essay about trans fats

Shining the Spotlight on Trans Fats

For years, only true diet detectives knew whether a particular food contained trans fat. This phantom fat—the worst type of fat for the heart, blood vessels, and rest of the body—was found in thousands of foods; but only those familiar with the “code words” partially hydrogenated oil and vegetable shortening knew when it was present. Fortunately, after a large body of research in the 1990s sounded the alarm on its deleterious health effects, a series of policy initiatives led to the near elimination of artificial trans fat in the U.S. food supply by 2018. However, the road to eliminating trans fat was not so straightforward, and outside the U.S. there’s still more work to be done. In many developing nations, trans fat intake remains high.

Where Do Trans Fats Come From?

In the late 19th century, chemists discovered that they could add hydrogen atoms to unsaturated fats by bubbling hydrogen gas through vegetable oil in the presence of a nickel catalyst. [1] This was far more than a chemical curiosity. Partially hydrogenated oils don’t turn rancid as easily as non-hydrogenated fats. They can withstand repeated heating without breaking down, and the process can turn a liquid oil into a solid, which allowed for easier transportation and wider uses. This solid fat was also much less expensive than many solid animal fats. These characteristics were attractive to food makers, and partially hydrogenated oils became a mainstay in margarines, vegetable shortenings, doughnuts, commercial baked goods like packaged pastries and cookies, other snack foods, and in fast-food restaurant deep fryers.

At the time, switching from butter or lard (both of which contain high amounts of saturated fat ) to a product made from healthy vegetable oil seemed to make sense—and intake of trans fat increased dramatically. Before the advent of partial hydrogenation, the only trans fat that humans consumed came from eating cows (or dairy products), lamb, and deer. In ruminant animals like these, bacteria living in the stomach naturally make small amounts of trans fat. But due to the growth of partial hydrogenation, by the early 1990s, trans fat intake in the United States averaged 2% to 3% of total calories—with many Americans consuming up to three times this amount.

Research Sounds the Alarm

Today, thanks to a series of research studies, we know that trans fats should be avoided. Eating trans fats increases levels of low-density lipoprotein (LDL, or “bad” cholesterol ), especially the small, dense LDL particles that may be more damaging to arteries. It lowers levels of high-density lipoprotein (HDL, or “good” cholesterol) particles, which scour blood vessels for bad cholesterol and truck it to the liver for disposal. It also promotes inflammation, [2] an overactivity of the immune system that has been implicated in heart disease , stroke , diabetes , and other chronic conditions. Additionally, consuming trans fat reduces the normal healthy responsiveness of endothelial cells, the cells that line all of our blood vessels. In animal studies, eating trans fat also promotes obesity and resistance to insulin—the precursor to diabetes. So when did the research on this harmful fat begin?

In 1981, a group of Welsh researchers speculated that trans fats from partially hydrogenated oils might be linked with heart disease. [3] In 1990, a controlled feeding study by two Dutch researchers showed that trans fat consumption increased LDL cholesterol and reduced HDL cholesterol. [4]  A 1993 Harvard study strongly supported the hypothesis that intake of partially hydrogenated vegetable oils contributed to the risk of having a heart attack. [5] In this study, researchers found that replacing just 2% of energy from trans fat with healthy unsaturated fat would decrease the risk of coronary heart disease by about one-third. An influential symposium on trans fat later in the 1990s drew public attention to the issue.

Science and Advocacy Lead to Change in the U.S.

In 2003, following a long campaign led by Dr. Fred Kummerow , along with the Center for Science in the Public Interest and researchers from the Harvard School of Public Health’s Department of Nutrition, the U.S. Food and Drug Administration (FDA) ruled that trans fats must be declared on the Nutrition Facts label by 2006. [6]

Despite intense lobbying efforts against the label addition by some parts of the food industry, this ruling sparked a major makeover of the American food supply. The FDA once estimated that approximately 95% of prepared cookies, 100% of crackers, and 80% of frozen breakfast products contained trans fat. When food companies realized that consumers—armed with this new information—would avoid products containing trans fat, many found ways to make their products without partially hydrogenated oils. For example, major manufacturers started using trans-free oils for making tortilla chips and other crunchy snacks; frozen food makers introduced frozen fried chicken products without trans fat; and many major restaurant chains reformulated their products to reduce trans fats.

Impacts of the 2006 ruling

• By 2010, a survey of 83 major-brand grocery store products and restaurant dishes offered encouraging news: when most of these food makers reformulated their products, they cut back on trans fat without increasing saturated fat. [7]
• A study from the Centers for Disease Control and Prevention found that Americans’ blood-levels of trans fats dropped 58 percent from 2000 to 2009—evidence that the labeling law has had its desired effect. [8]

The addition of trans fat on the Nutrition Facts label was certainly a victory for public health—but there was more work to be done. Despite the ruling, manufacturers could still claim “0 grams of trans fat” on the label if the product contained less than 0.5 grams of trans fats per serving. While seemingly minimal, even small amounts of trans fat could add up over the course of a day. In these cases, the only way consumers could avoid trans fats from packaged products was by identifying partially hydrogenated oils in the ingredients list.

Furthermore, since the ruling did not cover foods without labels—such as those sold in bakeries, cafeterias, schools, and restaurants—consumers couldn’t easily choose to avoid potentially trans fat-laden foods in these settings.

Still, word on the harm of trans fat was out, and states, counties, and cities spurred additional change with educational efforts and local bans on trans fats. In 2006, New York City became the largest city in the nation to require its restaurants, cafeterias, and schools to go trans fat-free, and other cities and towns such as Boston followed its lead. California was the first state to pass legislation phasing out trans fats from restaurants and baked goods by 2010 and 2011, respectively.

NYC leads by example

“This will save many hundreds, and probably thousands, of premature deaths each year in New York and will also likely reduce the development of type 2 diabetes and dementia,” said Dr. Walter Willett , then chair of Harvard School of Public Health’s Department of Nutrition, in response to the ban.

Leading up to the decision, Willett and Dr. Dariush Mozaffarian detailed the many negative health effects associated with trans fat intake in testimony to the New York City Board of Health .

In 2015—over 10 years since the initial ruling and decades after research showed the harms of trans fat intake—the FDA ruled that partially hydrogenated oils are no longer “generally recognized as safe” for use in human food. Although earlier educational efforts and local bans had vastly reduced partially hydrogenated oils, this decision was the final nail in the coffin for industrial trans fat in America’s food supply. Given three years to comply, food manufacturers are banned from using partially hydrogenated oils as of June 18, 2018. (Industry will be allowed some minor manufacturing and petitioned uses, though even these are set to be phased out by 2021. However, the FDA denied a last-minute petition by the Grocery Manufacturers Association for certain continued uses.)

The story of trans fat in the U.S., while lengthy, serves as an excellent example where scientific evidence was translated into policy actions to improve public health. As early as 2006, researchers estimated that eliminating trans fats from America’s food supply could prevent up to 1 in 5 heart attacks and related deaths; which would mean a quarter of a million fewer heart attacks and related deaths each year in the U.S. alone! [9] Encouragingly, research has already found that earlier bans on the use of trans fats in New York State public eateries are associated with a drop in heart attacks and strokes . [10]

Work to be Done Worldwide

Outside of the U.S., a number of countries, such as Denmark, Switzerland, Canada, and Britain, have already restricted or banned trans fats. However, trans fat remains prevalent in many developing nations where inexpensive partially hydrogenated oils have become staples not only for the food industry, but also for home use. This shift away from traditional cooking oils toward partially hydrogenated oils is contributing to the growing global epidemic of cardiovascular disease. For example, trans fats in India are often found in “vanaspati,” a partially hydrogenated oil often used as a low-cost alternative in food preparation. [11]

Encouragingly, in 2018 the World Health Organization (WHO) also put trans fat in the spotlight on a global stage. Estimating that industrial trans fat intake leads to more than 500 thousand deaths from cardiovascular disease annually, the WHO is calling on governments to eliminate, or “ REPLACE ,” trans fats by 2023 through six strategic actions:

• RE view dietary sources of industrially-produced trans fats and the landscape for required policy change.
• P romote the replacement of industrially-produced trans fats with healthier fats and oils.
• L egislate or enact regulatory actions to eliminate industrially-produced trans fats.
• A ssess and monitor trans fats content in the food supply and changes in trans fat consumption in the population.
• C reate awareness of the negative health impact of trans fats among policy makers , producers, suppliers, and the public.
• E nforce compliance of policies and regulations.

Because the WHO has no enforcement capacity, it is up to national and local governments to carry out these actions in to eliminate industrial trans fats.

Two years into the campaign, the WHO reported that 58 countries so far have introduced laws that will protect 3.2 billion people from the harmful substance by the end of 2021. However, more than 100 countries still need to take actions to remove trans fat from their food supplies.

Progress in Asia

• Thailand:  In January 2018, Thailand’s Ministry of Public Health released a notification banning partially hydrogenated oils and food products containing them by January 2019.
• India: In early 2021, the Food Safety and Standards Authority of India passed a policy reducing the current permissible limit of trans fats in oils/fats in food products from 5% to 2% by 2022.

Tips for Lowering Trans Fat Intake

If you live or spend time in a country where there is weak regulation or no ban on industrial trans fat, here are a few tips that may help you lower your intake:

• Choose liquid vegetable oils.
• Avoid eating commercially prepared baked foods (cookies, pies, donuts, etc.), snack foods, and processed foods, including fast foods. To be on the safe side, assume that all such products contain trans fats unless they are labeled otherwise.
• When foods containing partially hydrogenated oils can’t be avoided, choose products that list the partially hydrogenated oils near the end of the ingredient list.
• To avoid trans fats in restaurants, one strategy is to avoid deep-fried foods (since restaurants may use partially hydrogenated oils in their fryers) and desserts. You may be able to help change these cooking practices by asking your server, the chef, or manager if the establishment uses only trans fat-free oils and foods.
• Katan MB, Zock PL, Mensink RP. Trans fatty acids and their effects on lipoproteins in humans. Annual Review of Nutrition . 1995 Jul;15(1):473-93.
• Mozaffarian D, Pischon T, Hankinson SE, Rifai N, Joshipura K, Willett WC, Rimm EB. Dietary intake of trans fatty acids and systemic inflammation in women. The American Journal of Clinical Nutrition . 2004 Apr 1;79(4):606-12.
• Thomas LH, Jones PR, Winter JA, Smith H. Hydrogenated oils and fats: the presence of chemically-modified fatty acids in human adipose tissue. The American Journal of Clinical Nutrition . 1981 May 1;34(5):877-86.
• Mensink RP, Katan MB. Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects. New England Journal of Medicine . 1990 Aug 16;323(7):439-45.
• Willett WC, Stampfer MJ, Manson JE, Colditz GA, Speizer FE, Rosner BA, Hennekens CH, Sampson LA. Intake of trans fatty acids and risk of coronary heart disease among women. The Lancet . 1993 Mar 6;341(8845):581-5.
• U.S. Food and Drug Administration. (2003). “Food Labeling: Trans.” Retrieved from: https://www.federalregister.gov/documents/2003/07/11/03-17525/food-labeling-trans .
• Mozaffarian D, Jacobson MF, Greenstein JS. Food reformulations to reduce trans fatty acids. New England Journal of Medicine . 2010 May 27;362(21):2037-9.
• Vesper HW, Kuiper HC, Mirel LB, Johnson CL, Pirkle JL. Levels of plasma trans-fatty acids in non-Hispanic white adults in the United States in 2000 and 2009. JAMA . 2012 Feb 8;307(6):562-3.
• Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. New England Journal of Medicine . 2006 Apr 13;354(15):1601-13.
• Brandt EJ, Myerson R, Perraillon MC, Polonsky TS. Hospital admissions for myocardial infarction and stroke before and after the trans-fatty acid restrictions in New York. JAMA cardiology . 2017 Jun 1;2(6):627-34.
• Dorni C, Sharma P, Saikia G, Longvah T. Fatty acid profile of edible oils and fats consumed in India. Food chemistry . 2018 Jan 1;238:9-15.

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Trans Fats: A Review of Their Sources, Consumption, Health Implications, International and National Policies and Regulation

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Sorting the Shifting Facts on Trans Fat

Humans have a very complicated relationship with fat. We’re kind of obsessed with it, but we are only vaguely aware that eating foods containing fat doesn’t necessarily make us fat. It’s all about the kind of fat we’re eating, and the amount we’re eating in balance with everything else. We’re confused, and it’s no wonder–the science and the diet fads have shifted over time.

Take trans fats, for example. Earlier this month, the U.S. Food and Drug Administration made a long-awaited announcement it would clear most trans most fats from our diets by 2018. The science shows its bad for our hearts, and the Obama administration says it is no longer worth the risk.

But trans fats, primarily those found in   partially hydrogenated vegetable oil (PHO), were once the darling of the food industry. Trans fats, introduced in the 1950s , made packaged foods tasty and shelf-stable, and became cheaper substitutes for the butter, lard and beef tallow that was used before they came along. Use continued to soar through the 1980s, as doctors warned us to cut back on the saturated fat in meat and dairy products.

Crackers, cookies, cakes and Crisco could all live practically forever in the pantry. But now, we may be paying for it.

In the last decade or so, science suggests that trans fats raised our LDL or “bad” cholesterol, and lower our “good” cholesterol, increasing the risk of heart disease. Some doctors call it “the worst type of fat you can eat.” The   Danes limited trans fats in 2003   for that reason, and figured out how to make the country’s signature pastry without it, and the FDA estimates it could save thousands of lives each year in the U.S. through its restrictions.

(Meanwhile, there’s been increasing evidence that some fats might be good for us, such as the fat found in coconut oil and avocados, which we now may be loving too much . No wonder we’re confused!)

Since the FDA has been aiming at trans fats for years, and has required it on the nutrition label of foods sold in the U.S. since 2006 , most major food companies have worked out ways to replace the trans fat they once relied on with other ingredients, so there won’t likely be major taste disruptions in our favorite snack foods.

Now technically, what FDA has done is not a ban , as the Grocery Manufacturers of America point out. The FDA just reclassified the status of trans fats, which allows foodmakers to petition the agency for an exemption. But don’t expect too many petitions. “It’s important to know that food and beverage companies have already voluntarily lowered the amount of PHOs added to products by more than 86 percent—and are continuing to lower usage even further,” says Leon Bruner, executive vice president and chief science officer at GMA, in a recent blog post.

In fact, it was pretty hard to find items at my local Target store recently that contain any trans fat, with notable exceptions, such as Movie Theater Butter flavored Pop Secret Popcorn (the highest I saw, 4.5 grams of trans fat per serving), some Slim Jim meat sticks (0.5 g), and certain types of Nabisco cookies, all less than 1 g of trans fat per serving.

According to FDA, trans fat still lurks in some non-dairy creamers, stick margarine, and processed dough items in the freezer aisle, but it’s fair to say, trans fats’ days are likely numbered.

Still, it will be in “fast food french fries, doughnuts—the usual places,” at least until 2018, says Katherine Tallmadge , dietician and author of   Diet Simple: 195 Mental Tricks, Substitutions, Habits & Inspirations .

“Restaurants and processed foods will have trouble finding substitutes,” she predicts. Butter or lard are the likely replacements, “but they are more expensive and have a shorter shelf life, so foods like this may end up being more expensive,” Tallmadge says.

And then there are a few holdouts, notably smaller establishments with historic recipes, including Bergers cookies, a famous treat made in Baltimore since the 1800s that’s basically a soft white cake with a generous dollop of rich chocolate fudge on top. It has 1g of trans fat per serving, which is one cookie, according to the nutrition label .

A couple of years ago,   the Bergers baker told the Baltimore Sun   he   would have to shut down operations if trans fat was blocked,   because he had not found a good substitute for the shortening he uses. Now he has three more years to work it out.

Then again, who knows what new fat science will pop   out three years from now?

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• Copy URL https://www.pbs.org/newshour/health/qa-trans-fats-unhealthy

Q&A: What are trans fats and why are they unhealthy?

WASHINGTON — You may not even know you are eating them, but trans fats will soon be mostly gone from your food. The Food and Drug Administration said Tuesday it will require food companies to phase them out over the next three years because the agency says they are a threat to public health.

Among the foods that commonly contain trans fats: frostings, pie crusts, biscuits, microwave popcorn, coffee creamers, frozen pizza, refrigerated dough, vegetable shortenings and stick margarines. The fats help give a more solid texture and richness to certain foods, like baked goods and ready-to-eat frostings.

Questions and answers about the dangerous fats:

WHAT ARE TRANS FATS?

Trans fats are created when hydrogen is added to vegetable oil to make it more solid, which is why they are also called partially hydrogenated oils. They can contribute to heart disease and are considered even less healthy than saturated fats, which can also contribute to heart problems.

WHY ARE THEY SO BAD FOR YOU?

Trans fats can raise “bad” cholesterol and lower “good” cholesterol. That can contribute to heart disease — the leading cause of death in the United States.

HOW WILL TRANS FATS BE PHASED OUT?

The FDA has determined that trans fats no longer fall in the agency’s “generally recognized as safe” category, which is reserved for thousands of additives that manufacturers can add to foods without FDA review. Once trans fats are off the list, anyone who wants to use them would have to petition the agency for a regulation allowing it.

SO THEY WON’T BE COMPLETELY BANNED?

No. Food companies can petition the FDA to use them. The Grocery Manufacturers Association, the main trade group for the food industry, is working with companies on a petition that would formally ask the FDA if it can say there is a “reasonable certainty of no harm” from some specific uses of the fats. But the agency isn’t likely to approve many uses since it has determined the fats are a threat to public health.

There will also be some trans fats in the food supply that occur naturally in meat and dairy products — the FDA has not targeted those small amounts because they would be too difficult to remove and aren’t considered a major public health threat by themselves.

HAVEN’T THEY ALREADY BEEN LARGELY PHASED OUT?

Yes. The FDA says that between 2003 and 2012, people ate about 78 percent less trans fat as food companies began using other kinds of oils to replace them.

SO WHY IS THE FDA DOING THIS?

The FDA is aiming to get rid of those trans fats that are left in the marketplace, saying they are still a public health concern. While the fats have been phased out in a lot of foods, some companies still use them.

HOW DO I KNOW I AM EATING THEM?

The FDA has required the amount of trans fats in foods to be listed on the backs of food packages since 2006, but that doesn’t always tell the whole story — companies are allowed to round less than half of a gram of trans fat to zero on the package label. Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, says those hidden amounts can still “add up to a considerable intake of trans fats if you look at the overall diet.”

For now, the agency is recommending that consumers take a look at ingredient lists on packaged foods to make sure they don’t contain partially hydrogenated oils. Once the three-year compliance period is up, none of those ingredients would be allowed unless FDA specifically approves them.

ARE ALL FATS BAD FOR YOU?

No, but they should be eaten in moderation. Unsaturated fats found in nuts, vegetable oils and fish are the best for you. Saturated fats mostly derived from animals are less healthy and should be less than 10 percent of a person’s daily calories.

IS IT HARD TO FIND SUBSTITUTES?

In some cases, no. Frying oils are easily substituted and food scientists have already figured out how to substitute other fats for trans fats in many items. In other cases, it will be harder. Ready-to-eat cake frosting, for example, gets some of its solid shape from trans fats.

WILL I NOTICE THE CHANGE?

Probably not. Trans fats don’t have any particular taste, and in most cases other fats will simply be substituted. Your heart might notice, though. The Obama administration says the move will reduce coronary heart disease and prevent thousands of fatal heart attacks every year.

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• REPLACE Trans fat-free

Trans Fat-Free

An action package to eliminate industrially-produced trans fat from the global food supply

Since WHO first called for the global elimination of industrially produced trans fat in 2018, remarkable progress has been achieved with population coverage of best-practice trans fat elimination policies increasing more than six-fold globally.

High intake of trans fat (>1% of total energy intake) is associated with increased risk of coronary heart disease and mortality. Eliminating trans fat is a powerful way to prevent heart disease and the high costs it incurs for individuals and economies in medical treatment and lost productivity. WHO remains committed in supporting countries in their efforts to eliminate industrial trans fats for good and in celebrating their achievements to this end.

WHO calls for accelerated action till 2025 to complete this effort and remains committed to supporting countries in their efforts and celebrating their achievements.

The REPLACE action package provides a strategic approach to eliminating industrially-produced trans fat from national food supplies.

The package comprises an overarching technical document that provides a rationale and framework for this integrated approach to trans fat elimination, along with six modules and additional web resources to facilitate implementation.

The six areas of action include:

RE view dietary sources of industrially-produced trans fat and the landscape for required policy change.

P romote the replacement of industrially-produced trans fat with healthier fats and oils.

L egislate or enact regulatory actions to eliminate industrially-produced trans fat.

A ssess and monitor trans fat content in the food supply and changes in trans fat consumption in the population.

C reate awareness of the negative health impact of trans fat among policy-makers, producers, suppliers, and the public.

E nforce compliance with policies and regulations.

WHO awards countries for progress in eliminating industrially produced trans fats for first time

WHO’s trans fat elimination validation program is now open for country applications

Countries with regulations protecting people from industrially produced trans fat tripled over the past year

WHO developed a global laboratory protocol for measuring trans fat in foods

How-to guide for landscape assessment and road map development for elimination of trans fats

How-to guide for determining the best replacement oils and interventions to promote their use

How-to guide for trans fat policy action

• REPLACE Roadmap Outline Stakeholder Tracking Tool Policy Tracking Worksheet Oils and Fats Worksheet
• Elements of economic analysis of removing industrially produced trans fat from the food supply

How-to guide for trans fat surveillance

How-to guide for creating trans fat awareness

How-to guide for trans fat policies and enforcement of regulations

Food analysis: lab protocol

Fatty acids calculation spreadsheets

Fatty acid calculation spreadsheet for the simplified protocol

Background discussion paper on trans fat assessment in food: summary of analytical methods and examples of their uses

Blood analysis: survey protocol

Blood analysis: laboratory protocol

FEEDCITIES Project Protocol

• Video: Trans fat Public Service Announcement (PSA) Example media action plan to run and promote PSA
• Enforcement Checklist

Countdown to 2023: WHO 5-year milestone report on global trans fat elimination 2023

This fifth milestone report summarizes the progress from 2018-2023 towards the global elimination of industrially produced trans-fatty acids (TFA), highlighting...

Countdown to 2023: progress of selected international food and beverage companies towards eliminating...

In support of the WHO’s goal of eliminating industrially produced trans-fatty acids (iTFA) from the global food supply by 2023, 11 members...

Simplified protocol for measuring trans-fatty acids content as a percentage of total fatty acids in food...

Assessing and monitoring TFA content in the food supply and changes in trans-fatty acids (TFA) consumption in the population is one of the key...

Saturated fat and trans-fat intakes and their replacement with other macronutrients: a systematic review...

Together with other modifiable risk factors such as physical inactivity, tobacco use and harmful use of alcohol, unhealthy diets – including high...

REPLACE trans fat: an action package to eliminate industrially produced trans-fatty acids

Elimination of industrially produced trans-fatty acids (TFA) from the food supply is one of the priority targets identified in the draft 13th General...

Global protocol for measuring fatty acid profiles of foods, with emphasis on monitoring trans-fatty acids...

Provides a globally harmonized method to measure trans fats in foods. It will enable countries to assess the levels of trans-fatty acids (TFA) in...

REPLACE trans fat: policies to eliminate industrially produced trans fat

REPLACE, the WHO Action Package and guide to global elimination of trans fat, provides a six step action package including enacting regulations to strictly...

REPLACE trans fat: frequently asked questions

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Eliminating industrially-produced trans fat from the world food supply and replacing them with healthier oils could save more than 500,000 lives per year. The...

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Trans fat elimination: communications toolkit

This toolkit was developed to support communications and advocacy activities to accelerate the adoption of trans fat elimination policies. The materials...

Annual reports

Countdown to 2023: WHO report on global trans-fat elimination 2022

This fourth annual report monitors global progress towards the 2023 target for global elimination of industrially produced trans-fatty acids (TFA), highlighting...

Countdown to 2023: WHO report on global trans-fat elimination 2021

This third annual report monitors global progress towards the 2023 target for global elimination of industrially produced trans-fatty acids (TFA),...

Countdown to 2023: WHO report on global trans-fat elimination 2020

In 2018, TFA elimination was identified as one of the priority targets in the World Health Organization (WHO) 13th General Programme of Work, which guides...

Countdown to 2023: WHO report on global trans-fat elimination 2019

In May 2018, the World Health Organization (WHO) launched the REPLACE action package to support governments to eliminate industrially produced TFA from...

High-level event: Trans fat elimination validation ceremony

Virtual High-level Event: Fourth Progress Report on Global Trans Fat Elimination

Episode #91 - Everything you need to know about trans fat

WHO is urging action by Governments and the food industry to remove industrial trans fat from our food chain. Which foods contain trans fat? How do they harm us? WHO’s Dr Francesco Branca explains in Science in 5.

Heart Attack Rewind: WHO raises awareness of the dangers of trans fat

New WHO REPLACE initiative launched to eliminate industrially-produced trans fat

More information.

The following organizations support the REPLACE modules:

• American Heart Association
• Centre for Chronic Disease Control (CCDC)
• NCD Alliance
• Resolve to Save Lives
• World Heart Federation

Regional resources

Trans fats are unsaturated fats produced from vegetable oils. They are commonly found in commercially baked or fried foods.

Trans Fat History

Trans fat chemistry, trans fat nutritional guidelines, feature articles, trans fat food industry response, trans fat in food, trans fat regulation, latest trans fat news and research.

Kids' exposure to unhealthy food ads on TV drops, but remains high

Study shows a significant reduction in children's exposure to food and beverage commercials from 2013 to 2022, though most ads still promote unhealthy foods, especially on non-pediatric programming.

Study: Kids still exposed to unhealthy food ads despite regulations

Children's exposure to food and drink ads during kids' TV shows has dropped substantially since food and beverage makers pledged to stop advertising unhealthy fare during children's TV shows.

Greater plant fat intake associated with lower overall and cardiovascular disease mortality

Researchers determined the relationship between animal and dietary plant fat intake with mortality from cardiovascular disease (CVD) and other causes.

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Trans Fatty Acids

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What is the healthiest oil for frying? Dietitians share their top 3

Fried foods aren't exactly a top food choice among most dietitians, but they can be part of a healthy diet when enjoyed as a treat in moderation and cooked in healthier oils.

Whether it’s french fries, fried chicken or donuts, sometimes frying is just the optimal cooking method for texture and taste.

You've probably heard that some cooking oils are better for you than others, but the nutritional value of the oil in the bottle may not be the same after cooking, especially at high temperatures.

What are the healthiest oils to use for frying? Dietitians explain which oils are best to use for frying and which to limit or avoid.

What cooking oils are healthiest for frying?

“Frying and cooking methods that require the use of a lot of oil are generally not recommended, however, in moderation, they can definitely be a part of a healthy, balanced diet,” Jamie Mok, registered dietitian nutritionist and media spokesperson for the Academy of Nutrition and Dietetics, tells TODAY.com.

Oils are basically pure fat that's liquid at room temperature. Though it can get a bad rap, fat is an essential nutrient the body needs to function properly. It provides us with energy and helps the gut absorb vitamins, says Mok.

The key is to eat more healthy or "good" fats, aka polyunsaturated and monounsaturated fats, and limit or avoid unhealthy or “bad” fats (saturated and trans fats), per  the American Heart Association .

Healthy fats have been shown to reduce inflammation, lower the risk of heart disease, stabilize blood glucose levels and boost brain health,  TODAY.com previously reported .

Oils rich in healthy fats

“From a nutrition perspective, I recommend cooking mostly with plant oils, which are generally lower in saturated fat, and higher in mono- and polyunsaturated fats,” says Mok.

“Studies have shown that replacing saturated fats with unsaturated fats coming from these plant oils can help decrease our total and LDL (or “bad”) cholesterol,” says Mok.

The lower the saturated fat content of the cooking oil, the better. AHA recommends choosing cooking oils with less than four grams of saturated fats per tablespoon.

Plant oils rich in unsaturated fats also provide essential fatty acids, such as omega-3s, which the body can’t create on its own and we need to get from dietary sources.

Oils from nontropical plants

"I would exclude tropical oils in the plant oil recommendation," says Mok. Plant oils may come from fruits, vegetables, nuts or seeds.

Oils from nontropical plant sources tend to be healthier whereas those from tropical plants — such as coconut or palm oil — are significantly higher in saturated fat and solid at room temperature.

Animal fats — such as butter or lard — also contain high amounts of saturated fat and have been shown to raise bad cholesterol, TODAY.com previously reported .

Oils with a high smoke point

Frying involves cooking food in hot oil. The normal temperature range for frying is about 325 to 375 degrees Fahrenheit, but it can be as high as 400 degrees, according to Oklahoma State University .

“When it comes to frying, we want to pay attention to oil smoke points, which is the temperature at which oils start to break down and burn,” says Mok.

All cooking oils have a particular smoke point, which can vary greatly, according to the  U.S. Department of Agriculture .

Heating oil beyond its smoke point can cause the oil to react with oxygen (oxidize), which can destroy nutrients and release harmful pollutants, says Mok. These include compounds called free radicals, which can damage cells. Oxidization can also degrade the oil's taste, causing it to become bitter and rancid.

Oils that are higher in monounsaturated fats are best for frying because these are more stable when exposed to high temperatures and do not oxidize as quickly, Mok notes.

“The antioxidants and fat levels in the oil (also) determine how quickly it will oxidize,” Natalie Rizzo, nutrition editor for TODAY, previously told TODAY.com. The higher the antioxidant levels, the more stable the cooking oil is when heated at high temperatures.

The healthiest oil to use for frying

Other factors to consider when choosing oil for frying are flavor and processing. Ideally, you want a milder, neutral-tasting oil — these are typically refined oils, which also have a higher smoke point.

Avocado oil

Avocado oil is a top pick among experts for frying. "Looking at the smoke points of nontropical plant oils and looking at which one is healthiest, what stands out to me is avocado oil," says Mok.

Avocado oil is rich in heart-healthy monounsaturated fats, specifically, oleic acid, says Mok. Oleic acid is an omega-9 fatty acid which can help lower bad cholesterol. Avocado oil is also low in saturated fat, and polyunsaturated fats — the latter is less stable.

"It has a higher smoke point, and a neutral flavor too," says Mok, which makes avocado ideal for frying and other high-heat cooking methods. The smoke point of avocado oil is about 520 degrees Fahrenheit, TODAY.com previously reported .

The only downside? Avocado oil can be expensive and is often sold in smaller quantities. Because frying requires using a lot of oil, it may not be the most affordable or practical choice for some.

One tablespoon of avocado oil contains about 124 calories and 14 grams of fat, according to the UDSA.

Olive oil is another healthy choice for frying, but the type of olive oil you use matters. Refined or "light" olive oil is your best bet, as it has a milder taste and can withstand higher temperatures.

Nutritionally, avocado oil and olive oil are very similar, says Mok. Olive oil is rich in monounsaturated fatty acids and low in saturated fat. It also contains high amounts of vitamins, minerals and antioxidants which have been shown to help reduce inflammation.

Olive oil has a lower smoke point than avocado oil — it withstand temperatures up to about 410 degrees Fahrenheit,  per the USDA . As long as you're frying food in the recommended temperature range of 325 to 375 degrees Fahrenheit, it shouldn't burn or go rancid.

Refined olive oil has a higher smoke point, up to 470 degrees. The refining process makes oil more shelf- and heat-stable, but also removes some of the nutrients, TODAY.com previously reported .

While unrefined extra virgin olive oil is one of the healthiest oils you can buy, it has a low smoke point and stronger flavor — which means it should be used for dressings or low-heat cooking, not frying.

One tablespoon of olive oil contains about 119 calories and 13.5 grams of fat, per the USDA.

Peanut oil is another top choice for frying, says Mok, due to its healthy fat content, neutral flavor and high smoke point.

Peanut oil is high in unsaturated fats, which can help lower the risk of heart disease and blood sugar levels, and it's also a great source of heart-healthy oleic acid, Mok notes. Peanut oil is also rich in vitamin E, which can help protect heart, brain, skin and eye health.

Refined peanut oil can withstand temperatures up to 450 degrees Farhenheit, per the USDA. Because it's also more accessible and affordable, peanut oil is a great choice for deep-frying.

However, peanuts are a common allergen, says Mok, so it's not a healthy choice if you have an allergy or sensitivity to peanuts.

One tablespoon of peanut oil contains about 119 calories and 14 grams of fat, per the USDA.

Other healthy oils for frying

Due to their higher smoke point and low saturated fat content, the following oils are also good choices for frying, says Mok:

• Grapeseed oil
• Safflower oil
• Sunflower oil
• Vegetable oil

Least healthy oil for frying

Oils with low smoke points are the least healthy oils to fry with because the high heat will burn and oxidize the oil, which destroys nutrients and releases harmful pollutants, Mok says. These include:

• Unrefined flaxseed oil
• Wheat germ oil
• Unrefined walnut oil
• Pumpkin seed oil
• Hemp seed oil

While these oils can be healthy as-is when used in dressings or drizzled on foods, they can degrade rapidly and lose their benefits if used for frying or other high-heat cooking methods.

Tropical oils that are high in saturated fat should also be limited, says Mok. Coconut oil is 80–90% saturated fat and the smoke point is only 350 degrees Fahrenheit, making it a less healthy choice for frying or cooking in general, TODAY.com previously reported .

"According to experts, across the board, we're recommending to lower our intake of saturated fat," Mok notes. The  Dietary Guidelines for Americans  recommends adults limit saturated fat intake to less than 10% of their daily calories.

“It’s not to say you can’t cook with coconut oil at all, but we should cut back on tropical oils, as well as the other forms of saturated fat such as animal fats,” says Mok.

Tips for cooking with and storing oil

Moderation is key. The serving size for oil is small (one tablespoon) and having more than that can drastically up the calorie count, Rizzo noted.

Draining the oil from fried food after it's done cooking can help reduce your intake. Using oil sprays and measuring spoons can also help you control the amount you use when pan-frying, Mok adds.

It's important to use and store cooking oil properly to maintain its freshness, taste and nutrition value.

• Store oil in a dark, cool place
• Do not use expired cooking oil
• Discard oil if it catches fire or smokes
• Do not reuse cooking oil
• Do not refrigerate cooking oils

Caroline Kee is a health reporter at TODAY based in New York City.

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Trans Fat Bans and Human Freedom

David resnik.

National Institutes of Health

A growing body of evidence has linked consumption of trans fatty acids to cardiovascular disease. To promote public health, numerous state and local governments in the United States have banned the use of artificial trans fats in restaurant foods, and additional bans may follow. Although these policies may have a positive impact on human health, they open the door to excessive government control over food, which could restrict dietary choices, interfere with cultural, ethnic, and religious traditions, and exacerbate socioeconomic inequalities. These slippery slope concerns cannot be dismissed as far-fetched, because the social and political pressures are place to induce additional food regulations. 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 labeling, are likely to be ineffective.

Trans fatty acids (or trans fats) are unsaturated trans -isomer fatty acids, which may be monosaturated or polyunsaturated. Small amounts of trans fats occur naturally in meat and dairy products, but the largest source of these lipids in the human diet comes from artificial sources, such as partially hydrogenated vegetable oils used in cooking and food preparation ( Institute of Medicine 2002 ). Trans fats became popular with food manufacturers, bakeries, and restaurants in the 1960s, because they can enhance the taste of some foods and help to preserve texture. Trans fats used in frying also are more durable than other types of oils and have a neutral taste ( Severson 2003 ).

A growing body of evidence has linked consumption of trans fats to cardiovascular disease ( Woodside et al. 2008 ). According to a meta-analysis of four prospective cohort studies, a 2% increase in energy uptake from trans fats is associated with a 23% increased risk of cardiovascular disease. Trans fats are also associated with sudden death from cardiac causes ( Mozaffarian et al. 2006 ). Trans fats are thought to promote cardiovascular disease by increasing levels of low-density lipoprotein (LDL or “bad”) cholesterol in the blood and decreasing levels of high-density lipoprotein (HDL or “good”) cholesterol ( Institute of Medicine 2002 ; Ascherio 2006 ). According to some experts, replacing artificial trans fats with healthier oils, such as olive oil or canola oil, could save 30,000 to 100,000 lives per year in the United States ( American Medical Association 2008 ).

In January 2006, the Food and Drug Administration (FDA) required that nutrition labels on foods include information about trans fat content ( Food and Drug Administration 2006 ). The FDA estimates that trans fat labeling could save up to 500 lives per year in the United States by reducing the incidence of cardiovascular disease ( Food and Drug Administration 2006 ). Consumer groups and public health organizations have argued that product labeling is not a sufficient response to the problem posed by trans fats, and that there should be a ban on all artificial trans fats in food ( Ban Trans Fats 2009 ; Center for Science in the Public Interest 2008 ; American Medical Association 2008 ). Several major cities and counties (New York City, Boston, Philadelphia, King County, WA, and Nassau Country, NY), the state of California, and Puerto Rico have heeded this call and passed laws banning the use of artificial trans fats in restaurant food. More bans are likely to follow ( Steinhauer 2008 ; Center for Science in the Public Interest 2008 ).

While many view trans fat bans as an important policy tool for promoting public health, others are disturbed by the government’s encroachment on freedom and autonomy. ABC News’s John Stossell writes, “This week, New York became the first big city to ban trans fats. Gee, I’m all for good health, but shouldn’t it be a matter of individual choice?” David White (2007) expresses a similar sentiment: “Like smoking, the choice to eat high-calorie foods might not always be prudent. But government prohibition of that choice is a remarkable confiscation of freedom.” National newspaper columnist Walter Williams raises slippery slope concerns:

The nation’s food zealots have … started out with a small target—a ban on restaurant use of trans fats. Here’s what I predict is their true agenda: If banning a fat that’s only two percent of our daily caloric intake is wonderful, why not ban saturated fats, the intake of which is much higher? Then there’s the size of restaurant servings. Instead of a law simply requiring restaurants to label the calories in a meal, there will be laws setting a legal limit on portions. ( Williams 2007 )

Should we embrace trans fat bans as a sound public policy or should we be wary of this strategy for controlling the human diet? Are trans fat bans the best thing since sliced bread or the road to food fascism? In this essay I examine the ethical arguments for and against trans fat bans (i.e., bans on trans fats in foods prepared by restaurants or other commercial food producers). I argue that while trans fat bans may help to improve public health, they represent a worrisome policy trend, because they open the door to further restrictions on food. Though few people will mourn the loss of artificial trans fats from restaurant food, the issue here is much larger than that. At stake is a freedom that most of us exercise every day but often take for granted: the freedom to choose what we eat.

ARGUMENTS FOR TRANS FAT BANS

Public health promotion.

The two main arguments for trans fat bans are consequentialist in form. According to the first argument, trans fat bans are justified in order to promote an important social good, public health. Trans fat bans can promote public health by reducing the consumption of trans fats, which could reduce the incidence and severity of cardiovascular disease. According to one estimate, totally eliminating artificial trans fats from the food supply in the United States would save 50,000 lives per year ( Center for Science and the Pubic Interest 2008 ). Trans fat bans are cut from the same cloth as other laws that safeguard the food supply, such as such as quality and safety standards for restaurants and food manufacturers, regulation of food additives, and product labeling requirements ( Fortin 2009 ). Food safety and quality laws help to prevent food manufacturers from harming the public with unsafe or unhealthy products, and they can assist consumers in making healthy choices. Recent events, such as adulteration of powdered milk in China with the industrial chemical melamine, which killed five children and sickened over 300,000, and contamination of peanut butter with Salmonella in the United States, which killed nine people and sickened over 570, illustrate the importance of food safety and quality as a public health matter ( Barboza 2008 ; Martin 2009 ).

The strength of the public health argument depends on the empirical premise that trans fat bans will promote public health. While this assertion is highly plausible, given what we know about the adverse effects of trans fats on the cardiovascular system, it is not indubitable. Because trans fat bans have been in effect for only a few years, very little is known about how they impact public health. One study has shown that mandatory labeling of products with trans fats reduces consumption of trans fats, but there have been no studies on the effects of trans fat bans ( Niederdeppe and Frosch 2009 ). Trans fat bans could, paradoxically, reduce some unhealthy behaviors but encourage others. Many food manufacturers began using artificial trans fats in commercial products during the 1980s and 1990s to reduce the saturated fat and cholesterol content of food, because the medical consensus at that time was that saturated fats and cholesterol are unhealthy. As it turned out, trans fats are much worse for the human heart than saturated fats; some saturated fats, such as those contained in peanut and canola oils, are good for you; and moderate amounts of cholesterol in the diet are essential to health ( Severson 2003 ). While I am not suggesting that there is no scientific basis for reducing the consumption of artificial trans fats, I do think that much more research is needed on the public health effects of trans fat policies, so that we can avoid repeating the nutrition policy mistakes of the past.

Economic Cost-Savings

The second argument for trans fat bans is an economic one. According to this line of thought, bans on artificial trans fats can save potentially billions of dollars in health care and related costs by reducing prevalence and severity of cardiovascular disease ( Ban Trans Fats 2009 ). In the United States, over 80 million people (36% of the population) have cardiovascular disease ( American Heat Association 2009 ). The direct and indirect costs of cardiovascular disease amount to an estimated $305 billion in the United States in 2009 ( Centers for Disease Control and Prevention 2009a ). If a nationwide ban on artificial trans fats reduced the costs of cardiovascular disease by only 10%, this would save $30 billion per year.

The strength of the economic argument depends on the empirical premise that trans fats ban will reduce the costs associated with cardiovascular disease. This assertion, like the empirical premise in the public health argument, is also highly plausible, given what we know about the effects artificial trans fats on human health, but it is not unassailable. Consider the costs of smoking. For many years, health policy analysts have assumed that smoking places enormous economic burdens on society by increasing costs related to lung cancer, pulmonary disease, cardiovascular disease, and other health problems ( World Bank 1999 ). Smoking costs the United States nearly $200 billion per year in health care expenditures and lost productivity ( Centers for Disease Control and Prevention 2009b ). A recent study examining the lifetime costs of smoking found that smokers actually cost society less than nonsmokers, because smokers die earlier. The investigators examined the costs of three cohorts: an obese cohort, a smoking cohort, and a healthy living cohort. The healthy living cohort cost society the most money, because they lived an average of 7 years longer than the smoking cohort and 4.5 years longer than the obese cohort. During those extra years of life, people in the healthy living cohort had costs associated with various diseases of aging, such as bone fractures, arthritis, stroke, dementia, urinary-tract infections, and loss of hearing and vision ( van Baal et al. 2008 ). Some authors have disputed the policy implications of this study because it does not take into account costs of quality-adjusted life years lost ( McPherson 2008 ). The debate over the costs of smoking suggests that we should be careful about making claims about the potential cost-savings of trans fat bans. While there clearly is a factual basis for claiming that trans fat bans can save society a great deal of money, more research is needed on the effects of these policies, including effects on the food industry.

ARGUMENTS AGAINST TRANS FAT BANS

Restrictions of freedom.

The main ethical argument 1 against trans fat bans is that these laws, whether at the local, state, or federal level, constitute an unjustifiable restriction on the freedom to decide what one eats. One could argue that the ability to decide what one eats, though not important as freedom of speech or religion, is an important freedom nonetheless. First, food has a significant impact on one’s quality of life. People take great pleasure in eating, preparing, and serving food. Food is more than mere nutrition: it is one of life’s simple pleasures. Second, food has considerable ethnic, cultural, and religious significance. Different ethnic and cultural groups have their own cuisines and culinary practices. In any medium-sized city in the United States, one can find restaurants that serve Chinese, Japanese, Italian, French, Mexican, Indian, and Thai food. There are also many different foods associated with particular geographic regions in the United States, such as Southern fried chicken, Texas barbeque, Boston baked beans, Philadelphia steak sandwiches, and so on. Food also has religious significance, as different faiths have various rules, customs, and teachings related to food ( Montanari 2006 ). Third, food plays an important role in family traditions and customs. Food takes center stage at family reunions and at gatherings associated with particular holidays, such as Thanksgiving, Christmas, and Independence Day. Families also have special recipes handed down from generation to generation. Thus, the freedom to decide what one eats is an important freedom that should not be restricted unnecessarily.

A proponent of trans fat bans can acknowledge that the ability to decide what one eats is an important freedom but still maintain that trans fat bans are justifiable. First, bans on artificial trans fats do not have a major impact on food consumers, since most people do not care whether they eat products that contain these substances. People do not have a special fondness for artificial trans fats, but rather for the foods that contain them. Removing artificial trans fats from cookies, crackers, hamburgers, and French fries will make little difference to consumers as long as this does not affect how these foods taste, smell, look, or feel. Bans on artificial trans fats mostly affect food producers, not consumers.

Second, even if some consumers have a strong preference for artificial trans fats, laws that ban commerce and trade in these substances can be justified to promote public health. As noted earlier, trans fat bans fit into the safety and quality regulatory framework that operates in the United States and other industrialized nations. Banning trans fats is no different, in principle, from banning food additives that have been found to be unhealthy, such as cyclamate (Henkle 1999). The reasoning that justifies food safety and quality laws is similar to the reasoning that justifies other public health measures that restrict human freedom, such as mandatory vaccinations, disease surveillance, and isolation and quarantine. Though freedom is an important value, it can be overridden in some circumstances to promote important social goals, such as preventing people from harming themselves or others, and promoting the health of the population as a whole ( Kass 2001 ; Childress et al. 2002 ; Gostin 2007 ; Buchanan 2008 ; Gostin and Gostin 2009 ).

The Slippery Slope

A critic of trans fat bans could acknowledge that not many people have a particular fondness for artificial trans fats and that food safety and quality laws can be justified to promote public health, but could maintain that there is a larger issue at stake here: the continued erosion of dietary freedom. Trans fat bans are very different from food safety and quality laws because they aim to prevent consumers from making unhealthy choices, instead of preventing producers from causing harm. Requiring food manufacturers to ensure that their products are not contaminated with microorganisms that can cause severe illness or death is very different from preventing manufacturers from selling products that increase the risk of cardiovascular disease if consumed for many years, because most people will not voluntarily choose to eat food that is contaminated or spoiled, while people often choose to eat foods that can cause harm if eaten for many years. Bans on the use of trans fats in restaurant food would lead to additional bans on trans fats, which would open the door to further restrictions on the human diet, since there is no difference, in principle, between banning artificial trans fats and banning other unhealthy foods, such as processed meats and sugared drinks. Today, trans fats; tomorrow, hot dogs.

Support for this empirical slippery slope argument comes from the following facts: (1) we already know about the adverse health effects of many foods and science is likely to discover more; (2) health advocates are likely to continue to push for additional regulations; and (3) health-conscious consumers and politicians are likely to be receptive to additional regulations. For example, consumption of red meat and processed meat increases the risk of colon cancer ( Johnson and Lund 2007 ), and consumption of sugared drinks, especially those high in fructose, increases the risk of obesity, diabetes, and heart disease ( Brown et al. 2008 ). Emboldened by victories against trans fats, health advocates could go after red meats, processed meats, sugared drinks, and other unhealthy foods ( Chan 2008 ).

The social consequences of sliding down the slope toward additional food regulation could outweigh any public health gains that might result. Since restrictions on the human diet can impact quality of life, family traditions, and cultural, ethnic, and religious practices, wide-ranging attempts to control food choices could have adverse consequence on society. Few people would want to live in a world in which government health experts dictate what is on the menu or how it should be prepared.

Additionally, increased regulation of the human diet could lead to social and economic injustices. Policies that make it more difficult to obtain affordable nutrition, such as taxes on food, can exacerbate socioeconomic inequalities ( Caraher and Cowburn 2005 ). For example, hot dogs, bologna, and other processed meat products provide an inexpensive form of protein, but they also are high in saturated animal fat, the consumption of which contributes to cardiovascular disease ( Woodside et al. 2008 ). If the government taxes or bans these foods on the grounds that they contribute to heart disease, then low-income people might need to seek other, more expensive sources of protein.

A standard response to an empirical slippery slope argument is to assert that the slide toward undesirable outcomes can be avoided by implementing rules, procedures, or definitions designed to stabilize policy and practice (Lewis 1999). A proponent of trans fat bans could claim that society can avoid excessive food regulation by distinguishing between bans on food additives and bans on foods. A food additive is a substance added to food to improve taste, texture, flavor, color, or freshness. Bans on cyclamates, which are food additives that enhance sweetness, have not led to bans on foods that enhance sweetness, such as sugar (Henkle 1999). By limiting the scope of trans fat bans to prohibitions on food additives, such as artificial trans fats, society can promote public health while safeguarding other values.

A proponent of trans fats bans could also point out that there are social and economic forces in place that would counteract a move from trans fat bans to bans on other foods. For example, tobacco companies, automobile manufacturers, and many other corporations have mounted influential (and often successful) campaigns against government regulation. The food industry would be a powerful opponent of any attempt to extend the scope of food regulation beyond trans fats.

While I appreciate the merits of these critiques of the empirical slippery slope argument, I am not convinced that they defuse concerns about excessive food regulation. First, the distinction between foods and food additives is not as clear as one might think. Many substances added to improve the taste, texture, flavor, color, or freshness of food, such as sugar, corn syrup, yeast, citric acid, and vitamins, might also be viewed as foods. It is not at all obvious how one could make a conceptually stable distinction between artificial trans fats and other lipids added to foods. A policy framework that focused on specific kinds of fats defined as “food additives” could collapse under social and political pressure for additional food regulation. Second, although there are powerful forces that would resist attempts to extend the scope of food regulation beyond trans fats, it is not clear to me that these forces would be able to hold the line. Restaurants and food connoisseurs who opposed trans fats bans in New York City, California, and other jurisdictions could not resist effective campaigns by public health organizations and consumer groups.

TOWARD RATIONAL FOOD POLICIES

The empirical slippery slope argument developed in the previous section cannot be easily dismissed as a flight of fancy, since it is firmly rooted in existing political, social, economic, and biological realities. To avoid the undesirable outcomes that could occur from excessive government control over the human diet, food policy decisions should be made with an eye toward not only promoting public health but also preserving human freedom. One of the central dilemmas in public health policy is how to balance health promotion and other important values, such as freedom and justice ( Kass 2001 ; Childress et al. 2002 ; Gostin 2007 ).

To develop food policies that appropriately balance public health and freedom, and therefore address slippery slope concerns, it will be useful is to establish a set of conditions that must be met to restrict human freedom. These conditions can help to ensure that policy decisions will not be made willy-nilly, but will be appropriately articulated, reviewed, and justified ( Kass 2001 ). The following are some conditions that can be applied to proposed policies that restrict human freedom to promote public health ( Childress et al. 2002 ):

• Effectiveness: there must be substantial scientific evidence that the policy is likely to be effective at achieving an important pubic health goal.
• Necessity: there must be substantial scientific evidence that the policy is necessary to achieve the public health goal.
• Proportionality: the potential public health gains of the policy must outweigh the adverse social impacts and other moral considerations.
• Least infringement: the policy must impose the least restrictions on freedom necessary to promote the public health goals.
• Publicity: the policy must be justified to the public, with the reasons for restricting freedom clearly explained.

How might these conditions apply to trans fat bans? The trans fat bans enacted by state and local governments may meet three of these conditions. Trans fat bans probably may be effective, because, as mentioned previously, trans fat bans may help to promote public health, though more research is needed. Trans fat bans may also meet the proportionality condition as well, because the public health gains could outweigh adverse social impacts and other moral considerations. Because few people have special preference for artificial trans fats, trans fats bans probably do not have a significant impact quality of life, cultural, ethnic, or religious traditions, or family values. Trans fat bans will not exacerbate socioeconomic inequalities by increasing the price of food, though more research is needed to verify this point. Trans fat bans also meet the publicity condition, because they have been discussed and debated government hearings, public comment meetings, and other public forums ( Mello 2009 ).

The trans fat bans that have been enacted thus far may not meet the other two conditions, however. The bans may not meet the necessity condition, because a combination of other policies, such as education and mandatory labeling, may be equally effective at achieving public health goals. Proponents of trans fat bans have asserted that they are necessary, because the other methods for promoting public health are not effective enough, since consumers may not understand the risks of trans fats or heed warnings or advice ( Ban Trans Fats 2009 ). However, this claim rings hollow, because bans have been imposed before public education and food labeling have been given a chance to work. Trans fats have only been on the public’s radar screen since about 2001. Prior to this time, people were more concerned about saturated fats in the diet ( Severson 2003 ). FDA labeling and voluntary labeling by fast food restaurants began in 2006, but the movement to ban trans fats began before then. Admittedly, educational campaigns and product labeling may prove to be ineffective, but then again, they may not. The important point is that we simply do not have enough evidence at this time to declare that educational campaigns and product labeling will fail and that some other policies are necessary.

If it turns out that other methods of decreasing the consumption of trans fats are as effective as bans, then trans fats bans also do not meet the least infringement condition as well. To develop this point, it will be useful to classify different trans fat policies with respect to how much they restrict human freedom. Education involves virtually no restriction on freedom, because the objectives of education are to convey information and enhance decision-making, not to manipulate or control individual choices. Mandatory food labeling is more restrictive than education, because labeling controls the decisions made by food producers, even though this helps to promote effective decision making by consumers. Taxation is more restrictive than labeling because it can place financial constraints on decisions made by food producers and consumers. Food safety and quality standards are highly restrictive, because they require food producers to follow specific rules, and impose penalties for noncompliance. Bans on particular food items are the most restrictive methods of promoting public health, because bans prevent people from making some types of dietary choices and they prevent food producers from selling particular types of foods.

Thus, although trans fat bans probably will help to promote public health, a convincing argument can be made that governments have enacted these policies without determining whether other policies, which do not significantly restrict human freedom, are effective at promoting public health. A better way of dealing with the trans fat problem would be give education and product labeling a chance to work, before resorting to the extreme measure of banning trans fats. By enacting food policies that limit the freedom to choose what one eats only as an option of last resort, the government can strike a fair balance between promoting public health and protecting human freedom ( Wikler 1978 ; Mytton 2007 ).

While it is clear that consumption of artificial trans fats poses a significant risk to human health, it is not clear how societies should respond to this risk. Numerous state and local governments in the United States have banned the use of artificial trans fats in restaurant foods, and other bans may follow. Although these policies may have a positive impact on human health, they open the door to excessive government control over food, which could restrict dietary choices, interfere with cultural, ethnic, and religious traditions, and exacerbate socioeconomic inequalities. These slippery slope concerns cannot be dismissed as far-fetched, because the social and political pressures are in place to induce additional food regulations. 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 educational campaigns and product labeling, are likely to be ineffective.

Acknowledgments

This research was supported by the intramural program of the National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH). The views expressed in this article are solely the views of the author. They do not represent the opinions of the NIEHS, NIH, or the U.S. government. I am grateful to Chris Portier and Bill Schrader for helpful comments.

1 Mello (2009) has examined some of the legal issues concerning the trans fat policies adopted by New York City and other cities and states, including preemption by federal laws and insufficient opportunities for public comment. According to Mello, one of the problems with local policymaking on trans fats is that this could create a patchwork of rules that will create compliance problems for businesses and spark legal battles over preemption issues. Though Mello raises some important legal issues, her analysis does not get to the heart of the matter, since she does not voice any ethical objections to trans fat laws. Rather, her article supports the view that trans fat policies should be made at the federal level, not the local or state level.

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Former NHA head Dr Bhushan on why eliminating trans fats is an urgent need in India

With strict enforcement of trans fat regulations, including penalties for business and manufacturers failing to meet the fssai standards, trans fat in the food supply will decline, writes former national health authority ceo dr indu bhushan..