Tracing industrial trans fat in popular foods in EU and neigbouring countries

Transcription

1 Tracing industrial trans fat in popular foods in EU and neigbouring countries European Parliament, Brussels by Steen Stender Professor, MD, Lab director Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev-Gentofte Denmark

2 70 C 44 C 13 C

3 Max. 50 % trans fat Max. 5% trans fat

4 The use of industrial trans fat has been favoured by food industry- and removal resisted- because: They are cheap They are semisolid at room temperatures which makes them easier to use in baked products They have a long shelf life They can withstand repeated heating

5 Fatty acids in the diet and LDL- and HDL-cholesterol in the blood LDL HDL (Lousy) (Healthy) Saturated fatty acids Unsaturated fatty acids Trans fatty acids

6 Atherosclerotic Plaque Development Stroke TIA Rupture Calcification Thrombosis Occlusion Plaque instability Myocardial infarction Angina Peripheral arterial disease Years of life

7 Isocaloric substitution of 2E% carbohydrates with trans fatty acids ~ 5 gram/day Mozaffarian et al. NEJM 2006;354(15):

8 WHO recommends global phasing out of trans fats By Anthony Fletcher 29/09/ The World Health Organization (WHO) has recommended that governments around the world phase out partially hydrogenated oils if trans-fat labeling alone doesn't spur significant reductions.

9 JN Kiage et al. Am J Clin Nutr April 3, 2013 doi: /ajcn Proportion Alive 1.00 trans-fat INTAKE AND ALL-CAUSE MORTALITY 0.95 Worser Better Quintiles of trans fat intake g/d g/d g/d g/d g/d Years of Follow-up 18,513 participants recruited from all across US from 2003 to 2007

10 The Dutch statement "In conclusion, the detrimental effects of industrial trans fatty acids on heart health are beyond dispute."

11 Conclusion: This study of 1000 subjects provides the first evidence linking dietary trans fatty acids with behavioral irritability and aggression. Although confounding is a concern, several relationships add weight to the prospect of a causal connection. The results may have relevance to public policy determinations regarding dietary trans fats. March 5, 2012

12 An intake of 5 grams per day is associated with 23 % increase in risk of heart disease There is no beneficial effect of trans fatty acids on health In light of the Danish Nutrition Council s reports on trans fatty acids from 1994, 2001, 2003, and the present update, the Danish Nutrition Council recommends the following: That industrially produced trans fatty acids should not be used in food.

13 A high trans fat menu Danmark Grams of industrially produced trans fatty acids A large serving of of nuggets and and French fries fries 100 g grams biscuits/cakes/wafers 100 g grams microwave popcorn popcorn

14 Ritt Bjerregaard Marian Fischer Boel Member of the Danish parliament from 1971 EU Environment Commissioner Minister of food from Member of the Danish parliament from Minister of food from EU Agriculture Commissioner

15 Order No. 160 of 11 March 2003 Courtesy translation Order on the content of trans fatty acids in oils and fats etc. The following is laid down pursuant to Section 13, Section 55, subsection 2 and Section 78 subsection 3 of Act No 471 of 1 July 1998 on foodstuffs etc. (Foodstuffs Act): Chapter 1 Scope Section 1. This Order applies to oils and fats, including emulsions with fat as the continuous phase which, either alone or as part of processed foodstuffs, are intended, or are likely, to be consumed by humans. Subsection 2. The Order does not apply to the naturally occurring content of trans fatty acids in animal fats or products governed under other legislation. Subsection 3. The Order only applies to products sold to the final consumer. Section 2. It is prohibited to sell the oils and fats covered by the Order to consumers if they contain a higher level of the trans fatty acids defined in the Annex than that stated in Section 3. Section 3. As from 1 June 2003, the content of trans fatty acids in the oils and fats covered by this Order must not exceed 2 grams per 100 grams of oil or fat, cf. however subsection 2. Subsection 2. From 1 June 2003 until 31 December 2003 the oils and fats covered by this Order and included in processed foodstuffs which also contain ingredients other than oils and fats and which are produced by the foodstuffs industry, in retail outlets, catering establishments, restaurants, institutions, bakeries etc. may, however, contain up to 5 grams of trans fatty acids per 100 grams of oil or fat. Section 4. In products which are claimed to be free from trans fatty acids, the content of trans fatty acids in the finished product shall be less than 1 gram per 100 grams of the individual oil or fat. Chapter 2 Penalty provisions etc. Section 5. A fine shall be imposed on anyone who contravenes Section 2 or Section 4 of this Order. Subsection 2. The penalty may increase to imprisonment for up to two years if the contravention was committed wilfully or through gross negligence, and the contravention 1) caused damage to health or led to the risk thereof, or 2) resulted in, or was intended to result in, financial gain for the perpetrator themselves or for others, including as a result of savings made. Subsection 3. Criminal liability may be incurred by companies etc. (legal entities) in accordance with the rules of Chapter 5 of the Penal Code. Section 6. This Order shall enter into force on 31 March Subsection 2. Products manufactured before this Order has entered into force, as well as products manufactured within the periods stated in Section 3(2), may be sold until expiry of the best before date. Annex 1 Definition of trans fatty acids For the purposes of this Order, trans fatty acids are defined as the sum of all fatty acid isomers with 14, 16, 18, 20 or 22 carbon atoms and one or more trans double bonds, i.e. C14:1, C16:1, C18:1, C18:2, C18:3, C20:1, C20:2, C22:1, C22:2 fatty acid trans isomers, but only polyunsaturated fatty acids with methylene interrupted double bonds. Section 3. As from 1 June 2003, the content of trans fatty acids in the oils and fats covered by this Order must not exceed 2 grams per 100 grams of oil or fat, cf. however subsection 2. Section 5. Subsection 2. The penalty may increase to imprisonment for up to two years if the contravention was committed willfully or through gross negligence 11 March 2003

16 A high trans fat menu A large fast food serving French fries and fried chicken meat from McDonalds and from KFC Biscuits/cakes/wafers and microwave popcorn More than 15% fat in the product Partially hydrogenated fat or similar term high on the list of ingredients 3 large supermarkets in the capital chosen by the local Turist Information Office were visited

17 Places where a potentially high trans fat menu was bought during USA South Africa TURKEY Jan 2008

18 Trans fatty acids in a high trans fat menu USA Czech Rep. Poland Hungary Bulgaria Canada Iceland Peru Romania South Africa France Lithuania Germany Portugal Spain UK The Netherlands Russia Austria Italy Sweden Norway China Finland Switzerland Denmark 2001 Denmark 2005 A large serving of nuggets and French fries 100 g biscuits/cakes/wafers 100 g microwave popcorn Grams of industrially Grams of trans produced fatty acids trans fatty acids

19 FAST FOOD McDonald s meal KFC meal

20 Amounts of industrially produced trans fatty acids in a large serving Hungary Bulgaria USA, Boston Poland Peru Romania Czech Republic Iceland Canada Bahamas S. Africa, Durban S. Africa, Jo.burg Oman USA, NYC The Netherlands Germany, Hamburg France Thailand UK, London China UK, Glasgow Spain, Barcelona Portugal Spain, Malaga Malaysia UK, Aberdeen Denmark Russia India Germany, Wiesbaden Egypt Spain, Madrid KFC French fries Chicken (grams) Stender et al. NEJM April 12; Grams of industrially produced trans fatty acid

21 Amounts of industrially produced trans fatty acids in a large serving USA, NYC USA, Chicago Peru USA, Atlanta UK, Glasgow S. Africa, Jo.berg Poland UK, Aberdeen UK, London France Turkey Finland Italy Norway Spain, Barcelona Sweden Germany, Hamburg Germany, Wiesbaden Hungary Austria 12/6] Portugal Romania The Netherlands Russia Bulgaria Czech republic Spain, Malaga Canada Denmark China McDonald s French fries Chicken (grams) Stender et al. NEJM April 12; Grams of industrially produced trans fatty acid

22 11. april 2006: 200 hits 14. april 2006: hits

23 Market Cap 35,55 $ 46,39 x 10 9 A decrease of $1.5 billion Market Cap 34,32 $ 44,84 x apr 2006 NEJM 13 apr

24 McDonald s Europe takes action to reduce Trans Fatty Acids in cooking oil Press release fra McDonald s Europe London, United Kingdom (November ) McDonald s Europe today made public its 2-year plan to achieve a substantial reduction in trans fatty acids in its cooking oil. By mid 2008 (depending on supply availabilities), McDonald s plans to have more than 6,300 restaurants across Europe using the new oil that will contain no more than 2% trans fatty acids.

25 KFC's fried chicken is about to become finger-lickin' trans-fat-less. The chicken kingpin on Monday will unveil plans to switch to a new soybean oil from a partially hydrogenated oil by April and eliminate the arteryclogging trans fats in its fried chicken sold in the USA. The chain, with 5,500 units in the USA, plans ultimately to make the same changes in its 8,600 locations outside the USA.

26 Trans fatty acid in a high trans fat menu in 2006 and 2009 Latvia Hungary Czech Rep. Poland France Germany UK Denmark Latvia Czech Rep. Poland Hungary France Germany UK A large serving of nuggets and French fries 100 g biscuits/cakes/wafers 100 g microwave popcorn A large serving of nuggets and French fries 100 g biscuits/cakes/wafers 100 g microwave popcorn Denmark Grams trans fatty acid Stender S et al. BMJ Open 2012;

27 Foods bought in Riga,Latvia in March 2011

28 Amounts of trans fat in biscuits/cakes/wafers with more than 2% of the fat as trans fat Bought March 2011 in 3 large supermarkets in the capital of Latvia. 10 products Gram trans fat per 100 gram product

29

30

31 (September 2011)

32 Intake of trans fat per day (gram) The average intake of industrially produced trans fat in Denmark Jakobsen, MU et al. AJCM 2006; 60:

33 Gram/dag/person / day / The average intake of industrially produced trans fat and the intake among the 1 % with the highest intake in Denmark % ABOVE 99 % BELOW DANISH LEGISLATION OTHER COUNTRIES % ABOVE 50 % BELOW DENMARK Nov 2008

34 Regulation in various countries concerning industrial trans fatty acids (TFA) in food Legislative limits for TFA No limits for TFA No labelling Labelling by Labelling of naming TFA amounts of TFA Countries Denmark, Switzerland, Austria, Iceland EU US, Canada , 2005 Latest legislation Hungary, Norway, NY-City, California ,2011 Example No need for information Partially "Trans 3 grams hydrogenated fat per serving" Advantage Virtually eliminated TFA at the May reduce individual level in few years the intake Registration of effects Easy (basket investigation) Difficult Disadvantage None Information campaigns Unpackaged food is not labelled Subgroups in the population may still have a high intake

35

36 Purchase of food for trans fat analysis 3 large supermarkets in the capital chosen by the local tourist Information office are visited. Pre-packaged biscuits/cakes/wafers More than15 gram total fat per 100 gram product Partially hydrogenated fat or similar term high on the list of ingredients

37

38 Amounts of trans fat in biscuits/cakes/wafers with more than 2% of the fat as trans fat. Bought 2012/2013 in 3 large supermarkets in the capital of 20 European countries N:61 N:35 N:40 N:17 N:27 N: 26 FYROM N: 36 N: 20 N: 18 N: 11 N: 7 N: 6 N: 5 N: 3 0 PRODUCTS BERLIN, GERMANY COPENHAGEN, DENMARK LONDON, UK OSLO, NORWAY 0 PRODUCTS PARIS, FRANCE STOCKHOLM, SWEDEN VIENNA, AUSTRIA Gram trans fat per 100 gram product BMJ Open; May 2014

39 Amounts of trans fat in biscuits/cakes/wafers with more than 2% of the fat as trans fat. Bought in 3 large supermarkets in 2012 and in the same supermarkets in Gram trans fat per 100 gram product

40 There is plenty of popular foods with high amounts of trans fat in several EU- countries and in neighbouring countries The availability of this type of foods has increased substantially from 2012 to 2014 in some EU-countries Large international fast food providers have removed trans fat Smaller national food providers have removed trans fat in a matter of few months Several smaller countries in Europe have effectively removed trans fat from food by legislation

41 Two stragegies for minimizing the intake of trans fat Legislators stop the use of artificial trans fat Informed customers stop buying food with artificial trans fat, then food producers stop using artificial trans fat

42 Average annual percentage decline in coronary heart disease mortality in the EU from M Nichols et al. Eurheart J, November 2013,

43 Aged-standardized death rates from coronary heart disease in Europe M Nichols et al. Eur Heart J 2014; 35,

44 SUMMARY A low average intake of industrial trans fat at the population level does not preclude a high intake among subgroups as long as foods with high amounts of trans fats are available. An effective strategy that minimizes intake of trans fat in all subgroups of the population is legislative trans fat limits for the food. This has so far been used only by a few European countries although it appears to be a low hanging fruit in the prevention of premature heart disease.

45 Thank You