53 Virgin Olive Oil Benefits These calculations are theoretical, nevertheless, if we consider that every year 1 million myocardial infarctions are diagnosed in the USA, a reduction of 6% and 20% would imply a health improvement for 70,000 and 200,000 individuals, respectively. These figures should be taken into consideration by the Health Authorities of industrialised countries. In a another meta-analysis performed by De Souza et al., for trans fats, one to six prospective cohort studies for each association were pooled (two to seven comparisons with 12 942-230 135 participants). Total trans fat intake was associated with allcause and coronary heart disease mortality, but not with type 2 diabetes. Industrial, but not ruminant, trans fats were associated with coronary heart disease mortality. Data from several studies suggest that a rich saturated fat diet impairs insulin sensitivity. Given that trans fatty acids are structurally more similar to saturated fatty acids than unsaturated ones, they could also increase diabetes incidence at the population level. Some epidemiological studies, revised by Li et al., in 2019, reported that a high intake of trans fatty acids increased cancer and diabetes incidence. Concerning inflammation, most human studies show a direct relationship between industrial trans-fatty acid consumption and raised levels of inflammatory markers (Valenzuela et al, 2019). Data from a remarkable epidemiological study (Nurses’ Health Study) described a direct relationship between trans fatty acid consumption and type 2 diabetes incidence. The study, however, was an observational one, and further research is needed to assess this relationship. In contrast, no noteworthy effect on insulin sensitivity was reported in clinical trials testing the effects of 5-9% total energy as trans fatty acids. Differences among studies are complex, and maybe trans fat ingestion is not a risk factor for type 2 diabetes development. Figure 2.5 depicts the effect of a diet with high levels of saturated fats and trans isomers, and low levels of essential fatty acids, on obesity, type 2 diabetes, and dyslipidaemia. No significant differences were observed in trans fatty acid consumption between obese children and controls in a study performed by Larqué et al., (Córdoba, Spain, 2006) with participants aged from 6 to 13 years. However, the plasma clearance rate of trans fatty acids was lower in obese children than in controls. Moreover, the fact that trans fats were present for a longer time in blood circulation could impair obese children’s lipid metabolism and increase cardiovascular problems when adults. The “Internacional Study of Asthma and Allergies in Childhood” (ISAAC), developed in ten European countries, reported that 1.4% energy as trans fatty acids was directly related to a higher prevalence of asthma and atopic eczema in children. Mechanisms suggested to explain such a relationship included a trans fat effect on the polyunsaturated fatty acid profile, particularly inflammatory eicosanoids. The
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