Banning trans fats may decrease the risk of death and heart attacks
We all need fat in our diets, but what fats do we really need and what can we do without? There are several types of fats that have differing impacts on our health, including trans fats, saturated and unsaturated fats.
Trans fats are fats that we can definitely do without. The Food and Drug Administration has taken one of its most aggressive stances in years regarding trans fats. The agency announced recently they are in the preliminary stages of potentially banning artificial trans fats, based on findings from expert panels and scientific studies.
Trans fats are found in processed foods, baked goods and fried foods, as well as margarine, frozen pizzas, coffee creamers and microwave popcorn. To determine whether a food has trans fats, check the label for partially hydrogenated oils. Some restaurants may also use trans fats.
Why is the FDA’s potential banning of trans fats important? According to the agency, just by eliminating this one type of fat, it could reduce annual incidences of heart attacks by 20,000 and deaths due to heart disease by 7,000 (federalregister.gov). The Institute of Medicine’s position is that there is no benefit to trans fats, only potential harm from consuming any amount.
However, it is still unclear how far the FDA will go to eliminate trans fats. Will they force food manufacturers to eliminate trans fats if they are less than 0.5 g per serving? Products with low levels per serving, such as Skippy peanut butter, are allowed to say they are free of trans fats. There are some foods that contain small amounts of natural trans fats, but not the ones mentioned above.
Does this mean that bakery goods and fast foods are going to be healthy for us? Hardly! Many food establishment have already eliminated trans fats. We consume significantly less than we once did. In 2003, we consumed 4.6 g per day, but in 2012, we consumed 1 gram daily, according to the FDA. However, consuming any trans fats may be too much.
Mayor Bloomberg may be remembered for his impact on dietary composition. In a study, trans fat consumption decreased dramatically in fast food establishments throughout NYC in just two years from 2007 to 2009 (Ann Intern Med. 2012;157:81-86). And the amount of products purchased from these establishments that were trans fat-free increased dramatically.
Trans fats and stroke
In the Women’s Health Initiative Observation Study, trans fats were associated with an approximate 40% increased risk of ischemic (clot-based) strokes in postmenopausal women in the highest consumption quintile compared to the lowest (Ann Neurol. 2012 Nov.;72:704-715). Ischemic strokes are by far the most common type of stroke. There were over 87,000 women in this study between the ages of 50 and 79. Interestingly, aspirin seemed to help prevent the strokes in this population. Many of us are on the fence about taking aspirin, but this may a reason for postmenopausal women to discuss aspirin with their physicians. Though, if the FDA does ban trans fats, aspirin may not be needed.
Trans fats and aggression
Psychological changes are another concern. In a recent study with 945 men and women, results showed that the more trans fats consumed, the greater the probability of irritability, aggression and impatience (PLoS ONE 7:e32175). This may be an indication that diet plays a role in mood changes and disorders.
Saturated fats and cognitive impact
What if we ate more saturated fats? In the observational Women’s Health Study, results for 6,000 postmenopausal women showed that those who consumed the most saturated fat had a significant decline in global memory and verbal memory scores, compared to those who consumed the least.
The good news is that those who consumed the highest amounts of monounsaturated fats had an improvement in these scores, compared to those who consumed the least (Ann Neurol. 2012 July;72:124-134). Researchers concluded that the amounts of specific fat types were more important than the overall amount of fat consumed.
There are better fats, such as monounsaturated and polyunsaturated fats, and there are fats that are worse for us, such as saturated fats. However, some foods contain both saturated and unsaturated fats, and this is where those critical of calling saturated fat “bad” tend to utilize examples. With the right balance of unsaturated to saturated fats, certain foods can be beneficial, like nuts, olive oil and avocado – in moderation, of course.
In a randomized controlled trial, considered the gold standard of studies, type 2 diabetes patients who received mixed nuts saw a decrease in their HbA1C (a three-month measure of glucose or sugar levels) and a decrease in their LDL “bad” cholesterol (Diabetes Care. 2011;34:1706-1711).
Those who consumed muffins instead of nuts or who consumed half nuts and half muffins saw no improvement in their HbA1C or LDL levels. The takeaway is that a small handful of nuts, about 2 ounces daily in place of carbohydrates, can have a significantly positive impact on the health of type 2 diabetes patients.
Unsaturated fat impact
In a randomized controlled study comparing a Mediterranean diet to a low-fat diet, those on MEDI showed a significant 30% decrease in the risk of cardiovascular disease and related death (N Engl J Med. 2013;368:1279-1290). However, those in the low-fat group could not maintain low-fat levels, thus they consumed a diet similar to the standard American diet, and those in the MEDI group consumed more vegetables, olive oil and/or nuts than is typical.
It also speaks to the fact that it is not enough to reduce fat; it’s important to replace it with the right things. If you eat pasta and grains instead, this may not alter results; however, if you replace high levels of fat with nutrient-dense vegetables, then the effects, as seen in the MEDI, tend to be very favorable.
I applaud the FDA for considering banning artificial trans fats, but be forewarned that you need to be wary of partially hydrogenated oils on labels, even if the product says “trans fat-free.” Saturated fats by themselves may be unhealthy as well. However, saturated fats in combination with unsaturated fats may promote positive effects on your overall health. Regardless, moderation is important when it comes to fats, even with good fats. Too much is bad, no matter what the source.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.