title: Meta-regression analysis of the effect of trans fatty acids on low-density lipoprotein cholesterol.
abstract: We conducted a meta-regression of controlled clinical trial data to investigate quantitatively the relationship between dietary intake of industrial trans fatty acids (iTFA) and increased low-density lipoprotein cholesterol (LDL-C). Previous regression analyses included insufficient data to determine the nature of the dose response in the low-dose region and have nonetheless assumed a linear relationship between iTFA intake and LDL-C levels. This work contributes to the previous work by 1) including additional studies examining low-dose intake (identified using an evidence mapping procedure); 2) investigating a range of curve shapes, including both linear and nonlinear models; and 3) using Bayesian meta-regression to combine results across trials. We found that, contrary to previous assumptions, the linear model does not acceptably fit the data, while the nonlinear, S-shaped Hill model fits the data well. Based on a conservative estimate of the degree of intra-individual variability in LDL-C (0.1 mmoL/L), as an estimate of a change in LDL-C that is not adverse, a change in iTFA intake of 2.2% of energy intake (%en) (corresponding to a total iTFA intake of 2.2-2.9%en) does not cause adverse effects on LDL-C. The iTFA intake associated with this change in LDL-C is substantially higher than the average iTFA intake (0.5%en).
authors.affiliation: Independent Consultant, 101 Corbin Hill Circle, Chapel Hill, NC 27514, USA.
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Allen
authors.affiliation: Toxicology Excellence for Risk Assessment (TERA), 2300 Montana Ave., Suite 409, Cincinnati, OH 45211, USA.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Vincent
authors.affiliation: BioFortis Innovation Services, 211 East Lake Street, Addison, IL 60101, USA.
authors.forename: DeAnn
authors.initials: D
authors.lastname: Liska
authors.affiliation: Toxicology Excellence for Risk Assessment (TERA), 2300 Montana Ave., Suite 409, Cincinnati, OH 45211, USA. Electronic address: Lynne.Haber@uc.edu.
authors.forename: Lynne T
authors.initials: LT
authors.lastname: Haber
mesh_terms: D001499:Bayes Theorem; D008078:Cholesterol, LDL / Q000378:metabolism*; D006801:Humans; D015201:Meta-Analysis as Topic; D008954:Models, Biological; D012044:Regression Analysis; D012307:Risk Factors; D044242:Trans Fatty Acids / Q000494:pharmacology*
chemical_list: D008078:Cholesterol, LDL; D044242:Trans Fatty Acids
keywords: CHD; LDL-C; Meta-regression; PHO; TFA