Trans Fats, Insulin Resistance and Type 2 Diabetes: Nestle

Speaker: Dr. B. Sivakumar - Ex Director National Institute of Nutrition, Hyderabad Presented at: Nestlé Nutrition Institute and NDOC Scientific Workshop, New Delhi.

Summary

The presentation talks about insulin resistance and Type 2 Diabetes Mellitus. He explains metabolic syndrome and highlights the rise of diabetes among Indians primarily due to fat consumption in diet. Dr. Shivkumar shares the prescribed proportions of different components of fat in diet for long term health. He elaborates the dietary fat components and shares proved findings of clinical trials with trans fats. Dr. Shivkumar states estimates of Trans Fat intakes in Indian recipes. He emphasises the need for awareness among people about harms of Trans Fats, promotion of healthy oils, lifestyles and industry efforts to self-regulate and innovate.

Insulin Resistance is the decreased efficiency of glucose disposal by insulin and increased blood insulin or glucose levels at basal or at random or after 2hr-PP state.

Diabetes (T2DM) is decreased efficiency of both secretion of insulin and utilization of glucose from blood (fasting glucose and insulin increased beyond set levels along with impaired glucose tolerance). In most individuals who develop T2DM insulin resistance is generally present for many years before the occurrence of hyperglycaemia (5 years). First 3 years insulin secretion increases to maintain glucose but fails to respond 1 or 2 years before detection of T2D

A look at technical terms for fatty acid nutrition reveals the following.

FAT= Solid at room temp, example Butter

Oil= Liquid at room temp, example ghee

Partially hydrogenated vegetable fat (PHVF) is “Vanaspathi. Its purpose is to enable easy handling, texture (smooth and crispy) long shelf life and acceptable taste and smell.

1. Most physico-chemical and health related properties of fat or oil are attributed to the fatty acid constituents and other phyto chemicals.

2. Trans fatty acids of two kinds: Animal fats have natural small amounts of unsaturated fatty acids (usually MUFA or linoleic) which are hydrogenated microbially to trans fatty acids. But most trans fatty acids are formed during industrial preparation of PHVO (Vanaspathi). Cooking has very little role in trans-fat production in Food

The following has been proved with trans fats. Increased LDL cholesterol, decreased HDL cholesterol, increased TG level, increased LP(a), reduced size of LDL particle, reduced FA desaturase activity (compete to block PUFA endogenous synthesis, so less conversion), increased inflammation (TNFa and CRP) and CLA and risk of Met Syn, obesity etc. is inconsistent. A high intake of n-6 PUFA and high carbohydrate intake is correlated with fasting hyperinsulinaemia and postprandial hyperglycaemia and hypertriacylglycerolaemia. Dietary supplementation with n-3 PUFA leads to an improved lipid profile but not insulin sensitivity

Awareness in public about the harms of trans fat (FDA approves ‘O trans-fat’ label when the TFA is less than 0.5gm/serving. This can be more than 5g and harm if 10 serves of such recipes are consumed in a day). Encourage the industry’s efforts to self-regulate and Innovate Promotion of healthy oils, life styles and minds. Avoid outside food particularly Bakery products, Fast foods like French fries and ice-cream etc.