For a health outcome or disease that interests you and will be of use to you after you graduate from JMU or graduate school, identify 4 epidemiologic studies to use in a critical appraisal of your thesis statement. All articles should be original (human) research, not reviews or meta-analyses, published in the last 6 years. Use PubMed or CINAHL to identify and locate your articles. (Also, do not use articles that I have used in class or that were used in group presentations.) You should include one cross-sectional study, one case-control study, one cohort study, and one randomized controlled trial.

Trans fatty acids are unsaturated fatty acids with at least one double bond with trans configuration. The source of trans fatty acids is mostly industrial food such as fried foods, bakery products and packed snacks, while the intake from the natural food is very limited. It is shown that trans fatty acids induce systemic inflammation and impair endothelial function (Mozaffarian, 2006). It is, therefore, reasonable to think that trans fatty acids are the risk factor for all major cardiovascular diseases such as myocardial infarction, atherosclerosis, heart failure, etc. Many studies have investigated the role of fatty acids in pathogenesis of various disease states, and proven the negative effect of trans fatty acids on human health, especially on cardiovascular system. Since the main source of trans fatty acids is the dietary intake, it is clear that unhealthy lifestyle of the modern man has led to the pandemic outbreak of cardiovascular diseases today. Among all macronutrients, trans fatty acids increase the risk of coronary heart disease the most (on per calorie basis). It is stated that even very low dietary intake leads to substantial increase in that risk: 2 percent increase in dietary intake increases the risk of coronary heart disease by 23%. Also, it is shown that trans fatty acids increase the risk of diabetes, heart disorders and even sudden cardiac death (Mozaffarian, 2006). The dietary intake of trans fatty acids has been linked by observational, experimental and epidemiological studies to various cardiovascular-related problems. The investigation of presence of trans fatty acids in food and their metabolism in the body in relation to cardiovascular diseases can lead to better understanding of the heart disease and possible prevention and death reduction. The most reliable results of the effects of trans fatty acids on the incidence of cardiovascular disease would be obtained by conducting a randomized, long-term controlled trial. Having in mind the negative effects of trans fatty acids on serum lipid status and inflammation

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