Trans Fat Ban Research Articles

Food Manufacturers’ Compliance With the FDA’s Trans Fat Ban: Evidence From Scanner Data

Food Manufacturers’ Compliance With the FDA’s Trans Fat Ban: Evidence From Scanner Data

Best Investments in Chronic, Noncommunicable Disease Prevention and Control in Low- and Lower–Middle-Income Countries

AbstractThe world remains off-track for the sustainable development goal (SDG) target 3.4, which calls for a one-third reduction in noncommunicable diseases (NCDs) mortality by 2030. This paper presents benefit–cost analyses of various NCD interventions in low-income (LICs) and lower–middle-income (LMCs) countries. We looked at 30 interventions recommended by the Disease Control Priorities Project, including six intersectoral policies (e.g., taxes) and 24 clinical services. We used a previously published model to estimate intervention costs and benefits through 2030, discounted at 8%. We focused on interventions with benefit–cost ratios (BCRs) > 15 and their contribution toward achieving the SDG target. We found that intersectoral policies often provided great value for money, with BCRs ranging from 40 (trans-fat bans) to 100 (tobacco excise taxes). However, seven clinical interventions (e.g., basic treatment of cardiovascular disease or breast cancer) also had BCRs > 15. The overall population impact of clinical interventions over the 2023–2030 period would be much higher than that of the intersectoral policies, which can take many years to reach their peak effects. Fully implementing the best-investment interventions would accelerate progress toward SDG 3.4 everywhere, but only one in 10 countries would achieve the target. This strategy would require an additional US$ 2.4 billion annually across all LICs and LMCs. We conclude that there are several cost-beneficial opportunities to tackle NCDs in LICs and LMCs. In countries with very limited resources, the best-investment interventions could begin to address the major NCD risk factors and build greater health system capacity, with benefits continuing to accrue beyond 2030.

Does a ban on trans fats improve public health: synthetic control evidence from Denmark

We examine the impact of the trans fat ban on a variety of public health outcomes. To this end, we consider a de facto trans fat ban that was introduced by Denmark in 2001. Using the synthetic control method, parallel trends between Denmark and countries in a control group in the years prior to the ban are used to construct a “synthetic Denmark” without any such trans fat ban. Our synthetic control estimates suggest the ban led to substantial improvements in public health. Following the ban, cardiovascular mortality dropped considerably, while the trends of adolescent and child obesity came to a halt and decreased significantly compared to the synthetic control group. Our findings provide new insights into the benefits for public health arising from the banning of trans fats.

Does the ban on trans-fats improve public health? In search of the optimal policy response

This paper examines the contribution of the regulatory ban on trans-fats and voluntary trans-fat regulation to public health outcomes for a sample of 39 countries in the period 1990–2015. To this end, we exploit within-country variation in trans-fat legislation to estimate the impact of the trans fat ban on cardiovascular mortality and obesity rates. Our difference-in-difference estimates indicate modest and beneficial effects of the trans-fats ban in reducing cardiovascular mortality and obesity rate. We find that the ban on trans fats tends to decrease the mortality rate attributed to cardiovascular diseases while the effects on the obesity rates are significant, especially among children and adolescent age group. By contrast, voluntary regulation of trans fats and demand-driven regulatory strategies are generally not associated with a marked drop in the obesity rate. By controlling for country-specific time trends, we show that the estimated mortality- and obesity-related impact of the ban is not driven by pre-existing trends, and does not affect non-cardiovascular mortality rate.

Retooling American Foodralism

Food policy action on the state and local levels is necessary and important for at least two reasons. First, the complexity and breadth of our nation’s food system requires layered policy and regulation; the system’s functioning needs both national uniformity and local distinctions. Second, there are crucial gaps in national regulation that provide rich opportunities for state and local action. These gaps, in areas such as the regulation of antibiotics in animal feed and the oversight of food additives, are not priorities of the federal agencies that oversee food. Although the Food and Drug Administration (FDA) has made nutrition policy a priority for 2018, the current administration’s explicitly articulated anti-regulatory agenda makes it unlikely that these previously underprioritized areas will be addressed. State and local food policy action allows regional difference, but also has the potential to spark national change. For example, at least eight localities have enacted controversial sugary drink taxes as a means of addressing the obesity crisis, a strategy that has not been embraced nationally, while initiatives such as New York City’s trans fat ban and menu labeling regulations have been adopted as national policy. Subnational action, however, can also cause friction; state and local laws may interfere with federal authority and national regulatory uniformity, or with the methods by which other states or localities wish to regulate food. In this Essay, we provide a brief overview of the food regulatory system in the United States and then describe several areas where states currently have the opportunity to take action to fill federal gaps. We conclude by arguing for an approach that involves a retooling of American foodralism to embrace a complementary regulatory relationship between the federal and state governments that respects the need for uniformity, but properly allows states and localities to more actively participate and regulate in the interests of their citizens for the benefit of the public health, safety, and welfare. In this “dynamic federalism,” the states can experiment and function as the laboratories of democracy. This is not only in keeping with our country’s historic notions of federalism, but is practically necessary given current gaps in federal oversight.

The Impact of Policies to Reduce trans Fat Consumption: A Systematic Review of the Evidence

BackgroundThe consumption of industrially produced trans fatty acids (TFAs) has been associated with an increased risk of heart disease. In recognition of this, countries, states, and cities worldwide have implemented TFA policies aimed at reducing their availability in the food supply. ObjectiveThis article aims to provide an update of the evidence of the effectiveness of policies aimed at reducing TFAs in the food supply. MethodsA systematic review of the literature from 2013 onward was conducted, building on a previously published review that examined the evidence of the impact of TFA policies worldwide from 2000 to 2012. Studies that were 1) empirical, 2) examined a TFA policy, and 3) examined the effect of the policy on TFA amounts and availability pre– and post–policy intervention were included. Modeling studies examining the impact of TFA policies on cardiovascular, equity, and economic outcomes were also included. ResultsA total of 18 articles from the updated search were combined with 14 articles from the previous review (total = 32 articles). All types of TFA policies led to their reduction; however, trans fat bans had a larger impact (TFAs virtually eliminated) than did voluntary (range: 20–38% reduction in TFA intakes) or labeling (range: 30–74% reduction in TFA intakes, plasma serum, or breast-milk concentrations) approaches to reducing TFA amounts in the food supply. Product reformulation to reduce TFAs had variable effects on saturated fatty acid (SFA) contents in these foods; however, the combined amount of TFAs and SFAs declined in most products. Overall, the modeling studies indicated that TFA bans would reduce heart disease risk, benefit socioeconomically disadvantaged populations the most, and be cost-saving. ConclusionsPolicies aimed at reducing TFAs in the food supply are effective and will likely reduce the burden of diet-related disease, particularly among the most vulnerable socioeconomic groups. Although all policy approaches lead to reductions in TFAs in foods, TFA bans are likely the most effective, economical, and equitable policy approach to reducing TFAs in the food supply.

Trans fat and cardiovascular disease mortality: Evidence from bans in restaurants in New York

This paper analyzes the impact of trans fat bans on cardiovascular disease (CVD) mortality rates. Several New York State jurisdictions have restricted the use of ingredients containing artificial trans fat in food service establishments. The resulting within-county variation over time and the differential timing of the policy's rollout is used in estimation. The results indicate that the policy caused a 4.5% reduction in CVD mortality rates, or 13 fewer CVD deaths per 100,000 persons per year. The averted deaths can be valued at about $3.9 million per 100,000 persons annually.

Deregulation, Distrust, and Democracy: State and Local Action to Ensure Equitable Access to Healthy, Sustainably Produced Food.

Environmental, public health, alternative food, and food justice advocates are working together to achieve incremental agricultural subsidy and nutrition assistance reforms that increase access to fresh fruits and vegetables. When it comes to targeting food and beverage products for increased regulation and decreased consumption, however, the priorities of various food reform movements diverge. This article argues that foundational legal issues, including preemption of state and local authority to protect the public's health and welfare, increasing First Amendment protection for commercial speech, and eroding judicial deference to legislative policy judgments, present a more promising avenue for collaboration across movements than discrete food reform priorities around issues like sugary drinks, genetic modification, or organics. Using the Vermont Genetically Modified Organism (GMO) Labeling Act litigation, the Kauai GMO Cultivation Ordinance litigation, the New York City Sugary Drinks Portion Rule litigation, and the Cleveland Trans Fat Ban litigation as case studies, I discuss the foundational legal challenges faced by diverse food reformers, even when their discrete reform priorities diverge. I also 'explore the broader implications of cooperation among groups that respond differently to the "irrationalities" (from the public health perspective) or "values" (from the environmental and alternative food perspective) that permeate public risk perception for democratic governance in the face of scientific uncertainty.

Reversing food desertification: examining urban farming in Louisville, Chicago and Detroit

The Urban Farming Movement is relatively young in Louisville, Kentucky but it seems to be off to a good start. Being in its earliest stages, assessments of this effort must be made cautiously, even tentatively. Examining a movement that is in progress requires a study of the state's land use and segregation policies, both of which have been dynamic in Kentucky. Further, this study is also relevant as there is a growing convergence of national and regional attitudes towards American obesity, while there are competing notions of food preference and food choice. All of which are influenced by racial politics, and there is a deep concern regarding food security. Considering all of these, it is necessary to examine the Government's efforts to address obesity/food imbalance in a variety of settings, especially where urban farming is expanding, such as Chicago and Detroit. In New York, roof-top gardens dot the landscape and the urban farm movement is largely a “success”. So, city leaders have chosen to address another health issue – trans fat. Rather than joining the food choice/preference debate by banning fast-food restaurants, city leaders have chosen to enact a trans-fat ban. Unpopular at first, other cities and states have followed, and the Federal Government will mandate a trans-fat ban this year. In Louisville, Chicago and Detroit, where the trans-fat bans did not succeed, the urban farm movement may be the primary means of addressing malnutrition, in the form of obesity.

First Time Compliance Inspections to Evaluate an Artificial Trans Fat Ban in Nassau County

BackgroundIn 2007, Nassau County, New York, restricted the use of artificial trans fats in food establishments licensed by the Nassau County Department of Health (NCDH). The regulation took effect April 1, 2008. ObjectiveThis study assesses first-time inspection compliance rates with the trans fat ban and examines barriers to enforcement. MethodsA sample of food service establishments was inspected by an NCDH employee for labels documenting trans fat. Surveys that examined operator awareness and attitudes toward the ban were administered. A separate survey was conducted among the NCDH Office of Food Protection public health sanitarians to determine organizational barriers to enforcement. All inspections and surveys were conducted in Nassau County from June to September 2010. ResultsA total of 360 food service establishments were randomly selected for inspection; 328 completed the operator surveys. Compliance was 81%, even though 52% of operators were not aware of the ban. Of those who were aware, 57% heard about the regulation from the media, and almost all (92%) reported that compliance with the ban was easy. Of noncompliant respondents, 59% cited lack of knowledge regarding the ban as the primary reason for noncompliance. Of those who indicated they had received any customer feedback (9%), almost all reported the feedback to be positive. Knowledge of trans fats was not associated with compliance, but owners who were aware of the ban were more likely to be in compliance. Among the 23 participating sanitarians, 96% believed the ban was effective; language barriers were cited as the primary obstacle to enforcement. ConclusionsAs assessed through surveys and inspections, the trans fat ban in Nassau County yielded relatively high compliance rates within 2 years and was accepted by sanitarians, establishment operators, and consumers.

The Future of Fat

The Future of Fat Anna E. Ward (bio) Fat Shame: Stigma and the Fat Body in American Culture. By Amy Erdman Farrell. New York: New York University Press, 2011. 219 pages. $75.00 (cloth). $22.00 (paper). The Fat Studies Reader. Edited by Esther Rothblum and Sondra Solovay. New York: New York University Press, 2009. 396 pages. $85.00 (cloth). $27.00 (paper). Seeking the Straight and Narrow: Weight Loss and Sexual Reorientation in Evangelical America. By Lynne Gerber. Chicago: University of Chicago Press, 2011. 296 pages. $97.00 (cloth). $29.00 (paper). What’s Wrong with Fat? By Abigail C. Saguy. New York: Oxford University Press, 2013. 272 pages. $29.95 (cloth). Of all of the topics I teach, including a range of controversial issues within gender and sexuality studies, fat studies is, by far, the topic that generates the most discomfort among my otherwise open-minded students. There is a general unwillingness to hear perspectives that contradict what they think they already know about fat and a disregard for sound research that points in different directions than common wisdom. I suppose their response is not surprising given that they have come of age in the era of “the obesity epidemic.” Is it any wonder that US college students would have a hard time taking in information that disputes what has become strangely defining of US citizenship itself? With book titles like Greg Critser’s Fat Land: How Americans Became the Fattest People in the World, countless headlines in newspapers and magazines proclaiming the United States’ dire obesity problem, including the Atlantic’s May 2010 cover featuring a fat Statue of Liberty emblazoned with the text “Fat Nation,” and a 2003 symposium at the University of California at Berkeley titled “The Politics of Obesity: A National Eating Disorder,” it is clear that fat—or fat panic—has become thoroughly nationalized. Fat panic has also found tremendous resonance with policymakers and politicians of all stripes. [End Page 937] Recent legislation targeting the so-called obesity epidemic includes Mayor Michael Bloomberg’s attempt to ban the sale of large sugary beverages in New York City, trans-fat bans, increased regulation of school lunch programs, and the use of zoning ordinances to regulate fast-food establishments. In 2010 First Lady Michelle Obama launched the Let’s Move! campaign aimed at “solving the challenge of childhood obesity within a generation” and declaring that the “physical and emotional health of an entire generation and the economic health and security of our nation is at stake.”1 In a recent HBO documentary series, The Weight of the Nation (2012), public health researchers repeatedly nationalize weight; one expert contends, “It’s not only health, it’s about the survival and well-being of the United States as a nation,” while another claims, “Obesity will crush the United States in oblivion.” American studies would be remiss not to carefully track the phenomenon of “the obesity epidemic” and responses to it. As Marilyn Wann contends in her foreword to The Fat Studies Reader, “Whenever members of a society have recourse to only one opinion on a basic human experience, that is precisely the discourse and the experience that should attract intellectual curiosity” (x). Fat studies, borne from grassroots activism, online communities, and scholarship from both inside and outside the parameters of traditional publishing, offers analyses that begin with the premise that fat is one element of human variation. Unlike terms such as overweight or obese that inherently imply abnormality, fat is embraced by the field as a word that should function as a descriptor, rather than as a term of derision. The field of fat studies faces tremendous resistance, the kind of resistance backed by entrenched ideologies reinforced by stakeholders with a lot to lose. While fat studies should hold on tightly to its roots in activism and the widely accessible domain of online communities, it also needs researchers with access, resources, and training in various academic and professional disciplines. The four texts under review continue to advance the field in this direction. The publication of The Fat Studies Reader marks an important moment in the evolution of fat studies as a field. Edited by Esther Rothblum and...

OP16 Utilising a Novel Framework to Assess Public Health Nutrition Actions Across 30 European Countries (EuroHeart II Project)

BackgroundEuroHeart II is a European programme designed to inform cardiovascular health strategies across Europe. Our project examines the role of food policies in cardiovascular disease prevention, including the development and...

Changes in Trans Fatty Acid Content

Letters4 December 2012Changes in Trans Fatty Acid ContentPaul R. Marantz, MD, MPHPaul R. Marantz, MD, MPHFrom Albert Einstein College of Medicine, Bronx, NY 10461.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-11-201212040-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article by Angell and colleagues (1) seeks to explore the effect of New York City's trans fat ban. This kind of analysis of empirical evidence is critically important, and infrequently or seldom conducted, to evaluate the net outcomes of well-meaning public health policy, and the authors (and the New York City Department of Health and Mental Hygiene) should be credited for doing this important work. The study's main finding, that trans fat intake declined after the trans fat ban, is statistically significant but unsurprising: Indeed, if this were not found, it would indicate that the ban ...

New York City Trans Fat Ban: Improving the Default Option When Purchasing Foods Prepared Outside of the Home

Editorials17 July 2012New York City Trans Fat Ban: Improving the Default Option When Purchasing Foods Prepared Outside of the HomeAlice H. Lichtenstein, DScAlice H. Lichtenstein, DScFrom Tufts University, Boston, MA 02111.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-2-201207170-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The adverse effects of trans fatty acid (trans fat) on cardiovascular health have been known for at least 2 decades (1). During that time, both the Dietary Guidelines for Americans (2) and the Institute of Medicine's Dietary Reference Intake guidelines (3) have recommended restricting trans fat intake to the extent possible. To facilitate adherence to this guidance, the U.S. Food and Drug Administration mandated in 2003 that trans fat content be listed on the Nutrient Facts panel of packaged foods by 2006 (4). This ruling enabled consumers to make purchasing decisions based on the information provided, and it incentivized food ...

Competing Frames for a Public Health Issue and Their Effects on Public Opinion

This study examines the effects of goal framing on opinion about a public health issue. A content analysis of newspaper coverage regarding a New York City trans fat ban identified four frames, each of which invoked a policy goal (promoting public health or protecting business). An experiment tested the effects of goal framing on support for banning trans fat, as well as the effects of competition between frames invoking the same goal and competition between frames invoking different goals. The findings suggest that goal framing can shape opinion about public health issues but that competitive framing can undermine these effects.

Lipids, Liberty, and the Integrity of Free Actions

In many ways, I agree with one of the major themes in David Resnik's article “Trans Fat Bans and Human Freedom” (2010). The article is founded on a major challenge to the concept of “public health....

Response to Open Peer Commentaries on “Trans Fat Bans and Human Freedom”

Click to increase image sizeClick to decrease image size Acknowledgments This article is not subject to US copyright law. This research was supported by the intramural program of the National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH). The views expressed in this article are solely the views of the author. They do not represent the opinions of the NIEHS, NIH, or the U.S. government. I am grateful to Chris Portier and Bill Schrader for helpful comments.

Trans Fat Bans and Human Freedom

A growing body of evidence has linked consumption of trans fatty acids to cardiovascular disease. To promote public health, numerous state and local governments in the United States have banned the use of artificial trans fats in restaurant foods, and additional bans may follow. Although these policies may have a positive impact on human health, they open the door to excessive government control over food, which could restrict dietary choices, interfere with cultural, ethnic, and religious traditions, and exacerbate socioeconomic inequalities. These slippery slope concerns cannot be dismissed as far-fetched, because the social and political pressures are place to induce additional food regulations. To protect human freedom and other values, policies that significantly restrict food choices, such as bans on types of food, should be adopted only when they are supported by substantial scientific evidence, and when policies that impose fewer restrictions on freedom, such as educational campaigns and product labeling, are likely to be ineffective.

Trans Fat Bans and the Dynamic of Public Health Regulation

Trans Fat Bans and the Dynamic of Public Health Regulation

Cut the Fat! Defending Trans Fats Bans

Is banning trans fat a bad policy? Resnik (2010) offers two general reasons for thinking so: first, because trans fat bans could lead to the government's placing other objectionable restrictions up...