NICE recommends trans fat ban

On June 22 2010 the UK's National Institute for Clinical Excellence (NICE) published its Prevention of cardiovascular disease at population level, which advices, among other measures, a ban on industrially produced trans fatty acids.

This is an important development, and one which may now make a trans fat ban in the UK inevitable. Simply put, it hard for a Government to go against the advice of NICE, without some very good reason for doing so. And in this case, there are no such reasons, good or otherwise.

This in turns follows from the advice of the UK Faculty of Public Health and Royal Society for Public Health, published in the BMJ in April 2010.

This does of course raise one big question: where is the Food Standards Agency? The FSA has consistently opposed any ban on trans fats, on pretty unconvincing grounds. The fact that NICE has gone out on its own on this topic, disregarding the FSA, is an indication that the 'public health establishment' is now, in effect, at war with the conservative and outdated 'food and diet establishment' on this issue.

Guidance on the prevention of cardiovascular disease at the population level - web page with links etc.
Prevention of cardiovascular disease at population level - direct link to the pdf document.
NHS watchdog NICE calls for trans-fats ban in foods - BBC news article by Jane Dreaper, Health correspondent.
Convenience food changes could save 'thousands of lives' - news story in The Guardian, 22 June 2010, by health editor Sarah Bosely.
Ban bad fats and cut salt to save 40,000 lives a year, says Nice - news story in The Telegraph, 22 June 2010, by Rebecca Smith, Medical Editor.

Key quotes from the NICE document ...

Recommendation 3 - Trans fats

Industrially-produced trans fatty acids (IPTFAs) constitute a significant health hazard. In recent years many manufacturers and caterers, with the encouragement of the Food Standards Agency and other organisations, have considerably reduced the amount of IPTFAs in their products. However, certain sections of the population may be consuming a substantially higher amount of IPTFAs than average (for instance, those who regularly eat fried fast-food). It is important to protect all social groups from the adverse effects of IPTFAs.

In some countries and regions (for instance, Denmark, Austria and New York), IPTFAs have been successfully banned. A study for the European Parliament recently recommended that it, too, should consider an EU-wide ban. In the meantime, some large UK caterers, retailers and producers have removed IPTFAs from their products.

Policy goal

Ensure all groups in the population are protected from the harmful effects of IPTFAs. To achieve this, the evidence suggests that the following are among the measures that should be considered.

What action should be taken?

Eliminate the use of IPTFAs for human consumption.
In line with other EU countries (specifically, Denmark and Austria),introduce legislation to ensure that IPTFA levels do not exceed 2% in the fats and oils used in food manufacturing and cooking.
Direct the bodies responsible for national surveys to measure and report on consumption of IPTFAs by different population subgroups - rather than only by mean consumption across the population as a whole.
Establish guidelines for local authorities to monitor independently IPTFA levels in the restaurant, fast-food and home food trades using existing statutory powers (in relation to trading standards or environmental health).
Create and sustain local and national conditions which support a reduction in the amount of IPTFAs in foods, while ensuring levels of saturated fat are not increased. Encourage the use of vegetable oils high in polyunsaturated and monounsaturated fatty acids to replace oils containing IPTFAs. Saturated fats should not be used as an IPTFA substitute.
Develop UK-validated guidelines and information for the food service sector and local government on removing IPTFAs from the food preparation process. This will support UK-wide implementation of any legislation produced on IPTFAs.

...

3 Considerations

The Programme Development Group (PDG) took account of a number of factors and issues when developing the recommendations.

...

3.44 The PDG agreed with the 2009 World Health Organization (WHO) review of industrially-produced trans fatty acids (IPTFAs) - also known as partially hydrogenated vegetable oils (PHVOs). In line with the WHO review, the PDG concluded that IPTFAs are unnecessary and 'toxic' and should be eliminated from foodstuffs. The WHO review states that because IPTFAs are produced by partial hydrogenation they are not normally present naturally in foods and have no known health benefits. The review defined them as 'industrial additives'. It recommended that food services, restaurants, and food and cooking fat manufacturers should avoid their use (Uauy et al. 2009). A recent study commissioned by the European Parliament advocated that an EU-wide ban on IPTFAs should be considered. The PDG noted that IPTFAs have been successfully banned in Denmark and New York City.
3.45 The WHO review of industrially-produced trans fatty acids noted that people who use partially hydrogenated vegetable oils (PHVOs) for cooking would have mean trans fatty acids intakes considerably higher than the national average. The same would be true for those who eat a high proportion of industrially processed or 'fast food'. The review noted that ' ... replacing TFAs [trans fatty acids] with vegetable oils high in polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA) is the preferred option for health benefits ... Eliminating use of TFA-containing PHVO [partially hydrogenated vegetable oils] should be considered as hazard removal, in line with risk management models used to address many other food safety issues.' The PDG concurred.
3.46 Assuming a linear dose response, if less than 1% of food energy came from IPTFAs, between 4500 and nearly 7000 lives might be saved in England.
3.47 The PDG commended the substantial efforts made by much of the UK-based food industry and the Food Standards Agency to remove IPTFAs from the UK food chain. It also noted the review of trans fats by the Scientific Advisory Committee on Nutrition (SACN). New concerns have now emerged, particularly in relation to imported products and fried food prepared in some settings. People from disadvantaged groups are likely consume more of these products which, in turn, could be an important contributory factor to health inequalities.
3.48 Some products (this includes fried food from take-away venues) may contain substantial levels of IPTFAs. The PDG noted that some people may be consuming this sort of meal on a frequent basis. Hence, it considered that IPTFA consumption across different population groups is relevant - and that simply looking at average intake will not suffice.