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HEART Insight:
doi: 10.1097/01.HEARTI.0000285625.85255.59
Features: Nutrition Know-Knows

The Trouble With Trans Fats

GORMAN, RACHAEL MOELLER

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Abstract

In December New York City became the first city in the United States to restrict the content of artificial trans fats in baked, fried and prepared foods served by the more than 20,000 fast food joints, bakeries, delis and “white tablecloth” restaurants its citizens patronize every day.

The new regulation, an amendment to the city's Health Code, will be enforced during regular restaurant inspections. Though some food industry opponents are vocal, the ban was welcomed by many nutrition experts.

Some foods—like meat and dairy products, for instance—naturally contain very small amounts of trans fats; the ban doesn't affect those foods. New York's new regulation allows up to 0.5g trans fat per serving; food service establishments have until July 1, 2007 to switch to low trans fat oils, margarines and shortenings used for pan-frying or in spreads, and until July 1, 2008 to switch to trans fat-free alternatives used for baking, deep frying or as an ingredient in any food. Both deadlines have a built-in three-month grace period.

“Restaurants, food companies, schools and workplace cafeterias need to start trying to remove trans fats,” says nutritionist Kathy McManus, M.S., R.D., director of the Department of Nutrition at Brigham and Women's Hospital in Boston. “Trans fats are not essential, and people should eat as little of them as possible, she adds.”

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How Trans Fats Hurt Your Heart

Trans fats not only raise levels of LDL or “bad” cholesterol and triglycerides (a type of fat found in the blood), they also lower HDL or “good” cholesterol. This combination sets people up for hardening of the arteries (atherosclerosis).

The New England Journal of Medicine published a research review in April 2006 that concluded, “near-elimination of industrially produced trans fats” could prevent 72,000 to 228,000 heart attacks, strokes and other cardiovascular complications each year. Just 2 to 7g of trans fats a day—that's one doughnut, one serving of french fries or one serving of microwave popcorn—can raise your cardiovascular risk. Every day, the average American eats about 6g of trans fats.

According to American Heart Association guidelines, trans fat intake should be as low as possible. To help people keep track of how much trans fat they are eating—and the foods and products they buy that have the most of it —the Food and Drug Administration has required manufacturers to list trans fat content on food labels since January 2006 (it's right underneath the saturated fat listing). [For more on food nutrition labels, see p. 34.]

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Figure. JUST SAY NO!...
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The FDA's new food labeling requirement pushed some manufacturers to reduce or eliminate trans fats voluntarily, including: Oreos and Wheat Thins (Kraft) and Doritos, Fritos, and Lay's potato chips (Frito-Lay).

But sometimes reading food labels isn't enough. “The only way to really know whether a food contains trans fats is to look at the ingredient list for ‘partially hydrogenated oils,’” advises McManus, explaining that for up to 0.5g, manufacturers can list trans fat content as 0.

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New York City Steps Into The Fray

Roughly 23,000 New Yorkers die of heart disease each year. Since the average American eats about one-third of his or her calories out of the home, a ban on trans fats at the city's chain restaurants, pizza parlors and fine dining establishments could save at least 500 lives each year.

“Like lead in paints, trans fats certainly can be removed and replaced without being missed,” says Sonia Angell, M.D., M.P.H., director of the Cardiovascular Disease Prevention and Control Program at the New York City Department of Health. “All the same foods can be available to people without artificial trans fats; there are excellent substitutes.”

While Chicago, Seattle and Los Angeles are also considering following in New York's trans fat-banning footsteps, this approach is not new in Europe. Denmark virtually eliminated partially hydrogenated oils by order of the government in 2003. If convicted of selling food that contains more than 2g of trans fats per 100g oil, violators are fined; if restaurants or food manufacturers intentionally break the law or are found guilty of gross negligence, the penalty is up to two years in jail.

The result? In Denmark—but not in the United States—a serving of Chicken McNuggets has less than 1g of trans fats. In the U.S., that same serving has 10 times the amount of trans fat.

Figure. SYLVIAS, THE...
Figure. SYLVIAS, THE...
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Other fast food and restaurant chains are voluntarily switching to alternative fats: Kentucky Fried Chicken, Arby's, and Taco Bell have announced they will soon use trans fat-free cooking oil; Wendy's, Ruby Tuesday, and Chili's already do. And Starbucks Corp. has taken steps to cut trans fats from the baked goods it sells.

Legal Sea Foods, an East coast chain of restaurants famous for its fried fish, led the pack by throwing trans fats overboard six years ago.

“Here I am in the business of selling the healthiest of proteins, but I negate that benefit when I cook in oils that contain trans fats,” says Legal Sea Foods CEO and owner Roger Berkowitz.

A blind test showed people preferred the taste of scallops fried in trans fat-free oil—and since food absorbs less oil when fried in a trans fat-free oil, the restaurant's costs did not go up significantly.

“I think if restaurants tested [trans fat-free] products, they'd be pleasantly surprised, because it enhances flavor,” says Berkowitz. He adds, “I don't think the public would mind paying ten, fifteen, twenty-five cents more for a dish that contains trans fat-free oils.”

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The Law of Unintended Consequences

New York's ban may trigger lawsuits from the New York State Restaurant Association and other trade groups. The supply of fry-stable, tasty trans fat-free oil with a long shelf life is limited to just a handful of brands, among them, NuSun (derived from sunflower seeds), and the trans fat-free canola oils Clear Valley and Odyssey.

The AHA was concerned at first that restaurants would just replace trans fat–laden oils with other unhealthy alternatives, such as saturated fat-packed palm and coconut oils, or butter and other animal fats because they weren't given enough time to train their workers, and to rework their recipes. Amendments made to the proposed ban by the Board of Health addressed these concerns, and the AHA now supports the version of the regulation that passed.

“As we reviewed all of the comments, we found that there seemed to be legitimate concern that some products would require more time for reformulation,” says Angell. “This includes yeast dough and cake batter, doughnuts, churros, funnel cakes. These are some products that we know require more time to make sure that they get the right oils so that the taste is consistent without switching to high saturated fat alternatives.”

Nutritionists still have some reservations about New York's attempts to control what its citizens eat. They caution the trans fat ban should not be a license to pig out on fried foods that may still contain lots of salt, saturated fat and empty calories. The way to go, say experts, is to avoid fried food and snacks like potato chips, and to cook with canola oil, olive oil or soft margarine (unlike stick margarine, the soft variety typically does not contain partially hydrogenated oils). Oh—and eat plenty of whole fruits, vegetables and grains. HI

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How Do Trans Fats Get Into Food?

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Figure. LEGAL SEA FO...
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Figure. OIL FROM NUS...
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Figure. STARBUCKS CO...
Figure. STARBUCKS CO...
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In the early 1900s, foods were typically fried in saturated fat-packed animal fats, such as lard or butter. As scientists began to link saturated fats with cardiovascular disease, food manufacturers and restaurants gradually switched to a type of fat thought to be healthier: partially hydrogenated oils.

It was win-win for consumers and the food industry, because these oils were cheaper; they had a long shelf life; they could be reused to deep fry potatoes and other foods; and they added crispiness and texture to cookies, cakes, pastries, crackers and some breads.

It wasn't until the 1990s that researchers discovered that trans fats—which form when liquid oils are transformed into solid fats by adding hydrogen (“hydrogenation”)—are even worse for cardio-vascular health than saturated fats.

“Trans fats have a significant effect on increasing the risk of cardiovascular disease,” says nutritionist Kathy McManus. “When I see patients I tell them to keep it out of their diets.”

© 2007 American Heart Association, Inc.

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