<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112016000500011</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2016.04.007</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Trans-fatty acid content of food products in Spain in 2015]]></article-title>
<article-title xml:lang="es"><![CDATA[Contenido de ácidos grasos trans en los alimentos en España en 2015]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Farinós]]></surname>
<given-names><![CDATA[Napoleón]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dal Re Saavedra]]></surname>
<given-names><![CDATA[María Ángeles]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villar Villalba]]></surname>
<given-names><![CDATA[Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Robledo de Dios]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Ministry of Health, Social Services and Equality Spanish Agency for Consumer Affairs, Food Safety and Nutrition ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>30</volume>
<numero>5</numero>
<fpage>379</fpage>
<lpage>382</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112016000500011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112016000500011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112016000500011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Objective: To ascertain the content of trans-fatty acids (TFA) in food products in Spain in 2015 and assess trends in TFA content since 2010. Methods: We analysed the fat content of 277 food products purchased in Spanish supermarkets in 2015 and calculated both the total fat and TFA content and the proportion of TFA to total fats. The results obtained in 2015 were compared to those yielded by a similar study in 2010. Results: In 2015, the majority of food products studied had a TFA content of less than 0.2 g/100 g product, and a TFA/total fat ratio of less than 2%. No significant increases were found compared to 2010. Food groups with a higher TFA content were dairy products of possible natural origin. Conclusions: TFA content in Spain is low and has significantly fallen since 2010.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Objetivo: Conocer el contenido de ácidos grasos trans en los alimentos en España en 2015 y evaluar la tendencia desde 2010. Métodos: Se analizó la composición grasa de 277 alimentos adquiridos en supermercados en España en 2015. Se calcularon el contenido en ácidos grasos trans y en grasas totales, y el porcentaje de ácidos grasos trans respecto de la grasa total. Se compararon los resultados con los de un estudio similar realizado en 2010. Resultados: En 2015 la mayoría de los alimentos estudiados tenían menos de 0,2 g de ácidos grasos trans por 100 g de producto, y menos del 2% de ácidos grasos trans respecto a las grasas totales. No se hallaron aumentos significativos desde 2010. Los grupos con contenidos más altos de ácidos grasos trans eran derivados lácteos, con posible origen natural. Conclusiones: El contenido de ácidos grasos trans en España es bajo y se ha reducido significativamente desde 2010.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Trans-fatty acids]]></kwd>
<kwd lng="en"><![CDATA[Diet]]></kwd>
<kwd lng="en"><![CDATA[Food and nutrition]]></kwd>
<kwd lng="en"><![CDATA[Nutrition policy]]></kwd>
<kwd lng="en"><![CDATA[Reformulation]]></kwd>
<kwd lng="en"><![CDATA[Food quality]]></kwd>
<kwd lng="en"><![CDATA[Cardiovascular diseases]]></kwd>
<kwd lng="es"><![CDATA[Ácidos grasos trans]]></kwd>
<kwd lng="es"><![CDATA[Dieta]]></kwd>
<kwd lng="es"><![CDATA[Alimentos y nutrición]]></kwd>
<kwd lng="es"><![CDATA[Políticas de nutrición]]></kwd>
<kwd lng="es"><![CDATA[Reformulación]]></kwd>
<kwd lng="es"><![CDATA[Calidad de los alimentos]]></kwd>
<kwd lng="es"><![CDATA[Enfermedades cardiovasculares]]></kwd>
</kwd-group>
</article-meta>
</front><body><![CDATA[ <p><a name="top"></a><font face="Verdana" size="2"><b>BRIEF ORIGINAL ARTICLE</b></font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="4"><b>Trans-fatty acid content of food products in Spain in 2015</b></font></p>     <p><font face="Verdana" size="4"><b>Contenido de &aacute;cidos grasos <i>trans</i> en los alimentos en Espa&ntilde;a en 2015</b></font></p>     <p>&nbsp;</p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Napole&oacute;n P&eacute;rez-Farin&oacute;s, Mar&iacute;a &Aacute;ngeles Dal Re Saavedra, Carmen Villar Villalba and Teresa Robledo de Dios</b></font></p>     <p><font face="Verdana" size="2">Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, Madrid, Spain</font></p>     <p><font face="Verdana" size="2">The study was entirely funded by the Spanish Agency for Consumer Affairs, Food Safety and Nutrition.</font></p>     <p><font face="Verdana" size="2"><a href="#bajo">Correspondence</a></font></p>     ]]></body>
<body><![CDATA[<p>&nbsp;</p>     <p>&nbsp;</p> <hr size="1">    <p><font face="Verdana" size="2"><b>ABSTRACT</b></font></p>     <p><font face="Verdana" size="2"><b>Objective:</b> To ascertain the content of trans-fatty acids (TFA) in food products in Spain in 2015 and assess trends in TFA content since 2010.    <br><b>Methods:</b> We analysed the fat content of 277 food products purchased in Spanish supermarkets in 2015 and calculated both the total fat and TFA content and the proportion of TFA to total fats. The results obtained in 2015 were compared to those yielded by a similar study in 2010.    <br><b>Results:</b> In 2015, the majority of food products studied had a TFA content of less than 0.2 g/100 g product, and a TFA/total fat ratio of less than 2%. No significant increases were found compared to 2010. Food groups with a higher TFA content were dairy products of possible natural origin.    <br><b>Conclusions:</b> TFA content in Spain is low and has significantly fallen since 2010.</font></p>     <p><font face="Verdana" size="2"><b>Keywords:</b> Trans-fatty acids. Diet. Food and nutrition. Nutrition policy. Reformulation. Food quality. Cardiovascular diseases.</font></p> <hr size="1">    <p><font face="Verdana" size="2"><b>RESUMEN</b></font></p>     <p><font face="Verdana" size="2"><b>Objetivo:</b> Conocer el contenido de &aacute;cidos grasos <i>trans</i> en los alimentos en Espa&ntilde;a en 2015 y evaluar la tendencia desde 2010.    ]]></body>
<body><![CDATA[<br><b>M&eacute;todos:</b> Se analiz&oacute; la composici&oacute;n grasa de 277 alimentos adquiridos en supermercados en Espa&ntilde;a en 2015. Se calcularon el contenido en &aacute;cidos grasos <i>trans</i> y en grasas totales, y el porcentaje de &aacute;cidos grasos <i>trans</i> respecto de la grasa total. Se compararon los resultados con los de un estudio similar realizado en 2010.    <br><b>Resultados:</b> En 2015 la mayor&iacute;a de los alimentos estudiados ten&iacute;an menos de 0,2 g de &aacute;cidos grasos <i>trans</i> por 100 g de producto, y menos del 2% de &aacute;cidos grasos <i>trans</i> respecto a las grasas totales. No se hallaron aumentos significativos desde 2010. Los grupos con contenidos m&aacute;s altos de &aacute;cidos grasos <i>trans</i> eran derivados l&aacute;cteos, con posible origen natural.    <br><b>Conclusiones:</b> El contenido de &aacute;cidos grasos <i>trans</i> en Espa&ntilde;a es bajo y se ha reducido significativamente desde 2010.</font></p>     <p><font face="Verdana" size="2"><b>Palabras clave:</b> &Aacute;cidos grasos trans. Dieta. Alimentos y nutrici&oacute;n. Pol&iacute;ticas de nutrici&oacute;n. Reformulaci&oacute;n. Calidad de los alimentos. Enfermedades cardiovasculares.</font></p> <hr size="1">     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Introduction</b></font></p>     <p><font face="Verdana" size="2">Trans fatty acids (TFA) are unsaturated fatty acids with at least one double bond in the transconfiguration.<sup>1</sup> This configuration can come about naturally from ruminant-based meat and dairy products, or artificially through partial hydrogenation of vegetable oils in the food industry and manufacturing processes.<sup>1,2</sup></font></p>     <p><font face="Verdana" size="2">There is scientific evidence to show that TFA intake is associated with cardiovascular diseases in different ways.<sup>3,4</sup> In addition, associations between TFA intake and other diseases, such as diabetes mellitus,<sup>1,3-5</sup> cancer<sup>6</sup> and asthma,<sup>7</sup> have also been proposed.</font></p>     <p><font face="Verdana" size="2">Due to those health risks, it is clear that TFA intake should be as low as possible, and that TFA content in food products should be reduced or eliminated. Some countries have regulated TFA content, such as Denmark, by means of an Order which came into force in 2003.<sup>8</sup> In Spain, the 2011 Food Safety and Nutrition Act included a specific provision targeted at reducing artificial TFA in food products.<sup>9</sup></font></p>     <p><font face="Verdana" size="2">Although an important decrease in TFA content and intake has been detected in some countries,<sup>10,11</sup> as a result of statutory regulation, health promotion actions and voluntary food-industry initiatives, more efforts are nevertheless called for.</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana" size="2">The aim of this study was thus to ascertain the average TFA content of food products in Spain in 2015, and assess time trends in TFA content since 2010 when an earlier study was undertaken.<sup>10</sup></font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Methods</b></font></p>     <p><font face="Verdana" size="2">To assess the TFA content in Spain, food products were acquired from hypermarkets and supermarkets countrywide.</font></p>     <p><font face="Verdana" size="2">The most sold food items in each group were selected for a previous study conducted by the Spanish Agency for Consumer Affairs, Food Safety and Nutrition (<i>Agencia Espa&ntilde;ola de Consumo, Seguridad Alimentaria y Nutrici&oacute;n/AECOSAN</i>) in 2010.<sup>10</sup> We selected the same products for the purposes of our study, in order to compare TFA content between 2010 and 2015. The methodology used in both the 2010 and 2015 studies was similar.</font></p>     <p><font face="Verdana" size="2">We measured total fat and TFA content in the selected food items (g/100 g of product). Analytical tests were performed by an independent laboratory accredited by the Spanish National Accreditation Board (<i>Entidad Nacional de Acreditaci&oacute;n/ENAC</i>), using gas chromatography with a flame ionization detector for food samples.</font></p>     <p><font face="Verdana" size="2">Mean and standard deviation were computed for TFA and total fat content in each group of food items. The TFA/total fat ratio was also calculated for each food product and group.</font></p>     <p><font face="Verdana" size="2">To assess the differences between 2010 and 2015, we compared the mean TFA values (g/100 g of product) and TFA/total fat percentage ratios for those years using the U Mann-Whitney test.</font></p>     <p><font face="Verdana" size="2">In any case where there was no exact match between 2010 and 2015, the product concerned was excluded from the analysis to ensure the comparability of all groups.</font></p>     <p>&nbsp;</p>     ]]></body>
<body><![CDATA[<p><font face="Verdana" size="2"><b>Results</b></font></p>     <p><font face="Verdana" size="2">Based on the 2010 study, a set of 443 food items was initially selected.<sup>10</sup> After the excluding all items that failed to show a match between 2010 and 2015, a total of 277 products was finally analyzed and grouped (<a href="#t1">Table 1</a>).</font></p>     <p>&nbsp;</p>     <p align="center"><font face="Verdana" size="2"><b><a name="t1"></a>Table 1.</b> Trans-fatty-acids and total fat content (g/100 g of product) of food products in Spain.    <br><img src="/img/revistas/gs/v30n5/original_breve4_t1.jpg">    <br>SD: Standard deviation; TFA: trans fatty acids.    <br><sup>a</sup> - p for differences between means from 2010 to 2015.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2">In 2015, the average TFA content was less than 0.2 g/100 g of product across all food groups, with only two exceptions (butter: 2.011 g; spreadable cheeses: 0.536 g). TFA were undetectable in several groups, such as breakfast cereals, biscuits, industrial bread and tomato sauce. Comparison against the 2010 results showed reductions in TFA content in most groups, with some of these decreases proving statistically significant (salty snacks, confectionary and pastries, chocolates, biscuits and chips), and indicated only a few non-significant increases (<a href="#t1">Table 1</a>).</font></p>     <p><font face="Verdana" size="2">The average proportion of TFA to total fats in 2015 was lower than 2% across all food-product groups, except yoghourts and dairy products (2.30%), butter (2.45%) and spreadable cheeses (2.52%), as shown in <a href="#t2">Table 2</a>. Non-significant increases were found and there were some significant reductions in salty snacks, confectionary and pastries, chocolates, biscuits, and chips.</font></p>     ]]></body>
<body><![CDATA[<p>&nbsp;</p>     <p align="center"><font face="Verdana" size="2"><b><a name="t2"></a>Table 2.</b> Average proportion of trans-fatty-acids/total fats in food products in Spain.    <br><img src="/img/revistas/gs/v30n5/original_breve4_t2.jpg">    <br>SD: standard deviation; TFA: trans fatty acids.    <br><sup>a</sup> - p for differences between means from 2010 to 2015.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Discussion</b></font></p>     <p><font face="Verdana" size="2">There is solid scientific evidence to show an association between TFA intake and cardiovascular diseases. A reduction in TFA content in food products and TFA intake should thus be recommended. While TFA content in Spain was reported to be high by a number of studies,<sup>2,12</sup> one study suggested that in 2010 TFA content had been reduced in the majority of the food groups studied.<sup>10</sup></font></p>     <p><font face="Verdana" size="2">This study confirms the situation found five years previously. The comparison between TFA content in 2010 and 2015 showed that there had been no significant changes. In some groups, such as breakfast cereals, industrial bread and tomato sauce, TFA were undetectable, and in other groups, significant reductions were even found (salty snacks, confectionery and pastries, chocolates, biscuits, chips). Some food groups displayed slight, non-significant increases but the magnitude of the content was so low as to be of no concern.</font></p>     <p><font face="Verdana" size="2">It is also interesting to establish the proportion of TFA to total fats because the majority of regulations use this ratio to set the permitted limit. Our study shows that only in three groups (yoghourts and dairy products, butter, and spreadable cheeses) is this proportion higher than 2%. Even so, TFA content in yoghourts and dairy products is very low (0.073% of the total product). Moreover, TFA of natural origin can be present in meat and dairy products from ruminants (which is the case in point). Another issue lies in the fact that in some groups, such as yoghourts and dairy products, total fat content has been significantly reduced, and this could go some way to explain the rise in the TFA/total fat ratio.</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana" size="2">Insofar as TFA of natural origin is concerned, some studies have postulated that such TFA are not associated with cardiovascular diseases and, indeed, might even have some health benefits.<sup>13</sup> More studies are needed to address this issue.</font></p>     <p><font face="Verdana" size="2">Following the Danish initiative, some laws in Europe (including the Spanish Food Safety and Nutrition Act) and the USA have sought to reinforce the reduction in TFA content in the case of food products.<sup>8,11,14</sup> In June 2015, the US Food and Drug Administration (FDA) finalized its determination whereby food manufacturers were ordered to remove TFA from their products in 2018. A combination of statutory regulations and voluntary actions would appear to be the most advisable strategy.<sup>15</sup></font></p>     <p><font face="Verdana" size="2">The social responsibility of food manufacturers in Spain warrants a special mention. The food industry has made remarkable efforts to reduce TFA since the consequences to health became known.</font></p>     <p><font face="Verdana" size="2">The main strength of this study is its strict methodology which successfully ensured comparability of the results obtained in 2010 and 2015.</font></p>     <p><font face="Verdana" size="2">One limitation might lie in the fact that the selected food-product sample belonged to leading consumer brands enjoying widespread distribution, whereas there are also other locally distributed, lower-impact brands which may have been overlooked by the study. Subsequent assessments are called for.</font></p>     <p><font face="Verdana" size="2">The main conclusion of our study is that the average TFA content of food products in Spain is low, and that in the context of a balanced diet, exposure to TFA should thus be minimal. Although it cannot be stated with certainty in the absence of data on TFA intake, it is safe to assume that, where exposure is low, the average intake in Spain would likewise be low. Nonetheless, regular surveillance of the TFA content of food products should be maintained. By way of a public health goal, reformulation of food products must be reinforced in order to ensure that the nutritional quality of food is improved.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Editor in charge</b></font></p>     <p><font face="Verdana" size="2">Carlos &Aacute;lvarez-Dardet.</font></p>     <p>&nbsp;</p>     ]]></body>
<body><![CDATA[<p><font face="Verdana" size="2"><b>Transparency declaration</b></font></p>     <p><font face="Verdana" size="2">The corresponding author on behalf of the other authors guarantee the accuracy, transparency and honesty of the data and information contained in the study, that no relevant information has been omitted and that all discrepancies between authors have been adequately resolved and described.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Authorship contributions</b></font></p>     <p><font face="Verdana" size="2">All authors conceived and designed the study, collaborated in the analysis and interpretation of results, and reviewed and approved the final version of the manuscript. N. P&eacute;rez-Farin&oacute;s wrote the article and was chiefly responsible for the methodological aspects and analysis of the data.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><b>Conflicts of interest</b></font></p>     <p><font face="Verdana" size="2">None.</font></p>     <p>&nbsp;</p>     <p><img src="/img/revistas/gs/v30n5/original_breve4_cuadro.jpg"></p>     ]]></body>
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<body><![CDATA[<!-- ref --><p><font face="Verdana" size="2">5. De Souza RJ, Mente A, Maroleanu A, 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;351:1-16.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519429&pid=S0213-9111201600050001100005&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">6. Chaj&egrave;s V, Thi&eacute;baut ACM, Rotival M, et al. Association between serum trans-monounsaturated fatty acids and breast cancer risk in the E3N-EPIC study. Am J Epidemiol. 2008;167:1312-20.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519431&pid=S0213-9111201600050001100006&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">7. Weiland SK, von Mutius E., Husing A, et al. Intake of trans fatty acids and prevalence of childhood asthma and allergies in Europe. Lancet. 1999;353:2040-1.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519433&pid=S0213-9111201600050001100007&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">8. Leth T, Jensen HG, Mikkelsen AÃ†, et al. The effect of the regulation on trans fatty acid content in Danish food. Atheroscler Suppl. 2006;7:53-6.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519435&pid=S0213-9111201600050001100008&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">9. Ley 17/2011, de 5 de julio, de seguridad alimentaria y nutrici&oacute;n. Espa&ntilde;a: Bolet&iacute;n Oficial del Estado 160, 6 de julio de 2011: 71283-319.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519437&pid=S0213-9111201600050001100009&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    ]]></body>
<body><![CDATA[<!-- ref --><p><font face="Verdana" size="2">10. Robledo de Dios T, Dal Re Saavedra MA, Villar Villalba C, et al. Contenido de &aacute;cidos grasos trans en los alimentos en Espa&ntilde;a. Nutr Hosp. 2015;32:1329-33.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519439&pid=S0213-9111201600050001100010&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">11. Temme EHM, Millenaar IL, Donkersgoed GVAN, et al. Impact of fatty acid food reformulations on intake of Dutch young adults. Acta Cardiol. 2011;66:721-8.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519441&pid=S0213-9111201600050001100011&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">12. Fern&aacute;ndez-San Juan PM. Trans fatty acids (tFA): sources and intake levels, biological effects and content in commercial Spanish food. Nutr Hosp. 2009;24:515-20.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519443&pid=S0213-9111201600050001100012&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">13. Chardigny JM, Destaillats F, Malpuech-Brug&egrave;re C, et al. Do trans fatty acids from industrially produced sources and from natural sources have the same effect on cardiovascular disease risk factors in healthy subjects? Results of the trans Fatty Acids Collaboration (TRANSFACT) study. Am J Clin Nutr. 2008;87:558-66.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519445&pid=S0213-9111201600050001100013&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    <!-- ref --><p><font face="Verdana" size="2">14. Monge-Rojas R, Col&oacute;n-Ramos U, Jacoby E, et al. Voluntary reduction of trans-fatty acids in Latin America and the Caribbean: current situation. Rev Panam Salud P&uacute;blica. 2011;29:126-9.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519447&pid=S0213-9111201600050001100014&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>    ]]></body>
<body><![CDATA[<!-- ref --><p><font face="Verdana" size="2">15. Downs SM, Thow M, Leeder SR. The effectiveness of policies for reducing dietary trans fat: a systematic review of the evidence. Bull World Health Organ. 2013;91:262-9.    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=2519449&pid=S0213-9111201600050001100015&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --></font></p>     <p>&nbsp;</p>     <p>&nbsp;</p>     <p><font face="Verdana" size="2"><a href="#top"><img border="0" src="/img/revistas/gs/v30n5/seta.gif" width="15" height="17"></a><a name="bajo"></a><b>Correspondence:</b>    <br>Napole&oacute;n P&eacute;rez-Farin&oacute;s    <br><a href="mailto:nperezf@msssi.es">nperezf@msssi.es</a></font></p>     <p><font face="Verdana" size="2">Received 26 February 2016    <br>Accepted 5 April 2016</font></p>      ]]></body><back>
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