Big Apple to Go Trans Fat Free

With the unanimous Board of Health vote to ban trans fat in New York yesterday the city has become the second in the nation to require restaurants to eliminate the use of the artificial ingredient in their foods. Tiburon on San Francisco Bay -- a slightly smaller metropolis -- beat the Big Apple to it in 2004. (The other NYC Board of Health proposal approved today will require restaurant chains operating in the city to post calorie content on menu boards. Might make you think twice about a 1,110 calorie Mickey D's Vanilla Triple Shake.)

At the public hearing on these two proposals on October 30, a diverse cross-section of New Yorkers from academic institutions such as Columbia University's Medical Center to public health centers such as the Institute for Urban Family Health to community organizations crammed a meeting hall to voice their nearly unanimous support of both proposals.

In the snaking security line on the way to the hearing, I overhead a woman explaining to her neighbor: "You can find trans fats in Parkay, I Can't Believe It's Not Butter, in most cookies..." Her list went on and on and on and on. Trans fat -- as the woman, who is a prominent public health advocate in the city, was trying to convey -- are everywhere, we just don't see them, rarely realize when we're eating them.

It didn't used to be this way. Trans fats were developed in the 1940s, in a process through which vegetable oil is hydrogenated, converting unsaturated fatty acids into saturated ones. (If you see "partially hydrogenated" on an ingredients list, that's trans fat). In processed foods, trans fats replace naturally occurring solid fats like butter and liquid oils.

Trans fats became popular with industry because they enable products to sit on shelves longer. The other winning element? They can be less expensive than other fats traditionally used in baking. By the 1960s, trans fats had become ubiquitous in baked products and fast foods. They've been with us ever since.

Today, most of our dietary trans fat intake comes in the form of cakes, cookies, crackers, and bread as well as French fries, potato chips and popcorn. Restaurants are another major source. And while the government now requires trans fats be listed on nutritional labels, restaurants have no such required transparency.

So what's the trouble with trans fats? For several decades the evidence has been accumulating. The results are pretty damning.

Testifying at the public hearing, Dr. Walter Willett, whose team at the Harvard School of Public Health has been at the leading edge of this research, reminded the council members, the TV news crews, and the hundreds gathered that trans fats are known to increase coronary heart disease, one of the leading causes of death in the United States. Currently, 12.5 million Americans have the disease, with half a million dying every year from it, according to the USDA.

As even the FDA acknowledges, consumption of trans fat raises low-density lipoprotein, or "bad cholesterol" levels, which increases the risk of the disease. Based on more than two decades of study of more than 200,000 participants, Willett and his colleagues estimate that trans fat consumption is responsible for tens of thousands of premature deaths annually from coronary heart disease.

In a recent report from The Netherlands, researchers suggest that eliminating trans fat in the U.S. could avert between 72,000 and 228,000 coronary heart "events" -- as they call them -- each year.

In his testimony, Willett's colleague Dr. Dariush Mozaffarian added that trans fats increase inflammation -- a risk factor for diabetes, among other ailments -- and are linked to weight gain. Even more troubling are findings that even very low levels of consumption can lead to higher risk: consuming just 5 grams of trans fat -- that's roughly 2 percent of your daily calories and just under the average 5.8 grams of trans fat we Americans consume -- can increase your risk of heart disease by 25 percent. (It is precisely these health concerns that led Denmark in 2004 to ban trans fats use in the country).

As these studies show, the trouble with trans fats is now well-documented. There is no longer cause for debate, but this isn't to say there's no debate. Industry is still working overtime to confuse the public. Consider this claim on one industry-backed website, Trans Fat Facts: "Trans fats have been a staple in the American diet for decades. And during that time, American life expectancy has seen dramatic increases. In fact, it recently reached a record high." It seems the authors missed the statistics lesson on causal relationships.

With all the sound science, maybe we should be asking why not ban trans fats? That's just what many people are doing.

At the hearing, 53 people spoke in support of the ban, from a steely-voiced octogenarian, Florence Rice, president of the Harlem Consumer Education Council to a six-year-old who asked the Board to please help her "stay healthy," and "out of the hospital." In total, the Department received 2,266 public comments, 95 percent were in support of the ban. Across the street from the official hearing, a public rally organized by volunteers of the Trans Fat Free NYC network included trans fat free treats and speeches from a local restaurateur, Michael Jacobson from the Center for Science and the Public Interest, a provider of trans fat free oils to the restaurant industry, and yours truly.

At the hearing, those opposed to the ban included representatives from restaurant associations and the founder of CLASH, the organization formed to fight the ultimately losing battle against the New York City smoking ban.

Their chorus? In part, the ban will be bad for business. They said that it would be impossible for businesses to comply; there's simply not enough supply. They also warned that mom and pops would be hurt worst.

Brooklyn-born Ina "Breakfast Queen of Chicago" Pinkney and the "mom" of her Chicago-based restaurant, Ina's, begged to differ. She found it easy to replace trans fats with alternatives. Pinkney added that as a small business owner this kind of policy is exactly what she wants.

"We welcome these regulations," she said. "It levels the playing field."

The other industry complaint? It's "Big Brother" all over again, just one more inch down the slippery slope toward a "food nanny" police state. The industry funded ConsumerFreedom.com even called Health Commissioner Thomas Frieden a "diet dictator." A FoxNews opinion piece about the ban posed the question this way: "Should the government regulate what we eat?"

But that's actually not the question the resolution really raises. Sure, the government shouldn't dictate whether or not we can devour a Krispy Kreme donut. But the government most certainly should protect its citizens from unnecessary artificial added ingredients in our food --which are invisible to us, are undetectable to our tongues, and harm us. The government also must certainly protect children who are even less equipped to make informed choices about the food they eat.

Indeed, that is precisely what we expect our government to do. When we find out about contaminants in food that cause harm -- take E. coli O157:H7 for instance -- we expect the government to step in, and step in fast on the side of public health.

In a similar way, the proposed ban on trans fats isn't regulating what we can or can't eat; it is simply helping rid our food system of an ingredient that has been shown to cause thousands of premature deaths each year.

The other industry theme song is that these kinds of decisions should be voluntary, not government mandated. But although the food industry is savvy about getting media mileage on bold announcements to voluntarily ban trans fats, with no laws requiring accountability, their claims have tended to be mere smoke and mirrors.

As public health attorney Michele Simon, who documents just this kind of industry spin in her book Appetite for Profit, explained to me: "Take McDonald's, for instance: When McDonald's announced in 2002 that it was removing trans fat from their cooking oil, the story got extensive positive coverage in major national newspapers. Yet, four years, and a lawsuit later, McDonald's still hasn't followed through on the promise."

Simon continues, "We need more government agencies to pass laws to require companies to do the right thing. That's the way real change happens."

This resolution is a part of doing just that. It's not a draconian Big Brother move, but government taking leadership to protect the public health.

The question isn't "Should the government regulate what we eat?" But, "Shouldn't the government protect us from harm?" And the answer is, yes.

A final industry grumble, and a corollary to the Big Brother complaint, is that such bans limit "choice;" they're an affront to our "freedom." Wrote one commentator: this kind of ban is a "push to legally prevent individuals from having a French fry 'their way.'"

But how many New Yorkers, or anyone else in the country for that matter, asked for trans fats? Or, even knows when they're eating them? We, the consumer, didn't demand trans fats. They were invented to increase shelf life of food products in order to increase profitability for the food industry.

Real choice and real food freedom means being able to eat out without worrying that the choice will be harmful to our health. This policy will help all New Yorkers do just that and, now passed, the rest of the country might just take New York City's lead.