Andrew Lansley argues against trans fat ban

In May 2010 tfX write to Andrew Lansley, the new Health Secretary, to enquire as to the Government's policy on trans fats, and in particular if they would follow the example of Denmark, New York City and other jurisdictions in setting legally binding limits on trans fats in food.

This is the response received in Mr Lansley's letter of 21 June 2010:

"The FSA in 2007 carried out a comprehensive review of the health impacts of trans fats, industry action to reduce artificial trans fats in foods and assessed consumers' dietary intakes. The results of this review demonstrated that voluntary action by the UK food industry had reduced levels of trans fatty acids in fats and oils used in food production to a minimum [1]. The review showed that levels had decreased from around 55% [2] to less than 2%. These benefits are equivalent to those achieved through legislation in Denmark and New York City. [3]

Industry action had reduced people's average dietary intakes to around one per cent of food energy. This is significantly less than the 2 to 4 % estimated by Mozaffarian and Stampfer in the British Medical Journal article cited by your constituent [4]. Moreover, trans fats levels [5] have been reduced to around just half the maximum average intake level recommended by the UK's independent Scientific Advisory Committee on Nutrition. Further assessments of people's intakes of trans fatty acids carried out in 2008/9, as part of the National Diet and Nutrition Survey, have estimated that average intakes account for just 0.8% of food energy. [6]

The low levels of average trans fatty acid intakes by the UK population, which reflect both artificial and naturally occurring trans fatty acid intakes from some meat and dairy products [7], are considered to be within safe levels. [8]

In contrast dietary intakes of saturated fats, which are a contributory factor to coronary heart disease, are around 20% higher than the maximum recommended intakes of 11 per cent food energy. Therefore reducing saturated fat intakes offer a far greater public health benefit [9]. In recent years the FSA has been working to raise consumer awareness of the health implications of consuming too much saturated fat. The food industry has also taken steps to reduce the amount of saturated fats found in our food.

Notes:

1. Wrong - the review refers specifically to the trans isomerisation that occurs during the refining and deodorising of natural vegetable oils, not to trans in hydrogenated oils.
2. Wrong - it referred to a maximum of 55%, with typical levels much lower than 55%.
3. Wrong: there are products on sale in the UK which would be illegal in NYC and Denmark, and people eating these are getting high levels of trans that they would not be attainable there.
4. Wrong - the paper actually refers to peer reviewed research published in 1994 applicable worldwide, so it is not an estimate and does not refer specifially to the UK.
5. They presumably mean average - individuals could be getting a lot more.
6. True, but misleading - the concern is for individuals and groups who could be getting much higher levels of trans, notwithstanding the average figure.
7. Misleading - they are trying to blur the distinction between natural TFAs found in butter etc which in their particular isomeric mix do not generally appear to be harmful to health, and the IPTFAs which are clearly demonstrated to be harmful to health.
8. Wrong - there are no 'safe' levels of IPTFAs as such. The less you eat, the less damage they will do to your health. In particular, there is no such thing as a safe average level of intake, so long as within that average there are individuals and groups eating high levels of trans which are damaging their health.
9. Wrong - gram for gram, IPTFAs are about ten times as bad for cardiovascular health as a typical mix of saturated fatty acids. So even a small reduction in IPTFA intake produces greater benefit than over-concentration on saturated. Moreover the reductions in IPTFAs can be achieved by regulation with no detriment to consumer enjoyment of food, while much of the saturated fat comes in foods we enjoy, like butter, cheese, meat, and eggs, and do not want to give up.

General: Lansley is constantly quoting average intake figures but what mattters, as recently highlighted by NICE, is that specific groups and individuals are exposed to levels of IPTFAs much higher than the average. These IPTFAs come mainly from imported products, and from 'hidden' hydrogenated oil in bakery products, take-aways, restaurants, canteens etc, where there is no labelling requirement for hydrogenated oil. The most effective, efficient way to deal with this problem is to set a maximum level of IPTFAs as a % of the fat content in any foodstuff.

Also see the Daily Mail article of 1 July 2010: They kill 7,000 people a year, but trans fats won't be banned.

What now?

A few important points about this letter:

• Lansley is clearly minded against a ban on trans fats, however he does not actually rule it out. So there is still scope to argue for a policy change.
• Lansley's letter pre-dates, by one day, the publication of the NICE report on Prevention of cardiovascular disease at population level, and does not in any way refer to it. We may therefore assume that it was written in ignorance of NICE's recommendation for legally bindings limits on industrial trans. This creates good cause for him to revisit the issue.
• There is therefore every reason to keep on pushing for a trans fat ban!

Further questions

tfX has now put additional questions to Andrew Lansley and we await his response ...

1. Trans fat levels in the British diet clearly have reduced as a result of voluntary action by the British food industry. However there are still products on the market which are made using partially hydrogenated oils with high levels of Industrially Produced Trans Fatty Acids (IPTFSs). Some culinary ingredients aimed at the catering sector also comprise, in all or part, partially hydrogenated oils, also high in IPTFAs. Furthermore some products are imported into the UK which contain high proportions of partially hydrogenated oils, with high levels of IPTFA. Such products are clearly injurious to health.

The danger here is that while the average level of IPTFA consumption may be greatly reduced, specific individuals and groups may nonetheless be eating high levels of IPTFAs at levels sufficient to damage their health.

The Institute for Health and Clinical Excellence (NICE) has further reported on the topic of trans fats in its 22 June 2010 "Prevention of cardiovascular disease at population level" report. It raises the concern that, followiing the FSA and SACN work reported in 2007, "New concerns have now emerged, particularly in relation to imported products and fried food prepared in some settings. People from disadvantaged groups are likely consume more of these products which, in turn, could be an important contributory factor to health inequalities." It consequently advises that the policy goal should be to "Ensure all groups in the population are protected from the harmful effects of IPTFAs."

Would Mr Lansley please set out what plans he has to protect the health of those groups and individuals, who are eating high levels of IPTFAs.

2. In its report, referred to above, NICE recommends the following measures in pursuit of that policy objective:

1. Eliminate the use of IPTFAs for human consumption.
2. In line with other EU countries (specifically, Denmark and Austria), introduce legislation to ensure that IPTFA levels do not exceed 2% in the fats and oils used in food manufacturing and cooking.
3. Direct the bodies responsible for national surveys to measure and report on consumption of IPTFAs by different population subgroups - rather than only by mean consumption across the population as a whole.
4. Establish guidelines for local authorities to monitor independently IPTFA levels in the restaurant, fast-food and home food trades using existing statutory powers (in relation to trading standards or environmental health).
5. Create and sustain local and national conditions which support a reduction in the amount of IPTFAs in foods, while ensuring levels of saturated fat are not increased. Encourage the use of vegetable oils high in polyunsaturated and monounsaturated fatty acids to replace oils containing IPTFAs. Saturated fats should not be used as an IPTFA substitute.
6. Develop UK-validated guidelines and information for the food service sector and local government on removing IPTFAs from the food preparation process. This will support UK-wide implementation of any legislation produced on IPTFAs.

NICE further goes on to say that, if this advice is implemented resulting in reduced IPTFA intake, "between 4500 and nearly 7000 lives might be saved in England".

Would Mr Lansley please respond to the advice from NICE and explain how he wishes to progress their recommendations.

3. The UK Food Safety Act 1990 section 7 makes it an offence to "render food injurious to health". Would Mr Lansley agree that the provision of food containing a high proportion of IPTFAs may, in fact, already be in breach of the 1990 Act? Will he and his colleagues in Government provide guidance accordingly to local authorities and the Food Standards Agency to bring prosections against producers, importers, distributors and retailers of such foods, with ligh levels of IPTFAs, under the 1990 Act?