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Trans-fats: health time bomb by regulatory omission

The failure of the EU to regulate transfats once more demonstrates the power of lobbies in Europe

Trans-fatty acids (TFA) were once thought to be a good idea. But the detrimental impact of industrial TFAs on health has become more than obvious over the past few decades. Strictly limiting the use of TFAs in food in Europe would save millions of people’s lives, help to tackle health inequalities and reduce health costs, according to a position paper by the European Heart Network (EHN), a Brussels-based alliance of heart foundations and like-minded non-governmental organisations.

Yet, there is currently no mandatory limit to the content of industrial TFAs in food in Europe. Already some countries have taken the matter in their own hands, as they are not willing to wait for Brussels to legislate. On 3rd December 2015, the European Commission has finally adopted a long awaited expert report on TFAs. The report clearly calls for legally limiting industrial TFAs on a European level. But there are still concerns that implementation of such advice may take a while, as considerable delays have plagued this expert publication. In this investigative piece, EuroScientist looks at how pan-European policy making can sometimes go wrong, even when lives are at risk.

A looming time bomb in your diet

What are known as partially hydrogenated plant oils, originating from industrial processes, constitute the major source of trans-fats in processed food. They are cheap, long lasting and easy to handle. They add texture and taste to different food products, such as some fast food, certain types of margerines, chips or commercial bakery products.

According to a recent WHO policy brief, there is now an “overwhelming evidence base on the adverse effects of consuming trans-fats.” “We know that TFAs are responsible for a large proportion of cardiovascular diseases,” says Roberto Bertollini, chief scientist and WHO representative to the EU in Brussels, Belgium. Data shows that heart diseases are the most common cause of death in the EU.

Aware of this public health threat and not willing to wait for a top-down impulse from Brussels, several European countries have already legislated against TFAs. In 2004, Denmark was the first country to legally limit TFAs in processed food to 2% of the total oil or fat content. Meanwhile, other countries in Europe, including Austria, Switzerland, Iceland, Norway, Hungary and Latvia, have followed suit.

Undue regulatory delays

Stakeholders in Brussels, such as the European Consumers’ Organisation BEUC, welcome the expert report presenting different options for dealing with TFAs. The report clearly favours a legally binding approach to limit industrial TFAs in food over other solutions such as mandatory labelling or voluntary approaches to food reformulation. This document was a year-long overdue, as it was initially mandated by the 2011 EU-regulation on the provision of food information to consumers (FIC).

Indeed, it is time to act now, experts believe. The scientific evidence is quite solid, according to Bertollini. Moreover, examples from countries like Denmark show that “it is possible to limit TFAs in food without major impact on the industry’s revenues,” he adds. Indeed, Denmark succeeded in legally limiting industrial TFAs, partly because the food industry supported the political will at the time, says Steen Stender, professor at the department of clinical biochemistry at Copenhagen University Hospital in Gentofte, Denmark.

Stender previously chaired the working group on TFAs of the Danish nutrition council, which began to look at the first scientific evidence back in the 1990s already. Now, two decades later, the benefits of legally limiting TFAs have become more obvious.

Public health

A recent publication estimates that 14.2 lives were saved per 100,000 per year in Denmark alone, after the government had adopted the law on TFAs. “If you extrapolate (this) […] to the entire EU with about 500 million people, you get 70,000 lives per year,” Stender points out. He then questions: “Who is responsible for this waste of lives?”

Tackling the TFA content in food also means tackling inequalities in public health. A 2014 study by Stender and colleagues revealed that people still consume high levels of TFAs, particularly in Eastern European countries. This is happening despite the voluntary agreements with the industry, which has decreased TFA use during the past few years.

In addition, products containing high levels of TFA are available in ethnic shops throughout Europe. So, even if the average intake in Europe is below the threshold the WHO recommends, “there are subgroups that have a very high intake,” Stender stresses. This is also true for socially disadvantaged groups.

Mandatory threshold

A legal limit would likely benefit these groups, agrees Jonathan Pearson-Stuttard, academic clinical fellow at the department of primary care and public health at Imperial College London, UK.

It is no coincidence that they have higher rates of mortality from [coronary heart diseases (CHD)],” he says. In a recent modelling study focussing on the UK, Pearson-Stuttard and colleagues revealed that virtually banning TFAs from food would reduce inequality in mortality from CHD by 15%.

In addition, positive effects of such limit on the economy could include large savings of informal care costs and averted productivity loss. These effects would be similar in other countries, regardless of health care services. “A structural intervention on population level such as in Denmark is not only cost-effective but also cost-saving,” Pearson-Stuttard stresses. In terms of preventing death, voluntary or labelling approaches are “at best half as good” as setting a legal limit, he adds.

Growing consensus

There appears to be little divergence of views among the different stakeholders, including the food industry. “A mandatory threshold is the only way forward to make sure that consumers are protected,” says Pauline Constant, communications officer at the European Consumer Organisation (BEUC) in Brussels. In an open letter published on 15th October 2015, the BEUC, the EHN as well as other stakeholders and multinational food companies therefore call upon the Commission to finally “propose a legislative limit for the amount of industrially produced TFAs in foods”.

Indeed, from the industry’s perspective, “setting a cut at 2% is the best option,” notes Nathalie Lecocq, director general of Fediol, the federation representing the European vegetable oil and protein meal industry, based in Brussels. Other previously more reluctant industry bodies are finally adopting the same views. As recently as 19 November 2015, the European food and drink industry organisation FoodDrinkEurope has adopted the same position on TFAs.

Apart from issues around consumer health, a legal limit would also “create a level playing field” for all stakeholders involved, Lecocq says. However, there may still be stakeholders favouring a labelling approach, Lecocq contends.

Commission blockage

Given that there appears to be a consensus across the board on the introduction of such legal limit, what has taken the Commission so long to get its act together? As regards the delayed report, “the fact that there has been a new Commission has possibly not helped the process to stick to the timeline,” Lecocq says.

The BEUC suspects “a blockage at a higher level” as the health commissioner generally supports a legal limit, says BEUC’s Constant. Some European countries may also have concerns regarding a legal limit because of potential costs arising for small and medium-sized enterprises, Bertollini believes.

Still, the delay of the report is barely understandable because “it will most likely propose policy options to countries, which will be further discussed,” he says.

Towards an agreement

In reality, such delay is typical when there is no political consensus at the European level, says Herman Lelieveldt, associate professor in political science at University College Roosevelt in Middelburg, The Netherlands. Moreover, even if there is scientific consensus, “science is always disputed in political debates,” he says. There needs to be absolute scientific certainty for the EU to be able to act, he adds.

Such process is much more difficult and lengthy for the EU than for the government of a single country like Denmark. In Lelieveldt’s view, it is therefore “very easy to block and delay stuff.”

Lelieveldt and colleagues analysed the amendments made to the initial proposal of the European Commission for the FIC-regulation. At that time, in 2010, there was no parliamentary consensus on how to deal with food labelling in terms of trans-fatty acids, they found. This is why, according to Lelieveldt, the pending report was mandated in the first place.

However, a push from across the Atlantic may now force the Commission to act. In June 2015, the US food regulator, the Food Drug Agency, declared partially hydrogenated oils as “no longer safe.” For Europe, “that is a very strong signal,” Lelieveldt stresses, compounded by the fact that many food-processing companies act on a global scale. Indeed, “it would be strange if the US had another policy than the EU,” Stender agrees.

Meanwhile, the expert report is due to be dealt with at as a meeting of the EU council on 7 December. Still, the extremely lengthy negotiations at the European level have, so far, prevented policy makers from tackling a pressing health issue. And nobody is held accountable!

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Constanze Böttcher

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