Trans-C18:1 in the diet originate predominantly from partially hydrogenated oils, with beef, mutton and dairy products being an additional source. These fatty acids are absorbed and incorporated into lipids. Their estimated consumption is about 5-7% of total fatty acids, although reliable data are lacking. In addition, large variations between individuals exist. There is no evidence that trans fatty acids accumulate in human tissues. Elaidic acid and its positional isomers do, however, raise LDL cholesterol and apoprotein B and Lp(a) and probably depress HDL cholesterol and apoprotein A-I, compared with the cis isomer, oleic acid. In view of these adverse effects, patients at high risk for atherosclerosis, in addition to reducing their intake of saturated fatty acids and of cholesterol might also do well to avoid excessive intakes of trans fatty acids. Still, trans fatty acids form only a minor component of the diets of most patients and therefore even marked relative reductions in intake will probably have less of an impact on LDL cholesterol than a sizeable reduction in saturated fatty acids and cholesterol will produce.