Food Policy 33 (2008) 497–503 Contents lists available at ScienceDirect Food Policy journal homepage: www.elsevier.com/locate/foodpol Getting rid of trans fats in the US diet: Policies, incentives and progress Laurian J. Unnevehr *, Evelina Jagmanaite 326 Mumford Hall, 1301 West Gregory Drive, Urbana, IL 61802, United States article info abstract Article history: Artificial trans fats in foods increase chronic disease risk in the US population. Federal nutrition label reg- Accepted 14 May 2008 ulation enacted in 2003 requires mandatory disclosure of trans fat content on packaged foods. This action created incentives for the food industry to reduce trans fats both in response to consumer demand and through competition to maintain product reputation. Subsequent public actions include a ban on trans fat Keywords: use in New York city restaurants and lawsuits against food companies, which created further incentives Nutrition labeling to remove trans fats, especially in the food service industry. Industry has reformulated packaged foods Food service and found substitutes for restaurant fry oils and trans fats are disappearing from the US food supply. Mar- Food industry ket response extends throughout the supply chain, and has spurred research to alter oilseed crop char- Trans fats Supply chain acteristics. The widespread and relatively rapid industry response likely has improved the quality of US diets, and demonstrates the potential for policy actions to spur such improvements. Ó 2008 Elsevier Ltd. All rights reserved. Processed foods choices in the US food market display a remark- We begin by providing the background on how this ingredient able variety, which can mask certain underlying similarities in became a health and policy issue. Then we outline the market product content. Widely used ingredients or formulations can have incentives created by three kinds of actions in the public arena, broad based impacts on diet quality, with possible consequences drawing on the economic literature regarding previous policies. for public health. Relative prices and available technologies deter- Next, we consider how these market incentives are playing out mine product formulations, and when changes occur, they can at different points in the food supply chain. This evidence reveals happen without much consumer awareness, especially when sub- the economic constraints to changes in food product composition stitute ingredients do not change flavor or product quality. Indus- and improvements in dietary quality. Finally, we draw lessons try incentives to pursue healthier ingredient formulations are from this case for other efforts and interventions to improve food debatable, although likely on the rise as consumers become more product composition. health-conscious. In some instances, public policy has emerged to mandate ingredient and nutrient disclosure, and less frequently, Background to regulate product content, usually with much debate about industry cost and public health outcomes. Partially hydrogenated oils, especially soybean oils, have been One notable case of an ingredient with public health conse- used in US processed foods for several decades, beginning notably quences is found in the growing use of partially hydrogenated oils with margarine. Partial hydrogenation makes these oils suitable during the last quarter of the twentieth century. Partial hydrogena- substitutes for saturated fats, such as butter, lard, or palm oil, be- tion allowed the substitution of relatively inexpensive soybean oil cause partial hydrogenation provides stability, flavor, and texture for alternatives with higher saturated fat, such as palm oil and lard. similar to saturated fats in many uses. Partial hydrogenation raises But partially hydrogenation also introduced artificial trans fats into the melting temperature of vegetable oils, so that they remain solid the US diet, and these were identified as a public health threat in the or semi-solid at room temperature, and also increases their shelf- 1990s. Beginning with US Food and Drug Administration’s proposed life. Historically, margarine and vegetable shortening products, regulations in 1999, attention to this public health issue has created using partially hydrogenated oils, replaced butter and lard in US incentives for industry to reduce trans fat content in foods. The diets in the 1950s and 1960s. Partially hydrogenated soybean oil reduction of trans fats in the US food supply provides a case study replaced palm oil in many processed food products, such as cookies of the links among policy actions, product composition, and public and crackers, beginning in the 1970s, in part due to a belief that it health. was more healthful than palm oil, which has the highest saturated fat content of any commonly used vegetable oil. Partial hydrogenation creates artificial trans fatty acids (herein- * Corresponding author. Tel.: +1 202 694 5400; fax: +1 202 694 5661. after used interchangeably with trans fats). Low levels of trans E-mail address: [email protected] (L.J. Unnevehr). fatty acids are found in animal products, and thus have always 0306-9192/$ - see front matter Ó 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.foodpol.2008.05.006 498 L.J. Unnevehr, E. Jagmanaite / Food Policy 33 (2008) 497–503 been part of the human diet. However, the level of trans fatty acids amended their petition in 1998. A preliminary rule was issued in introduced through the combination of partial hydrogenation and 1999, which brought forth a large volume of comment. In 2001, the product substitutions in the US diet is not something histori- the newly appointed director of the Office of Management and cally observed. Studies of the potential negative impact of this Budget, John Graham, sent a ‘‘push” letter to the FDA encouraging trans fatty acid intake on heart and circulatory health began them to finalize the regulation because ‘‘OMB believes there may emerging in the 1970s, but they were inconclusive. Scientific opin- be an opportunity here to pursue cost-effective rulemaking that ion regarding the risks associated with trans fats did not coalesce provides significant net benefits to the American people” (OIRA until the 1990s. Research findings associated trans fatty acid intake Prompt Letter, 2001). This type of request from OMB was unprec- with elevated risk of coronary heart disease, through its effects in edented, and brought significant attention to this public health is- worsening the ratio of harmful to beneficial cholesterol and sue (Graham, 2007). increasing systemic inflammation (Mozaffarian et al., 2006). Trans The prompt letter was motivated by the strong evidence of sub- fatty acid intake is also associated with increased risk of type 2 dia- stantial public health benefit. Because Coronary Heart Disease betes. An estimated 30,000 premature deaths per year in the US are (CHD) is associated with so many serious illnesses and premature associated with artificial trans fatty acid intake (Mozaffarian et al., deaths, and because even modest reductions in trans fats are asso- 2006). Replacing trans fatty acids with saturated fat would reduce ciated with reduced risk of CHD, the benefits from the rule were health risks, so that its use in place of saturated fats is not justified estimated to be quite large. For example, reducing trans fat intake on a health basis. by about 0.04% of calories would prevent about 600 heart attacks The scientific consensus is reflected in dietary advice to the US and 200 deaths per year. The final rule estimated benefits of $2 to public from two authoritative sources. The Institute of Medicine of $6 billion per year, or $13 to $27 billion cumulative over 20 years, the National Academy of Sciences recommended in their 2002 Die- from reduced illnesses and premature deaths. These benefits dwarf tary Reference Intake report that trans fatty acids in the diet be as the estimated one-time industry costs of $139 to $275 million for low as possible, as any intake above zero was associated with in- testing, re-labeling, and reformulation (USHHS/USDA, 2003). creased health risk (IOM, 2002). In 2005, the USDA’s Dietary Guide- At issue in the petition, comment, and final rule process was a lines recommended that trans fatty acid intake be less than 1% of debate over how to disclose trans fat content, and how to address total calories (USHHS/USDA, 2005). possible substitution between this ingredient and saturated fat. Sat- These consensus statements were based on clinical studies, but urated fat has been reported on the nutrition label since such labels estimated public health impacts rely on estimates of average trans were mandated in 1993. US diets continue to have too much satu- fatty acid consumption in US diets. Such estimates vary as there rated fat, which is associated with increased risk of both CHD and are no standard data on the amount of vegetable oil that undergoes cancer. As partially hydrogenated oils were developed and used partial hydrogenation (Eckel et al., 2007). Intake estimates have to substitute for saturated fats, the concern was that a move to dis- been made by the USDA and by the Harvard School of Public close trans fat content would lead to the use of more saturated fat. Health, and both agree that the major sources of artificial trans The 1998 CSPI petition asked that sum of saturated and trans fat be fatty acids in US diets are fried fast foods, pastries, margarine, reported on one line, with a breakout regarding the two ingredients and snacks such as cookies, crackers, and chips. Estimates based in a footnote. However, nutrition scientists maintain that trans fats on USDA intake data from the mid-1990s show the average Amer- are more harmful than saturated fat (Mozaffarian et al., 2006). The ican consumes 6.8 g per day of trans fats, of which 1.5 g are natu- expectation was that mandatory disclosure of trans fat content rally occurring trans fats in animal products, and the remaining would provide incentive to reduce trans fats in foods, and that even 5.3 g are from artificial sources (USHHS/FDA, 2003).