Palm oil and cardiovascular risk Gerard Hornstra, PhD Med Prof. Em. of Experimental Nutrition Maastricht University The Netherlands [email protected] ©NUTRI-SEARCH Gerard Hornstra Present potential conflicts of interest  Independent consultant of NUTRI-SEARCH, healthy lipid research and consultancy  Chairman of MVO task force ‘Choose Healthy Fat’  Member of the IUNS-related ‘International Expert Movement to improve dietary fat quality’  Member of EPOA’s Scientific Advisory Panel ©NUTRI-SEARCH Introduction  Palm oil, produced from the flesh of the oil palm fruit, contains 50% saturated and 50% unsaturated fatty acids and relatively high amounts of antioxidants (vitamin E and carotenoids)  Because of its composition, palm oil is the preferred vegetable oil for frying and for the production of a wide variety of food items, from margarines to confectionaries  For decades, saturated fat consumption is thought to increase cardiovascular risk because it increases plasma cholesterol levels  However, this view is now increasingly being challenged ©NUTRI-SEARCH Dietary fats and cardiovascular risk  Compared to dietary carbohydrates and mono- and polyunsaturated fatty acids, saturated fatty acids (SAFA) DO increase plasma cholesterol levels indeed  Yet, SAFA consumption per se is NOT associated with increased cardiovascular risk (Siri-Tarino, 2010)  Replacement of dietary saturates (and trans) by polyunsaturated fatty acids DOES reduce cardiovascular risk (Jakobsen 2009, Micha 2010)  Total replacement, however, is impossible because texture, stability, and palatability of fat-containing foods require the presence of saturated fatty acids ©NUTRI-SEARCH Major sources of dietary saturated fatty acids Dairy Coconut lauric myristic palmitic stearic lauric myristic Palm kernel lauric myristic Palm fruit Fatty meat palmitic palmitic stearic Cocoa stearic palmitic ©NUTRI-SEARCH Palmitic acid, the most abundant saturated fatty acid in nature, is the major SAFA in Western diets % of total SAFA 50 40 30 20 10 0 ©NUTRI-SEARCH In the European Union, palm oil is the major source of palmitate (estimated consumption in 2012) 2500 2000 1500 1000 500 0 Other vegetable oils ©NUTRI-SEARCH In the EU, the intake of saturated fatty acids from palm oil is low  Total fat intake in the EU is about 35 en%, but large differences occur between the various member states  According to IMACE, the present consumption of palm oil ‘in European diets’ is about 6 % of the total fat intake (~ 2 en%)  This implies that the consumption of saturated fatty acid originating from palm oil averages about 1 en%  This is far below the upper limits set for total saturates by most (inter)national advisory bodies (5 - 12 en%) ©NUTRI-SEARCH Palm oil diets increase plasma cholesterol levels as compared to diets with more unsaturated vegetable oils, but the cardiovascular risk score hardly changes 26 studies 27 comparisons 511 subjects PO higher Difference (mM) 0.40 0.30 0.20 0.10 0.00 -0.10 TC LDL-C HDL-C CV risk score p = 0.001 p = 0.004 p = 0.032 p = 0.164, NS PO lower ©NUTRI-SEARCH Palm oil and cardiovascular risk -summary and conclusion Palm oil contains 50 % saturated and 50% unsaturated fatty acids, as well as high amounts of antioxidants  It is the preferred oil for many food applications  In the EU, consumption of saturated fatty acids from palm oil is about 1 en%, whereas (inter)national advisory bodies allow at 5 - 12 en% SAFA in total  Compared to more unsaturated oils, palm oil consumption increases plasma cholesterol levels, but not the cholesterolrelated cardiovascular risk score  I, therefore, support the motion that ‘Sustainable palm oil in itself is not a harmful ingredient’ ©NUTRI-SEARCH Palm oil and cardiovascular risk -further info- www.palmoilandfood.eu ©NUTRI-SEARCH Recommendations for the consumption of saturated fatty acids  WHO/FAO (2010) Total saturate intake less than 10 en%  DAGC (USA, 2010) Immediately: total saturate intake less than 10 en% Intermediate step: total saturate intake less than 7 en% Ultimate goal: intake of lauric + myristic + palmitic acid less than 5 en%; no specific recommendation for stearic acid  EFSA (2010) Intake of total saturates as low as possible  ANSES (France, 2010) Total saturate intake: less than 12 en% Lauric + myristic + palmitic acids: less than 8 en% © NUTRI-SEARCH Major dietary SAFA sources in Western diets. NB: about 40% of the food items contain industrially modifiable fats Food group % bread & cake sweets & candy fats, oils & sauces cheese other dairy nuts & snacks 11.3 5.2 20.0 15.0 15.4 5.5 meat & poultry 18.1 other foods 9.5 ©NUTRI-SEARCH