November 21, 2018
Woman reading healthy food nutrition facts, ZERO trans fats.
Be Well

Trans Fats: Going, Going ... Gone

by John Swartzberg, M.D.  

This past June, I was pleased to note the passing of the deadline that the FDA gave manufacturers and restaurants to stop using partially hydrogenated oils (PHOs) in their products. This follows the FDA’s decision in 2015 to remove PHOs—the main source of artificial trans fats—from its list of food ingredients that are “generally recognized as safe,” or GRAS.

Trans fats are created when hydrogen atoms are added to liquid vegetable oils, turning them into semi-solid fats. These fats raise LDL (“bad”) cholesterol and lower HDL (“good”) cholesterol, among other adverse effects. In fact, they are the most unhealthful of all fats, increasing the risk of heart attacks, strokes, diabetes, and possibly infertility in women.

A review of observational studies in BMJ in 2015 found that people who ate higher amounts of trans fats were 21 percent more likely to develop heart disease, 28 percent more likely to die from heart disease, and 34 percent more likely to die of any cause, compared to those who ate less. Worldwide, trans fats are responsible for an estimated 540,000 deaths a year.

Not too long ago, PHOs—and thus trans fats—were ubiquitous in the U.S. food supply, present in margarines, crackers, doughnuts, pie crusts, cookies, and fast-food French fries, to name just a few sources. Manufacturers loved PHOs because they were cheap, gave foods a desirable consistency, and extended shelf life—and in the 1970s and 1980s they became the main ingredient in margarines, which were mistakenly thought to be a healthier alternative to butter.

But starting in 2006, when regulations went into effect requiring that trans fats content be listed on nutrition labels, manufacturers began reducing or eliminating these fats from their products, due to the bad press they were getting. News in 2015 that trans fats were no longer considered safe by the FDA sped up product reformulations.

Canada, Denmark, Britain, Switzerland, and several other countries have taken similar steps to eliminate trans fats. But they are still readily found in other parts of the world, notably in South Asia and the Middle East. That should be changing, too, since the World Health Organization is urging worldwide elimination of trans fats by 2023 as part of the Resolve to Save Lives campaign, which was begun by Dr. Thomas Frieden, the former CDC director. Dr. Frieden implemented the first city-wide restaurant ban on trans fats in the U.S. more than a decade ago while serving as New York City health commissioner.

The FDA’s goal now is to remove artificial trans fats entirely from our food supply, since even small amounts have adverse effects. The new ban is expected to prevent thousands of heart attacks and deaths in the U.S. Already there is evidence of health benefits. For instance, a study in JAMA Cardiology in 2017 found significant reductions in hospitalizations for strokes and heart attacks in New York State counties where trans fats had been restricted for at least three years.

End of an era

Although the vast majority of processed foods sold in supermarkets should now be trans-fat-free, it will be a couple more years before all of them are. That's because foods that were produced prior to the June 2018 compliance date and that are still working their way through distribution were given an extension until January 1, 2020. Until then, I’ll continue to check ingredients lists on processed foods for partially hydrogenated oils, an indication that artificial trans fats are still present, even if the label indicates “0” trans fats. (A regulatory loophole allows products with less than 0.5 grams of trans fats per serving to round the count down to zero on their Nutrition Facts labels.)

Another thing to note on food labels is what is being used in place of PHOs. While most vegetable oils are good substitutes, tropical oils such as palm and coconut oil are high in saturated fat, and their effects on the heart are still unclear. There are also environmental concerns with palm oil: Increased demand has led to large-scale deforestation and animal habitat destruction in Indonesia and Malaysia as land is cleared for new palm plantations. All of this is just more reason to eat whole unprocessed foods, which are naturally free of artificial trans fats.

This article first appeared in the UC Berkeley Wellness Letter.

Also see The End of the Debate? Fat Chance.