Trans fatty acids and coronary heart disease
BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7561.214 (Published 27 July 2006) Cite this as: BMJ 2006;333:214All rapid responses
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I think I shall take the advice of Peter Gotzsche, on page 233 of the
last issue of the BMJ, and discount the recommendation on page 214 to shun
trans fatty acids. The increased risk imputed to the latter is only 1.23
(CL 1.11 to 1.37), which doesn’t reach the size (3) required to impress
“experienced epidemiologists.”
Perhaps the editor should tell us when inconsistent advice is given- at
least, when present in the same issue!
Competing interests:
None declared
Competing interests: No competing interests
tfX (the UK campaign against trans fats in food) welcomes the
excellent article by Robert Clarke and Sarah Lewington, "Trans fatty acids
and coronary heart disease".
We agree with the call to label trans fats in nutrition panels on
packaged food. Astonishingly, the current European Directive on nutrition
labelling makes this illegal, unless accompanied by a claim regarding
trans fats.
However the labelling of trans fats is not a sufficient response, for
two main reasons:
1. There are many people who do not read food labels, understand
nutritional information or act on the information provided. By and large,
these are the people who are eating the highest levels of trans fat, as
more health-aware people are already avoiding products containing
hydrogenated oil. Trans fat labelling would be of no help to those who
ignore nutritional information, or their children, except by the indirect
route by which the compulsory labelling of trans fat will encourage
manufacturers to reduce levels generally.
2. Most of the trans fat many people eat is not in packaged food at
all, but in unpackaged baked goods, pub and restaurant food, and take-away
/ fast food. These unpackaged foods are not subject to any labelling
requirement and as such will be unaffected by a labelling regulation.
For these reasons the only truly effective solution is to impose
legal limits on trans fat, following the example of Denmark which imposed
such limits in 2003, and now Canada which has indicated its intention to
impose similar legislation.
To look at the Danish example, the food industry has been able to
comply with the regulation (Executive Order No. 160 of 11 March 2003)
which limits industrial trans fat to 2 percent of the fat and oil content
of food, with no apparent inconvenience to consumers or increase in the
price of food. There is no obvious reason why the UK should not do the
same, and realise considerable improvements in public health at little or
no cost to anyone.
Sincerely,
Oliver Tickell, tfX
The UK campaign against trans fats in food
Competing interests:
None declared
Competing interests: No competing interests
Re: Health warnings need statistical warnings
You may be surprised to get a response from just an 'ordinary mum'. I
work as a Primary School secretary and have two grown up children. I think
it is important that readers of the BMJ should know that 'Joe public' are
very grateful that they are now better informed and are able to make
educated choices about the foods we should or should not eat to be
healthy. This is thanks to the extensive research and papers being written
by the medical profession, most recently:-Robert Clarke and Sarah
Lewington July 06, David Spurgeon April 06.
Due to this most essential research over recent years there has now
been enough statistics given to the Food Standards Agency and the
Department of Health for them to make recommendations to the food
industry. At last it is noticeable on the supermarket shelves that the
nutritional value of our foods are being labelled clearly. Also notable
reductions in the use of potentially harmful chemicals, fats, sugars ans
salts in their products.
I have just received a very pleasing response from Waitrose saying
that they have have been eliminating Hydrogenated Vegetable Oils from a
variety of products since 2004, and reduce salt and sodium. They are
making rapid progress in this area to reflect their commitment to
improving the nutritional profile of its products. This follows
recommendations from the D of H and the FSA following the announcement
outlining the dangers of trans-fats and HVO's published in the BMJ. Also
they assure me that Waitrose feel strongly about clear food labeling.
(Once again this follows a study in the BMJ by researchers at the Uni of
Oxford). They gave me a very encouraging quote from the Waitrose
nutritionist, Moira Howie:- "At Waitrose we constantly aim to provide our
customers with a nutritionally sound choice of quality foods. Our
commitment to clearer labeling means that we list hydrogenated vegetable
oil in the ingredients panel. Our work in the removal of HVO's from our
products also means that the need to label trans-fats in a nutritional
panel will soon be completely redundant".
My husband had a heart attack a few years ago which has made me very
aware of trans fats and HVO's. I didn't know about these things a few
years ago so when media coverage brought this to my attention I was
absolutely appalled that we have, and still eat, this harmful fat hidden
in thousands of products. I and millions of other concerned 'ordinary
people' are now able to make an informed choice and I want to thank the
many doctors and nutritionist who have done extensive research on this
subject. I keep myself as informed as I possibly can to make the right
choices and listen to, and read media reports on the subject. I also want
to thank the BMJ for publishing these reports which have informed the
medical profession, the public, the D of H and the FSA, and last but not
least, the many food manufactures who, like Waitrose, are choosing to
abide by the recommendations and clearly label nutritional values, and
either reduce to safe levels, or not use potentially harmful substances.
Nobody would choose to eat harmful chemicals often used as
colourants, flavour enhancers and preservatives or too much sugar, salt,
and artery clogging saturated and trans-fats. Their links to cancers,
intestinal problems and heart problems are now proven. They should never
have been allowed to be used in our food manufacturing in the first place.
My response isn't your usual repose full of medical jargon and
statistics. Just a very simple 'thank you' from a grateful mum!
Competing interests:
None declared
Competing interests: No competing interests