Appendix 9ii

Invitation

Bureau of Nutritional Sciences
Banting Research Bldg. (P.L. 2203A)
Tunney's Pasture
Ottawa, Ontario
K1A 0L2

Dear. Dr. ...,

Subject: Consultation on the health implications of alternatives to trans fatty acids

In November 2004 the Government of Canada announced the formation of a Task Force to develop recommendations and concrete strategies to effectively eliminate or reduce industrially produced trans fats in Canadian foods to the lowest level possible. More information on the work of the Task Force can be found at www.healthcanada.gc.ca/transfat.

In preparing its recommendations, the Task Force is examining the health implications of identified alternatives to partially hydrogenated oils through an assessment of the health benefits and risks of each alternative. A number of questions, listed below, based on a review of current scientific literature on dietary fat, have been developed to aid in the task of assessing the alternatives.

• In North America, LDL- cholesterol has been identified as the major atherogenic lipoprotein and, therefore, the primary target for cholesterol-lowering therapy. However, the impact of dietary fat and fatty acids on CVD risk has been assessed in relation to various other bio-markers of atherosclerosis, such as serum HDL cholesterol, total/HDL or LDL/HDL ratios, triglycerides and lipoprotein(a). How should the Task Force consider the relative importance of these bio-markers?
  
  
• Would the replacement of partially hydrogenated oils by oils rich in monounsaturated fatty acids have positive effects on serum cholesterol and lipoprotein levels and CVD risk?
  
  
• Although the bulk of the scientific literature relating dietary fat to CVD has dealt with the risk factors surrounding atherosclerosis (viz., blood lipid levels and patterns), there is evidence implicating it in other aspects of the disease (e.g., thrombus/clot formation; cardiac arrhythmia; and in vivo oxidative stress). In addition, dietary fat has been implicated in other chronic diseases, such as cancer, diabetes and hypertension. Since many of these additional relationships appear to be associated with dietary n-6 and n-3 polyunsaturated fatty acids, how and to what extent should these relationships be taken into consideration in recommendations to eliminate or reduce trans fats?
  
  
• In Canada, it is estimated that, while meeting the essential fatty acids requirement, the ratio of linoleic acid to α-linolenic acid is relatively high? Many of the proposed alternatives to partially hydrogenated oils have low linolenic content. How should the Task Force consider a further increase of this ratio?
  
  
• There is a general consensus that trans fat has a more deleterious effect on risk factors for CVD than saturated fat. However, intakes of saturates are marginally high in Canada (about 11 % of total energy) and there is some evidence (Lichtenstein et al, 1999) that the adverse effect of trans fatty acids relative to saturated fatty acids may occur primarily at high dietary intakes of trans fat. Are there any conditions under which the replacement of trans fatty acids with saturated fatty acids could be considered? If yes, is there a threshold below which this replacement would not provide obvious benefits?
  
  
• There is growing evidence that the individual long chain saturated fatty acids do not have an equal effect on the risk factors for CVD. While it is generally recognized that myristic acid is the most hypercholesterolemic saturated fatty acid, there is still debate on the relative benefits of stearic, lauric and palmitic acids. Should recommendations regarding replacement of trans with saturates take into consideration that all saturates may not have the same effect on CVD risk?
  
  
• As consumers are turning away from trans fats and products made with partially hydrogenated oils, there is a temptation in some cases (e.g., some baked goods, cookies) to turn back towards alternatives such as butter and tropical oils which are major sources of saturated fats. Based on your analysis, would there still be an overall net health benefit to Canadians if partially hydrogenated oils were effectively eliminated from our food supply but substituted, in some instances, with butter and tropical oils?

As co-chairs of the Task Force, we would like to invite you to provide your comments on any or all of these questions, as well as any other questions regarding the health implications of alternatives to partially hydrogenated oils.

A technical consultation is planned during the next meeting of the Task Force on November 2, 2005 in Ottawa, Canada, to address the health implications of alternatives to trans fats. If it were possible for you to attend, this would provide an opportunity to present and discuss your perspectives with the Task Force members who are presently seeking expert advice before developing their final recommendations to the Canadian Minister of Health. We are currently finalizing a review paper regarding these questions and would also welcome your comments and/or review of the document.

If you agree to participate in the next public consultation meeting of the Task Force in Ottawa, Canada, on November 2, 2005, we will cover your expenses: transportation, hotel accommodations and meals. Please let us know by September 20^th which question(s) you intend to address in your presentation by sending a note to:

Cynthia Piazza

If you would rather provide us your input on the review paper, please let us know as well and we will contact you to discuss and establish appropriate arrangements.

We thank you in advance for accepting to share with the Task Force your expertise on this matter and we are looking forward to discussing with you these important issues which will form the basis of our final recommendations.

Sincerely,

Dr. Mary R. L'Abbé, Co-chair Director, Bureau of Nutritional Sciences Health Canada	Ms. Sally Brown, Co-chair CEO, Heart and Stroke Foundation of Canada