TCS Daily


Dietary Demons

By Elizabeth M. Whelan - July 25, 2003 12:00 AM

When the FDA announced its ruling last month requiring food labels to specify the amount of trans fatty acids (TFAs) present in products, media coverage was prodigious, completely one-sided, and lacking in any scientific perspective.

 

The take-home message was simple (and false): TFAs are a major cause of heart disease, and consumers need information so they can avoid consuming them. Journalists, as well as the government officials and self-appointed consumer advocates they interviewed, warned us that this "stealth fat" was an "artery-clogger" that "lurked" in our food. It would be understandable if most Americans concluded that trans fats are poisons, a major cause of death in the U.S., something used by the greedy food industry only to boost profits. From news coverage, you'd think hundreds of thousands of lives would be saved by labeling TFAs and that there would be no consumer-unfriendly consequences to eliminating them from our food.

 

Incredibly, in all the media coverage I reviewed, no scientists stepped forward with a serving of reality about the alleged relationship between trans fats and mortality. Let me try to remedy this one-sided view by offering another perspective.

 

First, coronary heart disease is the leading cause of death in the United States, killing over 500,000 of us annually. While a substantial portion of these deaths occur among the elderly, many other deaths are premature and could be prevented (in the sense that they could be postponed) through appropriate medical and lifestyle interventions.

 

Second, the top three preventable causes of heart disease -- about equal in their impact -- are cigarette smoking, high blood pressure (hypertension), and elevated blood cholesterol. (The other important risk factors, such as age and gender, are not modifiable.) No one is arguing that trans fats affect the first two risk factors, smoking and high blood pressure. But what role do TFAs play in raising blood cholesterol?

 

As is the case with saturated fats, trans fats can raise blood cholesterol (and adversely affect the subsets of "good" and "bad" cholesterol). But dietary factors comprise just one of the elements--possibly a minor one for many people--responsible for unhealthy cholesterol profiles. Other factors, including genetics, may be more important--and medication, not diet, is frequently the most effective solution for reducing cholesterol levels and preventing coronary heart disease. Indeed, while high blood cholesterol levels (and low levels of "the good cholesterol," HDL) are established risk factors for coronary heart disease, the role of specific dietary factors such as TFAs is much less clear. 

 

Third, when consumers hear trans fats hyped as a "cause" of heart disease, they are deprived of the broader picture and may overlook the far greater risks of smoking and high blood pressure. Worse, they may conclude that, as long as they count their trans fats, it's not as important to monitor the rest of their diet. Consumers chasing down trans fat data may take their eye off the real target in dietary risks for disease: obesity. We should focus primarily on calories--both the amount we eat and the amount we burn in exercise.

 

Fourth, the food industry uses trans fats for a reason. These substances are formed during the process of hydrogenation, which converts unsaturated liquid fat into solid ones. Among other things, the resulting trans fats prolong shelf life because hydrogenated fats are not as susceptible to oxidation as unhydrogenated ones. Thus the trans fat-containing oils are slower to lose their flavor and are more useful for frying foods. Since hydrogenation has a useful function, consumers will pay a price--in dollars and in food quality--if fewer trans fats are used. Each additional attempt to reformulate food or add another label to existing food in response to government mandates or public fears increases food production costs. That contributes to raising the price of food--an economic reality that hits low income Americans hardest, since they spend a greater portion of their disposable income on food.

 

What are we to get in return for the higher costs (and, presumably, more limited food choices) that will come with the labeling and phasing out of trans fats? The government estimates that perhaps 250 to 500 coronary heart disease deaths (out of the total 500,000 that occur annually in the U.S.) will be prevented.  But those numbers are purely hypothetical: The real number of lives saved might be zero.

 

Public health scientists who know the facts should find the media's out-of-proportion characterization of trans fats as a heart health risk very troubling -- and indeed these very scientists should place a good part of the blame on themselves. While it would be easier to blame the media for serving up a half-baked story on trans fats and health, the reality is that few, if any, knowledgeable scientists who had a grasp of the broader public health issues ever made an attempt to step forward and challenge the demonization of trans fats.

 

Dr. Elizabeth M. Whelan is President of the American Council on Science and Health.

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