Ce diaporama a bien été signalé.
Nous utilisons votre profil LinkedIn et vos données d’activité pour vous proposer des publicités personnalisées et pertinentes. Vous pouvez changer vos préférences de publicités à tout moment.
Albert J. Dijkstra
Specialist in edible oil processing
PALM OIL, FATTY ACIDS AND
TRIGLYCERIDES AND THEIR
COMPOSITION
Crude palm oil production
(Courtesy I. Debruyne)
Production vegetable oil (m tonnes)
Seven oil seeds 2008/09 2009/10 2010/11 2011/12
total 396.7 444.1 455.7 441.4
Soya bea...
Vegetable oils compared with other products
(in million tonnes in 2012)
Vegetable oils 160
Olive oil 3
Wheat 675
Rice 672
...
Why has palm oil production grown so much?
1. Growth of world population
2. Growth of per capita consumption of oils and
f...
Relation of other oils to palm oil
• Oils can be by-product, main product, or sole product
– By-products arise:
• when mea...
Market considerations (simplified)
• The feed industry (chickens, pigs) determines demand for
meal and determines soya bea...
Technical and historical considerations
• Originally, people used animal fats, olive oil, and butter
• Shortage of butter ...
R2
H
R1
H
H
R2
R1
H
cis trans
• Groups of atoms attached to carbon atoms forming a
single bond can rotate freely
• There i...
• Edible oils and fats are triacylglycerols
• The systematic name of the above molecule is: 1-hexadecanoyl-2-
(9Z,12Z-octa...
• For nearly all naturally occurring fatty acids holds:
– Straight chains with
– even number of carbon atoms;
– Unsaturati...
• Produced during industrial partial hydrogenation
– Elaidic acid (9t-18:1) 9E-octadecenoic acid
• Produced by ruminants d...
Nomenclature of fatty acids
Systematic name Trivial name Notation
Octanoic Caprylic (palm kernel) 8:0
Decanoic Capric (pal...
Fatty acid composition of various oils
oil 8:0 10:0 12:0 14:0 16:0 18:0 18:1 18:2 18:3 22:1
coconut oil 9.0 6.8 46.6 18.0 ...
Composition and properties of crude palm oil
COMPOSITION
• Glycerides 94%
• Of which diglycerides 5-8%
• Free Fatty Acids ...
Fractionation =
partial crystallization + filtration
Palm oil
Palm stearin Palm olein
Palm mid fraction Palm superolein
Triglyceride composition of
palm oil and fractions (in %)
Palm oil Palm stearin Palm olein Superolein
SSS 6.7 (5.2-8.8) 29...
Triglyceride Palm oil Stearin Olein Superolein
LLL 0.5 0.2 0.5 0.7
PLL/MOL 2.1 0.8 2.3 3.2
MLP/MOM 0.3 0.1 0.4 0.5
OOL 1.9...
• Food uses
– Palm oil itself for cooking and frying
– Palm olein for salad dressings, cooking and frying
– Palm stearin a...
25 June 2014
Palm Oil and Health
Brussels
21
DIXI
(I have spoken)
THANK YOU
Jean Graille
Consultant for Lipid technology
FOOD USE OF PALM OIL
PRODUCTION
(Million tons)
CIF US$/T
May 2012
YIELDS kg/ha
2011/2012 2012 2012
PALM 51.58 1075 3589
SOYA 41.70 1278 367
RAP...
Fatty acids composition
* Soft refined red oils
Minor
Biomolecules
(ppm)
PO Elaeis
Guineensis
Refined
PO
Elaeis
oleifera
Hybrid (H)* Stearin
(H)*
...
Plastoquinones
Exceptional properties of palm oil
Palm oil and its fractions elegantly solve the problem of
trans isomers and positional ...
GEOMETRICAL
ISOMERISATION
POSITIONAL
ISOMERISATION
CH3 CH
10
COORCH
9
R
C
H
C
R'
H
R
C
H
C
H
R'
CIS
TRANS
Deep frying of chips
History
According to the wish of Napoleon III to develop
a very cheap butter equivalent for working class
and navy, Mége M...
PO
PS POL
MF (Soft) Super olein
Medium F
CBE
MOI.iode = 34
II = 49
Palm oil fractionation
Refining reduces the bioactive
compounds content such as
carotenes, tocopherols and
tocotrienols.
It would be advisable to...
Situation today
The image of palm oil is tarnished for the
consumer.
Up to date scientists and producers' associations
mus...
Conclusion
The controversy over saturated fatty acids
observed particularly in France, in Europe and
on the American Conti...
the phenomenon affects university teachers
supposed to teach the biochemical and biological
mechanisms known for over 50 y...
The debate is also fed with politico-economic
reasons
like various protectionist manipulations based on
erroneous stereoty...
This intellectual disorder leads to a simplistic
perception of lipids by referring only to their
overall fatty acid compos...
No oil is perfect and palm oil is no exception.
They all have their advantages and
disadvantages; this is the reason why f...
A 60% fat spread, composed of a blend of
rapeseed, sunflower and palm is one of the
most elaborate example. It is therefor...
THANK YOU
Guy-André Pelouze MD
Thoracic and cardiovascular surgeon and IRC founder
CARDIOVASCULAR DISEASES,
ATHEROMA, SATURATED FATS...
CARDIOVASCULAR DISEASES (CVD)
What are we speaking about?
CVD =mainly CHD and Stroke
Global Atlas on Cardiovascular Diseases Prevention and Control
CVD are chronic diseases which are
underestimated
Global Atlas on Cardiovascular Diseases Prevention and Control
ATHEROMA, ATHEROSCLEROSIS,
ARTERIOSCLEROSIS
What is the present theoretical framework of atheroma?
The criterion of the sc...
From diet to CHD: multiple environmental factors
and a complex genomics
Atheromatous plaque is an inflammatory lesion
Inflammation leads to plaque growth
Plaque rupture leads to emboli and thrombosis
Symptomatic carotid atheroma: endarterectomy
for stroke prevention
Inflammation and risk of CHD
The American Journal of Cardiology (www.AJConline.org) Vol 97 (2A) January 16, 2006
SATURATED FATS
Sat fats culprit? Is it evidence based?
Risk ratios and 95% CIs for fully adjusted random-effects models examining associations
between saturated fat intake in re...
PALM OIL
Is palm oil atherogenous?
Does substitution lead to lower atherogenicity?
PALM OIL
1. Is palm oil a culprit is CVD?
HRs and 95%s of CVD risk according to quintiles of energy-adjusted SF from different
sources (n = 5209).
de Oliveira Otto ...
Fatty acid profiles for dairy and meat products.
de Oliveira Otto M C et al. Am J Clin Nutr 2012;96:397-404
©2012 by Ameri...
PALM OIL
2. What happens when palm oil is substituted ?
Substitution by trans fatty acids: high
atherogenicity
Partially hydrogenated oils and lipid markers
Industrial Trans Fatty Acids are atherogenic:
high level of evidence
Substitution by oils with a high content in
linoleic acid (W6)
Fig 3 Updated meta-analysis of effects of LA selective interventions and mixed n-3/n-6 PUFA
interventions on risk of death...
Substitution by carbs (1)
Mean (±SEM) effects of variation in dietary carbohydrate and saturated fat on LDL
subclasses.
Siri-Tarino P W et al. Am J ...
Substitution of sat fats by PUFA, Carbs, Olive oil
Conclusion (1)
Obesity is not only a matter of calorie
Fat consumption decreased and obesity increased
Macronutrients 1971-2000, USA
men
Macronutrients 1971-2000, USA
women
Since 2000 no change in calorie intake or
macronutrients but sedentarity still progressed
Macronutrients in USA 1999-
2000...
The framework of CVD
Canadian Journal of Cardiology 28 (2012) 642–652
Smoking, Sedentarity, central obesity are the main
present determinants of Atheroma
Canadian Journal of Cardiology 28 (201...
Conclusion (2)
• Palm Oil is about 8-10% of sat fat intake of French people (85% are
animal fat)
• Palm Oil consumption is...
Trends in CVD mortality in EU
Global Atlas on Cardiovascular Diseases Prevention and Control
Smoking
TV advertising
Global Atlas on Cardiovascular Diseases Prevention and Control
Conclusion (3)
• Tax on fat were abandoned in Europe because
of inefficiency
• Prevention is difficult because it needs
ed...
Conceptual framework for population-wide cardiovascular risk behaviors change: the optimal
health behaviors and factors, c...
The 6S rule for CVD prevention
both primary and secondary
• Quit Smoking
• Quit Sitting
• Quit Sugar
• Check your Scale
• ...
THANK YOU
Furio Brighenti a
Elena Fattore b
a Department of Food Sciences, University of Parma, Italy
b Department of Environmental ...
Disagreement between scientific findings on
hypercholesterolemic effects of palm oil
Disagreement about an “universal” pot...
Sys. Review/
meta-analysis RCTs
Rand. Contr. Trials (RCT)
Sys. review/meta-analysis NRCTs
Non-randomized, controlled trial...
Search on three databases:
1. PubMed
2. Embase
3. Cochrane Library
Key words:
“palm oil”; “palmitic acid”;
“cardiovascular...
Flowchart of studies selection for the meta-analysis
Records identified through PubMed,
Embase and Cochrane Library
search...
Characteristics of the 49 Trials (51 studies) included:
 1526 volunteers (1007 men and 519 women), age 16-70 years
 16 i...
Results II
PO vs MUFA
PO vs PUFA
Biomarker N. studies
WMD
(95% CI)a
Heterogeneity
p-value
I2 (%)
TC (mg/dl) 21 13.77 (8.85...
Results III
Biomarker N. studies
WMD
(95% CI)a
Heterogeneit
y
p-value
I2 (%)
TC (mg/dl) 8 14.15 (4.11,24.19) 0.02 57.72
LD...
Results IV
PO vs. TRANS
Biomarker N. studies
WMD
(95% CI)a
Heterogeneity
p-value
I2 (%)
TC (mg/dl) 11 3.52 (-3.54,10.58) 0...
Results V
Effect modifications for TC and LDL-C in:
elderly population
mild/hypercholesterolemic vs. normocholesterolemi...
Significantly stronger effects in elderly populations
TC/MUFA
LDL-C/MUFA
TC/PUFA
LDL-C/PUFA
Young
Mixed
Elderly
Young
Mixe...
Significantly stronger effect in fat-rich diets
TC/MUFA
LDL-C/MUFA
TC/PUFA
LDL-C/PUFA
Less than 35%
35% or more
Less than ...
Conclusions
• PO differentially modified different cholesterol fractions (either “favorable” or
unfavorable” in terms of c...
THANK YOU
Dr. Aseem Malhotra
Cardiologist
Science Director- Action On Sugar
Academy Of Medical Royal Colleges Obesity Steering
Group...
Scale of The Problem/ Why Does it Matter?
• 60% of the adult UK population are either overweight or obese
• 1 in 3 childre...
The Obesogenic
Environment
Processed, energy dense foods are EVERYWHERE!!
A quarter-pound cheeseburger, large
fries & a 500 ml soda provide:
 1,200 calories
 50 g fat
 95 mg cholesterol
 3 g s...
Snack Foods Are
Everywhere
• Car washes
• Book stores
• Hardware stores
• Gas stations
• Office buildings (vending machine...
Toxic Hospital Food Environment
• Branding opportunity for the junk food industry ( thousands
of visitors per week)
• Legi...
Obesity Is Rooted In The Food Environment
• “Food choices are often automatic and made without full conscious awareness”
T...
Food Industry Strategy That Hinders Progress for Public
Health- The Corporate Playbook Of Big Food
• Focus on personal res...
The Corporate Playbook Of Big Food
• Emphasise physical activity over diet
• Little change in exercise levels in the past ...
WHO Cardiovascular Disease -Key Facts
• CVDs are the number one cause of death globally: more people die annually from
CVD...
Rapid Mortality Falls After Risk Factor Changes In
Populations
• The underlying pathological process preceding most corona...
Rapid Mortality Falls Cont…
• Helena, Montana, USA- Smoke free legislation in 2002 led to 40% reduction in
hospital admiss...
Rapid Mortality Falls Cont…
CVD Prevention Policies
- are evidence-based
- are effective
“Upstream”  “Downstream”
determinants causes
Food  Salt  Blood Pressure ↑
Food  Trans Fat  Dyslipidaemia
www.nice.org...
www.nice.org.uk/guidance/PH25
SALT POLICIES WORK average consumption
UK FSA voluntary policies: 9.5  8.1 g/day
FINLAND RE...
IF UK salt consumption: 8.6  5.6 g/day
14,000-20 000 CVD deaths/year
130 000 QALYs gain
£350 million / year savings
BMJ...
Industrial trans fats
50% hidden in muffins, cakes, biscuits,
cookies & wafers
25% hidden in fast food, popcorn
Industrial Trans Fat POLICIES WORK
average consumption
UK FSA voluntary policy 2%  1% energy
DENMARK REGULATIONS 4%  0% ...
IF UK transfat consumption: 1%  0% /day
Eliminating industrial trans fats in UK
Prevent  5,000 deaths/year
Savings £230 ...
PREDIMED RCT: Primary prevention of CVD with a
Mediterranean diet. Estruch et al NEJM 2013
• Mediterranean diet supplement...
1
portion
 1
portion
1%
energy
2g
/day
 1
portion
 10%
energy
 3%
energy
 1
portion
Results
• 7447 persons enrolle...
1
portion
 1
portion
1%
energy
2g
/day
 1
portion
 10%
energy
 3%
energy
 1
portion
PREDIMED RCT: Primary preventi...
Mozaffarian & Capewell BMJ 2011 343 d5747
-90,000
-70,000
-50,000
-30,000
-10,000
Feasible changes
1
portion
 1
portion
...
Tom Frieden’s health impact pyramid
J A. Monroe AJPM 2011 41 (4) Suppl 3 S155 http://dx.doi.org/10.1016/j.amepre.2011.06.0...
“Downstream” preventive activities targeting individuals
(eg 1:1 personal advice, health education, “nudge” or statins)
co...
Time For Action On Sugar?
• Intrinsic sugars present in food not an issue, glucose is
necessary for life.
• The body doesn...
Elliot et al. Am J Clin Nutr, 2002
Bray et al. Am J Clin Nutr, 2004
Teff et al. J Clin Endocrinol Metab, 2004
Gaby, Alt Me...
Obese (30%)
Normal weight (70%)
240 million adults in U.S.
72 million
168 million
“Exclusive” view of obesity
and metaboli...
Obese (30%)
Obese and sick
(80% of 30%)
Normal weight (70%)
240 million adults in U.S.
72 million
168 million
Total: 57 mi...
Obese (30%)
Normal weight (70%)
240 million adults in U.S.
Normal weight,
Metabolic dysfunction
(40% of 70%)
Obese and sic...
“Beating obesity will take action by all of us, based on one simple
common sense fact: All calories count, no matter where...
The Science
• Some Calories Cause Disease More than Others
• Different Calories are Metabolized Differently
• A Calorie is...
Are All Calories The Same?
"It's extremely naive of the public and the medical profession to
imagine that a calorie of bre...
SSB’s and BMI-adjusted risk of diabetes in
EPIC-Interact (Europe)
Romaguera-Bosch et al. Diabetologia 56:1520, 2013
An international econometric analysis of
diet and diabetes
Only changes in sugar availability predicted changes in diabete...
Sugar Nutritional Labelling Guidelines
• WHO 2003- Added sugar No more than 10% of energy- Intrinsic sugars
10% (whole fru...
Recommends reduction in sugar intake from 22 tsp/day
to 9 tsp/day (males) and 6 tsp/day (females)
Circulation 120:1011, 20...
Action On Sugar- Aims
• To achieve a reduction in refined added sugar intake in the UK and ensure it does not
contribute t...
eg. clean water, sanitation, pollution, immunization, seatbelts, smoke free…
SUPPORT: Implementation path
for effective pu...
“ Faced with the choice between changing one’s mind
and proving that there’s no need to do so, almost
everyone gets busy o...
Christophe Didion
Health and Consumers Directorate General
European Commission
REGULATION (EU) NO 1169/2011
ON FOOD INFORM...
Health and
Consumers
Health and
Consumers
Regulation (EU) No 1169/2011
on food information to consumers
Christophe Didion
...
Health and
Consumers
Compulsory information
• in all cases:
• Name of the food
• Ingredient list
• Allergens
• QUID (quant...
Health and
Consumers
Compulsory information
• in all cases:
• Minimum durability/”use by” date
• Name or business name and...
Health and
Consumers
Mandatory particulars
accompanying the name of the food
• 'Defrosted'
• For meat products/preparation...
Health and
Consumers
Other mandatory particulars
• 'Packaged in a protective atmosphere'
• 'High caffeine content'
• 'With...
Health and
Consumers
Other mandatory particulars
• For oils and fats
• 'fully hydrogenated', 'partly hydrogenated'
• origin
Health and
Consumers
Health and
Consumers
Other mandatory particulars
Health and
Consumers
Improved legibility of labels
 Minimum font size of 1.2mm “x”-height ( ) and
of 0.9 mm “x”-height fo...
Health and
Consumers
Origin
• Basic principle - origin labelling remains voluntary
unless its omission could mislead the c...
Health and
Consumers
Partial move to extension of
mandatory origin labelling
• Mandatory origin labelling for:
• Meat (pig...
Health and
Consumers
Mandatory nutrition declaration
• energy (kilojoules and kilocalories)
• fat
• saturates
• carbohydra...
Health and
Consumers
Report on trans fat
• Levels of Trans fat in foods
• Trans fat intakes
• Impact of appropriate means ...
Health and
Consumers
Front-of-pack nutrition declaration
• Voluntary front-of-pack labelling for
• energy alone OR
• energ...
Health and
Consumers
Application of the new rules
13 December 2014
13 December 2016 for mandatory nutrition labelling
Health and
Consumers
Anne Bourdu
Lawyer and Member of the SYNNOV
« PALM OIL FREE » :
FROM CONSUMER INFORMATION
TO DISPARAGEMENT
• Palm oil undergoes a smear campaign, especially by
powerful NGOs, while a serious debate about its
nutritional qualities...
• The EU Regulation n°1169/2011 of 25 October 2011
reinforces the information and protection of consumers by
imposing esse...
Article 18 : List of ingredients
“Ingredients shall be designated by their specific name.”
Annex VII : Indication and Desi...
• Food producers, facing the psychosis of “junk food” and
by commercial interest, are seeking to join the “palm oil
free” ...
Article L121-1 of the French consumer code describes the following
as deceptive trading practices:
• creating confusion wi...
Example:
A company, by combining the term “label” with the
mention “Quality Charter” and the mention “checked by an
indepe...
• The mention “palm oil free” implies that such products own
qualities and properties better than those containing palm oi...
• The commercial Court of Paris (2012.12.04), requested by an
association of Ivorian palm oil producers, held that the
com...
This judgement complies with the case law of the French
Supreme Court (2007.01.30) that sanctioned an advertising
for a su...
Misleading advertising may lead to draw customers away
from a competing undertaking. Then, misleading
advertising may cons...
THANK YOU
QUESTIONS
THANK YOU
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Palm Oil and Health - European Symposium June 25, 2014
Prochain SlideShare
Chargement dans…5
×

Palm Oil and Health - European Symposium June 25, 2014

2 909 vues

Publié le

The European Symposium brought together scientists and legal experts to leverage the debate on palm oil and health. During the conference, three major questions were asked: “Does palm oil pose risks to human health?”, "What are the alternatives?” and “How to inform consumers?”.

  • Soyez le premier à commenter

Palm Oil and Health - European Symposium June 25, 2014

  1. 1. Albert J. Dijkstra Specialist in edible oil processing PALM OIL, FATTY ACIDS AND TRIGLYCERIDES AND THEIR COMPOSITION
  2. 2. Crude palm oil production (Courtesy I. Debruyne)
  3. 3. Production vegetable oil (m tonnes) Seven oil seeds 2008/09 2009/10 2010/11 2011/12 total 396.7 444.1 455.7 441.4 Soya bean 211.6 260.2 263.6 238.7 Other 185.1 183.9 192.1 202.7 Nine plant oils Total 133.4 140.8 147.8 155.7 Palm oil 44.0 45.9 47.9 50.7 Soya bean oil 35.9 38.8 41.3 42.4 Rapeseed oil 20.6 22.5 23.7 24.3 Sunflower seed oil 11.9 12.1 12.3 15.3 Lauric oils 8.7 9.1 9.4 9.5 Other (CS,GN,OO) 12.3 13.3 13.2 13.5
  4. 4. Vegetable oils compared with other products (in million tonnes in 2012) Vegetable oils 160 Olive oil 3 Wheat 675 Rice 672 Corn 868 Sugar 165 Milk 620 Mineral oil 3 735
  5. 5. Why has palm oil production grown so much? 1. Growth of world population 2. Growth of per capita consumption of oils and fats 1. With growing affluence, food oil consumption increases 2. Consumption of oleochemical products like detergents increases 3. Growth of outlets for oil (e.g. biodiesel) exceeds growth of outlets for by-products 4. Palm oil provides solid fat without trans isomers 5. Palm oil is the cheapest oil to produce
  6. 6. Relation of other oils to palm oil • Oils can be by-product, main product, or sole product – By-products arise: • when meal is main product (soya bean meal, fish meal) • during meat packing (lard and tallow) • when growing cotton (cottonseed oil) – Oil is main product when by-products have low value • Sunflower seed and rapeseed (Canola) are grown for the oil but also lead to meal production – Oil is sole product when there are no by-products or by- products are toxic and can only be used as fertiliser • Fruit oils have no by-products (olive oil, palm oil) • Meal of castor oil and Jatropha curcas cannot be used in feed
  7. 7. Market considerations (simplified) • The feed industry (chickens, pigs) determines demand for meal and determines soya bean production – and thus soya bean oil availability • The oil users (food, feed, biodiesel and oleo-chemicals) determine the total demand for oil • Total oil demand minus existing oil availability (soya bean oil, sunflower seed oil, Canola,animal fats etc) determines how much additional oil has to be produced • This additional oil is provided by palm oil since it has no by- products – (except palm kernel oil, 10% of palm oil production) • So when oil demand outpaces meal demand, this means a growing demand for palm oil
  8. 8. Technical and historical considerations • Originally, people used animal fats, olive oil, and butter • Shortage of butter lead to invention of margarine (Mège Mouriès, 1869) – Used beef tallow as fat to provide consistency • Shortage of beef tallow led to invention of partial hydrogenation of liquid oils (Normann, 1903) – This process converts liquid oils into solid fats – Also allowed use of fish oil and whale oil in hardstocks – Introduced trans-isomers into the hardstock • Now solid fats for margarine and shortenings can be obtained from palm oil and its fractions – Palm oil and its fractions provide a hardstock without trans-isomers – The raw materials often require modification by processes like fractionation and interesterification
  9. 9. R2 H R1 H H R2 R1 H cis trans • Groups of atoms attached to carbon atoms forming a single bond can rotate freely • There is no rotation possible when they are attached to carbon atoms that are connected by a double bond • Therefore the cis- and trans-isomers have different shapes • They provide the fatty acids and their compounds like oils and fats with different physical properties What are trans-isomers? Geometry of double bonds
  10. 10. • Edible oils and fats are triacylglycerols • The systematic name of the above molecule is: 1-hexadecanoyl-2- (9Z,12Z-octadecadienoyl)-3-(9Z-octadecenoyl)-sn-glycerol • Trivial name: 1-palmitoyl-2-linoleyl-3-oleyl-glycerol • Shorthand: PLO • Cis-double bonds cause a kink in the carbon chain as illustrated on the right for oleic acid. • The linoleic acid on the left is even more bent. O H2 C C H2 C O O O H O O What is the chemical structure of edible oils and fats?
  11. 11. • For nearly all naturally occurring fatty acids holds: – Straight chains with – even number of carbon atoms; – Unsaturation has cis configuration – Methylene interruption in polyunsaturated fatty acids – Elongation at carboxyl end so position of double bond does not shift with respect to methyl end (ω-6 remains ω-6) C O O H 912 118 linoleic acid (9c12c-18:2) (9Z,12Z)-Octadeca-9,12-dienoic acid Structure of fatty acids
  12. 12. • Produced during industrial partial hydrogenation – Elaidic acid (9t-18:1) 9E-octadecenoic acid • Produced by ruminants during biohydrogenation – Vaccenic acid (11t-18:1) 11-octadecenoic acid – Rumenic acid (9c11t-18:2) 9Z,11E-octadeca-9.11-dienoic acid – Other CLA-isomer (10t12c-18:2) – Vaccelenic acid (11t15c-18:2) – Rumelenic acid (9c11t15c-18:3) – Iso-rumelenic acid (9c13t15c-18:3) • This list is not complete since more isomers are formed during both hydrogenation processes by positional and geometrical isomerisation Fatty acids with trans double bonds
  13. 13. Nomenclature of fatty acids Systematic name Trivial name Notation Octanoic Caprylic (palm kernel) 8:0 Decanoic Capric (palm kernel,coconut) 10:0 Dodecanoic Lauric (palm kernel, coconut) 12:0 Tetradecanoic Myristic (palm kernel,coconut) 14:0 Hexadecanoic Palmitic (palm) 16:0 Octadecanoic Stearic (tallow) 18:0 9-cis-octadecenoic acid Oleic (olive, palm, canola) 18:1ω9 9-trans-octadecenoic acid Elaidic (hydrogenation) 18:1ω9 9c-12c-octadecadienoic Linoleic (sunflower, soya) 18:2ω6 6c-9c-12c-octadecatrienoic γ-Llinolenic (evening primrose) 18:3ω6 5c-8c-11c-14c-eicosatetraenoic Arachidonic (meat) 20:4ω6 9c-12c-15c-octadecatrienoic α-Linolenic9 (soya, canola) 18:3ω3 6c-9c-12c-15c-octadecatetraenoic Stearidonic (GMO soya) 18:4ω3 5c-8c-11c-14c-17c-eicosapentaenoic EPA (fish oil) 20:5ω3 4c-7c-10c-13c-16c-19c-docosahexaenoic DHA (fish oil) 22:6ω3
  14. 14. Fatty acid composition of various oils oil 8:0 10:0 12:0 14:0 16:0 18:0 18:1 18:2 18:3 22:1 coconut oil 9.0 6.8 46.6 18.0 9.0 1.0 7.6 1.6 palm kernel oil 2.7 6.0 46.9 14.1 8.8 1.3 18.5 0.7 palm oil 0.2 1.1 44.1 4.4 39.0 10.6 0.3 palm superolein 0.3 1.0 35.4 3.8 45.1 13.4 0.3 palm stearin 0.1 1.1 49.3 4.9 34.5 9.0 0.2 cocoa butter 26.2 34.4 37.3 2.1 olive oil 12.6 2.9 74.6 8.4 0.7 soya bean oil 11.0 4.0 23.4 53.2 7.8 rapeseed oil 3.6 1.6 32.9 17.5 9.0 42.4 canola oil 4.8 2.4 58.1 20.8 10.2 sunflower seed oil 6.4 4.7 21.0 67.7 linseed oil 6.0 2.5 19.0 24.1 47.4 N.B. Totals ≤ 100% because minor fatty acids have not been listed
  15. 15. Composition and properties of crude palm oil COMPOSITION • Glycerides 94% • Of which diglycerides 5-8% • Free Fatty Acids 3-5% • Unsaponifiable 1% – Carotenoids (ppm) 500-700 – Tocols 600-1000 – Phytosterols 300-500 – Squalenes 200-500 PROPERTIES • Iodine value 51-53 • Saponification value 198-200 • Melting point 35-37°C • Fatty acid composition – 14:0 1.0-1.4 – 16:0 43-45 – 18:0 4.0-4.6 – 18:1 37-41 – 18:2 9.6-10.6 – 18:3 < 0.5
  16. 16. Fractionation = partial crystallization + filtration Palm oil Palm stearin Palm olein Palm mid fraction Palm superolein
  17. 17. Triglyceride composition of palm oil and fractions (in %) Palm oil Palm stearin Palm olein Superolein SSS 6.7 (5.2-8.8) 29.9 - - SSU 45.9 (43.3-49.1) 47.8 45.6 32.4 SUU 40.4 (38.6-43.5) 19.4 46.4 57.8 UUU 7.0 (5.8-7.7) 2.9 8.0 9.8 (S. Braipson-Danthine & V. Gibon, Eur.J. Lipid Sci. Technol. 109 (2007) 359-372)
  18. 18. Triglyceride Palm oil Stearin Olein Superolein LLL 0.5 0.2 0.5 0.7 PLL/MOL 2.1 0.8 2.3 3.2 MLP/MOM 0.3 0.1 0.4 0.5 OOL 1.9 0.9 2.2 2.6 POL/SLL 10.3 5.2 11.7 14.3 PLP/MOP 9.4 7.8 9.9 10.0 MPP 0.4 1.8 OOO 4.6 2.1 5.3 6.5 POO 25.0 12.8 31.1 36.0 POP/PLS 30.0 32.2 30.0 18.4 PPP 5.3 23.9 SOO 3.0 1.2 3.3 1.5 POS 5.9 5.4 5.5 3.5 PPS 1.0 4.8 SOS 0.4 0.3 0.4
  19. 19. • Food uses – Palm oil itself for cooking and frying – Palm olein for salad dressings, cooking and frying – Palm stearin as interesterification component for hardstock for margarines and shortenings – Palm mid fraction for confectionery fats • Oleochemical uses – Fatty alcohols, fatty amines – Greases and lubricants • Biofuel use as fatty acid methyl ester (FAME) Uses of palm oil and its fractions
  20. 20. 25 June 2014 Palm Oil and Health Brussels 21 DIXI (I have spoken)
  21. 21. THANK YOU
  22. 22. Jean Graille Consultant for Lipid technology FOOD USE OF PALM OIL
  23. 23. PRODUCTION (Million tons) CIF US$/T May 2012 YIELDS kg/ha 2011/2012 2012 2012 PALM 51.58 1075 3589 SOYA 41.70 1278 367 RAPE 23.,60 1235 713 SUNFLOWER 14.63 1275 493 PKO & CNO 8.96 1200 421 ANIMAL FATS 42.43 LARD 1000 FISH 1880 Oil World 02/2013 Physical and economical data
  24. 24. Fatty acids composition
  25. 25. * Soft refined red oils Minor Biomolecules (ppm) PO Elaeis Guineensis Refined PO Elaeis oleifera Hybrid (H)* Stearin (H)* Oiein (H)* Carotenes 600 10 2230 740 355 640  Carotene 310 0 1210 540 330 420 Tocopherols 800 900 850 200 400 Toco. Vit. E 240 170 Tocotrienols 850 650 200 400
  26. 26. Plastoquinones
  27. 27. Exceptional properties of palm oil Palm oil and its fractions elegantly solve the problem of trans isomers and positional isomers Deep frying Margarines Shortenings Cocoa butter equivalents (CBE) Source of value added biomolecules
  28. 28. GEOMETRICAL ISOMERISATION POSITIONAL ISOMERISATION CH3 CH 10 COORCH 9 R C H C R' H R C H C H R' CIS TRANS
  29. 29. Deep frying of chips
  30. 30. History According to the wish of Napoleon III to develop a very cheap butter equivalent for working class and navy, Mége Mouriès has patented the margarine process in 1869 with beef tallow and skimmed milk as ingredients. Since this date, margarine became a very common product in food production. Today, tailor made margarines match with human health needs.
  31. 31. PO PS POL MF (Soft) Super olein Medium F CBE MOI.iode = 34 II = 49 Palm oil fractionation
  32. 32. Refining reduces the bioactive compounds content such as carotenes, tocopherols and tocotrienols. It would be advisable to make more place to red palm oil be it from common or hybrid oil palm. Blending red palm oil with fluid oils (soya, rape, sunflower, etc…), should be a wise act to develop.
  33. 33. Situation today The image of palm oil is tarnished for the consumer. Up to date scientists and producers' associations must intensify their communication effectively face to the demonization maintained by pressure groups. The RSPO is a suitable approach but the public is not sufficiently informed.
  34. 34. Conclusion The controversy over saturated fatty acids observed particularly in France, in Europe and on the American Continent has two origins: It is due to insufficient scientific knowledge leading to ignorance of basic biochemical mechanisms of digestion of human food intake.
  35. 35. the phenomenon affects university teachers supposed to teach the biochemical and biological mechanisms known for over 50 years; it also affects managers of food industry and nutritionists supposed to provide the best advice to consumers. These deficiencies lead to cast doubt among policy makers, managers of food industry and consumers which have assimilated therefore ideas totally wrong.
  36. 36. The debate is also fed with politico-economic reasons like various protectionist manipulations based on erroneous stereotypes described previously, to protect any national production. The soybean oil producing countries of the American continent demonize palm oil as do the producers of sunflower and rapeseed oil in Europe. Dairy lobbies have to be designated also.
  37. 37. This intellectual disorder leads to a simplistic perception of lipids by referring only to their overall fatty acid composition as if lipids were merely free fatty acid mixtures. This trivial approach naturally leads to a misclassification in terms of "good and bad" fats for human health.
  38. 38. No oil is perfect and palm oil is no exception. They all have their advantages and disadvantages; this is the reason why food industry performs smart assemblies ​​to improve simultaneously physical, sensory and nutritional qualities of finished products.
  39. 39. A 60% fat spread, composed of a blend of rapeseed, sunflower and palm is one of the most elaborate example. It is therefore unnecessary to demonize palm oil and to want to delete it because the food processing industry would be put in big trouble and the consumer would lose a lot in terms of nutritional quality of foods involved.
  40. 40. THANK YOU
  41. 41. Guy-André Pelouze MD Thoracic and cardiovascular surgeon and IRC founder CARDIOVASCULAR DISEASES, ATHEROMA, SATURATED FATS AND PALM OIL
  42. 42. CARDIOVASCULAR DISEASES (CVD) What are we speaking about?
  43. 43. CVD =mainly CHD and Stroke Global Atlas on Cardiovascular Diseases Prevention and Control
  44. 44. CVD are chronic diseases which are underestimated Global Atlas on Cardiovascular Diseases Prevention and Control
  45. 45. ATHEROMA, ATHEROSCLEROSIS, ARTERIOSCLEROSIS What is the present theoretical framework of atheroma? The criterion of the scientific status of a theory is its falsifiability, or refutability, or testability. — Karl Popper
  46. 46. From diet to CHD: multiple environmental factors and a complex genomics
  47. 47. Atheromatous plaque is an inflammatory lesion
  48. 48. Inflammation leads to plaque growth
  49. 49. Plaque rupture leads to emboli and thrombosis
  50. 50. Symptomatic carotid atheroma: endarterectomy for stroke prevention
  51. 51. Inflammation and risk of CHD The American Journal of Cardiology (www.AJConline.org) Vol 97 (2A) January 16, 2006
  52. 52. SATURATED FATS Sat fats culprit? Is it evidence based?
  53. 53. Risk ratios and 95% CIs for fully adjusted random-effects models examining associations between saturated fat intake in relation to coronary heart disease and stroke. 1Updated data were provided by respective investigators (4, 5, 8, 18, 29, 35) or derived f... Siri-Tarino P W et al. Am J Clin Nutr 2010;91:535-546 ©2010 by American Society for Nutrition
  54. 54. PALM OIL Is palm oil atherogenous? Does substitution lead to lower atherogenicity?
  55. 55. PALM OIL 1. Is palm oil a culprit is CVD?
  56. 56. HRs and 95%s of CVD risk according to quintiles of energy-adjusted SF from different sources (n = 5209). de Oliveira Otto M C et al. Am J Clin Nutr 2012;96:397-404
  57. 57. Fatty acid profiles for dairy and meat products. de Oliveira Otto M C et al. Am J Clin Nutr 2012;96:397-404 ©2012 by American Society for Nutrition
  58. 58. PALM OIL 2. What happens when palm oil is substituted ?
  59. 59. Substitution by trans fatty acids: high atherogenicity
  60. 60. Partially hydrogenated oils and lipid markers
  61. 61. Industrial Trans Fatty Acids are atherogenic: high level of evidence
  62. 62. Substitution by oils with a high content in linoleic acid (W6)
  63. 63. Fig 3 Updated meta-analysis of effects of LA selective interventions and mixed n-3/n-6 PUFA interventions on risk of death from coronary heart disease. Ramsden C E et al. BMJ 2013;346:bmj.e8707 ©2013 by British Medical Journal Publishing Group
  64. 64. Substitution by carbs (1)
  65. 65. Mean (±SEM) effects of variation in dietary carbohydrate and saturated fat on LDL subclasses. Siri-Tarino P W et al. Am J Clin Nutr 2010;91:502-509 ©2010 by American Society for Nutrition Substitution by carbs (2)
  66. 66. Substitution of sat fats by PUFA, Carbs, Olive oil
  67. 67. Conclusion (1)
  68. 68. Obesity is not only a matter of calorie
  69. 69. Fat consumption decreased and obesity increased Macronutrients 1971-2000, USA men Macronutrients 1971-2000, USA women
  70. 70. Since 2000 no change in calorie intake or macronutrients but sedentarity still progressed Macronutrients in USA 1999- 2000 Sat fats in USA 1999-2000
  71. 71. The framework of CVD Canadian Journal of Cardiology 28 (2012) 642–652
  72. 72. Smoking, Sedentarity, central obesity are the main present determinants of Atheroma Canadian Journal of Cardiology 28 (2012) 642–652
  73. 73. Conclusion (2) • Palm Oil is about 8-10% of sat fat intake of French people (85% are animal fat) • Palm Oil consumption is not a significant factor of CVD in France and its suppression will not lead to significant changes in mortality from CVD • In France sat fats are 15% of daily calorie intake (WHO recommends 7%) but the CVD mortality is the lowest of the Union. • To improve our CVD mortality we should – Reduce smoking rate which is still high, reduce calorie intake especially from sugars which lead to insulin resistance and metabolic syndrome – Increase the intake of fresh foods prepared at home instead of products • For people at risk with a high intake of sat fats (>20%) especially if they are diabetic a reduction in sat fat intake is mandatory. It should be more efficient by reducing fatty meats or fatty cheeses depending on patient consumption which represent 80% of the sat fats.
  74. 74. Trends in CVD mortality in EU Global Atlas on Cardiovascular Diseases Prevention and Control
  75. 75. Smoking
  76. 76. TV advertising Global Atlas on Cardiovascular Diseases Prevention and Control
  77. 77. Conclusion (3) • Tax on fat were abandoned in Europe because of inefficiency • Prevention is difficult because it needs education, prescription is easy because it’s « free » • It is mandatory to educate patients toward a healthy way of life instead of focusing on their blood cholesterol level
  78. 78. Conceptual framework for population-wide cardiovascular risk behaviors change: the optimal health behaviors and factors, community settings, and public health interventions. Pearson T et al. Circulation 2013;127:1730-1753 Copyright © American Heart Association
  79. 79. The 6S rule for CVD prevention both primary and secondary • Quit Smoking • Quit Sitting • Quit Sugar • Check your Scale • Check your Salt • Check your Stress
  80. 80. THANK YOU
  81. 81. Furio Brighenti a Elena Fattore b a Department of Food Sciences, University of Parma, Italy b Department of Environmental Health Sciences, Pharmacological Research Institute “Mario Negri”, Milan, Italy * In Press, June 2014, American Journal of Clinical Nutrition, DOI: 10.3945/​ajcn.113.081190 PALM OIL AND BIOMARKERS OF CARDIOVASCULAR DISEASE: A SYSTEMATIC REVIEW AND META- ANALYSIS OF DIETARY INTERVENTION TRIALS*
  82. 82. Disagreement between scientific findings on hypercholesterolemic effects of palm oil Disagreement about an “universal” potentially negative role for human health Aim: to assess the effect of the substitution of palm oil to the other main dietary fats on the main biomarkers of cardiovascular risk Background
  83. 83. Sys. Review/ meta-analysis RCTs Rand. Contr. Trials (RCT) Sys. review/meta-analysis NRCTs Non-randomized, controlled trial (NRCT) Sys. review/meta-analysis cohort/case-control studies Cohort study/case-control study Cross-sectional study Case series/time series Expert opinion Hierarchy of evidence in evidence-based medicine
  84. 84. Search on three databases: 1. PubMed 2. Embase 3. Cochrane Library Key words: “palm oil”; “palmitic acid”; “cardiovascular disease*”; “coronary heart disease”; “cerebrovascular disease*”; “acute myocardial infarction”; cholesterol; lipoprotein*; apolipoprotein* Eligibility Criteria i) Original data from intervention trials comparing palm oil or palm olein-rich diet with a fat-rich diet ii) Estimate of mean values, and a corresponding measure of dispersion for: i) TC ii) LDL-C iii) HDL-C iv) TC/HDL-C ratio v) TAG vi) Apo AI vii) Apo B viii) VLDL ix) Lp(a) iii) Conducted on humans iv) Published in English language v) Intervention duration > 2 weeks Search Strategy Methods
  85. 85. Flowchart of studies selection for the meta-analysis Records identified through PubMed, Embase and Cochrane Library searching (n = 902) ScreeningIncludedEligibilityIdentification Additional records identified through other sources (n = 2) Records after duplicates removed (n = 725) Records screened (n = 725) Records excluded (title and/or abstract not relevant; studies not satisfying the inclusion criteria) (n = 619) Full-text articles assessed for eligibility (n = 106) Full-text articles excluded (reviews, letters, commentaries, other fatty acids or markers, no enough statistical information, no enough intervention duration) (n = 57) Studies included in quantitative synthesis (meta-analysis) (n = 51)
  86. 86. Characteristics of the 49 Trials (51 studies) included:  1526 volunteers (1007 men and 519 women), age 16-70 years  16 in young/students, 8 in the elderly, 25 in mixed ages  15 different countries (18 in Europe, 14 in Asia, 8 in Australia, 7 in USA and 1 each in Canada, South Africa)  29 on normocholesterolemic, 9 mild-hypercholesterolemic and 11 on hypercholesterolemic subjects  Energy from fat in the intervention diets ranged between 28 and 53% Results I
  87. 87. Results II PO vs MUFA PO vs PUFA Biomarker N. studies WMD (95% CI)a Heterogeneity p-value I2 (%) TC (mg/dl) 21 13.77 (8.85,18.69) 0.043 37.6 LDL-C (mg/dl) 20 10.75(6.60,14.89) 0.096 30.6 VLDL-C (mg/dl) 9 0.01 (-1.36,1.37) 0.743 0.00 APO B (mg/l) 8 60.97 (24.01,97.93) 0.6 0.00 HDL-C (mg/dl) 21 1.54 (0.38,2.71) 0.936 0.00 APO AI (mg/l) 9 22.72 (-15.54,60.98) 0.787 0.00 TAG (mg/dl) 20 1.57 (-3.11,6.25) 1.00 0.00 TC/HDL-C 5 0.02 (-0.1,0.14) 0.918 0.00 Lp (a) (mg/l) 3 -1 (-44.84,42.84) 0.934 0.00 Biomarker N. studies WMD (95% CI)a Heterogeneity p-value I2 (%) TC (mg/dl) 16 9.36(2.39,16.34) <0.001 75.5 LDL-C (mg/dl) 14 7.27 (-0.15,14.70) <0.001 74.2 VLDL-C (mg/dl) 4 1.34 (-0.57,3.25) 0.471 0.00 APO B (mg/l) 7 50.73 (20.61,80.85) 0.743 0.00 HDL-C (mg/dl) 14 1.82 (0.54,3.10) 0.649 0.00 APO AI (mg/l) 7 76.74 (40.19,113.29) 0.639 0.00 TAG (mg/dl) 15 1.17 (-8.58,10.93) 0.001 60.0 TC/HDL-C 5 -0.19 (-0.43,0.06) 0.27 22.71 Lp (a) (mg/l) 2 -17.0 (-138.9,104.9) 1 0.00
  88. 88. Results III Biomarker N. studies WMD (95% CI)a Heterogeneit y p-value I2 (%) TC (mg/dl) 8 14.15 (4.11,24.19) 0.02 57.72 LDL-C (mg/dl) 8 10.83 (0.91,20.75) 0.003 67.45 VLDL-C (mg/dl) 4 -0.35 (-1.74,1.05) 0.783 0.00 APO B (mg/l) 3 97.08 (29.98,164.18) 0.631 0.00 HDL-C (mg/dl) 8 3.73 (1.43,6.03) 0.869 0.00 APO AI (mg/l) 3 142.45 (64.05,220.84) 0.66 0.00 TAG (mg/dl) 7 5.02 (-3.03,13.07) 0.973 0.00 TC/HDL-C 3 -0.12 (-0.4,0.16) 0.293 18.43 Lp (a) (mg/l) 1 -29 (-119.1,61.1) 100 Biomarker N. studies WMD (95% CI)a Heterogeneit y p-value I2 (%) TC (mg/dl) 11 -8.77 (-15,-2.53) 0.117 35.26 LDL-C (mg/dl) 11 -4.7 (-10.28,0.87) 0.102 37.13 VLDL-C (mg/dl) 6 -0.31 (-1.71,1.09) 0.866 0.00 APO B (mg/l) 9 -25.15 (-58.77,8.48) 0.231 23.84 HDL-C (mg/dl) 11 -3.7 (-6.26,-1.15) 0.063 42.95 APO AI (mg/l) 9 -52.21 (-95.46,-8.96) 0.366 8.32 TAG (mg/dl) 11 0.18 (-5.71,6.06) 0.99 0.00 Lp (a) (mg/l) 2 -8.49 (-54.29,37.3) 0.72 0.00 PO vs. stearic acid PO vs. myristic/lauric acid
  89. 89. Results IV PO vs. TRANS Biomarker N. studies WMD (95% CI)a Heterogeneity p-value I2 (%) TC (mg/dl) 11 3.52 (-3.54,10.58) 0.003 62.76 LDL-C (mg/dl) 11 1.07 (-7.51,9.64) <0.001 76.31 VLDL-C (mg/dl) 3 1.13 (-1.04,3.3) 0.65 0.00 APO B (mg/l) 6 -57.83 (-98.44,-17.22) 0.418 0.00 HDL-C (mg/dl) 11 4.98 (3.51,6.44) 0.748 0.00 APO AI (mg/l) 6 103.92 (57.78,150.07) 0.852 0.00 TAG (mg/dl) 11 -3.02 (-5.09,-0.96) 0.97 0.00 TC/HDL-C 3 -0.45 (-0.58,-0.31) 0.599 0.00 Lp (a) (mg/l) 4 -33.99 (-81.26,13.28) 0.996 0.00
  90. 90. Results V Effect modifications for TC and LDL-C in: elderly population mild/hypercholesterolemic vs. normocholesterolemic studies with higher energy from fat in studies conducted in Asia vs. other countries Age-related physiological conditions and overall dietary habits are important determining factors for the effects on TC and LDL induced by the main dietary fats Stratified analysis and meta-regression models
  91. 91. Significantly stronger effects in elderly populations TC/MUFA LDL-C/MUFA TC/PUFA LDL-C/PUFA Young Mixed Elderly Young Mixed Elderly Young Mixed Elderly Young Mixed Elderly group Age 1.04 (-6.13, 8.20) 12.42 (7.32, 17.52) 29.11 (20.60, 37.62) 1.80 (-3.81, 7.40) 10.65 (6.06, 15.25) 24.45 (16.32, 32.58) 0.62 (-5.41, 6.66) 9.84 (-1.47, 21.14) 21.34 (11.29, 31.39) -0.62 (-9.73, 8.48) 7.58 (-4.62, 19.79) 15.48 (5.59, 25.36) WMD (95% CI) 1.04 (-6.13, 8.20) 12.42 (7.32, 17.52) 29.11 (20.60, 37.62) 1.80 (-3.81, 7.40) 10.65 (6.06, 15.25) 24.45 (16.32, 32.58) 0.62 (-5.41, 6.66) 9.84 (-1.47, 21.14) 21.34 (11.29, 31.39) -0.62 (-9.73, 8.48) 7.58 (-4.62, 19.79) 15.48 (5.59, 25.36) WMD (95% CI) 0-37.6 0 37.6
  92. 92. Significantly stronger effect in fat-rich diets TC/MUFA LDL-C/MUFA TC/PUFA LDL-C/PUFA Less than 35% 35% or more Less than 35% 35% or more Less than 35% 35% or more Less than 35% 35% or more from fat Energy 4.93 (-2.15, 12.01) 17.47 (12.31, 22.64) 3.58 (-1.68, 8.84) 14.25 (10.01, 18.49) 4.39 (-2.05, 10.82) 22.54 (2.92, 42.17) 2.44 (-5.23, 10.10) 17.03 (0.88, 33.18) WMD (95% CI) 4.93 (-2.15, 12.01) 17.47 (12.31, 22.64) 3.58 (-1.68, 8.84) 14.25 (10.01, 18.49) 4.39 (-2.05, 10.82) 22.54 (2.92, 42.17) 2.44 (-5.23, 10.10) 17.03 (0.88, 33.18) WMD (95% CI) 0-42.2 0 42.2
  93. 93. Conclusions • PO differentially modified different cholesterol fractions (either “favorable” or unfavorable” in terms of cardiovascular risk) according to the fat substituted ; • Increase in TC and LDL-C were generally matched by an increase also in HDL-C and APO AI for substitution of MUFA, PUFA and Stearic acid, with no evident changes in the TC/HDL-C ratio ; • In comparison to myristic/lauric acid, PO decreased most lipid fractions. • Worth noting that all the changes where “favorable” when PO substituted hydrogenated trans fatty acids. • Increases of TC and LDL were strongly dependent from age and overall dietary patterns, and did not seem relevant for younger populations eating less than the average recommendations of energy from fat (i.e. 35% En) ; • From this meta-analysis it emerges a need to better differentiate dietary recommendations about the health effect of fat sources substitution, especially when they are addressed to emerging countries with a overall low caloric intake from fats.
  94. 94. THANK YOU
  95. 95. Dr. Aseem Malhotra Cardiologist Science Director- Action On Sugar Academy Of Medical Royal Colleges Obesity Steering Group Member HOW DIETARY CHANGES CAN RAPIDLY REDUCE CARDIOVASCULAR RISK BUT THE BAD BEHAVIOR OF BIG FOOD IS DAMAGING YOUR HEALTH- TACKLING THE OBESITY CRISIS AND THE INCREASING BURDEN OF DIET RELATED DISEASE
  96. 96. Scale of The Problem/ Why Does it Matter? • 60% of the adult UK population are either overweight or obese • 1 in 3 children in the same category –trends increasing • Foresight report: If we do nothing 90% Of UK population overweight or obese by 2050 • Currently costing the NHS £6 billion/year > £50 billion • Total cost of diabetes close to £20 billion; double by 2035 • NCDs (diet as a risk factor) have now overtaken under nutrition as the commonest cause of death worldwide – 35 million/year • Is obesity just the tip of the iceberg?
  97. 97. The Obesogenic Environment Processed, energy dense foods are EVERYWHERE!!
  98. 98. A quarter-pound cheeseburger, large fries & a 500 ml soda provide:  1,200 calories  50 g fat  95 mg cholesterol  3 g salt Brownell & Warner Milbank Quarterly, 2009
  99. 99. Snack Foods Are Everywhere • Car washes • Book stores • Hardware stores • Gas stations • Office buildings (vending machines) • Health clubs/gyms • Video stores • Car repair shops
  100. 100. Toxic Hospital Food Environment • Branding opportunity for the junk food industry ( thousands of visitors per week) • Legitimises the acceptability of junk food ( fast food on site, vending machines) • Hospital trolleys - loaded with junk • Education ineffective when food environment is working against you- 50% of 1.4 million NHS employees overweight or obese • Perpetuates the revolving door of health care
  101. 101. Obesity Is Rooted In The Food Environment • “Food choices are often automatic and made without full conscious awareness” Theresa Marteau, Director of Behaviour and Health Research Unit, Cambridge • Over supply of cheap sugary/energy dense foods • Made worse by aggressive marketing by junk food industry- target children and most vulnerable • Fast food advertising in US alone $4.2 billion dollars • The balance of power: for every £1 spent by the World Health Organisation in preventing diet related disease, £500 spent by industry in marketing high calorie, low nutrient foods • School Food Trust Survey- 72% of parents felt junk food advertising contributed to pester power
  102. 102. Food Industry Strategy That Hinders Progress for Public Health- The Corporate Playbook Of Big Food • Focus on personal responsibility as the cause of the nation’s unhealthy diet • Raise fears that government action usurps personal freedom Greatest public health successes: safe drinking water, seat belts in cars, smoke free buildings happened through regulation. Voluntary agreements ; impression of minor progress whilst detracting from more meaningful interventions. • Corporate Social responsibility: Soft drink industry gave Children’s Hospital Of Philadelphia $10 million whilst city was considering a sugary drinks tax. • Vilify critics with totalitarian language characterizing them as the food police, leaders of the nanny state, “food fascists” • Criticize studies that hurt industry as “junk science”
  103. 103. The Corporate Playbook Of Big Food • Emphasise physical activity over diet • Little change in exercise levels in the past 30 years whilst obesity has rocketed (Pontzer H, Raichlen DA, Wood BM, Mabulla AZ, Racette SB, Marlowe FW. Hunter-gatherer energetics and human obesity. PLoS One 2012;7:e40503) • Learn from History: 50 years from publication of links between smoking and lung cancer before regulation because Tobacco industry successfully adopted a strategy of planting doubt, denial, confusing the public and even buy the loyalty of scientists- whatever it takes to protect their only interest- profit • CEOs of every major Tobacco firm went in front of US Congress in 1994 and swore under oath that they didn’t believe that nicotine was addictive or smoking caused lung cancer
  104. 104. WHO Cardiovascular Disease -Key Facts • CVDs are the number one cause of death globally: more people die annually from CVDs than from any other cause • An estimated 17.3 million people died from CVDs in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease and 6.2 million were due to stroke • Low- and middle-income countries are disproportionally affected: over 80% of CVD deaths take place in low- and middle-income countries and occur almost equally in men and women • The number of people who die from CVDs, mainly from heart disease and stroke, will increase to reach 23.3. million by 2030 CVDs are projected to remain the single leading cause of death • Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, high blood pressure, diabetes and raised lipids • 9.4 million deaths each year, or 16.5% of all deaths can be attributed to high blood pressure. This includes 51% of deaths due to strokes and 45% of deaths due to coronary heart disease
  105. 105. Rapid Mortality Falls After Risk Factor Changes In Populations • The underlying pathological process preceding most coronary and stroke events— normally takes many decades to progress • Arterial stiffening can be shown in children who are obese, and aortic fatty streaks are visible in some teenagers and young adults (Strong JP, Malcom GT, McMahan CA, et al. Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis In Youth Study. JAMA 1999; 281: 727–35) • Most cardiovascular events manifest after the age of 60 • Perception of a process that will progress slowly and reverse slowly if at all is WRONG! • Extensive empirical and trial evidence shows that substantial reductions in mortality can occur within months of decreases in smoking, and within 1–3 years of dietary changes (Capewell S, O’Flaherty M. Can dietary changes rapidly decrease cardiovascular mortality rates? Eur Heart J 2011; published online March 2. DOI:10.1093/eurheartj/ehr049)
  106. 106. Rapid Mortality Falls Cont… • Helena, Montana, USA- Smoke free legislation in 2002 led to 40% reduction in hospital admissions for Acute Coronary Syndromes following smoke free legislation within 6 months. Law was recinded and admissions for ACS returned to preceding levels • Smoke free legislation in Scotland 2006, 17% reduction in hospital admissions within a year and 6% fall in out of hospital cardiac deaths. Meyers DG, Neuberger JS, He J. Cardiovascular eff ect of bans on smoking in public places: a systematic review and meta-analysis. J Am Coll Cardiol 2009;54: 1249–55 Randomised trials show that changes in diet can rapidly improve outcomes of cardiovascular disease. • DART trial- 2033 patients post MI, eating fatty fish led to 29% reduction in all cause mortality compared to control • GISSI Prevencione trial- 11,323 patients with CVD randomly assigned to Omega 3, Vitamin E, both or neither. In Omega 3 supplement group mortality significantly reduced after 3 months, sudden death within 4 months and cardiac and stroke deaths within 6-8 months
  107. 107. Rapid Mortality Falls Cont… CVD Prevention Policies - are evidence-based - are effective
  108. 108. “Upstream”  “Downstream” determinants causes Food  Salt  Blood Pressure ↑ Food  Trans Fat  Dyslipidaemia www.nice.org.uk/guidance/PH25 CVD causal pathways
  109. 109. www.nice.org.uk/guidance/PH25 SALT POLICIES WORK average consumption UK FSA voluntary policies: 9.5  8.1 g/day FINLAND REGULATIONS: 14  10 g/day  Healthy Diet Policies are effective
  110. 110. IF UK salt consumption: 8.6  5.6 g/day 14,000-20 000 CVD deaths/year 130 000 QALYs gain £350 million / year savings BMJ 2011 343 d4044 Healthy Diet Policies are beneficial
  111. 111. Industrial trans fats 50% hidden in muffins, cakes, biscuits, cookies & wafers 25% hidden in fast food, popcorn
  112. 112. Industrial Trans Fat POLICIES WORK average consumption UK FSA voluntary policy 2%  1% energy DENMARK REGULATIONS 4%  0% energy (now New York, Iceland, Sweden, Seattle, Canada, Austria, Switzerland...)  www.nice.org.uk/guidance/PH25 Healthy Diet Policies are effective
  113. 113. IF UK transfat consumption: 1%  0% /day Eliminating industrial trans fats in UK Prevent  5,000 deaths/year Savings £230 million/year & BMJ 2011 343 d4044BMJ 2010 340 c1826 Healthy Diet Policies are beneficial
  114. 114. PREDIMED RCT: Primary prevention of CVD with a Mediterranean diet. Estruch et al NEJM 2013 • Mediterranean diet supplemented with – extra-virgin olive oil • Mediterranean diet supplemented with – mixed nuts • Control diet (advice to reduce dietary fat)
  115. 115. 1 portion  1 portion 1% energy 2g /day  1 portion  10% energy  3% energy  1 portion Results • 7447 persons enrolled (age 55 - 80 years); 57% women • good adherence (self-reported intake & biomarkers) • CVD events occurred in 288 participants The multivariable-adjusted hazard ratios • 0.70 (0.54 to 0.92) with Mediterranean diet & extra-virgin olive oil • 0.72 (0.54 to 0.96) (96 events) in Mediterranean diet with nuts • No diet-related adverse effects reported Conclusions • Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events ↓30% within 4.8 years PREDIMED RCT: Primary prevention of CVD with a Mediterranean diet. Estruch et al NEJM 2013
  116. 116. 1 portion  1 portion 1% energy 2g /day  1 portion  10% energy  3% energy  1 portion PREDIMED RCT: Primary prevention of CVD with a Mediterranean diet. Estruch et al NEJM 2013
  117. 117. Mozaffarian & Capewell BMJ 2011 343 d5747 -90,000 -70,000 -50,000 -30,000 -10,000 Feasible changes 1 portion  1 portion 1% energy 2g /day  1 portion  10% energy  3% energy  1 portion CVD mortality reductions with healthier US food policy options US 2006 baseline: 810,000 CVD deaths
  118. 118. Tom Frieden’s health impact pyramid J A. Monroe AJPM 2011 41 (4) Suppl 3 S155 http://dx.doi.org/10.1016/j.amepre.2011.06.015
  119. 119. “Downstream” preventive activities targeting individuals (eg 1:1 personal advice, health education, “nudge” or statins) consistently achieve a smaller public health impact than interventions aimed further “upstream” (eg smokefree laws, alcohol pricing or transfats regulations). These policy-based interventions tend to be more effective, potentially reaching all parts of the population and not being dependent on a sustained individual response. EFFECTIVENESS Hierarchy
  120. 120. Time For Action On Sugar? • Intrinsic sugars present in food not an issue, glucose is necessary for life. • The body doesn’t require any carbohydrate from added sugar! (Fructose component) • Observational studies and RCTs have implicated SSBs with weight gain and Obesity • Commonest cause of chronic pain in children is tooth decay- main dietary cause=sugar!
  121. 121. Elliot et al. Am J Clin Nutr, 2002 Bray et al. Am J Clin Nutr, 2004 Teff et al. J Clin Endocrinol Metab, 2004 Gaby, Alt Med Rev, 2005 Le and Tappy, Curr Opin Clin Nutr Metab Care, 2006 Wei et al. J Nutr Biochem, 2006 Johnson et al. Am J Clin Nutr 2007 Rutledge and Adeli, Nutr Rev, 2007 Brown et al. Int. J. Obes, 2008 Common wisdom: A calorie is a calorie, and “Sugar is just “empty calories” But: • Chronic fructose exposure promotes liver fat accumulation, which promotes Metabolic Syndrome (toxicity) • Metabolic syndrome (3 of hypertension, dysglycaemia, increased triglycerides, decreased HDL, and increased waist circumference • 66% of those admitted with acute myocardial infarction have metabolic syndrome with 50% increased mortality or hospital readmission at 1 year Fructose is not glucose
  122. 122. Obese (30%) Normal weight (70%) 240 million adults in U.S. 72 million 168 million “Exclusive” view of obesity and metabolic dysfunction
  123. 123. Obese (30%) Obese and sick (80% of 30%) Normal weight (70%) 240 million adults in U.S. 72 million 168 million Total: 57 million sick “Exclusive” view of obesity and metabolic dysfunction
  124. 124. Obese (30%) Normal weight (70%) 240 million adults in U.S. Normal weight, Metabolic dysfunction (40% of 70%) Obese and sick (80% of 30%) 57 million 67 million Total: 124 million sick 72 million 168 million “Inclusive” view of obesity and metabolic dysfunction
  125. 125. “Beating obesity will take action by all of us, based on one simple common sense fact: All calories count, no matter where they come from, including Coca-Cola and everything else with calories…” The Coca Cola Company, “Coming Together”, 2013 The Fiction
  126. 126. The Science • Some Calories Cause Disease More than Others • Different Calories are Metabolized Differently • A Calorie is Not A Calorie – Fiber – Protein – Fat – Fructose
  127. 127. Are All Calories The Same? "It's extremely naive of the public and the medical profession to imagine that a calorie of bread, a calorie of meat and a calorie of alcohol are all dealt in the same way by the amazingly complex systems of the body. The assumption has been made that increased fat in the bloodstream is caused by increased saturated fat in the diet, whereas modern scientific evidence is proving that refined carbohydrates and sugar in particular are actually the culprits.“ Professor David Haslam, Guardian, 24th January 2013
  128. 128. SSB’s and BMI-adjusted risk of diabetes in EPIC-Interact (Europe) Romaguera-Bosch et al. Diabetologia 56:1520, 2013
  129. 129. An international econometric analysis of diet and diabetes Only changes in sugar availability predicted changes in diabetes prevalence Every extra 150 calories increased diabetes prevalence by 0.1% But if those 150 calories were a can of soda, diabetes prevalence increased 11-fold, by 1.1% (95% CI 0.03 — 1.71%, p <0.001)- Independent of BMI and Physical activity This study meets the Bradford Hill criteria for Causal Medical Inference: —dose —duration —directionality —precedence Basu et al. PLoS One 8:e57873, 2013
  130. 130. Sugar Nutritional Labelling Guidelines • WHO 2003- Added sugar No more than 10% of energy- Intrinsic sugars 10% (whole fruit, vegetables…) • But current UK labelling references only total sugars as GDA – 20% of energy or 90g (22.5 tea spoons of sugar) • In the United States sugar not considered a nutrient so no equivalent of GDA for sugar. • Extremely difficult for consumers to determine how much sugar is added to foods • In the United States 1/3 sugar from SSBs, 1/6 from Ice creams, chocolates etc. but half of sugar consumption from non-junk foods. • US Department of Agriculture recently removed a published database for the added sugar content of selected foods stating “no method can analyse for added sugars so their amounts must be extrapolated or supplied by food companies, many of which are not willing to make public such proprietary information.”
  131. 131. Recommends reduction in sugar intake from 22 tsp/day to 9 tsp/day (males) and 6 tsp/day (females) Circulation 120:1011, 2009 Recognition at the American Heart Association
  132. 132. Action On Sugar- Aims • To achieve a reduction in refined added sugar intake in the UK and ensure it does not contribute to more than 5% of total energy intake. ( 6 tea spoons max!) • To reach a consensus with the food manufacturers and suppliers that there is strong evidence that refined added sugar is a major cause of obesity and has other adverse health effects. • To persuade the food processors and suppliers to universally and gradually reduce the added sugar content of processed foods. • To ensure clear and comprehensive nutritional labelling of added sugar content of all processed foods and beverages, using the recommended traffic light system • To educate the public in becoming more sugar aware in terms of understanding the impact of added sugar on their health, checking labels when shopping and avoiding products with high levels of added sugar. • To ensure that children are highlighted as a particularly vulnerable group whose health is more at risk from high added sugar intakes. • To ensure the body of scientific evidence about the dangers of excessive refined added sugar consumption becomes translated into policy by the Government and relevant professional organisations • To conduct a Parliamentary campaign to ensure the Government and Department of Health take action, and that, if the food industry does not comply with the sugar targets, they will enact legislation or impose an added sugar tax.
  133. 133. eg. clean water, sanitation, pollution, immunization, seatbelts, smoke free… SUPPORT: Implementation path for effective public health interventions • SCIENTIFIC evidence emerges • UNDERSTANDING spreads • PROFESSIONALS accept paradigm • PUBLIC & POLITICIANS become aware, then supportive • OPPOSITION from vested interests is slowly Overcome • REGULATION is introduced, often strengthened by • TAXATION to reinforce regulations (eg Tobacco & alcohol control) Professor Simon Capewell UK Faculty of Public Health & University of Liverpool
  134. 134. “ Faced with the choice between changing one’s mind and proving that there’s no need to do so, almost everyone gets busy on the proof” John Kenneth Galbraith
  135. 135. Christophe Didion Health and Consumers Directorate General European Commission REGULATION (EU) NO 1169/2011 ON FOOD INFORMATION TO CONSUMERS
  136. 136. Health and Consumers Health and Consumers Regulation (EU) No 1169/2011 on food information to consumers Christophe Didion Health and Consumers Directorate General European Commission
  137. 137. Health and Consumers Compulsory information • in all cases: • Name of the food • Ingredient list • Allergens • QUID (quantity of certain ingredients) • Net quantity of the food
  138. 138. Health and Consumers Compulsory information • in all cases: • Minimum durability/”use by” date • Name or business name and address of the Food Business Operator responsible for the food information • Nutrition declaration • Allergens
  139. 139. Health and Consumers Mandatory particulars accompanying the name of the food • 'Defrosted' • For meat products/preparation and fishery products • added proteins and their origin • added water if >5% • 'formed meat' / 'formed fish' when the food gives the impression that it is made of a whole piece
  140. 140. Health and Consumers Other mandatory particulars • 'Packaged in a protective atmosphere' • 'High caffeine content' • 'With sweeteners' / 'Contains aspartame (a source of phenylalanine)' • If >10% polyols, 'excessive consumption may produce laxative effects'
  141. 141. Health and Consumers Other mandatory particulars • For oils and fats • 'fully hydrogenated', 'partly hydrogenated' • origin
  142. 142. Health and Consumers
  143. 143. Health and Consumers Other mandatory particulars
  144. 144. Health and Consumers Improved legibility of labels  Minimum font size of 1.2mm “x”-height ( ) and of 0.9 mm “x”-height for packs less than 80 cm2
  145. 145. Health and Consumers Origin • Basic principle - origin labelling remains voluntary unless its omission could mislead the consumer • New rules for the indication of the origin of the primary ingredient when it comes from a different place than the one where the last substantial transformation of the food happened Commission to adopt implementing acts
  146. 146. Health and Consumers Partial move to extension of mandatory origin labelling • Mandatory origin labelling for: • Meat (pig, sheep, goat and poultry) • Report on mandatory origin labelling for: • other types of meat • meat used as an ingredient • milk and milk used as an ingredient in dairy products • unprocessed foods • single ingredient products • ingredients that are more than 50% of a food
  147. 147. Health and Consumers Mandatory nutrition declaration • energy (kilojoules and kilocalories) • fat • saturates • carbohydrate • sugars • protein • salt (sodium expressed as “salt” equivalents) Information related to 100g or 100ml Voluntary labelling per portion and/or per reference intake
  148. 148. Health and Consumers Report on trans fat • Levels of Trans fat in foods • Trans fat intakes • Impact of appropriate means that could enable consumers to make healthier food choices (information, restrictions of use) By December 2014
  149. 149. Health and Consumers Front-of-pack nutrition declaration • Voluntary front-of-pack labelling for • energy alone OR • energy, fat, saturates, sugars and salt
  150. 150. Health and Consumers Application of the new rules 13 December 2014 13 December 2016 for mandatory nutrition labelling
  151. 151. Health and Consumers
  152. 152. Anne Bourdu Lawyer and Member of the SYNNOV « PALM OIL FREE » : FROM CONSUMER INFORMATION TO DISPARAGEMENT
  153. 153. • Palm oil undergoes a smear campaign, especially by powerful NGOs, while a serious debate about its nutritional qualities and its conditions of production would be required. • Up to now the negative impact of this oil on human health has not been demonstrated, subject to a non- excessive consumption.
  154. 154. • The EU Regulation n°1169/2011 of 25 October 2011 reinforces the information and protection of consumers by imposing essential, readable and understandable information affix on food products. • From 13 December 2014, the date from which it will be compulsory implemented, indicating the presence of palm oil (most often currently identified under the name “vegetable oil”) and any other vegetable oil in a pre-packaged food product will be required. Thus, the presence of palm oil in a foodstuff will be known by the consumer. The welcome improvement of consumer information
  155. 155. Article 18 : List of ingredients “Ingredients shall be designated by their specific name.” Annex VII : Indication and Designation of ingredients • “Refined oils of vegetable origin may be grouped together in the list of ingredients under the designation ‘vegetable oils’ followed immediately by a list of indications of specific vegetable origin, and may be followed by the phrase ‘in varying proportions’. If grouped together, vegetable oils shall be included in the list of ingredients […], on the basis of the total weight of the vegetable oils present”. EU Regulation n°1169/2011 of 25 October 2011
  156. 156. • Food producers, facing the psychosis of “junk food” and by commercial interest, are seeking to join the “palm oil free” camp. • Stigmatization of palm oil by the very apparent affixing of this statement on the products’ packaging that, for some, have never contained palm oil or have no reason to contain some. Misleading and disparaging commercial information
  157. 157. Article L121-1 of the French consumer code describes the following as deceptive trading practices: • creating confusion with another good or service, trademark, trading name or other defining hallmark of a competitive product or service; • practices based on false allegations, indications or presentations or that are likely to mislead people about the existence, availability, nature or characteristics of a product or service; • practices omitting or concealing important information or presenting it ambiguously. Protection of consumer Misleading advertising 1/3
  158. 158. Example: A company, by combining the term “label” with the mention “Quality Charter” and the mention “checked by an independent approved institution” changes the consumers' behaviour by making them believe that the products benefit from an official label (CA Lyon, Oct. 29th 2008). Misleading advertising 2/3
  159. 159. • The mention “palm oil free” implies that such products own qualities and properties better than those containing palm oil. • Article R.112-7 of the Consumer Code prohibits to make-believe that the foodstuff possesses special characteristics when in fact all similar foodstuffs possess such characteristics. • So, this practice may be considered as a breach of Consumer law. • Moreover, the statement “palm oil free” may lead consumers to believe that it is affixed pursuant a legal provision and then, that palm oil is objectively harmful. Misleading advertising 3/3
  160. 160. • The commercial Court of Paris (2012.12.04), requested by an association of Ivorian palm oil producers, held that the commercial communication of saying that “intensive farming of palm oil destroys rainforests, increases greenhouse gas emissions and threatens endangered species” constitutes a disparagement for these producers. • Judges considered that this statement leads consumers to believe that it is justified to remove palm oil from the foodstuffs’ composition and that it is beneficial for the environment to refrain from consuming food products containing palm oil. Protection of fair competition Unfair commercial practice
  161. 161. This judgement complies with the case law of the French Supreme Court (2007.01.30) that sanctioned an advertising for a sugary drink which disparaged the sugar. “It can not be excused by the humorous tone of the film, and such advertising contributes to the degradation, in the consumers’ mind, of the sugar’s image that is de facto disparaged”. Confirmation of previous « sugar case law »
  162. 162. Misleading advertising may lead to draw customers away from a competing undertaking. Then, misleading advertising may constitute an act of unfair competition. The risk of emergence of new litigation relating to the massive reproduction of the statement “palm oil free” is important should palm oil opponents continue their marketing actions with a widespread even standardized communication disparaging palm oil. Mention « palm oil free » / unfair competitive advantage
  163. 163. THANK YOU
  164. 164. QUESTIONS
  165. 165. THANK YOU

×