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Comparison of Fatty Acid Profiles in Vegans and Omnivores

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Comparison of Fatty Acid Profiles in Vegans and Omnivores Aus dem Bundesinstitut für Risikobewertung und Aus dem Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie der Medizinischen Fakultät Charité – Universitätsmedizin Berlin DISSERTATION Comparison of fatty acid profiles in vegans and omnivores zur Erlangung des akademischen Grades Doctor medicinae (Dr. med.) vorgelegt der Medizinischen Fakultät Charité – Universitätsmedizin Berlin von Alessa Longrée aus Mülheim an der Ruhr Datum der Promotion: 18.12.2020 Table of Contents i Table of Contents I. List of tables ........................................................................................................... iv II. List of figures ........................................................................................................... v III. List of abbreviations .............................................................................................. vi 1 Abstract ..................................................................................................................... 1 2 Zusammenfassung................................................................................................... 2 3 Introduction .............................................................................................................. 4 Definition of veganism and veganism in Germany ............................................ 4 Potential health benefits of vegan diets ............................................................. 5 Risk factors for cardiometabolic diseases .................................................... 5 Type 2 diabetes mellitus .............................................................................. 7 Cancer ......................................................................................................... 8 Cardiovascular diseases .............................................................................. 9 Potential lack of nutrients in vegan diets and related health risks ................... 10 Vitamin B12................................................................................................ 11 Calcium and vitamin D and bone health .................................................... 12 Omega-3 fatty acids ................................................................................... 12 Other critical nutrients ................................................................................ 13 Fatty acid profiles ............................................................................................ 14 Definition and chemical principles of fatty acids ......................................... 15 Measurement of fatty acid profiles ............................................................. 18 Aim of the study and research questions ........................................................ 20 4 Methods .................................................................................................................. 21 Study design ................................................................................................... 21 Study population ........................................................................................ 21 First visit ..................................................................................................... 21 Second visit................................................................................................ 22 Table of Contents ii Blood collection and laboratory analysis ......................................................... 24 Desaturase activity .......................................................................................... 26 Statistical analyses .......................................................................................... 27 5 Results .................................................................................................................... 29 Characteristics of the study population ............................................................ 29 Dietary fatty acid intake based on weighed food records ................................ 31 Analyses of plasma phospholipid fatty acids in vegans and omnivores .......... 36 Correlation of dietary fatty acids with plasma phospholipid fatty acids ....... 46 Correlation between plasma fatty acids and the duration of a vegan diet .. 47 Analyses of desaturase activity ....................................................................... 48 Analysis of cholesterol and triglyceride within dietary groups .......................... 49 Analysis of plasma phospholipid fatty acids and blood lipids .......................... 49 Analysis of dietary fatty acids and blood lipids ................................................ 51 Sensitivity analyses ......................................................................................... 52 6 Discussion .............................................................................................................. 53 Fatty acid profiles in vegans and omnivores ................................................... 53 6.1.1. Saturated fatty acids .................................................................................. 53 6.1.2. Monounsaturated fatty acids ...................................................................... 57 6.1.3. Polyunsaturated fatty acids ........................................................................ 59 6.1.4. Trans fatty acids ......................................................................................... 70 Discrepancy of dietary and plasma phospholipid fatty acids ...................... 71 6.2. Estimated desaturase activity .......................................................................... 71 6.3. Cholesterol and triglycerides in vegans and omnivores .................................. 73 6.4. Methods .......................................................................................................... 74 6.5. Strengths and limitations ................................................................................. 75 7 Summary ................................................................................................................. 77 8 References .............................................................................................................. 79 Table of Contents iii 9 Statutory Declaration ............................................................................................. 98 10 Curriculum Vitae .................................................................................................... 99 11 List of publications ............................................................................................... 101 12 Acknowledgements .............................................................................................. 102 List of tables iv I. List of tables Table 1: Basic characteristics of our study population ................................................... 29 Table 2: Dietary intake of fatty acids in mg/d based on weighed food records .............. 33 Table 3: Plasma phospholipid fatty acid proportions in vegans and omnivores ............ 38 Table 4: Correlation of intake of fatty acid group with plasma phospholipids of the respective fatty acid group ............................................................................................ 47 Table 5: Correlation between polyunsaturated fatty acids and duration of a vegan diet ...................................................................................................................................... 47 Table 6: Estimated desaturase activity in vegans and omnivores ................................ 48 Table 7: Correlation of plasma phospholipid fatty acids and blood lipids ....................... 50 Table 8: Correlation of dietary fatty acid intake (based on weighed food records) with blood lipids .................................................................................................................... 51 List of figures v II. List of figures Figure 1: Development of number of vegans in Germany ............................................... 4 Figure 2: Butanic acid as example of saturated fatty acids ............................................ 15 Figure 3: Palmitoleic acid as example of monounsaturated fatty acids ......................... 16 Figure 4: Linoleic acid as example of polyunsaturated fatty acids and omega-6 fatty acids .............................................................................................................................. 16 Figure 5: Pathway of metabolic conversion from ALA to EPA and DHA and LA to AA and DPA ....................................................................................................................... 17 Figure 6: Trans-configured fatty acid ............................................................................. 18 Figure 7: Cis-configured fatty acid ................................................................................. 18 Figure 8: Example of identifying FAMEs using known FAME standard mix ................. 26 Figure 9: Dietary intake of fatty acids in vegans and omnivores .................................... 31 Figure 10: Median daily fat intake as percentage of total daily energy intake ................ 32 Figure 11: Dietary omega-6 to omega-3 ratio in vegans and omnivores ....................... 36 Figure 12: Geometric means (percentage of total fatty acids) of plasma phospholipid fatty acid groups according to diet ................................................................................. 37 Figure
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