Last week my colleague Jon Gravel published an article with Maaike DeVries on the website Healthy Debate, arguing that Canada should move to ban trans fats. The article was well written and persuasive, and since it was published using a creative commons licence I have decided to republish it here so that our readers can benefit from it. Enjoy!
On November 7th 2013, the United States’ Food and Drug Administration (FDA) announced their proposed measures “to completely eliminate artificially produced trans fatty acids (TFAs) from the American food supply”. This measure would prevent food manufacturers from selling products containing artificial TFAs. Just as many Americans made their own New Year’s resolutions, their government has proposed quite a respectable one indeed.
There is an overwhelming volume of scientific literature demonstrating that consumption of partially hydrogenated oils (primary source for artificially produced TFAs) adversely affect multiple cardiovascular risk factors. Scientists from The Centers for Disease Control and Prevention (CDC) reported that complete elimination of TFAs could prevent 10,000 to 20,000 coronary events and 3,000 to 7,000 coronary deaths each year in the United States. TFAs are not essential to the human diet, provide no health benefit and their complete elimination from the global food supply has been called for by the World Health Organization (WHO).
The partial hydrogenation process, used to create TFAs, was developed in the 1930’s with a jump in popularity in the 1960’s due to public health campaigns calling to reduce the use of animal fats. Industry has since favoured artificial TFAs because they are cheap, increase shelf life, improve texture, and maintain flavour of foods. But, with greater awareness of the harmful effects of TFAs, their popularity waned and many foods have been reformulated to reduce or eliminate TFAs (e.g., Crisco’s shortening). There also came an increased appetite for policies surrounding their regulation. A recentsystematic review reports that all analyzed policy interventions (regulation and voluntary limits, labelling, and local or national bans)were associated with a reduction in availability of TFAs, demonstrating both the feasibility and achievability of reducing and removing TFAs from commercial sources.
In 2005, Health Canada and the Heart and Stroke Foundation co-chaired a multi-stakeholder task force that submitted a report to the Minister of Health recommending Canada take a regulatory approach and enforce limits of trans fats to 2% of the total fat content for vegetable oils and spreadable margarines and 5% for all other foods purchased by a food service establishment.
Health Canada adopted the recommendations in 2007 and requested the food industry voluntarily achieve these limits. Thus, Health Canada adopted the recommended limits but not the recommended regulatory approach. Also in 2007, Canada was the first country to introduce mandatory visible labelling of trans fat content on pre-packaged foods alongside total Calories and 13 core nutrients. However, despite significant progress in TFA content of food (likely due to motivation from nutritional labelling and driven by market decisions to please consumers), population intake continues to exceedthe WHO recommendation of less than 1% of total fat intake.
Former Health Minister Aglukkaq (as well as Minister Clement) stood firm with the voluntary strategy to motivate industry to reduce TFAs and suggested the use of tools such as the Canada Food Guide and Nutrition Facts Table to inform Canadians. Both of which have been criticized for heavy industry involvement in their creation. Current Health Minister Ambrose recently commented on the FDA’s announcement and sang the same tune as her predecessors – provide information and education to Canadians and encourage the food industry to voluntarily reduce TFAs.
The FDA announcement has awakened discussions (from the short list of pundits with an interest in health policy) on whether Health Canada should take similar measures and implement what has beendescribed as one of the most straightforward public health interventions for reducing non-communicable disease in the first world. The Centre for Science in the Public Interest has recentlyinsisted that the federal government follow suit.
This debate extends wider than population fat intake and demands a greater reflection on the role of the federal government in our everyday lives. Ottawa has public health, food safety and consumer health protection as constitutional obligations; however, does a ban of artificial TFAs undermine our right as Canadians to make informed decisions about what we consume, or does it, more likely, empower us to make more informed and better decisions, alleviating some of the burden associated with healthy eating?
For many years, products have been reformulated to decrease or eliminate TFAs and there has been a notable lack of opposition from the lay public, which is a good indication that the wide criticism of these devil fats over the last decade has resonated with most people. So, is the current state of inertia because Canadians are not ready to admit that more regulation, to a certain extent, is accepting defeat on the part of health promotion and certainly admitting that we, as a population, are incapable of making these decisions on our own? Or, is the lack of progress more simply, and again more likely, a lack of political leadership?
With the staggering rates of obesity and cardiovascular disease in this country and seemingly lackluster performance of current interventions to curb the incidence of these diseases, Canada should resolve to completely ban or at minimum further regulate artificial TFAs.
Maaike deVries is an epidemiologist and currently a methodologist at Health Quality Ontario. Jonathan Gravel is an epidemiologist, health economist and currently a medical student at the University of Ottawa. Follow Jonathan on Twitter @gravel_jon.