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Ban on trans fats likely to benefit public health
Increasing evidence has shown that trans fats, or partially hydrogenated oils, are associated with numerous health risks, such as CVD, coronary heart disease, stroke and elevated LDL cholesterol levels, yet many patients may be unaware of their detrimental effects, according to the American Heart Association and American Stroke Association.
In response to the threat that trans fats impose on public health, WHO recently called for the elimination of trans-fatty acids from the global food supply by 2023 and offered a guide that provides steps for eradication.
In the United States, the FDA has already taken steps to eliminate trans fats and has introduced a ban on trans fats from all commercially produced food that went into effect on June 18.
The ban can save lives; however, eradicating trans fats may prove difficult on an international scale, according to two experts who spoke with Healio Internal Medicine.
Studies have shown that trans fats increase LDL cholesterol while reducing HDL cholesterol and elevate the risk for visceral adiposity, insulin resistance and type 2 diabetes, according to Shauna Downs, PhD, assistant professor of the department of health systems and policy at Rutgers School of Public Health.
“Banning industrially-produced trans fats will virtually eliminate them from the United States food supply,” Downs told Healio Internal Medicine. “Consumers will no longer need to read food labels or to know which products are typically high in trans fats to avoid them. By taking a strong policy approach to improving the quality of the food supply, consumers will benefit in terms of heart health without having to make changes to their food choices.”
Unfortunately, avoiding consumption of trans fats is challenging, according to Lauren Chenarides, PhD, from the Morrison School of Agribusiness at Arizona State University.
“If you have ever eaten packaged snack foods, padded your toast with margarine, or added a dash of shelf-stable coffee creamer to your morning cup o’ joe, you have likely consumed a product made with trans fats,” Chenarides told Healio Internal Medicine. “The 2015 FDA ban on trans fats mandated that food manufacturers remove artificial trans fats from production, as long as the amount per serving is negligible. In other words, trace amounts of artificial trans fats could linger in the product. In the United States, this will likely change with the current FDA ban.”
Long-term evidence-based research is needed to confirm how the ban of trans fats will impact health care, according to Chenarides.
“In the near-term, the guidelines set forth by the WHO to eliminate trans fats should signal to physicians and others involved in medical care the importance of encouraging their patients to take a proactive role in their health,” she said. “For some patients, an announcement like this may go unseen or unnoticed. For others, because this announcement will circulate among news and media outlets, these consumers may seek advice from their health care professionals.”
Discussing the nuances and implications of the ban with patients may be difficult because health care professionals have limited time to engage with patients, she said.
“That said, there are ways in which physicians can facilitate a patient’s edification process, such as directing them to a reputable nutrition education program where patients can learn how to read labels, how to order when dining away from home, or how to choose healthier cooking oils,” she added.
Many foods that contain high amounts of trans fats are highly processed snack foods which physicians are likely already counseling patients to avoid consuming in high quantities, Downs said.
“Physicians should see a reduction in heart attacks — approximately 20,000 per year annually according to FDA estimates — without significant changes to the way they provide patient care,” she said.
The success of the WHO campaign worldwide depends on the development of public-policy interventions led by policy makers, public health activists, businesses and consumers within each country, according to Chenarides.
“The interventions within each country must set the boundaries to which food manufacturers and food service establishments comply,” she said
However, it is unknown how developing countries that have less infrastructure, fewer resources, and high risks of infectious diseases and other constraints, such as political volatility, will respond, according to Chenarides.
“It will take time and investment for food manufacturers to find viable substitutes that replace unhealthy oils in packaged goods,” she said. “But if the campaign is viewed as an instrument to educate consumers who had not otherwise been aware of the negative impacts of consuming trans fats, then it may be that the attention drawn to the topic because of the WHO is enough to contribute, at least marginally, to a shift in global demand away from food products formulated with unhealthy fats.”
The effectiveness of the campaign will likely vary across countries, she said.
“The pledge by the WHO to eliminate trans fats gets at the core of numerous ongoing research agendas within the medical and social science fields, namely to understand the consequences of poor food choices on health outcomes,” Chenarides added. – by Alaina Tedesco
Disclosure: Chenarides and Downs report no relevant financial disclosures.