Key role of dietary fats in coronary heart disease under progressive urbanization and nutritional transition

The increased vulnerability to non-communicable diseases (NCD) of developing populations experiencing a demographic and epidemiological transitions to increased risk of NCD at a time when the battle against infectious diseases, is ongoing. Apart from population growth, the major attributes of developmental transition are confined to changes in occupational pattern in family structure, lifestyle, dietary practices and progressive ageing of population. The emergence of the NCD is significantly associated with changes in dietary pattern, in most of the countries. Coronary heart disease (CHD) is the leading cause of death in developed countries and the incidence is increasing in developing countries, including India. The disease needs awareness of the risk factors responsible for prevention. The purpose of this review is to present an overview of the role of dietary fats in growth and development and in health and disease. Although the causation of CHD is multifaceted and the risk factors associated in general are several, there are specific and important elements, such as dietary fats and lifestyle. Dietary fats are an important component as they serve a number of functions in the body. The minimum desirable and upper limits of fat intake have been given, based on recommendations of expert groups. Sources of different fats are made available worldwide and the production, consumption, storage, oxidation and nomenclature are being discussed in the light of health and disease. The relative essentiality of the omega-6 and omega-3 fatty acids is recognized in terms of pharmacologically active eicosanoid metabolism. Nevertheless, epidemiological, physiological and clinical studies have demonstrated that long-chain omega-3 fatty acids present in fish oils have quite diverse health benefits. Appropriate guidelines need to be recommended at a national level consistent with dietary habits. The ratios of balanced fatty acids, namely omega-11, omega-9, omega-6 and omega-3, should be worked out appropriately in ameliorating nutrition-related disease states. Any simple dietary modification that can lead to a substantial reduction in morbidity and mortality from CHD would be of great medical, social and economic benefit.