EU Science Hub

Dietary Fats

Table of Contents

1. Defining fats

2. Dietary sources of fats
3. Labelling of fats in the EU
4. Fat intake: effects on health
5. Recommended intake of fat
6. Fat intake across European countries
7. Disease burden related to fat intake
8. Policy recommendations on fat intake
9. Implemented policies addressing fats

1. Defining fats

Dietary fats (or dietary lipids) are important dietary components that constitute a major energy source (supplying 9 kcal/g) for the human organism and are involved in many vital processes. They are critical components of cell membranes, carriers for nutrients such as fat soluble vitamins, precursors of bioactive compounds, while fats and fatty acids (components of fats) can also influence gene expression. In EU legislation (EU 2011) fats are referred to as total lipids including phospholipids.

Dietary fats consist mainly of triglycerides (triacylglycerols), mono- and diacylglycerols, phospholipids and lipids such as cholesterol) (Present Knowledge in Nutrition 2012, EFSA 2010). Triglycerides are molecules composed of three fatty acids attached to a glycerol backbone. Phospholipids have important roles in the body such as structural components of cell membranes and lipoprotein particles. As for cholesterol, it is a sterol that, due to its physicochemical properties, is also included in dietary fats. While it does not provide energy, cholesterol plays a central role in many metabolic processes including the synthesis of vitamin D, bile acids and several hormones (Present Knowledge in Nutrition 2012, EFSA 2010).

The nomenclature and grouping of the fatty acids is based on the number of carbon atoms (the majority have even number of carbon atoms) and number of double bonds they possess. This kind of classification has inherent limitations and although 'the large body of epidemiological evidence about total fats, fatty acids, and human health apply these groupings and show that the major groups of fatty acids are associated with different health effects' (FAO 2010), individual fatty acids within each broad category can have distinct biological properties. This has relevance in making global recommendations, 'because intakes of the individual fatty acids that make up the broad groupings will differ across regions of the world depending on the predominant food sources of total fats and oils' (FAO 2010).

Dietary fatty acids can be classified in saturated fatty acids (SFA), and unsaturated fatty acids which include monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA). Unsaturated fatty acids can also be classified based on the geometric configuration of their double bonds; most have the cis­ configuration, however some fatty acids have at least one double bond in the trans­ configuration. These are referred to as trans fatty acids (TFA). Definitions for the above fatty acid categories, as well as common examples of specific fatty acids can be found in Table 1.

SFAs can be further classified based on their chain length, i.e. number of carbon atoms (C) in the molecule, into short, medium, long and very long chain fatty acids. Two PUFAs, alpha-linolenic acid (ALA) and linoleic acid (LA), and also known as omega-3 (ω-3 or n-3) and omega-6 (ω-6 or n-6), respectively, are essential to humans (i.e. must be provided through the diet) (Present Knowledge in Nutrition 2012, EFSA 2010). In addition, other long-chain (LC) PUFAs (e.g., the ω-3 PUFAs eicosapentaenoic acid EPA and docosahexaenoic acid DHA) are sometimes referred to as conditionally essential as they can be synthesized by humans but this is not always sufficient and these fatty acids therefore may need to be supplied in certain disorders. The term conjugated linoleic acid (CLA) refers to a mixture of isomers of linoleic acid that differ from other PUFA in their double bond chemistry (EFSA 2010).

TFAs can be further classified into naturally occurring, ruminant TFA (rTFA) and industrially produced or iTFA; rTFA are produced by bacterial transformation of unsaturated fatty acids in ruminant animals, while iTFAs are formed during the incomplete (partial) hydrogenation of liquid (mostly plant) oils into solid or semi-solid fats, referred to as partially hydrogenated (vegetable) oils (PHO or PHVO). Industrial and ruminant TFA essentially contain the same compounds (Table 1), yet in different proportions (EFSA 2010).

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2. Dietary sources of fats

Dietary fat intake comes predominantly (98%) in the form of triglycerides, derived from both animal- and plant-based products (IOM 2005). Butter, margarine, vegetable oils, meat and poultry, milk and dairy products, egg yolk, nuts and a variety of processed foods are the main sources of dietary fat. Main dietary sources for the different categories of fatty acids can be found in Table 2.

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3. Labelling of fats in the EU

In the EU, Regulation (EU) 1169/20111 on food information to consumers requires mandatory nutrition declaration for total and saturated fats (in g per 100 g of product) in prepacked foods. This mandatory information may be supplemented with an indication of the amounts of MUFA and PUFA. It is not allowed to declare the TFA (as well as cholesterol) content in the nutrition declaration (EC 2015); however, Reg. (EU) 1169/2011 requires that information that is given in the ingredient list includes presence of partially (containing among others TFA) or fully (containing no TFA but SFA only) hydrogenated oils. Therefore, in the EU, 'checking the ingredient list of pre-packed foods for partially hydrogenated oils is the only possibility for consumers to identify products that may contain TFA, although this is not giving any indication about the actual TFA content' (EC 2015).

Other fat-related labelling provisions include the exclusion of refined soybean oil and fat from mandatory declaration as soybean product allergens, voluntary grouping together of refined fats or oils of vegetable origin under the generic designation 'vegetable fats' or 'vegetable oils', followed by a list of indications of specific vegetable origin, and limits for total fat content when designating animal minced or skeletal muscle with adherent tissue as 'meat'. Under Regulation (EU) 1924/2006 (EC 2006) for health and nutrition claims made on foods, the following fat-related nutrition claims are permitted:

  • Fat free claims 'may only be made where the product contains no more than 0,5 g of fat per 100 g or 100 ml. However, claims expressed as 'X % fat-free' shall be prohibited.'
  • Low fat claims 'may only be made where the product contains no more than 3 g of fat per 100 g for solids or 1,5 g of fat per 100 ml for liquids (1,8 g of fat per 100 ml for semi-skimmed milk).'
  • Saturated fat free claims 'may only be made where the sum of saturated fat and trans-fatty acids does not exceed 0,1 g of saturated fat per 100 g or 100 ml.'
  • Low saturated fat claims 'may only be made if the sum of saturated fatty acids and trans-fatty acids in the product does not exceed 1,5 g per 100 g for solids or 0,75 g/100 ml for liquids and in either case the sum of saturated fatty acids and trans-fatty acids must not provide more than 10% of energy.'
  • Source of omega-3 fatty acids claims 'may only be made where the product contains at least 0,3 g α-linolenic acid per 100g and per 100kcal, or at least 40mg of the sum of eicosapentaenoic acid and docosahexaenoic acid per 100g and per 100kcal.'
  • High omega-3 fatty acids claims 'may only be made where the product contains at least 0,6 g alpha-linolenic acid per 100 g and per 100 kcal, or at least 80 mg of the sum of eicosapentaenoic acid and docosahexaenoic acid per 100 g and per 100 kcal.'
  • High unsaturated fat claims 'may only be made where at least 70% of the fatty acids present in the product derive from unsaturated fat under the condition that unsaturated fat provides more than 20% of energy of the product.'
  • High monounsaturated fat claims 'may only be made where at least 45% of the fatty acids present in the product derive from monounsaturated fat under the condition that monounsaturated fat provides more than 20% of energy of the product.'
  • High polyunsaturated fat claims 'may only be made where at least 45% of the fatty acids present in the product derive from polyunsaturated fat under the condition that polyunsaturated fat provides more than 20% of energy of the product.'

Approved nutrition and health claims can be found at the relevant EU Register (DG SANTE).

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4. Fat intake: effects on health

A number of national or international institutions have examined the potential impact of fat consumption on health, focusing mainly on cardiovascular and Type 2 Diabetes (T2D) related effects. The statements or opinions of these institutions are shown in Table 3a-f. Most of the opinions listed below concur that replacing SFA with PUFA, and in some cases MUFA, has favourable effects on CVD- or T2D-related clinical endpoints, while all agree that replacing TFA with PUFA and MUFA has the most favourable effects on serum lipid concentration and coronary heart disease risk.

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5. Recommended intake of fats

Many nutrition and health-related organisations have issued dietary recommendations on fat intake (Table 4). These acknowledge the importance of fat intake for human physiology as well as the evidence regarding the health implications of high SFA and TFA intake. Most recommend a total fat consumption range of 20 – 35 E% (i.e. % of total daily energy intake), with recommendations ranging from 15 to 40 E% for specific populations or age categories. All recommendations reviewed here recommend reducing SFA intake, with recommendations varying between 7 – 12 E%, as well as indicate to avoid or limit TFA intake as much as possible or to less than 1 or 2 E%. The consumption of unsaturated fatty acids is instead encouraged, especially when replacing SFA and TFA. Specific recommendations vary, depending on type (MUFA, n-3 or n-6 PUFA), population group and on the institution issuing the recommendation. Cholesterol intake recommendations also vary.

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6. Fat intake across European countries

In the EU, EFSA 2010 compiled data on total fat, MUFA, PUFA, SFA, TFA and cholesterol intake, drawn from national food consumption surveys conducted from 1994 onwards, as well as from data in the European Nutrition Heath Report of 2009 (ENHR 2009). Table 5 reports fat intake across EU countries. Due to differences in the methodology used to assess individual intakes, different age classifications, and different time points analysed, EFSA notes that the quality and quantity of data varies, making direct comparisons difficult.

Excluding infants up to 18 months of age, the EFSA data demonstrate that the average total fat intakes in children and adolescents reported from European countries varied between 28-42 E%. In adults, average total fat intakes ranged from less than 30 up to 47 E%. Lowest total fat intakes were observed in Norway and Portugal and highest in Latvia, Lithuania and Greece.

Average SFA intakes were between 11 and 13 E% in infants and between 13 and 15 E% in children; lower intakes (10-11 E%) were observed in Italy and Hungary, while higher intakes (15 E% or more) were observed in some age groups in Belgium, Denmark and the UK. Adult SFA intake ranged from less than 9 to more than 26 E% in those aged 35 and older. About one third of those aged 35 and older had average intakes of ≥15 E%.

Average MUFA intakes varied from 8 to 11 E% in infants, children and adolescents, with highest intakes observed in Spain and Portugal. In adults, average intakes ranged from 11 to 18 E%, with the exception of Greece, where higher intakes were observed (22-23 E%).

For PUFA intakes, average intakes ranged between 4 and 5 E% for infants and between 4 and 9 E% for children and adolescents, with highest intakes in Hungary. Average PUFA intakes in adults ranged from 4 to 8 E%, and were highest in Lithuania and Hungary.

TFA intake data in children from Denmark, the Netherlands, Sweden and the UK showed average intakes between 0.6 and 1.7 E%. Adult TFA intake data from Denmark, Finland, Netherlands and the UK indicated a similar range, from 0.5 to 1.6 E %. A JRC study compiling data from 9 EU Member States reported that population average of daily TFA intakes are less than 1 E%. Post 2010 national surveys in Belgium, Denmark, France and the Netherlands show similar trends (Table 5). However, some population groups in specific countries exceed or are at risk of exceeding this threshold (JRC 2014, EC 2015a).

Cholesterol intakes ranged from 100 to more than 400 mg/day and 180 to 600 mg/day for children (<15 yrs.) and adolescents (15-18 yrs.), respectively; highest values were observed in Germany. In adults, average cholesterol intake ranged from 200 to 550 mg/day, except for Romania, where average intakes reached 700-800 mg/day.

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7. Disease burden related to fat intake

As described in Table 3, depending on the type of dietary fat in question, overconsumption or lack of intake of specific fatty acids can be a risk factor for ill health. For example, the Global Burden of Disease 2017 (GBD study 2017) study estimated that diets high in TFA (defined as consumption of more than 0.5 E% from TFA from all sources) resulted in more than 16.500 premature deaths in 2017 in the EU, as well as in approximately 250,000 Disability Adjusted Life years (DALYs – sum of years lost due to premature death and years lived with disability) (GBD results tool). Diets low in PUFA (defined as diets with less than 12 E% from PUFA from all sources) accounted for almost 70,000 premature deaths in the EU, and in almost 1 million DALYs (GBD results tool). In addition, diets low in omega-3 fatty acids from seafood (defined as diets with less than 250 mg of DHA and EPA – e.g. in tablet or fish form - intake per day), accounted for approx. 123,000 premature deaths in the EU, as well as in more than 1.7 million DALYs (GBD results tool).

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8. Policy recommendations on fat intake

A number of scientific associations, institutions and authorities have issued policy recommendations that ultimately aim to reduce intake of SFA and TFA (Table 6).

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9. Implemented policies addressing fat intake

The aim of this paragraph is to present examples of state policies that are already in place and address fat intake. Similarly to policy recommendations, most of the implemented policy approaches can be broadly categorised in those that aim to provide information, make the healthy option available, or provide financial (dis)incentives related to fat consumption. Governments around the world have adopted different measures aimed mainly to reduce SFA and TFA intake (Table 7), from legally binding obligations, e.g. limiting iTFA content in foods, to voluntary actions involving co-operation with related stakeholders, e.g. the voluntary reformulation of foods to reduce the SFA and TFA content.

 

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References