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27 Jun 2018

BY PROFESSOR STEPHEN LEEDER, EMERITUS PROFESSOR PUBLIC HEALTH, UNIVERSITY OF SYDNEY

Just about all the news from the US is dreadful at present, so the occasional good news story is to be treasured.

Here in Manhattan, I am tucking into a hot dog with mustard and pickles aboard a Circle Line Ferry circumnavigating the island. BUT!  The hot dog contains no trans fats! So I worry only about everything else it contains. Nor does President Donald Trump’s apocryphal diet of Big Macs contain trans fats. In the US, trans fats will no longer be legal in a few days. This ban does not, please note, stem from President Trump’s Ministry for Magical Tweets but from advocacy based on science.

Trans fats are a big deal.

Making liquid vegetable oils solid is achieved by adding hydrogen – go back and check your chemistry lecture notes for details. This makes for ‘pretend butter’ that lasts longer on the shelf than the oils and tastes better. The problem is that the solid stuff, containing partially hydrogenated trans fatty acids, elevates LDL cholesterol and lowers HDL. Trans fats are said to cause about 500,000 deaths each year.

The US is not alone in banning them. About 20 countries have restricted their use. WHO Director-General, Ethiopian Dr Tedros Adhanom Ghebreyesus, is interested because while the US, Canada and parts of Europe are banning trans fats, low and middle income countries use a lot of them. But on the upside, companies such as Nestle, with global reach including infant formula production, have already removed trans fats from their products. Denmark was the first country to ban them, in 2003, and consumer pushback has been minimal.

The WHO now has a program called REPLACE (http://www.who.int/news-room/detail/14-05-2018-who-plan-to-eliminate-industrially-produced-trans-fatty-acids-from-global-food-supply) that offers a six-point plan for countries wanting to reduce trans fat consumption. Using each letter of the acronym REPLACE in turn, it begins with reviewing (RE) and mapping the sources of industrially-produced trans fats in the country and ‘the landscape for policy change’.

The second step is to seek wherever possible to promote (P) the replacement of trans fats with healthier fats and oils. This includes communication with consumers and producers. The third step is the crunch – legislation (L) to eliminated trans fats. The last three letters of REPLACE – ACE – don’t add much.

So while self-regulation in the food industry is better than nothing, the legislative stick is important.  That trans fats can be removed without too much effort is surely a critical reason why the banning of trans fats is possible. It’s rather similar to the relative ease of removing chlorofluorocarbons from aerosols and so diminishing damage to the ozone layer (https://www.acs.org/content/acs/en/education/whatischemistry/landmarks/cfcs-ozone.html).  It has several – not many – similarities to tobacco as well.

However, Australia and New Zealand have adopted a very relaxed approach to trans fats – see (http://www.nutritionmyths.com/why-we-are-not-protected-in-australia-and-nz-against-trans-fats/#conclusion).

Trans fats will eventually be phased out thanks to technology and strong regulation.  WHO support will help. Australia will be late to the table for no compelling reason, but I predict we will eventually get there. But not without cost in lives lost.

 


Published: 27 Jun 2018