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(Circulation. 2002;105:669.)
© 2002 American Heart Association, Inc.

Editorials

Trans-Fatty Acids and Sudden Cardiac Death

Arnold M. Katz, MD, DMed (Hon)

From the Cardiology Division, Department of Medicine, University of Connecticut Health Center, Farmington, Conn. A.M.K. is a Professor of Medicine Emeritus at University of Connecticut School of Medicine and a Visiting Professor of Medicine and Physiology at Dartmouth Medical School.

Correspondence to Arnold M. Katz, MD, 1592 New Boston Rd, PO Box 1048, Norwich, VT 05055-1048. E-mail arnold.m.katz@dartmouth.edu

Key Words: Editorials • arrhythmia • fatty acids • diet • lipids

Der Mensch ist, was er isst ("A man is what he eats")

— German Proverb

A relationship between diet and human disease has been known at least since the time of Hippocrates. Our "modern" understanding of the role of nutrition in heart disease began in 1908, when a diet of meat, milk, or eggs was found to produce atherosclerosis in rabbits; a decade later, cholesterol was identified as causing the experimental lesions. Epidemiological studies that began in the 1930s confirmed this correlation in humans, but the importance of diet in causing atherosclerosis attracted little attention until the 1950s, when a high intake of saturated fats was recognized as a major risk factor for myocardial infarction and stroke. Although the role of dietary lipids in causing vascular disease is now established, an influence of fat intake on cardiac arrhythmias is less well-appreciated.¹ The potential importance of this relationship is highlighted by Lemaitre et al,² who in this issue of Circulation, suggest that dietary trans-fatty acids cause sudden cardiac death. Trans-fatty acids differ from the natural cis-isomers in the conformation around the double bond; in the former, the fatty acyl chains are on opposite (trans) sides of the molecule, whereas they are on the same (cis) side in the latter. Most dietary trans-fatty acids are formed when unsaturated fats are "hardened" by hydrogenation and when vegetable oils become hydrogenated during frying; they occur in hardened margarines, fast foods, and some commercially baked goods . . . [Full Text of this Article]

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