TY - JOUR
AU - Vesper, Hubert W
AB - ABSTRACT Background Intake of trans fatty acids (TFAs) increases LDL cholesterol, decreases HDL cholesterol, and increases the risk of heart disease morbidity and mortality. Many food products potentially contain industrially produced or ruminant TFAs. However, little is known about the dietary sources of plasma TFA concentrations. Objective The objective of this study was to examine associations between foods consumed and plasma TFA concentrations using 24-h dietary recall data and plasma TFA measures among adults aged ≥20 y who participated in the NHANES 2009–2010 in the United States. Methods Over 4400 food products in the dietary interview data were categorized into 32 food and beverage groups/subgroups. Four major plasma TFAs (palmitelaidic acid, elaidic acid, vaccenic acid, linolelaidic acid) and the sum of the 4 TFAs (sumTFAs) were analyzed using GC-MS. Multivariable linear regression analyses were conducted to identify associations of plasma TFAs with all 32 food and beverage groups/subgroups, controlling for the potential confounding effects of 11 demographic, socioeconomic, behavioral, lifestyle, and health-related variables. Results Consumption of the following food groups/subgroups was significantly associated with elevated plasma TFA concentrations: cream substitutes (P < 0.001 for palmitelaidic acid, elaidic acid, vaccenic acid, and sumTFAs); cakes, cookies, pastries, and pies (P < 0.001 for elaidic acid, vaccenic acid, and sumTFAs; P < 0.05 for linolelaidic acid); milk and milk desserts (P < 0.01 for palmitelaidic acid and vaccenic acid; P < 0.05 for linolelaidic acid and sumTFAs); beef/veal, lamb/goat, and venison/deer (P < 0.01 for vaccenic acid; P < 0.05 for sumTFAs); and butters (P < 0.001 for palmitelaidic acid and vaccenic acid; P < 0.05 for sumTFAs). Conclusions The findings suggest that the above 5 food groups/subgroups could be the main dietary sources of plasma TFAs among adults in the United States in 2009–2010. trans fatty acids, dietary intake, plasma, adults, nutrition, NHANES Introduction Dietary intake of trans fatty acids (TFAs) increases LDL cholesterol, decreases HDL cholesterol, and increases the risk of coronary artery disease morbidity and mortality and all-cause mortality (1, 2). Dietary TFA intake is estimated to cause half a million deaths from coronary artery disease annually worldwide (3). The WHO has called for elimination of industrially produced TFAs from the global food supply by 2023 (4). There are 2 main sources of TFAs from foods: industrially produced or artificial TFAs and ruminant or natural TFAs (5). Both industrially produced TFAs and ruminant TFAs consist of the same positional trans-isomers, with different distribution and quantity in foods. Partially hydrogenated oils (PHOs), the primary sources of industrially produced TFAs, had been widely used in margarines, shortenings, baked goods, and processed, frozen, and fried foods. Ruminant TFAs are found in smaller quantities in dairy products and meat of ruminant animals (e.g., cattle, sheep, and goats). Exposure to TFAs can be estimated in 2 ways. The first is to calculate total intake based on the consumption of all foods that possibly contain TFAs (6, 7); the second is to directly measure TFAs in human biological tissues (e.g., adipose tissues or blood fractions) (8–11). Estimation of TFA intake from foods relies on a dietary assessment and knowledge of the TFA contents of a wide range of food products (6, 7). In practice, this method is difficult to apply in large nutrition surveys because of a lack of timely and accurate information on the TFA contents in the food products. In contrast, TFA concentrations in human biological tissues can be used as a biomarker to measure dietary TFA intake from foods (8–11). Previous studies have shown a good correlation between TFA intake from foods and TFA concentrations in various human biological tissues, including adipose tissues, erythrocytes, and plasma (8, 9). Based on their distinct turnover rates, adipose tissues can be considered the best choice to assess long-term TFA intake, erythrocytes can be used to assess medium-term TFA intake, and plasma and serum are best used to assess short-term TFA intake (10, 11). In large population–based cross-sectional health and nutrition surveys, plasma or serum TFA concentrations have been used to assess short-term TFA exposure and their associations with serum lipoprotein concentrations (12–14). Many food products potentially contain industrially produced or ruminant TFAs (5). Recent research (14, 15) showed that blood concentrations of TFAs have declined in the United States and elimination of industrially produced TFAs in foods is proceeding worldwide. PHOs are no longer “generally recognized as safe” (GRAS) and they have been removed from the food supply since January 2021 in the United States (16). However, many countries around the world have not banned the use of TFAs in their food industry and little is known about the TFA contents in various foods and the food sources of plasma TFA concentrations. Assessing the direct relations between the consumption of food groups/subgroups that potentially contain TFAs and plasma TFA concentrations could help identify major dietary sources of TFA exposure in the American adult population at the time of survey prior to the ban of TFAs and provide useful information for other countries with consumption of similar foods. Therefore, the objective of this study was to examine the correlations and associations between the consumption of foods and beverages and plasma TFA concentrations using 24-h dietary recall data and plasma TFA measures among adults aged ≥20 y who participated in the NHANES 2009–2010 in the United States. Methods Study design and participants The NHANES, conducted by the National Center for Health Statistics (NCHS), CDC (https://www.cdc.gov/nchs/nhanes/index.htm), uses a complex, multistage, probability sampling design and includes a representative sample of the noninstitutionalized population in the United States. Among the adults aged ≥20 y who participated in the examination at the mobile examination center (MEC) in NHANES 2009–2010 (total n = 6059, unweighted response rate = 72.2%), males and nonpregnant females who provided blood samples after fasting ≥8 h were eligible for this study (n = 2595). Written informed consent was obtained from all adult participants. The Research Ethics Review Board at NCHS reviewed and approved the NHANES protocols. Dietary interview component The NHANES 2009–2010 dietary data were used to estimate the types and amounts of foods and beverages consumed during the 24-h period prior to the interview at the MEC. The data were collected in the dietary interview component, called “What We Eat in America,” as a partnership between the US Department of Agriculture (USDA) and the US Department of Health and Human Services (DHHS). All NHANES examinees were eligible for two 24-h dietary recall interviews. The first 24-h dietary recall interview was administered during the examination at the MEC. The dietary interviews were conducted by trained interviewers in person using USDA's Automated Multiple-Pass Method (AMPM). The respondents report an uninterrupted listing of all foods and beverages consumed in the 24-h midnight-to-midnight period the day before the interview. The AMPM was designed to provide an efficient and accurate means of collecting food intake in large-scale surveys. In NHANES 2009–2010, all participants were asked to complete a second 24-h dietary recall interview, which was administered by telephone ∼3–10 d after the MEC exam. A total of 4409 specific food products were recorded in the NHANES 2009–2010 dietary data. The USDA Food and Nutrient Database for Dietary Studies 2011–2012 (17) was used to categorize food products into 9 food groups: milk and milk products; meat, poultry, and fish; eggs; legumes, nuts, and seeds; grain products; fruits; vegetables; fats and oils; and sugars, sweets, and beverages. In addition, within some food groups, we distinguished several food subgroups that potentially contain TFAs: milk and milk desserts; cheese; dairy cream; other milk and milk products; beef/veal, lamb/goat, and venison/deer; cakes, cookies, pastries, and pies; crackers, popcorn, pretzels, and corn chips; ready-to-eat cereals; quick breads, pancakes, and French toast; fried potatoes; cream substitutes; margarine; and butters, resulting in a total of 32 food and beverage groups/subgroups (Supplementary Table 1). In each food and beverage group/subgroup, total quantity (g) and energy (kcal) of all individual food and beverage products were summed. Plasma TFA measures Details of the laboratory methods and plasma TFA measures in NHANES 2009–2010 have been published elsewhere (12–14). In brief, 4 TFAs in plasma were analyzed by using GC-MS following a standard laboratory protocol: palmitelaidic acid (C16:1n–7trans), trans-vaccenic acid (C18:1n–7trans), elaidic acid (C18:1n–9trans), and linolelaidic acid (C18:2n–6trans,9trans). These 4 TFAs represent the major TFAs in foods, which account for ∼40–60% of TFAs that have been reported in humans (18). Thus, the plasma TFAs measured in NHANES 2009–2010 provide information about the overall TFA exposure in the US population. Total dietary TFA intake from foods Total dietary TFA intake from foods and beverages (g/d) was calculated by multiplying the amount of each specific food product consumed in the past 24 h with the TFA content (g per 100 g) in the food product. The TFA content in food products was based on the USDA National Nutrient Database for Standard Reference Release 23 published in 2010 for the NHANES 2009–2010 dietary data (19). Covariates To account for potential confounding effects on the associations between consumption of foods and beverages and plasma TFA concentrations, 11 variables were included in the analyses: age (y), sex (male vs. female), race/Hispanic origin (White, Black, Mexican American, other), education (less than high school, high school, some college or above), income-to-poverty ratio (a ratio of family income to poverty thresholds defined by the 2009 DHHS poverty guidelines), smoking status (current, former, never), BMI (weight/height squared; in kg/m2), self-reported weight change in the past year (kg), physical activity [total metabolic equivalent (MET)-minutes in the past week], self-reported general health (excellent/very good/good vs. fair/poor), and use of statin medication (yes vs. no). Statistical analysis A total of 5 plasma TFA measures (4 individual plasma TFAs and their sum) were analyzed as dependent (or outcome) variables in separate multivariable (or multiple) linear regression models. A total of 32 food and beverage groups/subgroups were analyzed as independent (or exposure) variables in the regression models. A total of 11 selected demographic, socioeconomic, behavioral, lifestyle, and health-related variables were analyzed as covariates (or possible confounders) in the regression models. Among eligible adult participants (n = 2595), those with missing data in dietary recall (n = 68), in any of the 4 plasma TFA measures (n = 153), and in any of the 11 covariates (n = 282) were excluded in the final analytic sample (n = 2092). An additional 131 participants with missing data in total dietary TFA intake from foods and beverages were excluded from the analyses on the association between total dietary TFA intake from foods and beverages and plasma TFAs (n = 1961) (Supplementary Figure 1). In the main analyses (n = 2092), we examined the distributions of each of the 32 groups/subgroups, the percentage of participants who consumed the foods and beverages in the past 24 h, and the median, 75th percentile, and 95th percentile of dietary energy intake. Because of the skewed distribution of plasma TFAs and dietary intake data, Spearman's rank-order correlation was used to measure the strength of monotonic relations between dietary intake variables and plasma TFA concentrations. Due to skewness, plasma TFA measures were log-transformed to improve normality; the natural-logarithmic transformations of plasma TFA measures were used as outcome variables in multivariable linear regression analyses to identify their associations with all 32 food and beverage groups/subgroups, controlling for the potential confounding effects of 11 covariates that may be associated with both consumption of foods and beverages and plasma TFA concentrations. The consumption of food and beverage groups/subgroups was divided by 100 to create a new scale of 100-kcal units. To facilitate interpretations of the results, the regression coefficients and their 95% CIs of the log-transformed plasma TFA outcome variables for each food and beverage group/subgroup were back-transformed to their original metric scale (µmol/L) by exponentiating the regression coefficients [exp (β)] and the lower and upper limits of the 95% CIs [exp (β ± 1.96 × SE)]. Therefore, the regression coefficients of the food group/subgroup measures for each plasma TFA measure indicate the change (or ratio) in plasma TFA concentrations associated with each 100-kcal change in the consumption of each food and beverage group/subgroup while controlling for the consumption of all other foods and beverages as well as selected covariates. In the subanalysis (n = 1961), we examined the associations between the calculated TFA intake from foods and plasma concentrations of the sum of the 4 TFAs (sumTFAs). We used 2 cutoff points (0.5 g/d and 2.2 g/d) for the total calculated TFA intake from foods to categorize the participants into 3 groups (<0.5 g/d, 0.5 g/d to 2.1 g/d, and ≥2.2 g/d) and conducted a linear trend test and pairwise t tests for the mean plasma concentrations of sumTFAs across these 3 groups. Because 19.4% of data were missing for the main analyses and 24.4% of data were missing for the subanalyses, we compared the key characteristics of adults with complete data and missing data (Supplementary Table 2). We further examined the potential impact of nonresponse by adjusting the original sampling weights using the propensity modeling approach (20). There were minor differences in the point and variance estimates by using adjusted sampling weights (relative differences in the point estimates between the regression models with original sample weights and those with adjusted sample weights ranged from 0.0003% to 0.25%, with 87% of all relative differences <0.1%); therefore, we presented all estimates using the original TFA subsample 2-y weights (WTTFA2YR). We analyzed data using the SAS survey analysis procedures for Windows (release 9.4; SAS Institute, Inc.). The first 24-h dietary recall data were used as the main analysis to examine the cross-sectional associations between consumption of foods in the past 24 h and plasma TFA concentrations. The mean food consumption from the first and second 24-h dietary recalls was calculated to approximate usual intake in the past week, with an assumption that dietary patterns were similar before and after the week of the MEC exam, and these data were used to replicate the main analyses for the purpose of sensitivity assessment. In all analyses, stratification, clustering, and the TFA subsample 2-y weights were used to account for the varying probabilities of complex sampling design and nonresponse of the NHANES data. Potential multicollinearity among the predictor variables in the multivariable linear regression analyses was tested by examining their correlation coefficients, tolerance, and variance inflation statistics. A tolerance measure >0.1 and a variance inflation factor measure <10 were used to identify possible multicollinearity. We considered results of 2-tailed t tests to be significant if P values were <0.05. Results Descriptive statistics of the sample and the overall weighted geometric means of plasma TFA concentrations The analytic (complete-case) sample was similar in the distribution of age, sex, and income-to-poverty ratio (all P > 0.05), but differed in race/Hispanic origin and educational attainment (all P < 0.01) (Supplementary Table 2). The geometric means of plasma concentrations for 4 individual TFAs were similar between the analytic sample and the missing-data sample (all P >0.05). In the analytic sample, 48.4% were males. The mean age was 47.3 y. There were 70.6% non-Hispanic Whites, 10.7% non-Hispanic Blacks, 8.0% Mexican Americans, and 10.7% in the other race/Hispanic origin category. Most (60.1%) had some college, college, or higher education, and 34.4% had a high school education. Fourteen percent had a family income below the poverty threshold ($22,050 in 2009 and $22,314 in 2010). Nineteen percent were current smokers, 16.6% reported fair or poor health, and 17.5% reported use of statins. The mean BMI was 28.8 kg/m2. The overall weighted geometric means of plasma TFA concentrations were 3.86 µmol/L (95% CI: 3.75–3.98 µmol/L) for palmitelaidic acid, 13.50 µmol/L (95% CI: 12.84–14.20 µmol/L) for trans-vaccenic acid, 18.01 µmol/L (95% CI: 17.28–18.77 µmol/L) for elaidic acid, 1.58 µmol/L (95% CI: 1.52–1.65 µmol/L) for linolelaidic acid, and 37.49 µmol/L (95% CI: 35.99–39.07 µmol/L) for sumTFAs. The absolute magnitudes of Spearman correlation coefficients were <0.5 among the 32 food groups/subgroups (r ranging from −0.19 to 0.37), among the 11 covariates (r ranging from −0.28 to 0.43), and among the 43 food groups/subgroups and covariates (r ranging from −0.28 to 0.43). In the regression model to test the multicollinearity, all tolerance measures were >0.1 (ranging from 0.65 to 0.97) and all variance inflation factors were <1.6 (ranging from 1.0 to 1.5), indicating absence of multiple collinearity among the food groups/subgroups and the covariates. Distribution of consumption by USDA food and beverage groups/subgroups Among the food and beverage groups/subgroups that potentially contain TFAs, 56.4% of US adults consumed milk or milk desserts (Table 1); 43.5% consumed cakes, cookies, pastries, and pies; 21.1% consumed cream substitutes; 20.5% consumed beef/veal, lamb/goat, and venison/deer; and 22.0% consumed quick breads, pancakes, and French toast. More than 10% consumed butters (11.4%) or margarine (12.7%). Within these food groups/subgroups, the weighted median calories consumed during the past 24 h ranged from 0 to 45.4 kcal; the 75th percentile of calories ranged from 0 to 197.9 kcal. Almost 90% of US adults consumed foods that contain TFAs. Median TFA calories consumed from foods was 2.2 kcal or 0.3% of total energy. Approximately 16% of US adults had a TFA intake >0.5% of total energy in the past 24 h; 8% had a TFA intake >1% of total energy, the maximum amount recommended by the WHO. TABLE 1 Distribution of food consumption in the past 24 h among US adults aged ≥20 y, NHANES 2009–20101 . Participants who consumed the foods in past 24 h, % . Consumption, kcal . Percentage of total energy intake . USDA food group/subgroup2 . Median . 75th percentile . 95th percentile . Median . 75th percentile . 95th percentile . 1. Milk and milk products  1.1 Milk and milk desserts 56.4 45.4 180.2 467.9 2.4 9.1 22.0  1.2 Cheese 40.1 0.0 87.3 278.8 0.0 4.4 12.8  1.3 Dairy cream 11.6 0.0 0.0 52.6 0.0 0.0 2.5  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 10.2 0.0 0.0 178.6 0.0 0.0 8.4 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 62.8 97.6 283.1 667.8 4.7 13.8 32.3  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 38.1 0.0 270.4 808.4 0.0 13.4 37.5  2.3 Beef/veal, lamb/goat, and venison/deer 20.5 0.0 0.0 403.8 0.0 0.0 18.1 3. Eggs 20.6 0.0 0.0 282.6 0.0 0.0 13.8 4. Legumes; nuts and seeds  4.1 Nuts and seeds 21.1 0.0 0.0 374.7 0.0 0.0 16.4  4.2 Legumes 19.2 0.0 0.0 234.8 0.0 0.0 12.4 5. Grain products  5.1 Yeast breads and rolls 61.7 106.0 210.0 433.7 4.7 10.8 21.4  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 53.4 89.3 434.3 1127.2 4.5 21.6 45.7  5.3 Cakes, cookies, pastries, and pies 43.5 0.0 197.9 673.2 0.0 10.0 26.8  5.4 Crackers, popcorn, pretzels, and corn chips 33.3 0.0 78.7 375.3 0.0 4.0 15.9  5.5 Ready-to-eat cereals 23.7 0.0 0.0 248.8 0.0 0.0 14.2  5.6 Quick breads, pancakes, and French toast 22.0 0.0 0.0 419.9 0.0 0.0 20.6 6. Fruits 56.8 45.2 152.5 366.0 2.1 7.9 18.7 7. Vegetables  7.1 All other vegetables 75.9 30.5 120.4 342.8 1.5 6.1 18.0  7.2 Fried potatoes 29.4 0.0 96.6 406.7 0.0 3.8 17.0 8. Fats and oils  8.1 Salad dressing 29.7 0.0 18.4 173.4 0.0 1.0 9.1  8.2 Cream substitutes3 17.4 0.0 0.0 53.4 0.0 0.0 2.9  8.3 Margarine 12.7 0.0 0.0 50.8 0.0 0.0 3.0  8.4 Butters 11.4 0.0 0.0 60.6 0.0 0.0 3.0  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) 1.3 0.0 0.0 0.0 0.0 0.0 0.0  8.6 Vegetable oils 1.2 0.0 0.0 0.0 0.0 0.0 0.0 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 80.5 0.0 0.0 0.0 0.0 0.0 0.0  9.2 Sugar and candy 57.3 9.7 69.9 325.9 0.6 3.7 15.3  9.3 Coffee 53.8 0.0 5.0 31.7 0.0 0.3 1.8  9.4 Carbonated soft drinks 50.7 0.0 117.8 406.5 0.0 4.7 17.4  9.5 Alcoholic beverages 26.8 0.0 82.3 548.8 0.0 3.6 24.6  9.6 Tea 25.4 0.0 1.2 118.2 0.0 0.1 5.7  9.7 Fruit juice and fruit-flavored drinks 17.6 0.0 0.0 255.4 0.0 0.0 11.2 Total dietary TFA intake from foods (n = 1961) 89.9 2.2 7.0 41.2 0.1 0.3 1.7 . Participants who consumed the foods in past 24 h, % . Consumption, kcal . Percentage of total energy intake . USDA food group/subgroup2 . Median . 75th percentile . 95th percentile . Median . 75th percentile . 95th percentile . 1. Milk and milk products  1.1 Milk and milk desserts 56.4 45.4 180.2 467.9 2.4 9.1 22.0  1.2 Cheese 40.1 0.0 87.3 278.8 0.0 4.4 12.8  1.3 Dairy cream 11.6 0.0 0.0 52.6 0.0 0.0 2.5  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 10.2 0.0 0.0 178.6 0.0 0.0 8.4 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 62.8 97.6 283.1 667.8 4.7 13.8 32.3  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 38.1 0.0 270.4 808.4 0.0 13.4 37.5  2.3 Beef/veal, lamb/goat, and venison/deer 20.5 0.0 0.0 403.8 0.0 0.0 18.1 3. Eggs 20.6 0.0 0.0 282.6 0.0 0.0 13.8 4. Legumes; nuts and seeds  4.1 Nuts and seeds 21.1 0.0 0.0 374.7 0.0 0.0 16.4  4.2 Legumes 19.2 0.0 0.0 234.8 0.0 0.0 12.4 5. Grain products  5.1 Yeast breads and rolls 61.7 106.0 210.0 433.7 4.7 10.8 21.4  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 53.4 89.3 434.3 1127.2 4.5 21.6 45.7  5.3 Cakes, cookies, pastries, and pies 43.5 0.0 197.9 673.2 0.0 10.0 26.8  5.4 Crackers, popcorn, pretzels, and corn chips 33.3 0.0 78.7 375.3 0.0 4.0 15.9  5.5 Ready-to-eat cereals 23.7 0.0 0.0 248.8 0.0 0.0 14.2  5.6 Quick breads, pancakes, and French toast 22.0 0.0 0.0 419.9 0.0 0.0 20.6 6. Fruits 56.8 45.2 152.5 366.0 2.1 7.9 18.7 7. Vegetables  7.1 All other vegetables 75.9 30.5 120.4 342.8 1.5 6.1 18.0  7.2 Fried potatoes 29.4 0.0 96.6 406.7 0.0 3.8 17.0 8. Fats and oils  8.1 Salad dressing 29.7 0.0 18.4 173.4 0.0 1.0 9.1  8.2 Cream substitutes3 17.4 0.0 0.0 53.4 0.0 0.0 2.9  8.3 Margarine 12.7 0.0 0.0 50.8 0.0 0.0 3.0  8.4 Butters 11.4 0.0 0.0 60.6 0.0 0.0 3.0  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) 1.3 0.0 0.0 0.0 0.0 0.0 0.0  8.6 Vegetable oils 1.2 0.0 0.0 0.0 0.0 0.0 0.0 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 80.5 0.0 0.0 0.0 0.0 0.0 0.0  9.2 Sugar and candy 57.3 9.7 69.9 325.9 0.6 3.7 15.3  9.3 Coffee 53.8 0.0 5.0 31.7 0.0 0.3 1.8  9.4 Carbonated soft drinks 50.7 0.0 117.8 406.5 0.0 4.7 17.4  9.5 Alcoholic beverages 26.8 0.0 82.3 548.8 0.0 3.6 24.6  9.6 Tea 25.4 0.0 1.2 118.2 0.0 0.1 5.7  9.7 Fruit juice and fruit-flavored drinks 17.6 0.0 0.0 255.4 0.0 0.0 11.2 Total dietary TFA intake from foods (n = 1961) 89.9 2.2 7.0 41.2 0.1 0.3 1.7 1 n = 2092 with no missing data on the dependent variables, independent variables, and covariates, for all variables, except for total dietary TFA intake from foods (n = 1961). TFA, trans fatty acid. 2 The first 24-h (day 1) dietary recall data were used. Food subgroups were created to identify foods that potentially contain TFAs, including ruminant TFAs (milk and milk desserts; cheese, dairy cream; other milk and milk products; butters) or industrially produced TFAs (cakes, cookies, pastries, and pies; crackers, popcorn, pretzels, and corn chips; ready-to-eat cereals; quick breads, pancakes, and French toast; fried potatoes; cream substitutes; margarine). 3 Cream substitutes were considered as a nondairy product. Open in new tab TABLE 1 Distribution of food consumption in the past 24 h among US adults aged ≥20 y, NHANES 2009–20101 . Participants who consumed the foods in past 24 h, % . Consumption, kcal . Percentage of total energy intake . USDA food group/subgroup2 . Median . 75th percentile . 95th percentile . Median . 75th percentile . 95th percentile . 1. Milk and milk products  1.1 Milk and milk desserts 56.4 45.4 180.2 467.9 2.4 9.1 22.0  1.2 Cheese 40.1 0.0 87.3 278.8 0.0 4.4 12.8  1.3 Dairy cream 11.6 0.0 0.0 52.6 0.0 0.0 2.5  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 10.2 0.0 0.0 178.6 0.0 0.0 8.4 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 62.8 97.6 283.1 667.8 4.7 13.8 32.3  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 38.1 0.0 270.4 808.4 0.0 13.4 37.5  2.3 Beef/veal, lamb/goat, and venison/deer 20.5 0.0 0.0 403.8 0.0 0.0 18.1 3. Eggs 20.6 0.0 0.0 282.6 0.0 0.0 13.8 4. Legumes; nuts and seeds  4.1 Nuts and seeds 21.1 0.0 0.0 374.7 0.0 0.0 16.4  4.2 Legumes 19.2 0.0 0.0 234.8 0.0 0.0 12.4 5. Grain products  5.1 Yeast breads and rolls 61.7 106.0 210.0 433.7 4.7 10.8 21.4  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 53.4 89.3 434.3 1127.2 4.5 21.6 45.7  5.3 Cakes, cookies, pastries, and pies 43.5 0.0 197.9 673.2 0.0 10.0 26.8  5.4 Crackers, popcorn, pretzels, and corn chips 33.3 0.0 78.7 375.3 0.0 4.0 15.9  5.5 Ready-to-eat cereals 23.7 0.0 0.0 248.8 0.0 0.0 14.2  5.6 Quick breads, pancakes, and French toast 22.0 0.0 0.0 419.9 0.0 0.0 20.6 6. Fruits 56.8 45.2 152.5 366.0 2.1 7.9 18.7 7. Vegetables  7.1 All other vegetables 75.9 30.5 120.4 342.8 1.5 6.1 18.0  7.2 Fried potatoes 29.4 0.0 96.6 406.7 0.0 3.8 17.0 8. Fats and oils  8.1 Salad dressing 29.7 0.0 18.4 173.4 0.0 1.0 9.1  8.2 Cream substitutes3 17.4 0.0 0.0 53.4 0.0 0.0 2.9  8.3 Margarine 12.7 0.0 0.0 50.8 0.0 0.0 3.0  8.4 Butters 11.4 0.0 0.0 60.6 0.0 0.0 3.0  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) 1.3 0.0 0.0 0.0 0.0 0.0 0.0  8.6 Vegetable oils 1.2 0.0 0.0 0.0 0.0 0.0 0.0 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 80.5 0.0 0.0 0.0 0.0 0.0 0.0  9.2 Sugar and candy 57.3 9.7 69.9 325.9 0.6 3.7 15.3  9.3 Coffee 53.8 0.0 5.0 31.7 0.0 0.3 1.8  9.4 Carbonated soft drinks 50.7 0.0 117.8 406.5 0.0 4.7 17.4  9.5 Alcoholic beverages 26.8 0.0 82.3 548.8 0.0 3.6 24.6  9.6 Tea 25.4 0.0 1.2 118.2 0.0 0.1 5.7  9.7 Fruit juice and fruit-flavored drinks 17.6 0.0 0.0 255.4 0.0 0.0 11.2 Total dietary TFA intake from foods (n = 1961) 89.9 2.2 7.0 41.2 0.1 0.3 1.7 . Participants who consumed the foods in past 24 h, % . Consumption, kcal . Percentage of total energy intake . USDA food group/subgroup2 . Median . 75th percentile . 95th percentile . Median . 75th percentile . 95th percentile . 1. Milk and milk products  1.1 Milk and milk desserts 56.4 45.4 180.2 467.9 2.4 9.1 22.0  1.2 Cheese 40.1 0.0 87.3 278.8 0.0 4.4 12.8  1.3 Dairy cream 11.6 0.0 0.0 52.6 0.0 0.0 2.5  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 10.2 0.0 0.0 178.6 0.0 0.0 8.4 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 62.8 97.6 283.1 667.8 4.7 13.8 32.3  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 38.1 0.0 270.4 808.4 0.0 13.4 37.5  2.3 Beef/veal, lamb/goat, and venison/deer 20.5 0.0 0.0 403.8 0.0 0.0 18.1 3. Eggs 20.6 0.0 0.0 282.6 0.0 0.0 13.8 4. Legumes; nuts and seeds  4.1 Nuts and seeds 21.1 0.0 0.0 374.7 0.0 0.0 16.4  4.2 Legumes 19.2 0.0 0.0 234.8 0.0 0.0 12.4 5. Grain products  5.1 Yeast breads and rolls 61.7 106.0 210.0 433.7 4.7 10.8 21.4  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 53.4 89.3 434.3 1127.2 4.5 21.6 45.7  5.3 Cakes, cookies, pastries, and pies 43.5 0.0 197.9 673.2 0.0 10.0 26.8  5.4 Crackers, popcorn, pretzels, and corn chips 33.3 0.0 78.7 375.3 0.0 4.0 15.9  5.5 Ready-to-eat cereals 23.7 0.0 0.0 248.8 0.0 0.0 14.2  5.6 Quick breads, pancakes, and French toast 22.0 0.0 0.0 419.9 0.0 0.0 20.6 6. Fruits 56.8 45.2 152.5 366.0 2.1 7.9 18.7 7. Vegetables  7.1 All other vegetables 75.9 30.5 120.4 342.8 1.5 6.1 18.0  7.2 Fried potatoes 29.4 0.0 96.6 406.7 0.0 3.8 17.0 8. Fats and oils  8.1 Salad dressing 29.7 0.0 18.4 173.4 0.0 1.0 9.1  8.2 Cream substitutes3 17.4 0.0 0.0 53.4 0.0 0.0 2.9  8.3 Margarine 12.7 0.0 0.0 50.8 0.0 0.0 3.0  8.4 Butters 11.4 0.0 0.0 60.6 0.0 0.0 3.0  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) 1.3 0.0 0.0 0.0 0.0 0.0 0.0  8.6 Vegetable oils 1.2 0.0 0.0 0.0 0.0 0.0 0.0 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 80.5 0.0 0.0 0.0 0.0 0.0 0.0  9.2 Sugar and candy 57.3 9.7 69.9 325.9 0.6 3.7 15.3  9.3 Coffee 53.8 0.0 5.0 31.7 0.0 0.3 1.8  9.4 Carbonated soft drinks 50.7 0.0 117.8 406.5 0.0 4.7 17.4  9.5 Alcoholic beverages 26.8 0.0 82.3 548.8 0.0 3.6 24.6  9.6 Tea 25.4 0.0 1.2 118.2 0.0 0.1 5.7  9.7 Fruit juice and fruit-flavored drinks 17.6 0.0 0.0 255.4 0.0 0.0 11.2 Total dietary TFA intake from foods (n = 1961) 89.9 2.2 7.0 41.2 0.1 0.3 1.7 1 n = 2092 with no missing data on the dependent variables, independent variables, and covariates, for all variables, except for total dietary TFA intake from foods (n = 1961). TFA, trans fatty acid. 2 The first 24-h (day 1) dietary recall data were used. Food subgroups were created to identify foods that potentially contain TFAs, including ruminant TFAs (milk and milk desserts; cheese, dairy cream; other milk and milk products; butters) or industrially produced TFAs (cakes, cookies, pastries, and pies; crackers, popcorn, pretzels, and corn chips; ready-to-eat cereals; quick breads, pancakes, and French toast; fried potatoes; cream substitutes; margarine). 3 Cream substitutes were considered as a nondairy product. Open in new tab Correlations between consumption of foods and beverages and plasma TFA concentrations The consumption of the following food and beverage groups/subgroups was significantly correlated with sumTFAs and all individual TFAs: cream substitutes (r ranging from 0.08 to 0.14), quick breads, pancakes, and French toast (r ranging from 0.06 to 0.13); cakes, cookies, pastries, and pies (r ranging from 0.07 to 0.16); and coffee (r ranging from 0.06 to 0.10) (Table 2). The consumption of milk and milk desserts was significantly correlated with sumTFAs (r = 0.06), palmitelaidic acid (r = 0.11), vaccenic acid (r = 0.08), and linolelaidic acid (r = 0.06). The consumption of beef/veal, lamb/goat, and venison/deer was significantly correlated with sumTFAs (r = 0.07) and vaccenic acid (r = 0.10). The consumption of butters was significantly correlated with sumTFAs (r = 0.06), palmitelaidic acid (r = 0.09), and vaccenic acid (r = 0.08). The consumption of margarine was significantly correlated with sumTFAs (r = 0.07), palmitelaidic acid (r = 0.07), elaidic acid (r = 0.09), and vaccenic acid (r = 0.05). The consumption of carbonated soft drinks significantly correlated with sumTFAs (r = 0.11), elaidic acid (r = 0.12), vaccenic acid (r = 0.11), and linolelaidic acid (r = 0.11). TABLE 2 Spearman correlation coefficients between consumption of foods in the past 24 h (kcal) and plasma TFA concentrations (µmol/L, natural logarithmic scale) among US adults aged ≥20 y, NHANES 2009–20101 USDA food group/subgroup . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 0.11*** 0.02 0.08*** 0.06** 0.06**  1.2 Cheese 0.01 −0.07 0.02 0.00 −0.02  1.3 Dairy cream 0.02 −0.01 0.04 0.05 0.02  1.4 Other milk and milk products (flavored milk, protein supplement,smoothie) 0.00 −0.05 −0.03 −0.03 −0.04 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish −0.08*** −0.02 −0.06** −0.05* −0.05*  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food,fast food) −0.04 −0.02 −0.02 0.00 −0.03  2.3 Beef/veal, lamb/goat, and venison/deer 0.04 0.04 0.10*** 0.03 0.07** 3. Eggs −0.03 −0.01 −0.02 0.00 −0.02 4. Legumes; nuts and seeds  4.1 Nuts and seeds −0.03 −0.09*** −0.04 −0.10*** −0.07**  4.2 Legumes −0.06** −0.04* −0.05* −0.03 −0.05* 5. Grain products  5.1 Yeast breads and rolls 0.02 −0.01 0.03 −0.01 0.01  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) −0.07*** −0.09*** −0.05* −0.02 −0.07**  5.3 Cakes, cookies, pastries, and pies 0.08*** 0.13*** 0.16*** 0.07*** 0.14***  5.4 Crackers, popcorn, pretzels, and corn chips −0.02 −0.02 −0.01 0.00 −0.02  5.5 Ready-to-eat cereals 0.07 0.01 0.00 0.04 0.01  5.6 Quick breads, pancakes, and French toast 0.08*** 0.13*** 0.13*** 0.06*** 0.13*** 6. Fruits −0.02 −0.10*** −0.07** −0.07** −0.08*** 7. Vegetables  7.1 All other vegetables −0.01 −0.05 0.00 −0.04 −0.02  7.2 Fried potatoes −0.02 0.00 0.03 0.02 0.01 8. Fats and oils  8.1 Salad dressing −0.06** −0.09*** −0.04* −0.07*** −0.07**  8.2 Cream substitutes 0.08*** 0.14*** 0.13*** 0.09*** 0.13***  8.3 Margarine 0.07** 0.09*** 0.05* 0.03 0.07**  8.4 Butters 0.09*** 0.02 0.08*** 0.02 0.06*  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) −0.02 −0.03 −0.02 −0.01 −0.03  8.6 Vegetable oils −0.05* −0.08*** −0.06** −0.06* −0.07** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) −0.02 0.00 0.00 −0.01 0.00  9.2 Sugar and candy 0.02 0.01 0.03 0.03 0.02  9.3 Coffee 0.07** 0.07** 0.10*** 0.06** 0.09***  9.4 Carbonated soft drinks 0.01 0.12*** 0.11*** 0.11*** 0.11***  9.5 Alcoholic beverages −0.20*** −0.15*** −0.17*** 0.03 −0.17***  9.6 Tea −0.04 −0.10*** −0.08*** −0.06* −0.09***  9.7 Fruit juice and fruit-flavored drinks 0.01 0.03 0.05 0.00 0.04 Total dietary TFA intake from foods (n = 1961) 0.06* 0.09*** 0.11*** 0.06* 0.10*** USDA food group/subgroup . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 0.11*** 0.02 0.08*** 0.06** 0.06**  1.2 Cheese 0.01 −0.07 0.02 0.00 −0.02  1.3 Dairy cream 0.02 −0.01 0.04 0.05 0.02  1.4 Other milk and milk products (flavored milk, protein supplement,smoothie) 0.00 −0.05 −0.03 −0.03 −0.04 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish −0.08*** −0.02 −0.06** −0.05* −0.05*  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food,fast food) −0.04 −0.02 −0.02 0.00 −0.03  2.3 Beef/veal, lamb/goat, and venison/deer 0.04 0.04 0.10*** 0.03 0.07** 3. Eggs −0.03 −0.01 −0.02 0.00 −0.02 4. Legumes; nuts and seeds  4.1 Nuts and seeds −0.03 −0.09*** −0.04 −0.10*** −0.07**  4.2 Legumes −0.06** −0.04* −0.05* −0.03 −0.05* 5. Grain products  5.1 Yeast breads and rolls 0.02 −0.01 0.03 −0.01 0.01  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) −0.07*** −0.09*** −0.05* −0.02 −0.07**  5.3 Cakes, cookies, pastries, and pies 0.08*** 0.13*** 0.16*** 0.07*** 0.14***  5.4 Crackers, popcorn, pretzels, and corn chips −0.02 −0.02 −0.01 0.00 −0.02  5.5 Ready-to-eat cereals 0.07 0.01 0.00 0.04 0.01  5.6 Quick breads, pancakes, and French toast 0.08*** 0.13*** 0.13*** 0.06*** 0.13*** 6. Fruits −0.02 −0.10*** −0.07** −0.07** −0.08*** 7. Vegetables  7.1 All other vegetables −0.01 −0.05 0.00 −0.04 −0.02  7.2 Fried potatoes −0.02 0.00 0.03 0.02 0.01 8. Fats and oils  8.1 Salad dressing −0.06** −0.09*** −0.04* −0.07*** −0.07**  8.2 Cream substitutes 0.08*** 0.14*** 0.13*** 0.09*** 0.13***  8.3 Margarine 0.07** 0.09*** 0.05* 0.03 0.07**  8.4 Butters 0.09*** 0.02 0.08*** 0.02 0.06*  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) −0.02 −0.03 −0.02 −0.01 −0.03  8.6 Vegetable oils −0.05* −0.08*** −0.06** −0.06* −0.07** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) −0.02 0.00 0.00 −0.01 0.00  9.2 Sugar and candy 0.02 0.01 0.03 0.03 0.02  9.3 Coffee 0.07** 0.07** 0.10*** 0.06** 0.09***  9.4 Carbonated soft drinks 0.01 0.12*** 0.11*** 0.11*** 0.11***  9.5 Alcoholic beverages −0.20*** −0.15*** −0.17*** 0.03 −0.17***  9.6 Tea −0.04 −0.10*** −0.08*** −0.06* −0.09***  9.7 Fruit juice and fruit-flavored drinks 0.01 0.03 0.05 0.00 0.04 Total dietary TFA intake from foods (n = 1961) 0.06* 0.09*** 0.11*** 0.06* 0.10*** 1 n = 2092 with no missing data on the dependent variables, independent variables, and covariates for all variables, except for total dietary TFA intake from foods (n = 1961). *P < 0.05; **P < 0.01; ***P < 0.001. SumTFAs, sum of the 4 TFAs; TFA, trans fatty acid. Open in new tab TABLE 2 Spearman correlation coefficients between consumption of foods in the past 24 h (kcal) and plasma TFA concentrations (µmol/L, natural logarithmic scale) among US adults aged ≥20 y, NHANES 2009–20101 USDA food group/subgroup . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 0.11*** 0.02 0.08*** 0.06** 0.06**  1.2 Cheese 0.01 −0.07 0.02 0.00 −0.02  1.3 Dairy cream 0.02 −0.01 0.04 0.05 0.02  1.4 Other milk and milk products (flavored milk, protein supplement,smoothie) 0.00 −0.05 −0.03 −0.03 −0.04 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish −0.08*** −0.02 −0.06** −0.05* −0.05*  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food,fast food) −0.04 −0.02 −0.02 0.00 −0.03  2.3 Beef/veal, lamb/goat, and venison/deer 0.04 0.04 0.10*** 0.03 0.07** 3. Eggs −0.03 −0.01 −0.02 0.00 −0.02 4. Legumes; nuts and seeds  4.1 Nuts and seeds −0.03 −0.09*** −0.04 −0.10*** −0.07**  4.2 Legumes −0.06** −0.04* −0.05* −0.03 −0.05* 5. Grain products  5.1 Yeast breads and rolls 0.02 −0.01 0.03 −0.01 0.01  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) −0.07*** −0.09*** −0.05* −0.02 −0.07**  5.3 Cakes, cookies, pastries, and pies 0.08*** 0.13*** 0.16*** 0.07*** 0.14***  5.4 Crackers, popcorn, pretzels, and corn chips −0.02 −0.02 −0.01 0.00 −0.02  5.5 Ready-to-eat cereals 0.07 0.01 0.00 0.04 0.01  5.6 Quick breads, pancakes, and French toast 0.08*** 0.13*** 0.13*** 0.06*** 0.13*** 6. Fruits −0.02 −0.10*** −0.07** −0.07** −0.08*** 7. Vegetables  7.1 All other vegetables −0.01 −0.05 0.00 −0.04 −0.02  7.2 Fried potatoes −0.02 0.00 0.03 0.02 0.01 8. Fats and oils  8.1 Salad dressing −0.06** −0.09*** −0.04* −0.07*** −0.07**  8.2 Cream substitutes 0.08*** 0.14*** 0.13*** 0.09*** 0.13***  8.3 Margarine 0.07** 0.09*** 0.05* 0.03 0.07**  8.4 Butters 0.09*** 0.02 0.08*** 0.02 0.06*  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) −0.02 −0.03 −0.02 −0.01 −0.03  8.6 Vegetable oils −0.05* −0.08*** −0.06** −0.06* −0.07** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) −0.02 0.00 0.00 −0.01 0.00  9.2 Sugar and candy 0.02 0.01 0.03 0.03 0.02  9.3 Coffee 0.07** 0.07** 0.10*** 0.06** 0.09***  9.4 Carbonated soft drinks 0.01 0.12*** 0.11*** 0.11*** 0.11***  9.5 Alcoholic beverages −0.20*** −0.15*** −0.17*** 0.03 −0.17***  9.6 Tea −0.04 −0.10*** −0.08*** −0.06* −0.09***  9.7 Fruit juice and fruit-flavored drinks 0.01 0.03 0.05 0.00 0.04 Total dietary TFA intake from foods (n = 1961) 0.06* 0.09*** 0.11*** 0.06* 0.10*** USDA food group/subgroup . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 0.11*** 0.02 0.08*** 0.06** 0.06**  1.2 Cheese 0.01 −0.07 0.02 0.00 −0.02  1.3 Dairy cream 0.02 −0.01 0.04 0.05 0.02  1.4 Other milk and milk products (flavored milk, protein supplement,smoothie) 0.00 −0.05 −0.03 −0.03 −0.04 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish −0.08*** −0.02 −0.06** −0.05* −0.05*  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food,fast food) −0.04 −0.02 −0.02 0.00 −0.03  2.3 Beef/veal, lamb/goat, and venison/deer 0.04 0.04 0.10*** 0.03 0.07** 3. Eggs −0.03 −0.01 −0.02 0.00 −0.02 4. Legumes; nuts and seeds  4.1 Nuts and seeds −0.03 −0.09*** −0.04 −0.10*** −0.07**  4.2 Legumes −0.06** −0.04* −0.05* −0.03 −0.05* 5. Grain products  5.1 Yeast breads and rolls 0.02 −0.01 0.03 −0.01 0.01  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) −0.07*** −0.09*** −0.05* −0.02 −0.07**  5.3 Cakes, cookies, pastries, and pies 0.08*** 0.13*** 0.16*** 0.07*** 0.14***  5.4 Crackers, popcorn, pretzels, and corn chips −0.02 −0.02 −0.01 0.00 −0.02  5.5 Ready-to-eat cereals 0.07 0.01 0.00 0.04 0.01  5.6 Quick breads, pancakes, and French toast 0.08*** 0.13*** 0.13*** 0.06*** 0.13*** 6. Fruits −0.02 −0.10*** −0.07** −0.07** −0.08*** 7. Vegetables  7.1 All other vegetables −0.01 −0.05 0.00 −0.04 −0.02  7.2 Fried potatoes −0.02 0.00 0.03 0.02 0.01 8. Fats and oils  8.1 Salad dressing −0.06** −0.09*** −0.04* −0.07*** −0.07**  8.2 Cream substitutes 0.08*** 0.14*** 0.13*** 0.09*** 0.13***  8.3 Margarine 0.07** 0.09*** 0.05* 0.03 0.07**  8.4 Butters 0.09*** 0.02 0.08*** 0.02 0.06*  8.5 Other fats and oils (animal fats, garlic sauce, sandwich spread) −0.02 −0.03 −0.02 −0.01 −0.03  8.6 Vegetable oils −0.05* −0.08*** −0.06** −0.06* −0.07** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) −0.02 0.00 0.00 −0.01 0.00  9.2 Sugar and candy 0.02 0.01 0.03 0.03 0.02  9.3 Coffee 0.07** 0.07** 0.10*** 0.06** 0.09***  9.4 Carbonated soft drinks 0.01 0.12*** 0.11*** 0.11*** 0.11***  9.5 Alcoholic beverages −0.20*** −0.15*** −0.17*** 0.03 −0.17***  9.6 Tea −0.04 −0.10*** −0.08*** −0.06* −0.09***  9.7 Fruit juice and fruit-flavored drinks 0.01 0.03 0.05 0.00 0.04 Total dietary TFA intake from foods (n = 1961) 0.06* 0.09*** 0.11*** 0.06* 0.10*** 1 n = 2092 with no missing data on the dependent variables, independent variables, and covariates for all variables, except for total dietary TFA intake from foods (n = 1961). *P < 0.05; **P < 0.01; ***P < 0.001. SumTFAs, sum of the 4 TFAs; TFA, trans fatty acid. Open in new tab The consumption of the following foods and beverages was negatively correlated with sumTFAs or individual TFAs: pork, poultry, or fish (r ranging from −0.05 to −0.08); legumes (r ranging from −0.04 to −0.06); other grain products (r ranging from −0.05 to −0.09); fruits (r ranging from −0.07 to −0.10); vegetable oils (r ranging from −0.05 to −0.08); salad dressing (r ranging from −0.04 to −0.09); tea (r ranging from −0.06 to −0.10); and alcoholic beverages (r ranging from −0.15 to −0.20). Total calculated dietary TFA intake from all food and beverage groups/subgroups was significantly correlated with plasma sumTFAs and all individual TFAs (r ranging from 0.06 to 0.11). Multivariable linear regression analyses between the consumption of foods and beverages and plasma TFA concentrations After adjustment for potential confounding effects of all 32 food and beverage groups/subgroups and 11 variables, the consumption of the following foods and beverages remained significantly associated with the sumTFAs: milk and milk desserts (P = 0.028); cream substitutes (P < 0.0001); beef/veal, lamb/goat, and venison/deer (P = 0.019); cakes, cookies, pastries, and pies (P = 0.0008); and carbonated soft drinks (P = 0.016) (Table 3). The consumption of the following food and beverage groups/subgroups remained significantly associated with palmitelaidic acid: milk and milk desserts (P = 0.004), cream substitutes (P < 0.0001), and butters (P = 0.0002). The consumption of the following food and beverage groups/subgroups remained significantly associated with elaidic acid: cream substitutes (P < 0.0001); quick breads, pancakes, and French toast (P = 0.012); cakes, cookies, pastries, and pies (P = 0.0007); and carbonated soft drinks (P = 0.0013). The consumption of the following food and beverage groups/subgroups remained significantly associated with vaccenic acid: milk and milk desserts (P = 0.005); cream substitutes (P < 0.0001); beef/veal, lamb/goat, and venison/deer (P = 0.0014); cakes, cookies, pastries, and pies (P = 0.0006); and butters (P = 0.001). The consumption of the following food and beverage groups/subgroups remained significantly associated with linolelaidic acid: carbonated soft drinks (P = 0.003) and alcoholic beverages (P = 0.002). The consumption of the following food and beverage groups/subgroups remained negatively associated with sumTFAs or individual TFAs: other milk and milk products (P = 0.029), legumes (P = 0.002), nuts and seeds (P = 0.003), fruits (P = 0.005), other fats (P = 0.028), vegetable oils (P = 0.008), salad dressing (P = 0.004), and alcoholic beverages (P = 0.001). TABLE 3 Multivariable linear regression coefficients (β) between consumption of foods in the past 24 h (per 100 kcal) and plasma TFA concentrations (µmol/L) among US adults aged ≥20 y, NHANES 2009–20101 . β (95% CI)3 . USDA food group/subgroup2 . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 1.03 (1.01–1.04)** 1.01 (0.99–1.02) 1.03 (1.01–1.04)** 1.02 (1.00–1.03)* 1.02 (1.00–1.03)*  1.2 Cheese 1.00 (0.98–1.02) 0.98 (0.96–1.00) 1.01 (0.99–1.03) 0.99 (0.97–1.01) 1.00 (0.98–1.01)  1.3 Dairy cream 1.06 (1.01–1.11)* 0.98 (0.90–1.06) 1.08 (1.01–1.15)* 1.04 (1.00–1.08) 1.04 (0.98–1.11)  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 0.99 (0.97–1.01) 0.98 (0.96–1.00)* 0.98 (0.97–1.00) 0.99 (0.97–1.01) 0.98 (0.97–1.00) 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 0.99 (0.98–1.00) 1.00 (0.99–1.02) 1.00 (0.98–1.01) 1.00 (0.99–1.01) 1.00 (0.99–1.01)  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 1.00 (0.99–1.01) 0.99 (0.98–1.00)  2.3 Beef/veal, lamb/goat, and venison/deer 1.01 (1.00–1.02) 1.01 (0.99–1.03) 1.03 (1.02–1.05)** 1.00 (0.98–1.01) 1.02 (1.01–1.04)* 3. Eggs 1.00 (0.98–1.01) 0.99 (0.97–1.00) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 0.99 (0.98–1.01) 4. Legumes; nuts and seeds  4.1 Nuts and seeds 0.98 (0.97–0.99)*** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)***  4.2 Legumes 0.97 (0.95–0.99)* 0.97 (0.96–0.99)** 0.96 (0.94–0.98)** 0.99 (0.97–1.01) 0.97 (0.95–0.98)** 5. Grain products  5.1 Yeast breads and rolls 1.01 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (1.00–1.02) 1.01 (0.99–1.02) 1.01 (1.00–1.02)  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 1.00 (0.99–1.00) 1.00 (0.99–1.00) 1.00 (1.00–1.01) 1.00 (1.00–1.01) 1.00 (0.99–1.01)  5.3 Cakes, cookies, pastries, and pies 1.00 (1.00–1.01) 1.02 (1.01–1.03)*** 1.02 (1.01–1.04)*** 1.01 (1.00–1.02)* 1.02 (1.01–1.03)***  5.4 Crackers, popcorn, pretzels, and corn chips 1.00 (0.98–1.02) 1.01 (0.99–1.03) 0.99 (0.98–1.01) 1.00 (0.99–1.02) 1.00 (0.98–1.02)  5.5 Ready-to-eat cereals 1.00 (0.99–1.01) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 1.02 (1.00–1.03)* 1.00 (0.98–1.01)  5.6 Quick breads, pancakes, and French toast 1.00 (0.99–1.01) 1.02 (1.01–1.03)* 1.02 (1.00–1.03) 1.00 (0.99–1.02) 1.01 (1.00–1.03) 6. Fruits 0.98 (0.97–1.00) 0.97 (0.96–0.99)** 0.98 (0.96–1.00)* 0.99 (0.98–1.01) 0.98 (0.96–0.99)* 7. Vegetables  7.1 All other vegetables 1.00 (0.98–1.01) 1.01 (0.99–1.02) 1.00 (0.99–1.02) 1.00 (0.98–1.02) 1.00 (0.99–1.02)  7.2 Fried potatoes 1.00 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 8. Fats and oils  8.1 Salad dressing 0.96 (0.94–0.99)** 0.96 (0.94–0.98)** 0.98 (0.96–1.00) 0.97 (0.95–0.99)* 0.97 (0.95–0.99)*  8.2 Cream substitutes 1.11 (1.07–1.15)*** 1.15 (1.10–1.21)*** 1.17 (1.12–1.23)*** 1.04 (1.00–1.09) 1.15 (1.10–1.20)***  8.3 Margarine 0.99 (0.93–1.06) 1.06 (0.97–1.16) 1.03 (0.96–1.11) 1.00 (0.94–1.06) 1.03 (0.96–1.11)  8.4 Butters 1.10 (1.06–1.15)*** 0.97 (0.94–1.01) 1.08 (1.04–1.12)*** 0.99 (0.94–1.04) 1.04 (1.00–1.07)*  8.5 Other fats and oils (animal fats, garlic sauce) 1.02 (0.95–1.10) 0.91 (0.84–0.99)* 0.89 (0.74–1.07) 0.88 (0.81–0.95)** 0.92 (0.83–1.03)  8.6 Vegetable oils 0.93 (0.86–1.00) 0.91 (0.84–0.98)* 0.88 (0.82–0.96)** 0.94 (0.89–1.00) 0.90 (0.84–0.97)** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 0.97 (0.95–0.99)* 0.98 (0.95–1.01) 0.97 (0.93–1.00) 0.99 (0.96–1.02) 0.97 (0.94–1.00)  9.2 Sugar and candy 1.00 (0.99–1.01) 1.01 (1.00–1.01) 1.01 (1.00–1.02) 1.01 (1.00–1.01) 1.01 (1.00–1.01)  9.3 Coffee 1.02 (0.98–1.06) 1.00 (0.93–1.08) 1.01 (0.94–1.09) 1.00 (0.98–1.03) 1.01 (0.95–1.08)  9.4 Carbonated soft drinks 1.00 (0.99–1.01) 1.03 (1.01–1.04)** 1.01 (1.00–1.02) 1.02 (1.01–1.04)** 1.02 (1.00–1.03)*  9.5 Alcoholic beverages 0.98 (0.97–0.99)*** 0.99 (0.98–1.00) 0.98 (0.97–0.99)** 1.02 (1.01–1.03)*** 0.99 (0.98–1.00)*  9.6 Tea 1.00 (0.98–1.03) 0.99 (0.97–1.02) 1.00 (0.97–1.02) 1.01 (0.98–1.03) 1.00 (0.97–1.02)  9.7 Fruit juice and fruit-flavored drinks 1.00 (0.99–1.01) 1.02 (1.00–1.03) 1.02 (1.00–1.04) 1.01 (0.99–1.02) 1.02 (1.00–1.03) Model fit index  R2 0.22 0.27 0.21 0.19 0.23  Root MSE 0.38 0.45 0.46 0.40 0.42 . β (95% CI)3 . USDA food group/subgroup2 . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 1.03 (1.01–1.04)** 1.01 (0.99–1.02) 1.03 (1.01–1.04)** 1.02 (1.00–1.03)* 1.02 (1.00–1.03)*  1.2 Cheese 1.00 (0.98–1.02) 0.98 (0.96–1.00) 1.01 (0.99–1.03) 0.99 (0.97–1.01) 1.00 (0.98–1.01)  1.3 Dairy cream 1.06 (1.01–1.11)* 0.98 (0.90–1.06) 1.08 (1.01–1.15)* 1.04 (1.00–1.08) 1.04 (0.98–1.11)  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 0.99 (0.97–1.01) 0.98 (0.96–1.00)* 0.98 (0.97–1.00) 0.99 (0.97–1.01) 0.98 (0.97–1.00) 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 0.99 (0.98–1.00) 1.00 (0.99–1.02) 1.00 (0.98–1.01) 1.00 (0.99–1.01) 1.00 (0.99–1.01)  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 1.00 (0.99–1.01) 0.99 (0.98–1.00)  2.3 Beef/veal, lamb/goat, and venison/deer 1.01 (1.00–1.02) 1.01 (0.99–1.03) 1.03 (1.02–1.05)** 1.00 (0.98–1.01) 1.02 (1.01–1.04)* 3. Eggs 1.00 (0.98–1.01) 0.99 (0.97–1.00) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 0.99 (0.98–1.01) 4. Legumes; nuts and seeds  4.1 Nuts and seeds 0.98 (0.97–0.99)*** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)***  4.2 Legumes 0.97 (0.95–0.99)* 0.97 (0.96–0.99)** 0.96 (0.94–0.98)** 0.99 (0.97–1.01) 0.97 (0.95–0.98)** 5. Grain products  5.1 Yeast breads and rolls 1.01 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (1.00–1.02) 1.01 (0.99–1.02) 1.01 (1.00–1.02)  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 1.00 (0.99–1.00) 1.00 (0.99–1.00) 1.00 (1.00–1.01) 1.00 (1.00–1.01) 1.00 (0.99–1.01)  5.3 Cakes, cookies, pastries, and pies 1.00 (1.00–1.01) 1.02 (1.01–1.03)*** 1.02 (1.01–1.04)*** 1.01 (1.00–1.02)* 1.02 (1.01–1.03)***  5.4 Crackers, popcorn, pretzels, and corn chips 1.00 (0.98–1.02) 1.01 (0.99–1.03) 0.99 (0.98–1.01) 1.00 (0.99–1.02) 1.00 (0.98–1.02)  5.5 Ready-to-eat cereals 1.00 (0.99–1.01) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 1.02 (1.00–1.03)* 1.00 (0.98–1.01)  5.6 Quick breads, pancakes, and French toast 1.00 (0.99–1.01) 1.02 (1.01–1.03)* 1.02 (1.00–1.03) 1.00 (0.99–1.02) 1.01 (1.00–1.03) 6. Fruits 0.98 (0.97–1.00) 0.97 (0.96–0.99)** 0.98 (0.96–1.00)* 0.99 (0.98–1.01) 0.98 (0.96–0.99)* 7. Vegetables  7.1 All other vegetables 1.00 (0.98–1.01) 1.01 (0.99–1.02) 1.00 (0.99–1.02) 1.00 (0.98–1.02) 1.00 (0.99–1.02)  7.2 Fried potatoes 1.00 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 8. Fats and oils  8.1 Salad dressing 0.96 (0.94–0.99)** 0.96 (0.94–0.98)** 0.98 (0.96–1.00) 0.97 (0.95–0.99)* 0.97 (0.95–0.99)*  8.2 Cream substitutes 1.11 (1.07–1.15)*** 1.15 (1.10–1.21)*** 1.17 (1.12–1.23)*** 1.04 (1.00–1.09) 1.15 (1.10–1.20)***  8.3 Margarine 0.99 (0.93–1.06) 1.06 (0.97–1.16) 1.03 (0.96–1.11) 1.00 (0.94–1.06) 1.03 (0.96–1.11)  8.4 Butters 1.10 (1.06–1.15)*** 0.97 (0.94–1.01) 1.08 (1.04–1.12)*** 0.99 (0.94–1.04) 1.04 (1.00–1.07)*  8.5 Other fats and oils (animal fats, garlic sauce) 1.02 (0.95–1.10) 0.91 (0.84–0.99)* 0.89 (0.74–1.07) 0.88 (0.81–0.95)** 0.92 (0.83–1.03)  8.6 Vegetable oils 0.93 (0.86–1.00) 0.91 (0.84–0.98)* 0.88 (0.82–0.96)** 0.94 (0.89–1.00) 0.90 (0.84–0.97)** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 0.97 (0.95–0.99)* 0.98 (0.95–1.01) 0.97 (0.93–1.00) 0.99 (0.96–1.02) 0.97 (0.94–1.00)  9.2 Sugar and candy 1.00 (0.99–1.01) 1.01 (1.00–1.01) 1.01 (1.00–1.02) 1.01 (1.00–1.01) 1.01 (1.00–1.01)  9.3 Coffee 1.02 (0.98–1.06) 1.00 (0.93–1.08) 1.01 (0.94–1.09) 1.00 (0.98–1.03) 1.01 (0.95–1.08)  9.4 Carbonated soft drinks 1.00 (0.99–1.01) 1.03 (1.01–1.04)** 1.01 (1.00–1.02) 1.02 (1.01–1.04)** 1.02 (1.00–1.03)*  9.5 Alcoholic beverages 0.98 (0.97–0.99)*** 0.99 (0.98–1.00) 0.98 (0.97–0.99)** 1.02 (1.01–1.03)*** 0.99 (0.98–1.00)*  9.6 Tea 1.00 (0.98–1.03) 0.99 (0.97–1.02) 1.00 (0.97–1.02) 1.01 (0.98–1.03) 1.00 (0.97–1.02)  9.7 Fruit juice and fruit-flavored drinks 1.00 (0.99–1.01) 1.02 (1.00–1.03) 1.02 (1.00–1.04) 1.01 (0.99–1.02) 1.02 (1.00–1.03) Model fit index  R2 0.22 0.27 0.21 0.19 0.23  Root MSE 0.38 0.45 0.46 0.40 0.42 1 n = 2092 with no missing data on the dependent variables, independent variables, and covariates. All tolerance measures were >0.1 (ranging from 0.65 to 0.97) and all variance inflation factors were <1.6 (ranging from 1.0 to 1.5), indicating absence of multiple collinearity among the food groups/subgroups and the covariates. *P < 0.05; **P < 0.01; ***P < 0.001. Denominator degree of freedom = 16. MET, metabolic equivalent; MSE, mean squared error; SumTFAs, sum of the 4 TFAs; TFA, trans fatty acid. 2 All 32 food subgroups in 100-kcal unit were included in the regression models simultaneously. 3 Regression coefficients (β) and their 95% CIs indicate change (or ratio) in plasma TFA concentrations in µmol/L associated with 100-kcal change in dietary intake of the foods and beverages, adjusting for age (y), sex (male vs. female), race/ethnicity (White, Black, Mexican American, other), education (<high school, high school, some college or above), income-to-poverty ratio, smoking status (current, former, never), BMI (weight/height squared, kg/m2), self-reported weight change in the past year (kg), physical activity (total METs in the past week), self-reported general health (excellent, very good, and good vs. fair and poor), and use of statin medication (yes vs. no). Open in new tab TABLE 3 Multivariable linear regression coefficients (β) between consumption of foods in the past 24 h (per 100 kcal) and plasma TFA concentrations (µmol/L) among US adults aged ≥20 y, NHANES 2009–20101 . β (95% CI)3 . USDA food group/subgroup2 . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 1.03 (1.01–1.04)** 1.01 (0.99–1.02) 1.03 (1.01–1.04)** 1.02 (1.00–1.03)* 1.02 (1.00–1.03)*  1.2 Cheese 1.00 (0.98–1.02) 0.98 (0.96–1.00) 1.01 (0.99–1.03) 0.99 (0.97–1.01) 1.00 (0.98–1.01)  1.3 Dairy cream 1.06 (1.01–1.11)* 0.98 (0.90–1.06) 1.08 (1.01–1.15)* 1.04 (1.00–1.08) 1.04 (0.98–1.11)  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 0.99 (0.97–1.01) 0.98 (0.96–1.00)* 0.98 (0.97–1.00) 0.99 (0.97–1.01) 0.98 (0.97–1.00) 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 0.99 (0.98–1.00) 1.00 (0.99–1.02) 1.00 (0.98–1.01) 1.00 (0.99–1.01) 1.00 (0.99–1.01)  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 1.00 (0.99–1.01) 0.99 (0.98–1.00)  2.3 Beef/veal, lamb/goat, and venison/deer 1.01 (1.00–1.02) 1.01 (0.99–1.03) 1.03 (1.02–1.05)** 1.00 (0.98–1.01) 1.02 (1.01–1.04)* 3. Eggs 1.00 (0.98–1.01) 0.99 (0.97–1.00) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 0.99 (0.98–1.01) 4. Legumes; nuts and seeds  4.1 Nuts and seeds 0.98 (0.97–0.99)*** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)***  4.2 Legumes 0.97 (0.95–0.99)* 0.97 (0.96–0.99)** 0.96 (0.94–0.98)** 0.99 (0.97–1.01) 0.97 (0.95–0.98)** 5. Grain products  5.1 Yeast breads and rolls 1.01 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (1.00–1.02) 1.01 (0.99–1.02) 1.01 (1.00–1.02)  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 1.00 (0.99–1.00) 1.00 (0.99–1.00) 1.00 (1.00–1.01) 1.00 (1.00–1.01) 1.00 (0.99–1.01)  5.3 Cakes, cookies, pastries, and pies 1.00 (1.00–1.01) 1.02 (1.01–1.03)*** 1.02 (1.01–1.04)*** 1.01 (1.00–1.02)* 1.02 (1.01–1.03)***  5.4 Crackers, popcorn, pretzels, and corn chips 1.00 (0.98–1.02) 1.01 (0.99–1.03) 0.99 (0.98–1.01) 1.00 (0.99–1.02) 1.00 (0.98–1.02)  5.5 Ready-to-eat cereals 1.00 (0.99–1.01) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 1.02 (1.00–1.03)* 1.00 (0.98–1.01)  5.6 Quick breads, pancakes, and French toast 1.00 (0.99–1.01) 1.02 (1.01–1.03)* 1.02 (1.00–1.03) 1.00 (0.99–1.02) 1.01 (1.00–1.03) 6. Fruits 0.98 (0.97–1.00) 0.97 (0.96–0.99)** 0.98 (0.96–1.00)* 0.99 (0.98–1.01) 0.98 (0.96–0.99)* 7. Vegetables  7.1 All other vegetables 1.00 (0.98–1.01) 1.01 (0.99–1.02) 1.00 (0.99–1.02) 1.00 (0.98–1.02) 1.00 (0.99–1.02)  7.2 Fried potatoes 1.00 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 8. Fats and oils  8.1 Salad dressing 0.96 (0.94–0.99)** 0.96 (0.94–0.98)** 0.98 (0.96–1.00) 0.97 (0.95–0.99)* 0.97 (0.95–0.99)*  8.2 Cream substitutes 1.11 (1.07–1.15)*** 1.15 (1.10–1.21)*** 1.17 (1.12–1.23)*** 1.04 (1.00–1.09) 1.15 (1.10–1.20)***  8.3 Margarine 0.99 (0.93–1.06) 1.06 (0.97–1.16) 1.03 (0.96–1.11) 1.00 (0.94–1.06) 1.03 (0.96–1.11)  8.4 Butters 1.10 (1.06–1.15)*** 0.97 (0.94–1.01) 1.08 (1.04–1.12)*** 0.99 (0.94–1.04) 1.04 (1.00–1.07)*  8.5 Other fats and oils (animal fats, garlic sauce) 1.02 (0.95–1.10) 0.91 (0.84–0.99)* 0.89 (0.74–1.07) 0.88 (0.81–0.95)** 0.92 (0.83–1.03)  8.6 Vegetable oils 0.93 (0.86–1.00) 0.91 (0.84–0.98)* 0.88 (0.82–0.96)** 0.94 (0.89–1.00) 0.90 (0.84–0.97)** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 0.97 (0.95–0.99)* 0.98 (0.95–1.01) 0.97 (0.93–1.00) 0.99 (0.96–1.02) 0.97 (0.94–1.00)  9.2 Sugar and candy 1.00 (0.99–1.01) 1.01 (1.00–1.01) 1.01 (1.00–1.02) 1.01 (1.00–1.01) 1.01 (1.00–1.01)  9.3 Coffee 1.02 (0.98–1.06) 1.00 (0.93–1.08) 1.01 (0.94–1.09) 1.00 (0.98–1.03) 1.01 (0.95–1.08)  9.4 Carbonated soft drinks 1.00 (0.99–1.01) 1.03 (1.01–1.04)** 1.01 (1.00–1.02) 1.02 (1.01–1.04)** 1.02 (1.00–1.03)*  9.5 Alcoholic beverages 0.98 (0.97–0.99)*** 0.99 (0.98–1.00) 0.98 (0.97–0.99)** 1.02 (1.01–1.03)*** 0.99 (0.98–1.00)*  9.6 Tea 1.00 (0.98–1.03) 0.99 (0.97–1.02) 1.00 (0.97–1.02) 1.01 (0.98–1.03) 1.00 (0.97–1.02)  9.7 Fruit juice and fruit-flavored drinks 1.00 (0.99–1.01) 1.02 (1.00–1.03) 1.02 (1.00–1.04) 1.01 (0.99–1.02) 1.02 (1.00–1.03) Model fit index  R2 0.22 0.27 0.21 0.19 0.23  Root MSE 0.38 0.45 0.46 0.40 0.42 . β (95% CI)3 . USDA food group/subgroup2 . Palmitelaidic acid . Elaidic acid . Vaccenic acid . Linolelaidic acid . SumTFAs . 1. Milk and milk products  1.1 Milk and milk desserts 1.03 (1.01–1.04)** 1.01 (0.99–1.02) 1.03 (1.01–1.04)** 1.02 (1.00–1.03)* 1.02 (1.00–1.03)*  1.2 Cheese 1.00 (0.98–1.02) 0.98 (0.96–1.00) 1.01 (0.99–1.03) 0.99 (0.97–1.01) 1.00 (0.98–1.01)  1.3 Dairy cream 1.06 (1.01–1.11)* 0.98 (0.90–1.06) 1.08 (1.01–1.15)* 1.04 (1.00–1.08) 1.04 (0.98–1.11)  1.4 Other milk and milk products (flavored milk, protein supplement, smoothie) 0.99 (0.97–1.01) 0.98 (0.96–1.00)* 0.98 (0.97–1.00) 0.99 (0.97–1.01) 0.98 (0.97–1.00) 2. Meat, poultry, and fish  2.1 Pork, poultry, or fish 0.99 (0.98–1.00) 1.00 (0.99–1.02) 1.00 (0.98–1.01) 1.00 (0.99–1.01) 1.00 (0.99–1.01)  2.2 Mixtures mainly meat, poultry, fish (frozen meal, canned food, fast food) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 0.99 (0.98–1.00) 1.00 (0.99–1.01) 0.99 (0.98–1.00)  2.3 Beef/veal, lamb/goat, and venison/deer 1.01 (1.00–1.02) 1.01 (0.99–1.03) 1.03 (1.02–1.05)** 1.00 (0.98–1.01) 1.02 (1.01–1.04)* 3. Eggs 1.00 (0.98–1.01) 0.99 (0.97–1.00) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 0.99 (0.98–1.01) 4. Legumes; nuts and seeds  4.1 Nuts and seeds 0.98 (0.97–0.99)*** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)** 0.97 (0.96–0.98)*** 0.98 (0.97–0.99)***  4.2 Legumes 0.97 (0.95–0.99)* 0.97 (0.96–0.99)** 0.96 (0.94–0.98)** 0.99 (0.97–1.01) 0.97 (0.95–0.98)** 5. Grain products  5.1 Yeast breads and rolls 1.01 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (1.00–1.02) 1.01 (0.99–1.02) 1.01 (1.00–1.02)  5.2 Other grain products (rice, barley, oatmeal, cornmeal, wheat) 1.00 (0.99–1.00) 1.00 (0.99–1.00) 1.00 (1.00–1.01) 1.00 (1.00–1.01) 1.00 (0.99–1.01)  5.3 Cakes, cookies, pastries, and pies 1.00 (1.00–1.01) 1.02 (1.01–1.03)*** 1.02 (1.01–1.04)*** 1.01 (1.00–1.02)* 1.02 (1.01–1.03)***  5.4 Crackers, popcorn, pretzels, and corn chips 1.00 (0.98–1.02) 1.01 (0.99–1.03) 0.99 (0.98–1.01) 1.00 (0.99–1.02) 1.00 (0.98–1.02)  5.5 Ready-to-eat cereals 1.00 (0.99–1.01) 1.00 (0.98–1.02) 0.99 (0.98–1.01) 1.02 (1.00–1.03)* 1.00 (0.98–1.01)  5.6 Quick breads, pancakes, and French toast 1.00 (0.99–1.01) 1.02 (1.01–1.03)* 1.02 (1.00–1.03) 1.00 (0.99–1.02) 1.01 (1.00–1.03) 6. Fruits 0.98 (0.97–1.00) 0.97 (0.96–0.99)** 0.98 (0.96–1.00)* 0.99 (0.98–1.01) 0.98 (0.96–0.99)* 7. Vegetables  7.1 All other vegetables 1.00 (0.98–1.01) 1.01 (0.99–1.02) 1.00 (0.99–1.02) 1.00 (0.98–1.02) 1.00 (0.99–1.02)  7.2 Fried potatoes 1.00 (0.99–1.02) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 1.01 (0.99–1.03) 8. Fats and oils  8.1 Salad dressing 0.96 (0.94–0.99)** 0.96 (0.94–0.98)** 0.98 (0.96–1.00) 0.97 (0.95–0.99)* 0.97 (0.95–0.99)*  8.2 Cream substitutes 1.11 (1.07–1.15)*** 1.15 (1.10–1.21)*** 1.17 (1.12–1.23)*** 1.04 (1.00–1.09) 1.15 (1.10–1.20)***  8.3 Margarine 0.99 (0.93–1.06) 1.06 (0.97–1.16) 1.03 (0.96–1.11) 1.00 (0.94–1.06) 1.03 (0.96–1.11)  8.4 Butters 1.10 (1.06–1.15)*** 0.97 (0.94–1.01) 1.08 (1.04–1.12)*** 0.99 (0.94–1.04) 1.04 (1.00–1.07)*  8.5 Other fats and oils (animal fats, garlic sauce) 1.02 (0.95–1.10) 0.91 (0.84–0.99)* 0.89 (0.74–1.07) 0.88 (0.81–0.95)** 0.92 (0.83–1.03)  8.6 Vegetable oils 0.93 (0.86–1.00) 0.91 (0.84–0.98)* 0.88 (0.82–0.96)** 0.94 (0.89–1.00) 0.90 (0.84–0.97)** 9. Sugars, sweets, and beverages  9.1 Other beverages (water, energy drinks, grain beverages) 0.97 (0.95–0.99)* 0.98 (0.95–1.01) 0.97 (0.93–1.00) 0.99 (0.96–1.02) 0.97 (0.94–1.00)  9.2 Sugar and candy 1.00 (0.99–1.01) 1.01 (1.00–1.01) 1.01 (1.00–1.02) 1.01 (1.00–1.01) 1.01 (1.00–1.01)  9.3 Coffee 1.02 (0.98–1.06) 1.00 (0.93–1.08) 1.01 (0.94–1.09) 1.00 (0.98–1.03) 1.01 (0.95–1.08)  9.4 Carbonated soft drinks 1.00 (0.99–1.01) 1.03 (1.01–1.04)** 1.01 (1.00–1.02) 1.02 (1.01–1.04)** 1.02 (1.00–1.03)*  9.5 Alcoholic beverages 0.98 (0.97–0.99)*** 0.99 (0.98–1.00) 0.98 (0.97–0.99)** 1.02 (1.01–1.03)*** 0.99 (0.98–1.00)*  9.6 Tea 1.00 (0.98–1.03) 0.99 (0.97–1.02) 1.00 (0.97–1.02) 1.01 (0.98–1.03) 1.00 (0.97–1.02)  9.7 Fruit juice and fruit-flavored drinks 1.00 (0.99–1.01) 1.02 (1.00–1.03) 1.02 (1.00–1.04) 1.01 (0.99–1.02) 1.02 (1.00–1.03) Model fit index  R2 0.22 0.27 0.21 0.19 0.23  Root MSE 0.38 0.45 0.46 0.40 0.42 1 n = 2092 with no missing data on the dependent variables, independent variables, and covariates. All tolerance measures were >0.1 (ranging from 0.65 to 0.97) and all variance inflation factors were <1.6 (ranging from 1.0 to 1.5), indicating absence of multiple collinearity among the food groups/subgroups and the covariates. *P < 0.05; **P < 0.01; ***P < 0.001. Denominator degree of freedom = 16. MET, metabolic equivalent; MSE, mean squared error; SumTFAs, sum of the 4 TFAs; TFA, trans fatty acid. 2 All 32 food subgroups in 100-kcal unit were included in the regression models simultaneously. 3 Regression coefficients (β) and their 95% CIs indicate change (or ratio) in plasma TFA concentrations in µmol/L associated with 100-kcal change in dietary intake of the foods and beverages, adjusting for age (y), sex (male vs. female), race/ethnicity (White, Black, Mexican American, other), education (<high school, high school, some college or above), income-to-poverty ratio, smoking status (current, former, never), BMI (weight/height squared, kg/m2), self-reported weight change in the past year (kg), physical activity (total METs in the past week), self-reported general health (excellent, very good, and good vs. fair and poor), and use of statin medication (yes vs. no). Open in new tab Associations between total calculated dietary TFA intake from foods and measured plasma TFA concentrations A 1% increase in the energy of total calculated TFA intake was associated with an approximate 1-µmol/L increase in measured plasma concentrations of sumTFAs ( P = 0.02) after adjustment for covariates. The adjusted geometric mean level of sumTFAs was significantly higher among adults with a total calculated dietary TFA intake ≥2.2 g/d (geometric mean = 43.7 µmol/L; P = 0.007) and among those with a total calculated dietary TFA intake between 0.5 g/d and 2.2 g/d (geometric mean = 40.5 µmol/L; P = 0.003) when compared with those with a total calculated dietary TFA intake <0.5 g/d (geometric mean = 37.6 µmol/L) (Figure 1). There was no significant difference in the geometric mean levels of sumTFAs between adults with a total calculated dietary TFA intake between 0.5 g/d and 2.2 g/d and those with a total calculated dietary TFA intake ≥2.2 g/d (P = 0.13). FIGURE 1 Open in new tabDownload slide Adjusted mean concentrations of sum of the 4 TFAs (µmol/L, natural logarithmic scale) by 3 levels of total dietary TFA intake from foods (g). Mean differences were adjusted for age (y), sex (male vs. female), race/ethnicity (White, Black, Mexican American, other), education (<high school, high school, some college or above), income-to-poverty ratio, smoking status (current, former, never), BMI (weight/height squared; kg/m2), self-reported weight change in the past year (kg), physical activity (total METs in the past week), self-reported general health (excellent, very good, and good vs. fair and poor), use of statin medication (yes vs. no), and total calorie intake (kcal). (A) Adjusted mean concentrations of the sum of the 4 TFAs by 3 categories of TFA intake from foods. (B) Pairwise comparsons in the LS-means of plasma concentrations of the sum of the 4 TFAs by the 3 categories of TFA intake from foods. The solid lines indicate statistical significance between category 1 and 2 (P = 0.007) and category 1 and 3 (P = 0.002); the dashed line indicates no statistical significance between category 2 and 3 (P = 0.13). P < 0.001 for linear trend. n = 1961. ‡The LS-means were based on the multivariable linear regression models that were being fit to the data, adjusting for the selected covariates. LS-means, least-squares means; MET, metabolic equivalent; TFA, trans fatty acid. FIGURE 1 Open in new tabDownload slide Adjusted mean concentrations of sum of the 4 TFAs (µmol/L, natural logarithmic scale) by 3 levels of total dietary TFA intake from foods (g). Mean differences were adjusted for age (y), sex (male vs. female), race/ethnicity (White, Black, Mexican American, other), education (<high school, high school, some college or above), income-to-poverty ratio, smoking status (current, former, never), BMI (weight/height squared; kg/m2), self-reported weight change in the past year (kg), physical activity (total METs in the past week), self-reported general health (excellent, very good, and good vs. fair and poor), use of statin medication (yes vs. no), and total calorie intake (kcal). (A) Adjusted mean concentrations of the sum of the 4 TFAs by 3 categories of TFA intake from foods. (B) Pairwise comparsons in the LS-means of plasma concentrations of the sum of the 4 TFAs by the 3 categories of TFA intake from foods. The solid lines indicate statistical significance between category 1 and 2 (P = 0.007) and category 1 and 3 (P = 0.002); the dashed line indicates no statistical significance between category 2 and 3 (P = 0.13). P < 0.001 for linear trend. n = 1961. ‡The LS-means were based on the multivariable linear regression models that were being fit to the data, adjusting for the selected covariates. LS-means, least-squares means; MET, metabolic equivalent; TFA, trans fatty acid. Sensitivity analysis The positive associations of cream substitutes, cakes, cookies, pastries, and pies and beef/veal, lamb/goat, and venison/deer with sumTFAs and individual TFAs in the replicated analyses using the mean consumption from first and second 24-h recall (sensitivity analyses) were generally similar to that of the main analyses (Supplementary Table 3), indicating the reliability of these associations. However, we observed a few discrepancies in results of the sensitivity analyses when compared with those of the main analyses. First, the associations of milk and milk desserts (P = 0.09) and butters (P = 0.99) with sumTFAs were not statistically significant at the α = 0.05 level. Second, the associations of quick breads (P = 0.03), margarine (P = 0.02), and fruit juice and fruit-flavored drinks (P = 0.01) with sumTFAs were statistically significant at the α = 0.05 level. Discussion In this study, we examined the associations between consumption of foods and beverages and plasma TFA concentrations using both the 24-h dietary recall data and 4 major plasma TFA measures among adults aged ≥20 y who participated in the NHANES 2009–2010 in the United States. After adjustment for demographic, socioeconomic, behavioral, lifestyle, and health-related variables, we found that consumption of cream substitutes; cakes, cookies, pastries, and pies; milk and milk desserts; beef/veal, lamb/goat, and venison/deer; butters; and carbonated soft drinks were significantly associated with elevated plasma TFA concentrations. To the best of our knowledge, this is the first study to examine the association of plasma TFA concentrations with the consumption of foods in the past 24 h among US adults. Our results were largely consistent with the USDA food-composition database (19) and previous studies (5–7, 21–24). Food products that contain >0.1 g TFAs per 100 g of foods in the USDA nutrient database include butters, cream, cakes, cookies, beef, lamb, and milk (19). Industrially produced TFAs were used in food supplies for their desirable physical properties (e.g., a melting temperature of 30–40°C and extended shelf-life), compared with other unsaturated fats. As a result, industrially produced TFAs were widely used in margarines, shortenings, baked goods, frozen foods, and fried foods (5). Our results were consistent with findings of TFAs in foods reported in some European countries (22–24) and India (25). For example, vanaspati ghee contains high levels of industrially produced TFAs and is commonly used in cooking and food processing in India. Snacks and street foods in low-socioeconomic settings in India contain an excessive amount of TFAs (25). Given the significant reduction in plasma TFA concentrations (54%) in US adults between 1999–2000 and 2009–2010 (14), these food groups may represent more persistent sources of trans fat consumed by American adults in 2009–2010. Vaccenic acid and palmitelaidic acid were major TFA isomers found in milk and other ruminant fats (18, 26), which agrees with our finding that both TFAs were associated with milk and milk desserts, as well as butters. In addition, the consumption of meat from ruminants (beef/veal, lamb/goat, and venison/deer) was significantly associated with plasma vaccenic acid concentrations. Even though vaccenic acid is a major TFA in ruminants, it is also present in PHOs along with elaidic acid, a major TFA in PHOs (26). We found both vaccenic and elaidic acids to be associated with consumption of cakes, cookies, pastries, and pies, which use PHOs in the form of shortenings and margarine to provide flaky texture and enhance product shelf life. We previously found that vaccenic acid was the major TFA in plasma, constituting 48.0% of the TFAs in the 2009–2010 NHANES (14); elaidic acid constituted 36.0%. Therefore, we would expect the consumption of milk and milk desserts; cream substitutes; beef/veal, lamb/goat, and venison/deer; and cakes, cookies, pastries, and pies to be significantly associated with the sum of 4 TFAs based on the individual TFA associations. The positive associations between the consumption of cream substitutes and elevated plasma TFA concentrations were noteworthy. Five decades ago, a study showed that cream substitutes contained 10–55% total fat with predominantly saturated fat (27). However, cream substitutes have rarely been reported as a source of TFAs in previous studies. No TFA information for cream substitutes was reported in the USDA nutrient database (19). Cream substitutes, including nondairy creamers, coffee whiteners, and nondairy whipped topping, are liquid or granular substances used as additives to coffee, tea, or hot chocolate or used for cake coating, filling, or ice cream. The main ingredients of cream substitutes include hydrogenated vegetable oils, corn syrup, sodium caseinate, and other sweeteners or artificial flavors (French vanilla, hazelnut, or Irish cream). While fully hydrogenated oils contain saturated fats with virtually no TFAs, PHOs are the main source of industrially produced TFAs. Although manufacturers were reducing the TFA content in their products through reformulation efforts starting in the early 2000s (28, 29), some cream substitutes appeared to still contain both fully hydrogenated oils and PHOs when our dietary data were collected in 2009–2010. An assessment of food product reformulation in the United States also found a reduction in TFA contents, but variability existed by food type and manufacturer (29). In our study, 17.4% of US adults used cream substitutes in the past 24 h in NHANES 2009–2010. Interestingly, we did not detect positive associations of plasma TFA concentrations with consumption of foods that traditionally contain high TFAs (e.g., margarines and shortenings, processed foods, frozen foods, and fried potatoes). This is perhaps partially explained by changes in TFA contents of these foods due to food reformulation under the impact of federal, state, and municipal policies and regulations directed at dietary TFA intake among adults in the United States (28,29). In 1999, the US FDA proposed that Nutrition Facts labels should be required to list trans fat content. This rule was finalized in 2003 and went in effect in 2006. Also, in 2006, the New York City Board of Health adopted regulations that virtually eliminated artificial trans fats in foods sold by the city's restaurants and food service establishments. This was followed by similar restaurant-focused regulations in California in 2008 and several other jurisdictions across the United States. During 2006 and 2009, both food manufacturers and chain restaurants reformulated products to reduce or remove trans fats (e.g., Crisco shortening, Kentucky Fried Chicken, Starbucks, Burger King, and McDonald's) (28, 29). In addition to the decline found in plasma TFA concentrations in US adults (14), there was a greater decline in New York City in adult serum TFA concentrations among frequent restaurant diners (61.6%) than among people who rarely dined out (51.1%) (30). To date, ∼40 countries, most of which are high-income or upper-middle-income countries, have adopted mandatory restrictions on industrially produced TFAs, banned the use of PHOs, and/or required mandatory labeling of TFAs on packaged foods (15). However, most low- and middle-income countries lack policies or regulations on industrially produced TFAs despite the growing burden of heart disease. From a global perspective, public health policies or regulations on banning or restricting the use of PHOs in foods have shown significant effects on the reduction in TFA-attributable coronary artery disease (31–33). There were several intriguing findings in this study: first, higher consumption of carbonated soft drinks was significantly associated with elevated plasma TFA concentrations; second, higher consumption of legumes, nuts and seeds, fruits, and alcoholic beverages was associated with lower plasma TFA concentrations. Residual confounding may partially explain these associations because consumption of carbonated soft drinks may be frequently consumed with foods that could be high in TFAs. In contrast, individuals who eat fruits and nuts may be less likely to eat unhealthy foods that potentially contain TFAs. Nonetheless, in the context of cardiovascular disease prevention and control, our findings add support for reducing the consumption of carbonated soft drinks and increasing the consumption of legumes, nuts and seeds, and fruits, because growing evidence has shown the adverse health effects of carbonated soft drink intake (34–36) and beneficial health effects of fruits, vegetable, and nut intakes (37–40). The inverse association between consumption of alcoholic beverages and plasma TFA concentrations is consistent with the results of previous studies on fatty acids (41–43) and adds support to the hypothesis that drinking alcohol may affect the absorption and metabolism of fatty acids (43). The associations we observed between calculated TFA intake from foods and TFAsums in plasma were weaker (r = 0.06∼0.11) compared with previous studies that assessed different biological tissues (e.g., r = 0.31 in adipose tissues, r = 0.43 in erythrocytes) (8, 9). In addition to the accuracy of and variations in TFA content database in food products, use of different laboratory protocols and types of biological tissues may be partially attributable to the differences in the strength of associations across studies. Previous studies have expressed the TFA values as a percentage of total fatty acids, which is dependent on the fatty acids measured. Our TFA results were absolute concentrations, which were independent of other fatty acids measured. We also separated and quantitated individual TFAs, instead of grouping trans-isomers such as the C18:1 isomers. In addition, intra- and interpersonal variations in food consumption and the biochemical processes of absorption and metabolism of foods may also play a role in the differences observed. The major strengths of this study include the use of a large representative sample of the US adult population, reliable and accurate data on plasma TFA concentrations, and reliable 24-h dietary recall data collected through in-person interview at the MEC. However, there were also some limitations. First, as noted above, our results were based on data collected during 2009–2010, and do not reflect the current status of TFA intake among US adults given the change in regulations in the past decade. However, our results were based on the most recent data available for the representative US adult population and could establish a baseline for future assessments. Second, the NHANES data may not be generalizable to other countries that either have different regulations or different general eating patterns; however, in countries where similar foods are consumed and no policy or regulation on TFAs is in place or being enforced, this information may be helpful to initially identify major TFA-containing food subgroups in their diet. Third, because plasma TFA measures reflect short-term dietary intake in the past week (11, 44, 45), the single 24-h dietary recall will not capture the full range and variability of what was consumed over the past week. We would expect to see a stronger relation if we had dietary data for the full week. We attempted to address this by including the second dietary recall in the sensitivity analyses and did see overall stronger correlations, suggesting added stability of pooled measures of 2 or multiple 24-h recalls when examining the associations between self-reported dietary intake and biochemical measures. Fourth, 24-h dietary recall data are often subject to both random and systematic errors including errors due to day-to-day variability in actual consumption, recall bias, energy underreporting, and errors in the underlying food-composition database. By using the standardized data collection tool (e.g., AMPM) and proper statistical methods (e.g., adjustment to the distribution, total energy intake, and possible confounding), these biases were minimalized but not eliminated (46). Fifth, although we included all 32 food/beverage groups/subgroups and 11 covariates simultaneously in our multivariable linear regression models to identify the associations between consumption of foods and plasma TFA concentrations, residual confounding may be possible due to unmeasured factors and variations within food groups/subgroups (47). Finally, possible multiplicity among the 32 food/beverage groups/subgroups and 11 covariates might have an impact on the interpretation of our results (48). However, given the moderate number and magnitude of correlations for these variables and the focus of our study design on a priori hypothesis testing to confirm the associations between consumption of foods/beverages and plasma TFA concentrations, adjusting for possible confounding effects, the impact of multiple testing adjustment on the interpretations of our results could be minimal (49, 50). In conclusion, the consumption of foods that contain either industrially produced TFAs such as cream substitutes, cakes, cookies, pastries, and pies or ruminant TFAs such as milk and milk desserts, beef/veal, lamb/goat, and venison/deer, and butters likely contributed to elevated plasma concentrations among US adults in 2009–2010. These results can serve as baseline data when monitoring the change in dietary sources of plasma TFAs over time in the United States. Dietary sources of plasma TFAs could vary at different time periods or in different countries; however, our findings suggest that these food groups could be key targets for public health education or nutrition intervention aiming to reduce TFA intake in countries or populations where similar foods are consumed. ACKNOWLEDGEMENTS We thank Drs. Quanhe Yang and Zefeng Zhang from the CDC for their consultation and technical assistance on the TFA database. We thank Drs. Rey DeCastro and Curtis Blanton from the CDC and Dr. Barry Graubard from the NIH/National Cancer Institute for their consultations on the coding of foods and beverages and statistical methods for the NHANES 2009–2010 dietary data. The authors’ responsibilities were as follows—CL and PR: designed the study; CL: conducted the data analyses and wrote the manuscript; CL, PR, LKC, HCK, JS, and HWV: interpreted the data; PR, LKC, HCK, JS, and HWV: critically reviewed and revised the manuscript; and all authors: read and approved the final manuscript. Notes This analysis was conducted in collaboration with Resolve to Save Lives, an initiative of Vital Strategies. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation. Author disclosures: The authors report no conflicts of interest. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Supplementary Tables 1–3 and Supplementary Figure 1 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/cdn/. Abbreviations used: AMPM, Automated Multiple-Pass Method; DHHS, US Department of Health and Human Services; MEC, mobile examination center; NCHS, National Center for Health Statistics; PHO, partially hydrogenated oil; sumTFAs, sum of the 4 TFAs; TFA, trans fatty acid; USDA, US Department of Agriculture. References 1. Mozaffarian D , Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease . N Engl J Med . 2006 ; 354 ( 15 ): 1601 – 13 . Google Scholar Crossref Search ADS PubMed WorldCat 2. de Souza RJ , Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schunemann H, Beyene J et al. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies . BMJ . 2015 ; 351 : h3978 . doi: 10.1136/bmj.h3978 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 3. Wang Q , Afshin A, Yakoob MY, Singh GM, Rehm CD, Khatibzadeh S, Micha R, Shi P, Mozaffarian D. Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease . J Am Heart Assoc . 2016 ; 5 ( 1 ). doi: 10.1161/jaha.115.002891 . Google Scholar OpenURL Placeholder Text WorldCat 4. Ghebreyesus TA , Frieden TR. REPLACE: a roadmap to make the world trans fat free by 2023 . Lancet North Am Ed . 2018 ; 391 ( 10134 ): 1978 – 80 . Google Scholar Crossref Search ADS WorldCat 5. Wanders AJ , Zock PL, Brouwer IA. Trans fat intake and its dietary sources in general populations worldwide: a systematic review . Nutrients . 2017 ; 9 ( 8 ): 1 – 14 . doi: 10.3390/nu9080840 . Google Scholar Crossref Search ADS WorldCat 6. Doell D , Folmer D, Lee H, Honigfort M, Carberry S. Updated estimate of trans fat intake by the US population . Food Addit Contam A . 2012 ; 29 ( 6 ): 861 – 74 . Google Scholar Crossref Search ADS WorldCat 7. Kris-Etherton PM , Lefevre M, Mensink RP, Petersen B, Fleming J, Flickinger BD. Trans fatty acid intakes and food sources in the U.S. population: NHANES 1999–2002 . Lipids . 2012 ; 47 ( 10 ): 931 – 40 . Google Scholar Crossref Search ADS PubMed WorldCat 8. Baylin A , Kim MK, Donovan-Palmer A, Siles X, Dougherty L, Tocco P, Campos H. Fasting whole blood as a biomarker of essential fatty acid intake in epidemiologic studies: comparison with adipose tissue and plasma . Am J Epidemiol . 2005 ; 162 ( 4 ): 373 – 81 . Google Scholar Crossref Search ADS PubMed WorldCat 9. Sun Q , Ma J, Campos H, Hankinson SE, Hu FB. Comparison between plasma and erythrocyte fatty acid content as biomarkers of fatty acid intake in US women . Am J Clin Nutr . 2007 ; 86 ( 1 ): 74 – 81 . Google Scholar Crossref Search ADS PubMed WorldCat 10. Arab L , Akbar J. Biomarkers and the measurement of fatty acids . Public Health Nutr . 2002 ; 5 ( 6a ): 865 – 71 . Google Scholar Crossref Search ADS PubMed WorldCat 11. Katan MB , Deslypere JP, van Birgelen AP, Penders M, Zegwaard M. Kinetics of the incorporation of dietary fatty acids into serum cholesteryl esters, erythrocyte membranes, and adipose tissue: an 18-month controlled study . J Lipid Res . 1997 ; 38 ( 10 ): 2012 – 22 . Google Scholar Crossref Search ADS PubMed WorldCat 12. Kuiper HC , Wei N, McGunigale SL, Vesper HW. Quantitation of trans-fatty acids in human blood via isotope dilution-gas chromatography-negative chemical ionization-mass spectrometry . J Chromatogr B . 2018 ; 1076 : 35 – 43 . Google Scholar Crossref Search ADS WorldCat 13. Yang Q , Zhang Z, Loustalot F, Vesper H, Caudill SP, Ritchey M, Gillespie C, Merritt R, Hong Y, Bowman BA. Plasma trans-fatty acid concentrations continue to be associated with serum lipid and lipoprotein concentrations among US adults after reductions in trans-fatty acid intake . J Nutr . 2017 ; 147 ( 5 ): 896 – 907 . Google Scholar Crossref Search ADS PubMed WorldCat 14. Vesper HW , Caudill SP, Kuiper HC, Yang Q, Ahluwalia N, Lacher DA, Pirkle JL. Plasma trans-fatty acid concentrations in fasting adults declined from NHANES 1999–2000 to 2009–2010 . Am J Clin Nutr . 2017 ; 105 ( 5 ): 1063 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 15. Li C , Cobb LK, Vesper HW, Asma S. Global surveillance of trans-fatty acids . Prev Chronic Dis . 2019 ; 16 : E147 . doi: 10.5888/pcd16.190121 . Google Scholar Crossref Search ADS PubMed WorldCat 16. Food and Drug Administration . Final determination regarding partially hydrogenated oils. Notification; declaratory order; extension of compliance date . Fed Regist . 2018 ; 83 ( 98 ): 23358 – 9 . PubMed OpenURL Placeholder Text WorldCat 17. Montville J , Ahuja JKC, Martin C, Heendeniya K, Omolewa-Tomobi G, Steinfeldt L, Anand J, Adler M, LaComb R, Moshfegh A. USDA Food and Nutrient Database for Dietary Studies (FNDDS), 5.0 . Procedia Food Science . 2013 ; 2 : 99 – 112 . Google Scholar Crossref Search ADS WorldCat 18. Gebauer SK , Psota TL, Kris-Etherton PM. The diversity of health effects of individual trans fatty acid isomers . Lipids . 2007 ; 42 ( 9 ): 787 – 99 . Google Scholar Crossref Search ADS PubMed WorldCat 19. US Department of Agriculture, Agricultural Research Service . USDA National Nutrient Database for Standard Reference, Release 23. Methods and Application of Food Composition Laboratory Home Page [Internet] . 2010 . Available from: http://www.ars.usda.gov/nea/bhnrc/mafcl . OpenURL Placeholder Text WorldCat 20. Little RJA . Survey nonresponse adjustments for estimates of means . International Statistical Review/Revue Internationale de Statistique . 1986 ; 54 ( 2 ): 139 – 57 . Google Scholar OpenURL Placeholder Text WorldCat 21. Micha R , King IB, Lemaitre RN, Rimm EB, Sacks F, Song X, Siscovick DS, Mozaffarian D. Food sources of individual plasma phospholipid trans fatty acid isomers: the Cardiovascular Health Study . Am J Clin Nutr . 2010 ; 91 ( 4 ): 883 – 93 . Google Scholar Crossref Search ADS PubMed WorldCat 22. Zupanic N , Hribar M, Pivk Kupirovic U, Kusar A, Zmitek K, Pravst I. Limiting trans fats in foods: use of partially hydrogenated vegetable oils in prepacked foods in Slovenia . Nutrients . 2018 ; 10 ( 3 ): 355 . Google Scholar Crossref Search ADS WorldCat 23. Stender S . Industrially produced trans fat in popular foods in 15 countries of the former Soviet Union from 2015 to 2016: a market basket investigation . BMJ Open . 2019 ; 9 ( 2 ): e023184 . doi: 10.1136/bmjopen-2018-023184 . Google Scholar Crossref Search ADS PubMed WorldCat 24. Stender S , Astrup A, Dyerberg J. Artificial trans fat in popular foods in 2012 and in 2014: a market basket investigation in six European countries . BMJ Open . 2016 ; 6 ( 3 ): e010673 . doi: 10.1136/bmjopen-2015-010673 . Google Scholar Crossref Search ADS PubMed WorldCat 25. Gupta V , Downs SM, Ghosh-Jerath S, Lock K, Singh A. Unhealthy fat in street and snack foods in low-socioeconomic settings in India: a case study of the food environments of rural villages and an urban slum . J Nutr Educ Behav . 2016 ; 48 ( 4 ): 269 – 79 . e1 . Google Scholar Crossref Search ADS PubMed WorldCat 26. Ratnayake W . Analysis of dietary trans fatty acids . J Oleo Sci . 2001 ; 50 ( 5 ): 339 – 52 . Google Scholar Crossref Search ADS WorldCat 27. Monsen ER , Adriaenssens L. Fatty acid composition and total lipid of cream and cream substitutes . Am J Clin Nutr . 1969 ; 22 ( 4 ): 458 – 63 . Google Scholar Crossref Search ADS PubMed WorldCat 28. Mozaffarian D , Jacobson MF, Greenstein JS. Food reformulations to reduce trans fatty acids . N Engl J Med . 2010 ; 362 ( 21 ): 2037 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 29. Otite FO , Jacobson MF, Dahmubed A, Mozaffarian D. Trends in trans fatty acids reformulations of US supermarket and brand-name foods from 2007 through 2011 . Prev Chronic Dis . 2013 ; 10 : E85 . doi: 10.5888/pcd10.120198 . Google Scholar Crossref Search ADS PubMed WorldCat 30. Wright M , McKelvey W, Curtis CJ, Thorpe LE, Vesper HW, Kuiper HC, Angell SY. Impact of a municipal policy restricting trans fatty acid use in New York City restaurants on serum trans fatty acid levels in adults . Am J Public Health . 2019 ; 21 ( 10 ): 304930 . Google Scholar OpenURL Placeholder Text WorldCat 31. Brandt EJ , Myerson R, Perraillon MC, Polonsky TS. Hospital admissions for myocardial infarction and stroke before and after the trans-fatty acid restrictions in New York . JAMA Cardiol . 2017 ; 2 ( 6 ): 627 – 34 . Google Scholar Crossref Search ADS PubMed WorldCat 32. Restrepo BJ , Rieger M. Denmark's policy on artificial trans fat and cardiovascular disease . Am J Prev Med . 2016 ; 50 ( 1 ): 69 – 76 . Google Scholar Crossref Search ADS PubMed WorldCat 33. Rubinstein A , Elorriaga N, Garay OU, Poggio R, Caporale J, Matta MG, Augustovski F, Pichon-Riviere A, Mozaffarian D. Eliminating artificial trans fatty acids in Argentina: estimated effects on the burden of coronary heart disease and costs . Bull World Health Organ . 2015 ; 93 ( 9 ): 614 – 22 . Google Scholar Crossref Search ADS PubMed WorldCat 34. Ruanpeng D , Thongprayoon C, Cheungpasitporn W, Harindhanavudhi T. Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis . QJM . 2017 ; 110 ( 8 ): 513 – 20 . Google Scholar Crossref Search ADS PubMed WorldCat 35. Imamura F , O'Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, Forouhi NG. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction . BMJ . 2015 ; 351 : h3576 . doi: 10.1136/bmj.h3576 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 36. Narain A , Kwok CS, Mamas MA. Soft drinks and sweetened beverages and the risk of cardiovascular disease and mortality: a systematic review and meta-analysis . Int J Clin Pract . 2016 ; 70 ( 10 ): 791 – 805 . Google Scholar Crossref Search ADS PubMed WorldCat 37. Alissa EM , Ferns GA. Dietary fruits and vegetables and cardiovascular diseases risk . Crit Rev Food Sci Nutr . 2017 ; 57 ( 9 ): 1950 – 62 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 38. de Souza RGM , Schincaglia RM, Pimentel GD, Mota JF. Nuts and human health outcomes: a systematic review . Nutrients . 2017 ; 9 ( 12 ). ( pii ): nu9121311 . doi: 10.3390/nu9121311 . Google Scholar OpenURL Placeholder Text WorldCat 39. Marventano S , Izquierdo Pulido M, Sanchez-Gonzalez C, Godos J, Speciani A, Galvano F, Grosso G. Legume consumption and CVD risk: a systematic review and meta-analysis . Public Health Nutr . 2017 ; 20 ( 2 ): 245 – 54 . Google Scholar Crossref Search ADS PubMed WorldCat 40. Kris-Etherton PM . Walnuts decrease risk of cardiovascular disease: a summary of efficacy and biologic mechanisms . J Nutr . 2014 ; 144 ( 4 ): 547S – 54S . Google Scholar Crossref Search ADS PubMed WorldCat 41. Laguzzi F , Riserus U, Marklund M, Vikstrom M, Sjogren P, Gigante B, Alsharari ZD, Hellenius ML, Cederholm T, Frumento P et al. Circulating fatty acids in relation to alcohol consumption: cross-sectional results from a cohort of 60-year-old men and women . Clin Nutr . 2018 ; 37 ( 6 ): 2001 – 10 . Google Scholar Crossref Search ADS PubMed WorldCat 42. Kim SY , Breslow RA, Ahn J, Salem N Jr. Alcohol consumption and fatty acid intakes in the 2001–2002 National Health and Nutrition Examination Survey . Alcohol Clin Exp Res . 2007 ; 31 ( 8 ): 1407 – 14 . Google Scholar Crossref Search ADS PubMed WorldCat 43. Simon JA , Fong J, Bernert JT Jr., Browner WS. Relation of smoking and alcohol consumption to serum fatty acids . Am J Epidemiol . 1996 ; 144 ( 4 ): 325 – 34 . Google Scholar Crossref Search ADS PubMed WorldCat 44. Baylin A , Campos H. The use of fatty acid biomarkers to reflect dietary intake . Curr Opin Lipidol . 2006 ; 17 ( 1 ): 22 – 27 . Google Scholar Crossref Search ADS PubMed WorldCat 45. Arab L . Biomarkers of fat and fatty acid intake . J Nutr . 2003 ; 133 ( 3 ): 925S – 32S . Google Scholar Crossref Search ADS PubMed WorldCat 46. Ahluwalia N , Dwyer J, Terry A, Moshfegh A, Johnson C. Update on NHANES dietary data: focus on collection, release, analytical considerations, and uses to inform public policy . Adv Nutr . 2016 ; 7 ( 1 ): 121 – 34 . Google Scholar Crossref Search ADS PubMed WorldCat 47. Innis SM , Green TJ, Halsey TK. Variability in the trans fatty acid content of foods within a food category: implications for estimation of dietary trans fatty acid intakes . J Am Coll Nutr . 1999 ; 18 ( 3 ): 255 – 60 . Google Scholar Crossref Search ADS PubMed WorldCat 48. Patel CJ , Ioannidis JP. Placing epidemiological results in the context of multiplicity and typical correlations of exposures . J Epidemiol Community Health . 2014 ; 68 ( 11 ): 1096 – 100 . Google Scholar Crossref Search ADS PubMed WorldCat 49. Perneger TV . What's wrong with Bonferroni adjustments . BMJ . 1998 ; 316 ( 7139 ): 1236 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 50. Rothman KJ . No adjustments are needed for multiple comparisons . Epidemiology . 1990 ; 1 ( 1 ): 43 – 46 . Google Scholar Crossref Search ADS PubMed WorldCat Published by Oxford University Press on behalf of the American Society for Nutrition 2021. This work is written by (a) US Government employee(s) and is in the public domain in the US.
TI - Dietary Sources of Plasma trans Fatty Acids among Adults in the United States: NHANES 2009–2010
JF - Current Developments in Nutrition
DO - 10.1093/cdn/nzab063
DA - 2021-05-17
UR - https://www.deepdyve.com/lp/oxford-university-press/dietary-sources-of-plasma-trans-fatty-acids-among-adults-in-the-united-x9dITOTZ1b
VL - 5
IS - 5
DP - DeepDyve
ER -