Trans-fatty acids (TFAs) occur naturally in tiny amounts in certain meats and oils, but the prevalence and danger of TFAs arises through industrial production, notably in partially hydrogenated oils. Highly advantageous in the industry thanks to their long shelf life and stability, they are used in products from margarine to breads and fried foods.
Campaigns to raise awareness and impose restrictions on TFAs have been ongoing for over a decade since nutritionists discovered strong correlations between TFA consumption and prevalence of cardiovascular diseases (CVDs).
CVDs remain the number one cause of death in the EU, killing around 17.5 million people per year globally – more than twice the rate of cancer. The European Heart Network estimates a 25% rise in CVD risk for every 2% energy of TFA consumption.
In Pakistan, where consumption of certain types of ghee with high TFA content is commonplace, over a third of men above the age of 45 suffers from hypertension, and the nation expects to have 13.9 million diabetes patients by 2020.
What is the European food industry doing to prevent a similar epidemic, and should the industry have its hand forced by government policy?
Fat chance
In October of last year, the EU adopted a resolution to begin a Europe-wide impact assessment of the effects TFAs have on public health, and devise policies accordingly.
Trade body FoodDrinkEurope supports forcing the industry to limit quantity of TFAs in products to a maximum of 2% total energy. The World Health Organisation (WHO) says this should be under 1%.
The impact assessment reiterated the correlation between TFAs and coronary heart disease, and highlighted public ignorance on TFAs (over a third of Europeans are unaware what TFAs are or their health consequences) implying improved labelling systems would be insufficient.
But is a blanket government ban necessary? Currently only Denmark, Latvia, Austria and Hungary have introduced mandatory limits on TFA use, whilst others – such as the UK – have set recommended daily allowances.
Dr. David Resnik, a bioethicist at the National Institute of Environmental Health Sciences (NIEHS) has argued that government enforcement on the industry should be avoided. “To protect human freedom and other values, policies that significantly restrict food choices, such as bans on types of food, should be adopted only when they are supported by substantial scientific evidence, and when policies that impose fewer restrictions on freedom, such as educational campaigns and product labelling, are likely to be ineffective.”
Bans and limits
Currently many health experts in Europe agree with Resnik’s conclusion, and observe that reformulation campaigns and raising awareness have been successful in bringing levels of TFA consumption down.
Nutritionist Dr. Carrie Ruxton observed that these efforts have been effective in the UK. “There has been a successful reduction of trans fats in the diet resulting in average intakes remaining well below the population target of 2% energy for several years (average intakes 1.2-1.5% depending on age).
“I don’t think a ban would be necessary. Looking at the UK’s National Diet and Nutrition Survey, the largest contributor to intakes of trans-fats is cheese, providing 11-14% of intakes. I am guessing that, since this is a natural product, it would not be subject to any EU ban. However, ignoring the contribution of cheese would undermine the justification for a ban.”
However, a recent study in the US has found that blanket bans on industrial TFAs do have the desired impact on public health. Researchers at the University of Chicago found that bans on TFAs in restaurants and food outlets in New York resulted in substantial decreases in heart attack rates in 2012 and 2013. The US’ Federal Drug Administration (FDA) has since imposed a nationwide ban on TFAs.
Rob Lyons, journalist and author of 'Panic on a plate: How society developed an eating disorder', said "While the risks from trans fats are routinely exaggerated, limiting them seems a relatively low-cost precautionary measure" and emphasised the industry has largely done this voluntarily.
Researchers said it highlighted the power of public policy, and added that the health implications for blanket bans (not limited to food outlets) would be huge.