trans Fatty acids in the Canadian food supply : an updated analysis 1 – 3

Background: Dietary trans fatty acids (TFAs) increase the risk of heart disease. In 2007, Canada set voluntary TFA limits for industrial TFAs added to food and encouraged substitution of TFAs with unsaturated fats during reformulation. No longitudinal follow-up assessment of TFA amounts in foods has occurred in Canada since termination of a government-led Trans Fat Monitoring Program (TFMP). Objective: The objective was to conduct an updated assessment and longitudinally evaluate TFA amounts in the food supply and to determine whether saturated fats have replaced TFAs in reformulation. Design: This was a cross-sectional study that used 3 databases: TFMP (Health Canada, 2005–2009; n = 921), the University of Toronto Food Label Information Program (2010–2011; n = 5544), and the Restaurant Database (2010; n = 4272). Outcomes were TFAs as a percentage of fat, proportion of foods meeting TFA limits, and saturated fat amounts in foods with high or low TFAs. Results: The proportion of foods meeting TFA limits improved from 75% in 2005–2009 to 97% in 2010–2011, particularly in the following packaged foods: croissants (25% to 100%), pies (36% to 98%), cakes (43% to 90%), and garlic spreads (33% to 100%). Most restaurant categories assessed by the TFMP had 100% of foods meeting TFA limits. Some categories had a large proportion that exceeded TFA limits: dairy-free cheeses (100%), frosting (72.0%), lard and shortening (66.7%), coffee whiteners (66.7%), and restaurant-prepared biscuits and scones (47.4%). Saturated fat amounts were significantly higher (P , 0.05) among some foods with the lowest TFAs, such as cookies, brownies and squares, cakes with pudding/mousse, dessert toppings, and lard and shortening. Conclusions: There has been an impressive improvement in TFA amounts in the Canadian food supply since the termination of the TFMP. However, action by the food industry is required to reduce TFAs in foods that exceed the recommended TFA limits and to minimize the use of saturated fats in replacing TFAs during reformulation. Am J Clin Nutr doi: 10.3945/ajcn.114. 088732. INTRODUCTION The consumption of industrial trans fatty acids (TFAs), produced through the partial hydrogenation of vegetable oils, increases the risk of heart disease and causes multiple cardiovascular disease risk factors, which are effects that occur even at low intakes (1–3% of total energy) (1, 2). Because cardiovascular disease risk increases incrementally with increasing TFA consumption, there is no Estimated Average Requirement, Adequate Intake, or Tolerable Upper Intake Level of consumption (3). The WHO recommends that ,1% of total energy should come from TFAs (4). In the 1990s Canada had the highest TFA intakes in the world, consuming an average of 8.4 g/d (3.7% of total energy) (5), leading to the mandatory declaration of TFAs on the Nutrition Facts table (NFt) for all foods containing $0.2 g/serving (6). The primary dietary sources of TFAs were crackers, margarines, shortenings, doughnuts, cookies, pie shells, breaded chicken, cake mixes, fries, and sauces and gravies (7). Lower amounts of TFAs are found naturally in ruminant sources (2–5% of total fat content) (5); however, these contribute a small amount to total dietary TFAs and are not associated with adverse health outcomes (8). A recent United Nations high-level meeting emphasized the importance of policies to reduce and/or eliminate TFAs in the food supply (9). The US Food and Drug Administration also recently released a proposal to limit TFAs in foods by considering partially hydrogenated oils as not “generally recognized as safe” for use in food (10). In 2005, the Canadian government assembled a multistakeholder Trans Fat Task Force to develop recommendations to reduce TFAs in Canadian foods to the lowest amounts possible (to ,2% of total fat for fats and oils and ,5% of total fat for all other foods) (11). This included a recommendation to replace TFAs with unsaturated fats, rather than with saturated fats, during reformulation. Although the task force recommended implementing regulations, the government opted for a voluntary approach in 2007 with the option for regulatory measures after 2 y if industry did not respond (5). The Trans Fat Monitoring Program (TFMP) was established, which, between 2006 and 2009, conducted planned twice-yearly 1 From the Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada. 2 This study was partially funded by grants from the Canadian Institutes for Health Research (201103SOK-118150) and the Canadian Stroke Network (201103SOK-01194-000) and from the Earl W McHenry endowed Chair (held by MRL) at the University of Toronto. JA holds a Heart and Stroke Foundation of Canada Research Fellowship. MFS holds a Vanier Canada Graduate Scholarship. 3 Address reprint requests and correspondence to MR L’Abbe, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Room 315, Toronto, ON, Canada M5S 3E2. E-mail: mary.labbe@utoronto.ca. 4 Abbreviations used: NFt, Nutrition Facts table; TFA, trans fatty acid; TFMP, Trans Fat Monitoring Program. ReceivedMarch 24, 2014. Accepted for publication July 3, 2014. doi: 10.3945/ajcn.114. 088732. Am J Clin Nutr doi: 10.3945/ajcn.114. 088732. Printed in USA. 2014 American Society for Nutrition 1 of 8 AJCN. First published ahead of print August 6, 2014 as doi: 10.3945/ajcn.114. 088732. Copyright (C) 2014 by the American Society for Nutrition monitoring and reporting of TFA amounts in foods (by product and brand name). By 2009, 76% of Canadian packaged, restaurant, and institutional foods had TFA amounts that fell within the recommended limits (12). Intake estimates of TFAs were reduced by 30%, from 4.9 g/d (2.0% of total energy) in 2004 to 3.4 g/d (1.4% of total energy) in 2008 (12). On termination of the TFMP in 2009, the federal government did not implement the proposed regulations, despite 24% of foods having unacceptably high amounts of TFAs and mean population intakes exceeding recommended amounts (5, 12). There has been no assessment of TFA amounts in the food supply since the termination of the TFMP; thus, it is unknown if the food industry has made additional progress in further reducing or eliminating industrial TFAs. The objective of this study was to conduct a detailed, updated assessment of TFA amounts in the Canadian packaged (grocery) and restaurant food supply and to assess changes in the proportion of foods that meet the recommended TFA limits. In addition, this study assessed whether saturated fat was substituted for TFAs during reformulation.