Following the New York City Board of Health's unanimous decision to phase trans fats off the city's restaurant menus, experts say the move could be an important step in saving many people from heart disease.
Restaurateurs and others, however, say the decision could have a devastating impact on New York's restaurant industry, and it might not even make restaurant food that much healthier.
The measure, first proposed on Sept. 26, will take effect July 1. By this date, restaurants will be barred from using most frying oils that contain artificial trans fats. And by July 1, 2008, they will have to eliminate artificial trans fats from all their foods.
Experts believe trans fats cause harm because they raise "bad" LDL cholesterol and lower "good" HDL cholesterol. This combination has been found to contribute to heart disease -- perhaps even more so than saturated fats.
"This is one of the most important actions taken by a city or state health department in many years," says Michael Jacobson, executive director of the Center for Science in the Public Interest in Washington, D.C., adding that the measure should be adopted by other cities and states.
"The trans-fat ban will save thousands of lives over the next decade."
"This is one of the most important pieces of health legislation this decade," says Lori Mosca, associate professor of medicine at Columbia University. "It has the potential to affect millions of people to reduce their exposure to an unnecessary substance that is known to increase the risk of heart disease."
"New York City has taken a major step forward to protect the health of everyone who lives or visits there," says Dr. Walter Willett, professor and chairman of the Harvard School of Public Health. "Hopefully, the rest of the nation will follow."
"This is a good idea," says Keith-Thomas Ayoob, associate professor in the department of pediatrics at the Albert Einstein College of Medicine. "Trans fat is not a necessity, and there are suitable substitutes."
"Well-known, highly quoted epidemiologic studies confirm that trans fats are by far and away the worst type of fat that can be ingested," says Dr. Christine Lawless, director of the section of preventive and sports cardiology at the Ohio State University Medical Center.
"These fats are far more atherogenic -- more likely to cause arteries to clog -- than any other type of saturated fat."
"Some opponents of this ban have characterized this as 'big brother in the kitchen,'" says Meir Stampfer, professor and chairman of the Harvard School of Health's department of epidemiology.
"To those I would ask, 'Do you oppose the regulations requiring employees to wash their hands? Do you oppose regulations limiting pesticide residue in food?'"
Stampfer adds that consumers probably will not even notice the absence of trans fats.
"This ban does not ban any food item, and its implementation will likely be virtually invisible to consumers," Stampfer says. "It bans an industrially produced artificial ingredient in the food supply that responsible manufacturers should have taken out themselves long ago."
Perhaps it is appropriate that the anti-trans-fat revolution, if it ignites, will have its roots in New York City. In this metropolis of nearly 19 million, heart disease is the No.1 killer.
One study in 1999 suggested that New York City was the heart attack capital of the country, with more people dying per capita from heart disease than in any other city in the United States.
Since 2003, the FDA has required that foods on grocery store shelves carry labels that list the trans fat content. However, since the food in restaurants does not come with labels, consumers are often unaware of how much fat they are eating when they dine out.
"A single fast-food meal can contain up to 10 grams of trans fat," Lawless says. "The current recommendation is that no serving contain more than 0.5 grams of trans fat. Clearly, there is room for improvement."
Concern From Restaurateurs
However, not everyone is pleased by the decision.
"We cannot come up with substitute products in this time frame, especially since many of these products are made from seeds and other things that are grown," says Charles Hunt, executive vice president of the New York City chapter of the New York State Restaurant Association. "There will be a supply shortage."
Hunt says, though, that eliminating trans fats is a worthy goal, provided restaurants have sufficient time to adjust to the ban.
"I want to stress the fact that we're not saying that trans fat is a health food," Hunt says. "We're not serving it in soup bowls. But we would just like to see this implemented in a moderated manner to help consumers."
Hunt says the association is exploring the possibility of litigation in response to the decision.
The American Council on Science and Health also questioned the decision.
According to Dr. Gilbert L. Ross, the council's medical director, "The heightened media attention now paid to trans fatty acids as a possible cause of heart disease distracts consumers from the three major known preventable causes of heart disease: cigarette smoking, high-blood pressure and unhealthy levels of LDL cholesterol and other blood lipids."
Trans Fats Just One Piece of the Big, Fat Puzzle
Some experts also say the move, while well-intentioned, will not make an impact on overall health unless restaurants replace trans fats with healthy alternatives instead of simply bringing back saturated fats.
"Last year [late expert nutritionist David Kritchevsky] described the New York City health department's request that restaurants stop using trans fats, found in commercially baked and fried foods, as a 'panic du jour,'" says Dr. George Blackburn, associate director of nutrition at Harvard University's division of nutrition.
"He suggested that the effort could lead to a wider use of saturated fats as a substitute, with no lessening of the health risks."
Other dietary changes are also necessary in order for Americans to truly eat healthy.
"This is one step in the process of changing the type of fat Americans consume, but total fat intake is still an important variable in the healthy eating equation, as is the type of fat restaurants choose to replace trans fats," says Connie Diekman, president-elect of the American Dietetic Association and director of university nutrition at Washington University in St. Louis.
"Hopefully, restaurants will choose healthy oils and not saturated fats instead of trans fats."