BOSTON – (November 25, 2013) – On Nov. 7, the Food and Drug Administration (FDA) put one of the final nails in the coffin of artificially-made trans fats with its decision to ban them from our nation’s food supply. The Joslin applauds the FDA’s decision and supports efforts to move this initiative forward as quickly as possible.

Reducing the risk of heart disease is especially important for people with diabetes. The vascular damage caused by diabetes makes those living with the disease two to four times more likely to develop cardiac events. More than 60 percent of deaths attributable to diabetes are caused by heart disease. Trans fats, which are made by injecting hydrogen atoms into hot vegetable oils to help solidify them, are responsible for both increasing the level of low-density lipoproteins (colloquially known as the bad cholesterol) and decreasing the amount of high density lipoproteins (the good cholesterol) in the blood.

"Not only do they adversely affect lipids, but trans fats are known to promote insulin resistance," says Dr. Om Ganda, MD, Senior Physician and Director of the Lipid clinic. ”The mechanisms underlying increased risk of heart disease by trans fats include low grade inflammation of blood vessels."

This makes trans fats an even more deadly enemy than saturated fat, which raises both LDL and HDL cholesterol.

With all its negative health consequences, it is a wonder that trans fats were approved for use in foods at all. But they have been around since the turn of the century, and the extent of their ability to damage our cardiovascular system has come to light only relatively recently. Previously, trans fats were considered a better alternative, from a health perspective, than saturated fats. Semi-solid stick margarines were hailed as being healthier than butter. Trans fats were also a boon for food manufacturers – they are very tasty and extend the shelf-life of packaged products. Instead of going bad in a couple of weeks, crackers could stay on the grocery shelves more than a year. And trans fats are less expensive than many alternatives.

But, as the Institute of Medicine says, “there is no safe level of consumption of artificial trans fat.”

Since the 2006 law that required that food packages list the trans fat content of their products, many manufacturers have either started to or completely phased out trans fats from their merchandise. American consumption of trans fats has decreased dramatically. However, there are plenty of foods that still contain trans fat.

Many manufacturers are still trying to determine how best to replace both the flavor and texture that trans fats give to baked products. They may try to reformulate fats, use a combination of sugars and emulsifiers or increase the use of saturated fats such as coconut oil or palm kernel oil. While saturated fats are not as atherogenic as trans fats, most health organizations still consider them unhealthy fats. This makes it as important as ever for people to continue to read food labels.

The demise of trans fat isn’t going to happen right away- the FDA is holding a 60-day review/commentary period, and there will have to be time allocated for food manufacturers to retool their products, but when the law does goes into effect, our patients and all people with diabetes in the United States can feel a little bit better about what they put into their mouths. Indeed the entire population of the USA will be better off.

In the meantime, people with and without diabetes should continue to check food labels for the presence of trans fat. Since manufacturers are allowed to label anything under .5 g as 0, it is also important to check the ingredient list for partially hydrogenated fat. And see the tips below from the Harvard School of Public Health.

Tips for Lowering Trans Fat Intake

• Choose liquid vegetable oils, or choose a soft tub margarine that contains little or no trans fats.
• Avoid eating commercially prepared baked foods (cookies, pies, donuts, etc.), snack foods, and processed foods, including fast foods. To be on the safe side, assume that all such products contain trans fats unless they are labeled otherwise.
• When foods containing partially hydrogenated oils can’t be avoided, choose products that list the partially hydrogenated oils near the end of the ingredient list.
• To avoid trans fats in restaurants, one strategy is to avoid deep-fried foods (since many restaurants still use partially hydrogenated oils in their fryers) and desserts. You may be able to help change these cooking practices by asking your server, the chef, or manager if the establishment uses only trans-free oils and foods.

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