OP-ED

The FDA Ban on Trans Fat Should Be Just the Beginning

It’s been clear for more than a decade that trans fat is a dangerous substance that increases the risk of heart disease.  Denmark banned its use in 2003.  Several American cities and states have followed suit, but the use of trans fat is still widespread despite the availability of suitable substitutes.

Over the past 10 years, trans fat consumption is thought to have contributed to an estimated 70,000 needless American deaths. Given  that universal, voluntary cooperation to eliminate trans fat hasn’t happened, the Food and Drug Administration (FDA) is justifiably seeking to designate trans fats as unsafe.

A nationwide ban on artery-clogging artificial trans fat is a long-overdue first step toward improving American diets, fighting obesity and limiting the risk of chronic disease. But it is just the first step in what should be a far broader campaign to help consumers make healthier choices at mealtime.

Public lack of awareness of the impact of prepared foods on individual health is not limited to trans fat.   When dining out, even in establishments that avoid trans fats in preparing food, Americans face a range of health risks often without realizing it. People are routinely served far more calories than they can burn.

They are routinely served too many low nutrient foods and insufficient quantities of fruits, vegetables, and whole grains.  What should become routine instead is the availability of menu options that put people’s health first.

Hopefully, the FDA’s trans fat initiative will succeed – previous city/state bans and labeling improvements have already managed to cut daily consumption by Americans from 4.6 grams in 2006 to 1 gram in 2012 – and pave the way for the creation of other standards and regulations regarding the quantity and quality of food that is offered to diners in restaurants.

The lack of such standards makes it difficult, if not impossible, for most people to recognize when they are being put at risk for a chronic disease.   If people are served too much of something (like calories), they would have to compensate by eating less later; conversely, if they are served too little of something (like vegetables), they would have to eat more later to neutralize the risk of chronic disease.

But most people lack the information they need to judge or track the quantity and quality of the nutrients they consume.


The FDA should take a disease prevention approach — as it is currently doing with trans fat — in promotingstandards that address how all foods are prepared and served away from home. Such regulations could be based on existing U.S. Department of Agriculture (USDA) dietary guidelines that limit exposure to foods that increase health risks and optimize exposure to foods that protect against chronic disease.

Both the FDA and USDA already have standards for  portion sizes. Creating standards for food away from home wouldn’t prevent people from eating whatever they want, but it would help them recognize the risks that accompany poor dietary choices.

Setting standards that promote public wellbeing would hardly be new. Building codes are designed to promote public safety, alcohol sales are regulated to prevent youth access, and restaurants already are subject to a variety health regulations.Standards are what make life predictable and secure.  They help people plan and prepare.  They set benchmarks that drive expectations, serve to ensure a minimum quality and establish conditions that limit harm.

Our food environment lacks sufficient standards to help people avoid the risk of chronic disease.   The health risks posed by added dietary trans fat are serious, to be sure, but they are just the tip of the iceberg. Reasonable standards that address all foods could herald a new era in which Americans could be free from the growing burden of diet-related chronic diseases.

Deborah Cohen, MD is a senior natural scientist at the nonprofit, nonpartisan RAND Corporation.

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David RamseyCassieAdamMD as HELLBC Recent comment authors
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Adam
Guest

I think people have the right to choose what they eat, and should deal themselves with the problems that decisions may cause. Restricting too much our decisions is not the best way, we should educate other and give them all the information so they can make the best decision for themselves.

Cassie
Guest
Cassie

You are right. People should have the right to choose what they want to eat just as long as they are educated on how harmful trans fats can be. I would recommend the American people to only eat trans fats in light moderation. But that approach puts the decision where it belongs to the individual free American citizen.

Saurabh Jha
Guest
Saurabh Jha

True, slippery slope arguments can slip out of control.

But one need not fear fascism to be wary of excessive central planning because it can lead to a behemoth that is too big to fail and too big to succeed; sclerotic, useless but omnipresent.

A bit like Humpty Dumpty that refuses to fall off the wall.

There is regulation and then there is excessive regulation.

Seatbelts save lives.

Car seats make life miserable for parents.

The trouble is that it’s hard to draw the line between definitely useful regulation and a possibly useful regulation.

Cassie
Guest
Cassie

Good point! I agree that it is a very difficult line to drawn between useful regulation and possible useful regulation.

Dr. David L. Katz
Guest

While it will not obviate discord, nor directly pertain to the merits of this column, it is worth noting that there is no ‘FDA ban’ on trans fats. Nothing of the sort has even been proposed. Rather, the FDA has made a preliminary recommendation to revoke the GRAS (generally recognized as safe) status trans fat enjoyed heretofore. Since trans fat is generally recognized as UNsafe by overwhelming scientific consensus, essentially all the FDA has decided to do is catch up with reality. If arguments about heavy-handed regulation need anecdotes to enliven them, they should find them elsewhere; this one doesn’t… Read more »

Joel Hassman, MD
Guest
Joel Hassman, MD

And yet, where is the FDA on Tobacco? Hard to tax Trans Fat still, otherwise, it would have been done. Here is an easier, and yet more rude and disruptive way to control diet: tax one’s weight, so if you are more than 20% above the “targeted” weight for your height and alleged bone density, then you pay your way to live in society. Outrageous?! Watch someone go to the authorities and offer it for the next suggestion to raise government income. It is the agenda of those in power in this country, and they just depend on their propagandists… Read more »

MD as HELL
Guest
MD as HELL

There is nothing “scientific” about “consensus”.

BC
Guest
BC

I apologize. My comment was over the top.

Joel Hassman, MD
Guest
Joel Hassman, MD

Why? The very propagandists behind such insults and intrusions into public lives are exactly how the likes of Nazis and Communist Countries came into power and maintained it like a vise around one’s gonads! Read up on Goebbels and Saul Alinsky, the demigods of those who use power and rule in the way they present their beliefs and goals as weapons and manipulations. Put these losers in their place when they defend the indefensible. It is a slippery slope, and to deny, minimize, deflect, or pathologically rationalize telling people what they can eat, drink, read, and eventually what to believe,… Read more »

BC
Guest
BC

Just to add I would support a moderate path. Banning tobacco for example. This would create a black market, but I think easily half would quit. Half quitting would make the ban worthwhile. I’m sure politicians wouldn’t like the loss of the tax revenue though. State and local tobacco revenue was $17.6 billion in 2011 for the US. http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Docid=403 Cigarettes are probably the most dangerous legal product on the market and certainly a product that increases medical costs a ton. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/ This said not easy to do and many earn a living off of it. Maybe one could phase it… Read more »

BC
Guest
BC

Dr. Cohen: I think your comments on bad diet are 100% accurate, but where does it end? Being angry or depressed one’s entire life is equally injurious to one’s health – how to you fix this? Then you have people with poor genetics that simply will not live as long as other people and cost the system more money. What kind of solution would you propose for the so called “genetically inferior?” “The FDA Ban on Trans Fat Should Be Just the Beginning” presupposes that the FDA is competent and honest and they are neither. In fact, it’s hard to… Read more »

Peter1
Guest
Peter1

“a very slippery slope to the fascism of the early 20th century.”

Say hello to Joel Hassman MD (mad doctor).

Dr. David L. Katz
Guest

Interesting diversity of perspective here. On the trans fat issue per se, I have already cast my own vote: http://health.usnews.com/health-news/blogs/eat-run/2013/11/12/trans-fats-the-latest-misstep-in-modern-nutrition On the matter of regulating overall nutritional quality/prevention as a FDA policy: there is an element of excess in this proposition, but there are practical applications as well. Overall nutritional quality can be put on display (http://www.huffingtonpost.com/david-katz-md/holistic-nutrition_b_842627.html) and potentially conjoined to the figurative ‘carrot’ to good effect: http://www.linkedin.com/today/post/article/20131119151551-23027997-fixing-food-stamps-for-all-could-be-a-snap?trk=mp-details-rr-rmpost Mostly, I would like to note that there are alternatives to nannies other than ninnies. To suggest that government regulation of ANYTHING is a slippery slope is silliness, just for ninnies. Of… Read more »

David Ramsey
Guest

trans fats are harmless. nobody can ever cite an actual study that shows increased death due to trans fats becasue there are none. the sydney diet heart study proved trans fats are harmless and the MESA trial further showed that trans fats actually result in better health than pufas. pufas resulted in 35% more heart attack deaths in the sydney diet heart study

Jimmy Jones
Guest

This altogether too prescriptive for me, and probably for the majority of people in my age group (mid fifties) who have lived their lives without such interference. Whilst you are right about the danger of some foods, it would be madness to try and force such regimentation ipon society – I can just imagine the ridicule and dissent such actions would cause to proliferate. No, gentle education remains the only viable option. Now I’l off for a 1kg (2 pounds steak and fries with many beers and a bottle of wine! (seriously), so pelase don’t call the food police.

Peter1
Guest
Peter1

Actually 2.2 pounds.

Are you happy that steak was processed in an FDA inspected and regulated plant? How bout the beer and wine being taxed to pay for adverse societal effects of alcohol?

Jimmy Jones
Guest

Good questions, Peter and fair – and yes, 2.2 pounds but I was trying earnestly to not be pedantic! I know I’m unrealistic but I would prefer that agencies like the FDA focused purely on informing people what’s good and what’s not and not actually doing anything else. People and companies make choices and government involvement is always a bad idea. As for the use of tax, I fail to understand why I should pay for the ‘adverse effects’ which arise from the behavior of those less responsible than I. In fact I am sick of paying for the poor… Read more »

Peter1
Guest
Peter1

Part of the tax may go to law enforcement of DUI. Do you feel safer on the roads because of that?

Alcohol probably accounts for more family problems than any other substance. Domestic violence, marriage break up with kids involved, family counseling, job loss. These are problems created by liquor manufacturers selling a legal product with horrendous consequences. All of this requires the police, courts, social services, and health care.

How do propose we pay for this – if you are a pay as you go conservative?

Jimmy Jones
Guest

The stance I take is logically inconsistent with the very existence of modern society – I know! If we wish to keep society as it is – large, inclusive, governed by a central authority with huge industries and governments that try to find ever-shrinking common ground between societal interest groups then we need ever bigger government and regulation. So my impractical stance is essentially nihilistic and iconoclastic – bring the whole house down – I don’t like living here and there’s nowhere else to go. I honestly believe big government is a disease, a mechanism of repression, but I also… Read more »

Peter1
Guest
Peter1

“The stance I take is logically inconsistent with the very existence of modern society.”

No, illogically consistent. Keep your guns loaded, one eye open and stock up on canned food.

Paranoia will destroy ya.

Joel Hassman, MD
Guest
Joel Hassman, MD

People have the right to make bad choices, just like they have the right to deal with the consequences without being bailed out by others forced to have to bail out such poor choices.

Wow, how do Democrats spell Freedom and Choice in this country today?

Simple. N O T!

As this party perversely pushes its agenda on the rest of us, what really differentiates it from the way Stalin Russia turned out to be!?

Think about it. Happy Thanksgiving, until the KGB come knocking at your door to inspect your dinner menu!!!

Idiots!

Bobby Gladd
Guest

Comrade.

David Ramsey
Guest

love it

Lua
Guest
Lua

Before we start talking about nanny states and people finding a way to eat trans fats no matter what, let’s get one thing straight: trans fats are basically man-made fats and were created as a “healthy” substitution for saturated fats. By banning trans fats, no one is talking about hamburgers; they are banning a dangerous saturated fat substitute. It’s a good move, and no one will notice the change but the food companies, who will have to switch back to saturated fats or concoct another kind of fat, something I’m sure we are all confident they can do.

Peter1
Guest
Peter1

“concoct another kind of fat, something I’m sure we are all confident they can do.”

Good point.

Industrial processed food corporations subtly market their “food” image as what your mother would prepare – ya, if your mother is a chemical engineer.

David Ramsey
Guest

let’s get this straight corn oil, cottonseed oil, soybean oil, canola oil, rapeseed oil etc are all man made fats. you can’t get them in nature

Saurabh Jha
Guest
Saurabh Jha

On a brighter note, the modern day Al Capone could be busted for evading broccoli (or sending too many of his gangsters on to the exchange).

Bubba For President
Guest

FILED UNDER: Those who forget the mistakes of the past are doomed to

a). repeat them b). forget them c). pay for them using taxpayer dollars d). both a and c …

Prohibition didn’t work for booze. It didn’t work for marijuana. It’s sure as hell not going to work for cheeseburgers

Bobby Gladd
Guest

Price it according to the risk it poses (via taxation — e.g., tobacco).

MD as HELL
Guest
MD as HELL

Risk to whom? Your consuming trans fat poses absolutely no risk to anyone else. If you refer to the cost of healthcare for such behavior, that cost should be born by you. If you think the populace should not pay for the consequences of your behavior, then you are correct. Get the populace out of individual healthcare. Having chosen to cover healthcare costs gives the populace no right to chose the behevior of others, just because you were stupid enough in the first place to assume such risk. If you think you do have the right to dictate the behavior… Read more »

Peter1
Guest
Peter1

“Prohibition didn’t work for booze.”

Yes, stills will be converted to produce trans fats and then it’ll be smuggled into the cities to be sold in trans fat speakeasies. People will carry illegal jars of trans fat to spread on their hamburger and fries.

Bobby Gladd
Guest

Great comeback.

David Ramsey
Guest

funny

Vik Khanna
Guest

If there is a more ludicrous and illogical discussion of the new FDA ban on trans fats available anywhere, will someone please point me to it? Here is what I learned from this lament: That the FDA, which can barely keep up with its current responsibilities vis a vis medications in the US market, should have its statutory authority expanded to include prevention, a term that means vastly different things to different people. Can’t wait to see the Federal Register comments on the definition that the bureaucrats devise in response to the undoubtedly crystal clear law that Congress will pass… Read more »

Peter1
Guest
Peter1

“That people are being force fed copious amounts of grossly unhealthy food that they should not want or eat in free, voluntary commercial transactions, and they need to be protected from themselves.” I don’t know, why do we conduct health inspections at restaurants – “voluntary commercial transactions”? Why do we inspect anything, even elevators; hell, they’re a voluntary device, take the damn stairs. The food industry will put anything into the food we eat, just to hit that taste sweet spot, and if allowed not divulge the contents. Would anyone like to know how much arsenic or mercury is in… Read more »

David Ramsey
Guest

excellent commentary

Saurabh Jha
Guest
Saurabh Jha

“Saurabh (and I’m sure the duo of Al Lewis and Vik Khanna, ever-present on THCB): Tell me what I’m missing.”

Unintended consequences of changing the fundamental relationship between the citizenry and state.

I am not a trans-fat aficionado. But if the state must intervene for every risk a citizen could incur…Well to be honest that does sound like a good thing.

Joel Hassman, MD
Guest
Joel Hassman, MD

Gee, government will tell us what to eat, what to drink, what health insurance to have, what next?

When to die!?

slippery slope? Nah, the government is only interested in you walking on ice near a cliff edge!

And SO MANY of you not only buy into it, you sell it like it is the second coming of a messiah. Pathetic, dangerous, and ugly!

David Ramsey
Guest

well said Dr. Hassman