Some 28 WHO member states, representing 31 percent of the global population, have moved to restrict or ban the use of health-harmful industrial trans fats (TFAs) in food products – but that leaves two-thirds of the world’s population still exposed to risks from TFAs that kill approximately half a million people a year.

This data from a new WHO Report on Global Trans Fat Elimination, released yesterday, tracks progress on the global plan to eliminate industrially produced trans fats from the food supply by 2023. The report is the first scorecard since WHO launched the REPLACE initiative in May 2018  – providing countries with a detailed roadmap for replacing TFAs with healthier alternatives, such as polyunsaturated fats (PUFAs).

The new WHO report showed that since 2018, six countries have already restricted industrially produced trans fat, and another 24 countries, along with the European Union, recently adopted trans fat regulations that will come into effect over the next two years. Yet, more than 110 countries still have no regulations against this harmful compound, meaning five billion people are at risk for industrially produced trans fat exposure in the foods that they eat every day, according to the report.

The report was released yesterday at a side event on Nutrition Policy Action to Save Lives, held on the margins of the World Health Assembly; the event was co-sponsored by the global health non-profit Vital Strategies and a spinoff initiative, Resolve to Safe Lives.

“NCDs are the leading problems of our day and we are looking for areas where there can be wins,” said Tom Frieden, President and CEO of Resolve to Save Lives. Frieden, former head of the United States Centers for Disease Control, as well as a past New York City Health Commissioner, noted that after New York City moved to eliminate industrial trans fats in 2006, there was a 4.5 percent decrease in cardiovascular deaths.

“This is part of a broader effort to show that we can make a difference,” Frieden said, referring to other policy-related measures now being considered by countries and regions that can potentially increase healthy food consumption and reduce consumption of unhealthy foods, including sugar-sweetened beverages, excess sodium and added sugar. “This initiative would eliminate a risk to 17 million people who would otherwise be killed by this toxic chemical product over the next 30 years,” he said. “I won’t say it is easy to do,… you can complain you cannot do anything, but you can do something here.”

While most progress on trans fat elimination has been fastest in high-income countries, Frieden said there were “huge increases” in momentum over the past year in some emerging economies as well. This has included the publication of draft rules or regulations by India, Thailand and Turkey.

While some trans fats exist naturally at low levels in the meat and dairy products of beef, lamb and other ruminants, most of those in the food supply today are artificially produced during the manufacture of partially hydrogenated oils for margarine or similar products. Originally thought to be healthier than saturated fats, it was later demonstrated that partially hydrogenated oils containing trans fats can be even more dangerous to cardiovascular health.

Beyond trans fat elimination, the other challenge for national policy makers and regulatory authorities is to replace TFAs with healthier polyunsaturated alternatives, such as sunflower, safflower and olive oils. In contrast, some widely used replacements, such as palm oil, are both bad for health because they are high in saturated fats, as well as being bad for the environment, said Shauna Downs, Assistant Professor of Urban-Global Public Health at Rutgers University, another panelist at the side event. The massive planting of palm oil plantations to produce palm oil for human consumption as well as products for animal feed has been blamed for fueling the destruction of natural forests and their replacement with palm oil plantations, particularly in South-East Asia.

Eliminating trans fats and replacing them with healthier alternatives is a complicated process for countries, Downs said, because it not only involves changes in manufacturing processes, but in securing local production of healthier oils, when agricultural and trade conditions may not be so favorable. If oils are imported, she said, then taxes and tariffs need to be examined to ensure that they do not favor the import of unhealthy products or discourage the import of healthier alternatives such as polyunsaturated fats, she noted.

In another step forward, the International Food and Beverage Alliance, a major food manufacturers’ association, committed to phase out trans fats by 2023, noted WHO Director-General Dr Tedros Adhanom Ghebreyesus. Dr Tedros, who appeared at the side event, met with industry leaders to discuss their commitment in early May, following the IFBA announcement.

The WHO Director-General and other panelists, however, emphasised that to make such commitments meaningful, the real action to eliminate trans fats has to take place at the country level.

“The strategy should really be ownership by each and every country… country by country. This is how you win this fight… get more countries… and fight aggressively. I am on your side,” he said.

Image Credits: WHO, Vital Strategies.