In November 2013, FDA made a tentative yet powerful statement concerning trans fats. It stated that artificial trans fats (otherwise known as partially-hydrogenated oils or PHOs) were no longer "generally recognised as safe"; framing this not as a nutritional issue but as a serious question of food safety. If this preliminary declaration is finalised, it could pave the way for a complete ban.

Many commenters welcomed the move, pointing out the welter of evidence that has stacked up against PHOs. According to FDA’s own figures, a ban would prevent around 7,000 deaths each year from heart disease, preventing some 20,000 heart attacks. Another study, by Kansas University researchers, has linked every 2% increase in energy intake from trans fats to a 23% rise in cardiovascular risk.

Supporters have remarked that civilisation survived without artificial trans fats for millennia, implying that their inclusion in the food chain has been little more than a temporary blip. In an era where the word ‘natural’ is a point of pride on any food label, PHOs are quite the opposite – a type of factory-altered Franken-fat that was originally designed for candle wax.

Michael Jacobson, executive director of the Center for Science in the Public Interest (CSPI), said of the declaration: "Artificial trans fat is a uniquely powerful promoter of heart disease, and today’s announcement will hasten its eventual disappearance from the food supply. Not only is artificial trans fat not safe, it’s not remotely necessary."

Transient nature
It’s important to keep in mind that trans fats are found in nature too – most notably in meat and dairy products – but there is not sufficient evidence to link these natural variants with adverse health effects. As such, the real point of focus is industrially manufactured PHOs, which are firmly established as toxic.

"Recent years have seen a significant drop in trans fat usage, suggesting complete elimination is just the next step down an already well-worn road."

At the time of writing, there is something of a limbo period, with US businesses attempting to plan their next steps as they await a final FDA decision. Should the move go ahead, it is likely they will have an 18-month window in which to replace their PHOs. This may prove somewhat easier for fried foods than it does for other products, which could require reformulated recipes.

There has been some fight-back from the industry though; the American Bakers’ Association has claimed the ban would have "unintended consequences" for baked goods and the American Soybean Association has queried the need for FDA action.
On the basis of the past decade, however, it seems that the move should be more than achievable. Recent years have seen a significant drop in trans fat usage, suggesting complete elimination is just the next step down an already well-worn road.

Fat of the land
PHOs are created when extra hydrogen is bubbled through hot oil, forming a fat that is solid at room temperature. While the process has existed for many decades, it reached a peak in the late 20th century – between 1994 and 1996 the average American consumed approximately 5.6g of trans fats every day.

In fact, these oils were once virtually ubiquitous across the processed-foods sector, finding their way into more than 40,000 distinct food products. These included biscuits, cakes, pies, pastries, cereal bars, microwaved popcorn, margarine, icing, fried foods and a litany of surprise offenders.

Because saturated fats were typically seen as ‘bad’ and unsaturated fats as ‘good’ – just think of early margarine adverts – trans fats tended to slip under the radar. As a type of monounsaturated fatty acids, they were not labelled separately for most of their history, while saturated fats faced the brunt of reduction efforts and public health campaigns.

By the early 1990s, however, the health risks were becoming clearer. Studies found a strong association between artificial trans fats and cardiovascular risk, with one 1994 paper suggesting PHOs caused 20,000 deaths through heart disease each year. The molecules were shown to increase harmful LDL cholesterol while lowering protective HDL cholesterol, a state of affairs not associated with other forms of unsaturated fat.

"Between 2003 and 2012, the average American’s daily intake of PHOs plummeted from 4.6 to 1.0g a day – a 78% reduction."

This paper, published in the American Journal of Public Health, concluded: "Because the consumption of partially hydrogenated fats is almost universal in the US, the number of deaths attributable to such fats is likely to be substantial. Federal regulations should require manufacturers to include trans fatty acid content in food labels and should aim to greatly reduce or eliminate the use of partially hydrogenated vegetable fats."

Since then, PHOs have been associated with other undesirable eventualities. While the links with cancer are subject to debate, one epidemiological study in Europe found that "women with elevated serum levels of trans fatty acid have almost twice the risk of developing breast cancer, compared with women with the lowest levels".

Other studies have found potential associations with obesity, infertility, Alzheimer’s disease, major depressive disorder and diabetes. None of these links are as strongly grounded as the one with heart disease, but the possibilities are worth taking seriously. A 2013 study, published in the American Journal of Clinical Nutrition, found that people who consumed high levels of trans fats were at a greater risk of dying from all causes.

Oil spill
With scientific research mounting and pressure building, the FDA adopted mandatory trans-fat labelling in 2006. This in turn spurred many manufacturers to change their recipes. Most major restaurant chains abandoned use of the oils, either as means of avoiding stigma or as a response to local regulation. In the meantime, the American Heart Association advised the public that trans fats should constitute less than 1% of their total calorie intake.

The results of this push have been impressive. Between 2003 and 2012, the average American’s daily intake of PHOs plummeted from 4.6 to 1.0g a day – a 78% reduction. Although it is difficult to pinpoint exact numbers, it is fair to assume that many lives have already been saved.

A ban would surely continue this trend. At present, US manufacturers are able to market their products as ‘zero trans fats’ when, in fact, up to 0.5% trans fats may still remain. The FDA’s move would close this regulatory loophole, ensuring that no PHOs are used at all.

As the US waits to see what transpires, other parts of the world are busy at work tackling the same problem. At a recent committee meeting in Copenhagen, the World Health Organization (WHO) called for the eradication of all trans fats in foods across Europe.

"Removing trans fats from the food supply is one of the most straightforward public health interventions for reducing the risk of cardiovascular diseases and some cancers, and improving diet," said Zsuzsanna Jakab, WHO regional director for Europe, speaking to representatives of the region’s 53 member states.

"Denmark’s virtual ban on the sale of products containing trans fats in 2003 was a worldwide first. Europe now leads the world in the number of countries that have taken action to virtually eliminate trans fats from our diets. If more countries act, the benefits to health can be substantial across the whole region."

Talking exclusively to Ingredients Insight, Jakab adds that the problem is deeply entrenched. "Consumption of trans fats can be as high as 30g a day, whereas consumption of only 5g a day is associated with a 23% increase in the risk of coronary heart disease," she says. "Low-socioeconomic groups may be exposed to higher levels of this unhealthy fat, thereby contributing to inequalities in health."

The Danish legislation, brought in more than a decade ago, has been held up by other countries as a template. Its law is a blanket ban in all but name. Because manufacturers must use ingredients containing no more than 2% trans fats, certain oils are effectively off the table. This applies to foods produced in Denmark and ingredients imported from elsewhere, and means Danes now eat less than 1g daily even if they consume a lot of processed foods.

"It’s premature to evaluate and assess the long-term benefits, but all the evidence and research shows that it will bring a considerable benefit in the reduction of cardiovascular diseases, if the legislation and policies are upheld over a period of time," says Jakab.

Follow the leader
As of September 2014, five more European countries have followed suit (Austria, Switzerland, Norway, Hungary and Iceland); a move that has been strongly welcomed by WHO. Unfortunately, this has served to open a window onto the disparities that remain, with other parts of the European region, particularly in Eastern Europe, lacking any policies at all. Even in the EU, consumption remains high among some poorer people and labelling standards can be lax.

The Regional Committee has duly brought in a new list of measures such as the WHO European Food and Nutrition Action Plan 2015-20, which aims to tackle the challenge of diet-related noncommunicable diseases. Directed at policymakers and actors in the food chain, the toolkit can be adapted by different countries in ways that suit their individual circumstances. Trans fats elimination is high on its priority list.

To date, the Netherlands and the UK have rejected an outright ban, placing the onus on individual stakeholders to cut down. In the UK, manufacturers are encouraged to sign a voluntary pledge to remove artificial trans fats from their food. This measure has shown some success but has been criticised by medical professionals for kowtowing to the food industry at the expense of public health.

"Reformulating a recipe may be expensive, but so is treating a patient with cardiovascular disease."

The British Heart Foundation, for one, has called for stricter controls, suggesting that voluntary targets should be clearly specified, legislative action should be introduced if these prove unsuccessful; and food manufacturers and retailers should label trans fats on their packaging. It may seem retrogressive that, in 2014, the onus is still on the consumer to trawl the ingredients for ‘partially hydrogenated vegetable oil’.

Jakab highlights that, where bans are brought in, the ramifications for the food industry are unlikely to be severe. "Trans fats can be gradually replaced with other fatty acids, ideally unsaturated fatty acids, according to the desired properties of the final product," she says. "New methods of production may be developed and improvement of production processes may be made. In Denmark, the economic consequences for the industry were very limited."

Banned substances
If an FDA ban does go ahead, it is expected to cost the US in the region of $8 billion – a sum that must be weighed against the likely public health benefits. After all, reformulating a recipe may be expensive, but so is treating a patient with cardiovascular disease.

"Getting rid of artificial trans fat is one of the most important life-saving measures the FDA could take," said CSPI’s Jacobson at the time of the preliminary proposal. "Thousands of heart-attack deaths could be prevented in the years ahead. FDA deserves credit for letting science, and not politics, shape its new proposed policy on artificial trans fat."

If the FDA ban is finalised, this will have implications beyond cutting PHOs from the US diet. It will shake up the whole paradigm for trans fats, meaning they are treated not as foodstuffs in their own right, but as carefully monitored additives. The question in point is not their ‘unhealthiness’ but their toxicity, a subtle shift in rhetoric with major implications.

One thing is for sure – while Europe and the US have come a long way in the past two decades, the pressure is set to rise on both sides of the Atlantic, with ripple effects down the entirety of the food chain. The consumer’s safety is at stake.

Sustainable palm oils: an alternative?

As manufacturers look to replace their PHOs, one alternative in particular may spring to mind. Palm oil, a natural fat that is semi-solid at room temperatures without tampering, is used widely in parts of Africa, South-East Asia and Brazil, and is one of the few highly saturated vegetable fats. It therefore retains many of the same properties as trans fats, arguably without the same deleterious side effects.
While palm oil should not be treated as a total solution to the problem, it has shown significant commercial success. Unfortunately, because it is harvested from the trees of the Malaysian and Indonesian rainforest, the impacts on the environment can be bleak.

The Round table on Sustainable Palm Oil (RSPO) was therefore set up to harvest palm oil in a more eco-conscious way. A global, multistakeholder initiative, it presents the certification standard for sustainable palm oil and aims to "transform markets to make sustainable palm oil the norm".

This entails advancing the production and use of sustainable palm oil products, developing global standards for the supply chain, monitoring the environmental impacts and engaging all stakeholders, including local communities and government.
These goals have shown some success – 18% of the palm oil produced globally is now RSPO-certified, and between 2008 and 2014 the annual production of certified sustainable palm oil (CSPO) swelled from 619,012 to 11.125 million tons. As of early 2014, RSPO-certified palm oil plantations covered an area 27 times the size of Singapore.

In order to become RSPO-certified, growers need to comply with RSPO principles and criteria, including commitment to transparency, commitment to applicable laws and regulations, conversation of natural resources and responsible development of new plantings. All these aspects must be verified by a third party and periodically reviewed.

RSPO spokesperson Stefano Savi believes the future looks promising.
"The main challenge today is to increase demand for sustainable palm oil," he says. "This can be done by involving new players in the process of market transformation, and also by making sure that those players who are already involved deliver in their commitments toward 100% CSPO.

"We expect Europe to continue to be a leading market in terms of CSPO purchases in the near future, as companies continue to implement their policies and increase demand for CSPO. We also see some growth in new markets, namely the US, Australia and China, which confirms a rising global industry trend towards 100% sustainable palm oil."