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).