The Nutrition Facts Label to List Trans Fat: From Bad to Worse

Written by Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition.

As of January 1, 2006 a new law requires food manufacturers to list the amount of trans fat contained in their products. This is the first major addendum to the Nutrition Facts packaging label since its inception in 1993. Although the manufacturing process of trans fat was originally discovered over a hundred years ago its large-scale use by the food industry began in the late 1970's and early 1980's. During that time an alarming body of scientific evidence emerged directly linking saturated fats, like lard, tropical oils and butter to vascular disease, heart attack and stroke. The food industry scrambled to offer a healthier alternative to the vilified saturated fats and embraced trans fats as the answer. Many of us remember the 'I Can't Believe It's Not Butter' ad-campaign. In addition to the marketing boom touting the healthier trans fat containing products the food industry enjoyed further economic benefits from the greatly enhanced shelf life of foods made with solid trans fats (just look at the expiration date on a Twinkie); this fostered even more extensive use of hydrogenated oils. But the benefits of this bit of food magic would be short lived.

Although very small amounts exist in nature, trans fat is almost exclusively a product of the laboratory. Through a process called hydrogenation, less health-offensive fats like those in vegetable oils are exposed to high pressure and temperature and bombarded with hydrogen gas. This processing changes the chemical structure transforming the oil into a waxy, gooey solid. But science leaped too quickly from the laboratory to our kitchen when it starting serving up this gunk. Research in the early 1990's uncovered that trans fat not only raises LDL (bad) cholesterol in the same way as saturated fat, it also lowers HDL (good) cholesterol. Furthermore, emerging science has shown that the altered chemical structure allows our bodies to more easily oxidize trans fat, an important step in the formation of artery clogging plaques. One example of the serious negative health effects of trans fats in our diets comes from the Walter Willett Nurses Study (Professor of Medicine, Harvard Medical School). The study of 80,000 women concluded that a mere 2% increase in dietary trans fat consumption increases a woman's risk of heart disease by 93%. Recently the FDA Food Advisory Committee voted in favor of recommending that trans fat intake be reduced to less than 1% of total caloric energy. This amounts to less than 1.5 g per day for a standard 1500 calorie diet.

Trans fat is lurking everywhere. It is extensively used in baked goods like crackers, cookies, pastries and cakes and in fried foods like French-fries, breaded fish, chicken and shrimp. Snack foods such as popcorn, chips and chocolate are loaded with trans fat as are sauces and condiments. Trans fat turns even some brands of healthy foods like tomato sauce and vegetable soup into artery clogging goop. And the next time you proudly go for that healthy salad take a closer look at that white sludge you're about to smother it in. Most salad dressings are loaded with trans fat. And don't forget that trans fat is commonly used in the food service industry and restaurants don't list the nutritional facts for the foods they serve.

It's very important to note that the new Nutritional Facts label law has a major loophole in it. Food manufacturers were able to preserve language in the rules that allows them to advertise and label their products as "trans fat free" if there is "an amount less than or equal to .5 grams of trans fat per serving". This is called the non-reportable amount. The key here is 'per serving'. Very often a serving size (an amount which is subjectively determined by the manufacture) is a much smaller portion then we realistically consume. For example, a popular 'trans fat free' golden cracker snack lists the per serving size of their product at "about 5 crackers". After the new law went into effect this particular manufacturer simply reduced their serving size to stay within the trans fat reporting threshold. There is actually .5 grams of trans fat in one serving. They just worked backwards and based their serving size on .5 grams of trans fat. The problem is that if you're like most of us, when you open that box and kick back with Jay Leno for some late night TV you're going for at least 3 to 5 servings. You'll be consuming an average of 2 grams (in excess of the FDA recommendation) of trans fat from a single snack that has a legal Nutrition Facts Label that clearly states - '0 Trans Fat'. What planet is this?

The new label law is confusing and misleading. Many American's will consume what they believe are healthier products because they are advertised as 'trans fat free'. But many of these products are loaded with equally unhealthy saturated fat or may have less than the reportable amount of trans fat per serving. The disease producing and aging effect of both trans fat and saturated fat is as clear as the link between cigarette smoking and lung cancer. Why try to calculate which one is the lesser of two dietary evils?

While the white coat geniuses at Kraft are back at the drawing board working hard on their next big chemical break though (like their last great invention, Olestra with its 'anal leakage' warning) I leave you with this simple solution to this dietary dilemma. The more calories you consume from natural foods the less you'll need to be concerned about processed food additives. Whole grains, fruits, vegetables, nuts, seeds and beans do not contain a list of unhealthy ingredients. And the last time I checked nature didn't need a nutrition label loophole.

Don't sabotage your weight-loss goal with oily dressings and sauces.

Vegetables and salads are very low in calories. However, if you cover these healthy, low calorie foods with tablespoons of a high-fat, high-calorie, oil-based dressing, you turn vegetables and salad into weight-promoting foods. (Remember Dr. Fuhrman's equation health = nutrition / calories.)

Here's what Dr. Fuhrman says about this in the upcoming revised version of Cholesterol Protection for Life:

I know you were told that olive oil is health food. It is not. Keep in mind, oil is processed food, it is not a natural whole food. Oils, even if they are monounsaturated, should not be health food because they are low in nutrients and contain 120 calories per tablespoon, promoting weight gain.

Sure, olive oil and almond oil are improvements over animal fats and margarine, but they still are a contributor to our overweight modern world. Overweight Americans consume and average of three tablespoons of oil in their daily diet, adding and extra 360 calories to their food each day. You need to reach a thinner, ideal weight to achieve maximum protection against heart disease and to reverse heart disease. Use oil, even olive oil sparingly or not at all; certainly, do not have more than one teaspoon per day.

As an alternative to oil, you can make great tasting salad dressings from raw nuts and seeds, such as walnuts, pecans, cashews, sunflower seeds, sesame seeds, pistachios and avocados.

Here are a few recipes to experiment with:

Hot Russian Dressing
1 small (4-ounce) can tomato paste
4 tbsp. raw almond butter
1/4 tsp. chili powder
1/4 cup soy milk
3 tbsp. ketchup
Blend all ingredients together. Works well as a sauce for steamed leafy greans; as a condiment spread for lettuce, tomato, and avocado pita pocket sandwiches; and as a salad dressing (serves 4-6).

Orange Cashew Dressing
2 peeled navel oranges
1/4 cup orange juice
1/4 cup raw cashews
2 tbsp. of blood orange vinegar or pear vinegar
Blend ingredients until silkly smooth. Use liberally on salad or as vegetable dip (serves 4-6).

Pistachio Mustard Salad Dressing
1/3 cup raw shelled pistachio nuts
1 tbsp. dijon mustard
2 tbsp. Vegi-Zest or low salt vegetable seasoning
1/4 tsp. garlic powder
1/2 cup unsweetened soy milk
Blend all ingredients until smooth in a high powered blender (serves 4-6).

U.S. Cities Weigh in on Bad Diets and Obesity

Earlier this month spotlighted The New York Times coverage of how NYC is facing increased diabetes, but New York isn't the only city concerned with expanding waistlines. Consider these other recent reports from around the nation:

Dr. Fuhrman: Drugs Won't Solve Obesity Epidemic

Stephanie Saul of The New York Times reports that two new approaches to the nation's obesity epidemic are coming up for review by the Food and Drug Administration. Sanofi-Aventis will launch a prescription appetite blocker called Acomplia and GlaxoSmithKline is proposing an over-the-counter version of the weight loss drug Xenical, which will be renamed Alli. As Saul reports, overweight individuals are excited about the drugs despite the health risks of previous weight loss medications:

"I think if we could get obesity treatments to a situation like cholesterol where there are several different products, where one or two in combination might be successful, at least that would arm physicians with more than they have now," said Morgan Downey, executive director of the American Obesity Association, a patients' advocacy group in Washington.

The Food and Drug Administration has scheduled an advisory panel hearing for Jan. 23 to review Alli. And the F.D.A. could make its decision on Acomplia as soon as next month.

Both drug companies are seeking approval in a difficult regulatory environment, as the F.D.A. is moving cautiously in the wake of the Vioxx debacle. Any diet drug is up against a backdrop of safety issues from the past - most notably problems with the diet drug combination fen-phen. Fenfluramine, the "fen" half of the combination, was withdrawn from the market in 1997 after it was found to cause heart damage.

Xenical has shown itself to be moderately effective and has a long safety record. But Alli - a name the company has proposed because the drug must be allied with a weight-loss program - faces the higher hurdle required when prescription drugs are proposed for sale without a doctor's oversight. "You have to not only provide data that shows it's safe, you have to show that it's safe when it's misused," said Gerald Meyer, a former F.D.A. associate commissioner.

Can't wait for the FDA to rule? Consider this excerpt taken from Dr. Fuhrman's book Eat to Live:
New drugs are continually introduced that attempt to lessen the effects our nation's self-destructive eating behavior. Most often, our society treats disease after the degenerative illness has appeared, an illness that is the result of from forty to sixty years of nutritional self-abuse.

Drug companies and researchers attempt to develop and market medications to stem the obesity epidemic. This approach will always be doomed to fail. The body will always pay a price for consuming medicines, which usually have toxic effects. The "side" effects are not the only toxic effect of medications. Doctors learn in their introductory pharmacology course in medical school that all medications are toxic in varying degrees, whether side effects are experienced or not. Pharmacology professors stress never to forget that. You cannot escape the immutable biological laws of cause and effect through ingesting medicinal substances.

If we don't make significant changes in the foods we choose to consumer, taking drugs prescribed by physicians will not improve our health or extend our lives. If we wish true health protection, we need to remove the cause. We must stop abusing ourselves with disease-causing foods.

Asian-American Diabetes Trends Point to Diet

According to New York Times reporter Marc Santora the current diabetes epidemic is hitting the city's Asian population like a tsunami. The article warns that immigrants abandoning their traditional diets for typical American foods are at extremely high risk of developing diabetes. Santora explains:

Asians, especially those from Far Eastern nations like China, Korea and Japan, are acutely susceptible to Type 2 diabetes, the most common form of the disease and the subject of this series. They develop it at far lower weights than people of other races, studies show; at any weight, they are 60 percent more likely to get the disease than whites.

And that peril is compounded by recent immigrants' sudden collision with American culture. Many of them left places where factory and fieldwork was strenuous, televisions were rare and advertising was limited. They may speak little English and have poor access to medical care.

Many have never even heard of diabetes, much less the recent scientific studies showing that a Western diet, high in fat and sugar, puts them in danger of getting Type 2 diabetes, which has been linked to obesity and inactivity, as well as to heredity. (Type 1, which comprises only 5 percent to 10 percent of cases, is not associated with behavior, and is believed to stem almost entirely from genetic factors.)

Many recent Chinese immigrants have come from places where food was scarce, and experts say some view fat as a trophy of wealth and status. Their children try to fit into their new country by embracing its foods and its sedentary pastimes.

In Asia diabetes is so rare that many people have never heard of it, yet as the Times reports, we now know that many Asians have the genes to be highly susceptible to the disease. Of course, genes don't change much when people move to a new country, but diets certainly do.

In his book Eat to Live Dr. Fuhrman offers some insight in to why some Asians are facing severe shocks to their health when switching to the typical American diet:

The Chinese [living in China], who on the average consume more calories, are thinner than Americans.1 In China the calorie intake per kilogram of body weight is 30 percent higher than in the United States. The Chinese eat about 270 more calories per day than Americans, yet they are invariably thin. Exercise cannot fully explain this difference, as researchers discovered the same thing with Chinese office workers as well.

This may be because calories from carbohydrates are not as likely to increase body fat as the same number of calories from high-fat foods such as oils and meats, which make up such a high proportion of the American diet. The data suggests that when a very low fat diet is consumed (15 percent average dietary fat in rural China), as compared to the typical Western diet (30-45 percent of calories from fat), more calories are burned to convert carbohydrate in fat, so the body cannot store fat easily.

The modern American diet receives about 37 percent of its calories from fat, with lots of sugar and refined carbohydrates. The combination of high fat and high sugar is a metabolic disaster that causes weight gain, independent of the number of calories.

Continue Reading...

A Tale of Two Cities: New York's Diabetic Dilemma

Continuing from yesterday's story, New York Times reporter N.R. Kleinfeld probes deeper into New York City's diabetic epicenter. In East Harlem diabetes is extremely common. The next neighborhood to the South, on the other hand, has one of the lowest rates in the city. As the article explains, culture and income drive important dietary differences:

A few things to notice. On Third Avenue, around the corner from the art shop, a banner outside McDonald's proclaimed, "$1 Menu." Down the way, plastered on Burger King, "New Enormous Omelet Sandwich. It's Huge." At KFC, a sign boasted, "Feed Your Family for Under $4 Each."
The art-shop gatherers sometimes talked about 96th Street, the tangible southern divide of a neighborhood and of a disease. Go north of 96th Street and you enter a constricted world laden with poverty. Go south and you find promise and riches, thin not fat, the difference between East Harlem and the Upper East Side, the difference between illness and health.
Go north and the chances of bumping into a diabetic are maybe 20 times greater than if you go south. For the Upper East Side, according to the health department, has the lowest prevalence in the city, about 1 percent.
In East Harlem, people sometimes have to choose between getting their diabetes medication and eating. They sometimes share their pills, cut them in half and take half-dosages. They improvise. Everywhere blare the signals that the best meal is the biggest meal.
Nutritious food exists, but it isn't easy to find. Dr. Carol R. Horowitz, an assistant professor at Mount Sinai School of Medicine, heads an East Harlem coalition trying to improve diabetes care. She oversaw a study several years ago that tracked the availability of diet soda, low-fat or fat-free milk, high-fiber bread, fresh fruit and fresh vegetables in food stores in East Harlem and the Upper East Side.
Stores on the Upper East Side were more than three times more likely than those in East Harlem to stock all five items. It did not seem to matter that East Harlem has more than twice as many food stores per capita as its wealthier neighbor to the south.

The plot thickens. Kleinfeld points out that a person's image also has a lot to do with their food selection. A resident of East Harlem comments:

"We've got cultural differences. Here, for a guy to eat a salad, he's a wimp. He'll eat a big portion of rice and beans and chicken. The women can't be chumps, either. A woman can eat a salad but has to eat it on the low. She has to do it quiet. They make fun of you: What are you, a rabbit?"

Diabetes Mine also has news that New York City recently announced plans to track people with diabetes.

For more of Dr. Fuhrman's thoughts about the diabetes epidemic, refer to New York City's Diabetes Epidemic from yesterday.