Trans fat ban in NYC can improve quality of meals purchased outside the home

By requiring commercial food establishments to replace trans fats with oils and spreads that are low in trans and saturated fats, New York City provides a good template for initiating public health measures to improve the quality of meals purchased outside the home, Tufts University Nutrition Scientist Alice H. Lichtenstein, DSc, writes in an editorial published July 17 in the Annals of Internal Medicine.

"What New York City's trans fat ban has done is force the removal of unhealthy fats from foods that are eaten on a daily basis by many people," says Lichtenstein, the director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging and the Gershoff professor at the Friedman School of Nutrition Science and Policy, both at Tufts University. "Creating a healthier default option is a powerful tool to improve diet quality independent of someone's health literacy, awareness and motivation, or level of nutrition knowledge."

The editorial appears alongside a New York City Department of Health & Mental Hygiene study that compares the trans fat content of fast food purchases before and after the 2007 ban went into effect. The authors report a significant decrease in trans fat content in foods purchased in 2009.

"Importantly, the results were consistent at all restaurants surveyed, regardless of their locations, meaning that patrons at all income levels benefitted -and not just those who could afford to pay for a healthier option," Lichtenstein said. "Prior to the ban, one of the initial concerns was that the replacement of partially hydrogenated oils would drive up food prices and operational costs, but there is no evidence that this has occurred."

The trans fat ban applies to New York City restaurants. It prohibits them from using partially hydrogenated oils and spreads that contain more than 0.5 grams of trans fat.
"Having a default option takes some of the stress of making healthy choices from the consumer, and this strategy could succeed where other population-wide initiatives, such as dietary guidelines or recommendations, have fallen short," Lichtenstein said. "The preliminary findings suggest that New York City's approach is worth pursuing for this and other nutrition interventions."

Lichtenstein underscores that a major contributor to the success of the public health initiative was New York City's carefully planned approach to the ban, which was implemented in two phases and was complimented by a strong education and support component. "New York City went beyond legislating a change. They supported food workers affected by the ban with concrete help translating the mandated changes into practice," she said. "They set up a telephone help hotline to field technical questions, offered 'trans fat 101' courses in English, Spanish and Chinese to educate these involved and created a comprehensive website with guidance for preparing trans fat-free foods."

While Lichtenstein considers the health department's preliminary results very promising, she acknowledges that more data are needed to fully understand the impact of trans fat bans on public health. "One caveat is that most Americans consume far too many calories, particularly relative to their levels of physical activity," she added. "It is important to keep in mind that simply removing trans fat from an item does not decrease the caloric content. It is just one step toward improving the nutritional quality of the food. There should be no mistake, eating too many calories, even if they all come from 'healthy foods,' will result in weight gain."