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Background    Trans  fatty acids are produced either by industrial hydrogenation or by biohydrogenation in the rumens of cows and sheep. Industrial  trans  fatty acids lower HDL cholesterol, raise LDL cholesterol, and increase the risk of coronary heart disease. The effects of conjugated linoleic acid and  trans  fatty acids from ruminant animals are less clear. We reviewed the literature, estimated the effects  trans  fatty acids from ruminant sources and of conjugated  trans  linoleic acid (CLA) on blood lipoproteins, and compared these with industrial trans fatty acids.    Methodology/Principal Findings  We searched Medline and scanned reference lists for intervention trials that reported effects of industrial trans fatty acids, ruminant trans fatty acids or conjugated linoleic acid on LDL and HDL cholesterol in humans. The 39 studies that met our criteria provided results of 29 treatments with industrial  trans  fatty acids, 6 with ruminant  trans  fatty acids and 17 with CLA. Control treatments differed between studies; to enable comparison between studies we recalculated for each study what the effect of  trans  fatty acids on lipoprotein would be if they isocalorically replaced  cis  mono unsaturated fatty acids. In linear regression analysis the plasma LDL to HDL cholesterol ratio increased by 0.055 (95%CI 0.044–0.066) for each % of dietary energy from industrial  trans  fatty acids replacing  cis  monounsaturated fatty acids The increase in the LDL to HDL ratio for each % of energy was 0.038 (95%CI 0.012–0.065) for ruminant trans fatty acids, and 0.043 (95% CI 0.012–0.074) for conjugated linoleic acid (p = 0.99 for difference between CLA and industrial  trans  fatty acids; p = 0.37 for ruminant versus industrial  trans  fatty acids).    Conclusions/Significance  Published data suggest that all fatty acids with a double bond in the  trans  configuration raise the ratio of plasma LDL to HDL cholesterol.

Effect of Animal and Industrial Trans Fatty Acids on HDL and LDL Cholesterol Levels in Humans – A Quantitative Review