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Death by Trans Fats? Not Quite (Testimony Before New York City Council 10/30/06)
By Elizabeth M. Whelan, Sc.D., M.P.H.
I oppose the New York City proposal to ban trans fats (TFAs) in local restaurants because it will not make New Yorkers healthier. Indeed, such a move may actually contribute to the toll of premature death by diverting our attention from the real causes of heart disease. My organization is releasing a full report on trans fats and health today. You can find it at: http://acsh.org/publications/pubID.1415/pub_detail.asp
High levels of dietary trans fats, derived primarily from partially hydrogenated vegetable oils, can raise levels of LDL, the so-called "bad cholesterol." But TFAs are only one of several dietary factors that affect blood lipids, and, more importantly, serum cholesterol is only one of several factors that may influence the risk of heart disease. Cigarette smoking and high blood pressure, as well as diabetes and obesity, contribute far more to heart disease than any specific dietary factor.
Any practicing physician who has treated patients with elevated cholesterol levels will tell you that even the strictest low-fat diets often result only in modest cholesterol reduction. So how could we expect significant effects on LDL cholesterol from banishing levels of just one type of fat -- one that represents only 2% of our total daily calorie intake, and which does not contribute more calories than other types of fat? Those individuals with unhealthy lipid levels should choose polyunsaturated or monounsaturated fats. It's saturated fats, not trans fats, which they should be concerned about -- because they represent over 10%, maybe l5% of calories. And those individuals need to discuss with their physicians the option of cholesterol-lowering drugs.
Given the scientific facts, why is there such an uproar -- one with regulatory teeth -- about TFA?
First, in recent years, public health authorities have increasingly turned to regulation to combat chronic disease in a fashion similar to using regulation in fighting infectious disease -- such as requiring water chlorination and inoculations. An example is the City Health Department's decision in January to make diabetes a reportable disease -- in the same way that sexually transmitted diseases are reportable. The problem is that government intervention for chronic diseases, which are primarily linked to lifestyle factors, is intrusive and simply will not work. By calling for a ban on TFAs on City menus, the public health establishment is responding as if TFAs were an imminent health threat -- like E. coli in spinach -- which they are not.
Second, as the hyperbole about TFAs has escalated -- with a New York Times columnist recently opining that TFAs in Girl Scout cookies have killed more Americans than Al Qaeda -- physicians and scientists have largely remained mute on the topic. Silence is interpreted as agreement -- and the momentum for bans builds.
Third, the food industry has turned the fear of TFAs into a brilliant marketing strategy -- trumpeting the "No Trans Fats" claim on labels. Unsuspecting customers will conclude the products are healthier -- and maybe even think they are lower in calories -- when in fact there are no health benefits. All fats, saturated or not, contain nine calories per gram. There are no caloric savings from replacing TFAs with other fats.
What will replace the allegedly malicious TFAs? In the late 1980s the Ralph Nader-inspired Center for Science in the Public Interest fomented a frenzy about the beef tallow that fast food restaurants used to fry potatoes because it contains cholesterol-raising saturated fats -- and demanded that they stop it. And what did CSPI recommend to take its place? Partially hydrogenated vegetable oils with TFAs. Now the wheel has turned and CSPI is outraged over trans fats.
We have lost perspective on the important threats to New Yorkers' health: smoking, obesity, excessive alcohol use, and more. And if we ban trans fats, we move one step closer to endorsing the principle that government should determine what we eat and how we should live -- even when the data and expected benefits are skimpy.
Dr. Elizabeth M. Whelan is president of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
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