Trans fat (g)
- Cholesterol (mg)

Panel may include:

- Polyunsaturated (g)
- Monounsaturated (g)

From Atherosclerosis to Embolus Formation

Cardiovascular Disease A thrombus that breaks away and travels through
Atherosclerosis — disease in the blood is an embolus
embolus..
which lipid-containing plaques • If an embolus lodges in the heart, it can cause a
build up inside artery walls.
Insert figure 6.15 heart attack (myocardial infarction)
infarction).
Plaque forms in arteries when • If an embolus lodges in the brain and deprives brain cells
something irritates artery walls.
of oxygen and nutrients, a stroke can result
result..
• Plaque narrows arteries,
interfering with circulation.
• Plaque may also result in the
formation of a fixed clot— a
thrombus.

Arteriosclerosis and Hypertension Cardiovascular Disease: Major Risk Factors

Arteriosclerosis
- Condition that results from atherosclerosis
- Characterized by loss of arterial flexibility Insert Table 6.3
- Commonly referred to as “hardening of the
arteries”
- Contributes to hypertension
Hypertension
- Chronic condition characterized by abnormally high
blood pressure levels
- May cause hardened arteries to tear or burst

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Roles of HDL, LDL, and Oxidized LDL

Modifiable Risk Factors

Hypertension*
Hypertension*
Insert figure 6. 19
Diabetes**
Diabetes
Excess body fat*
fat*
Elevated blood cholesterol (LDL)*
(LDL)*
Physical inactivity

*Influenced by diet

Assessing Your Risk of

Atherosclerosis
Levels of LP & CVD Risk
Lipid Profile
Blood test that determines total • HDL > 60mg/dl = Low risk
cholesterol, HDL and LDL cholesterol, and
triglyceride levels • HDL < 35 mg/dl = High risk
• LDL/HDL ratio < 4 = Low risk
Desirable levels:
Total Cholesterol < 200 mg/dl
LDL Cholesterol < 100 mg/dl • men’s HDL run from high 30’s to high
HDL Cholesterol > 40 mg/dl 40’s
Triglycerides < 150 mg/dl
• women’s from low 50’s to low 60’s
(estrogen effect)

C-reactive Protein Dietary Recommendations to

Reduce Risk of CVD
• High
High--sensitivity C-
C-reactive protein
(hs
hs--CRP
CRP)
 Limit
Limit:
- Protein produced primarily by liver in - saturated fats to <7% of kcal
response to infection and - trans fats to <1% of kcal
- polyunsaturated fats to ~10% of kcal
inflammation
- total fat to 35% or less of total energy
intake
- Marker for CVD and hypertension
(“Marker” = early physiological warning  Choose unsaturated fats to replace
sign that can be measured) saturated and trans fats.
 Include omega
omega--3 rich fish twice a week.

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Dietary Recommendations to Rich Food Sources of Omega-

Omega-3 Fatty Acids
Reduce Risk of CVD (continued)

 Include fiber
fiber--rich foods, especially
sources of soluble fiber.
Insert Table 6.5
 For people who consume
alcohol, limit to 1-2 drinks/day.

Ways to Lower Your Risk of CVD Genetic Factors

Homocysteine
- Amino acid associated with risk of CVD
- Vitamin B-6 and folate are needed to
metabolize homocysteine.
- Some people have a genetic predisposition
Insert Table 6.6 for high homocysteine levels.

High--fat Diet and CVD

High
- Scientists have identified gene that increases
risk of CVD, particularly when people with
the gene consume high-fat diets.

Should You Avoid Eggs? Benefits from n-3 PUFA

• Eating an egg/day does not increase coronary artery disease
or stroke risk.
• Inuit people in Alaska & Greenland – less CHD
 Is It Safe to Eat Butter? • EPA & DHA
Common Questions
• “Stick” margarine About
may be more harmful to health,Fats
because it
• Lower blood cholesterol
contains cholesterol-raising trans fat. Liquid or soft margarines
may be less harmful. • Reduce TAG
• Prevents blood clots
 Will Weight Loss and Exercise Help? • Lower blood pressure, especially in people with
• Achieving a healthy body weight often reduces CVD risk. hypertension & atherosclerosis
Excess abdominal fat is associated with elevated LDL levels.
• Japanese – lower CVD and cancer; but now
increasing

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Cancer & fat

• Less conclusive
Fat & Obesity
• Animal studies:
• Energy dense
– Not initiate cancer development but promote
cancer • High fat eaters – tend to store more fat
– PUFA promote cancer than SFA …through • Independent of total energy!
prostaglandins (derived from Arachidonic acid)
– n-3 PUFA reduce growth, size and number of • Don’t overdo fat restriction
tumors
• Epidemiological studies
– Evidence of specific cancers and SFA/animal fats

• Select lean meats and non-fat milks

Fat: Recommended intakes
• Eat plenty of vegetables, fruits and grains
• 30% or less of your daily calories from total • Use fats and oils sparingly
fat. • Look for invisible fats
• Diets low in saturated (less than 10% of • Read the food label.
calories) and trans-fats.
• Reduce cholesterol intake (<300mg/day)
• Consume foods rich in Omega-3 and
Omega-6 fatty-acids 2 times per week.
• n-3 : n-6 = 1:4

Food Selection and Preparation Fat Replacers

Strategies to reduce dietary fat include
include: Synthetic fat replacers developed to
 Reduce intake of fried foods. meet consumer requests for lower fat
 Purchase lean cuts of meat and trim visible foods
fat.
 Replace some fatty foods with reduced-
reduced -fat or
Oatrim
fat--free alternatives.
fat Simplesse
Choose low-low-fat snack foods. Olestra

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What If Lifestyle Changes Don’t Work?

People who cannot lower blood cholesterol

levels after lifestyle modifications may
need prescription drugs such as:
Statins — class of medications that
interfere with liver’s metabolism of
cholesterol
Zetia©” — inhibits intestinal absorption
“Zetia
of cholesterol

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