Coverage of FDA’s trans fat decision a high-water mark for health journalism

This is the first in a mutli-post series on the FDA’s trans fat decision by Bill Heisel, a former investigative reporter at the LA Times and a longtime contributor to HealthNewsReview.org. 


001Arrowmen[ƒeƒ“ƒvƒŒ]News reports on the decision by the FDA to phase out artificially made trans fatty acids in food products represent what I would consider a high-water mark in consumer health coverage.

While so often stories about dietary science are a mish-mash of he said/she said providing equal weight to opinions lacking equal scientific validity, the stories about the FDA ban for the most part put the proper emphasis on the long road to reach this decision and the consensus around the fact that trans fats are, as the FDA has now officially declared in its bureaucratic parlance, not Generally Recognized As Safe. There were few astro turf consumer groups complaining about assaults on their doughnuts. No naysayers shouting about the nanny state.

And yet that does not mean the doubters aren’t out there. As HealthNewsReview.org has so often pointed out, people feel whipsawed by conflicting stories over the span of a few years or even months. They don’t know what or who to trust. And that’s why it’s critically important to present some of the science behind a major decision like a trans fat limit.

Why dig into the science if the FDA is already moving on the ban?

First, because the depth of evidence often goes back much farther than the typical reader may know. Read this story by Brady Dennis in the Washington Post about one of the first scientists to research trans fats, Fred Kummerow. As Dennis noted, Kummerow first published a paper about trans fats showing up in high quantities in human tissues in 1957. Dennis wrote:

In the 1950s, as a young university researcher, Kummerow convinced a local hospital to let him examine the arteries of people who had died from heart disease. He made a jarring discovery. The tissue contained high levels of artificial trans fat, a substance that had been discovered decades earlier but had become ubiquitous in processed foods throughout the country. Later, he conducted a study showing that rats developed atherosclerosis after being fed artificial trans fats. When he removed the substance from their diets, the atherosclerosis disappeared from their arteries.

Second, because sometimes the FDA and other agencies are very late to the party. As I have noted in my Antidote blog at ReportingOnHealth.org, Denmark and Argentina are among a host of countries around the world that have acted more aggressively to rid food products of trans fats, often starting with requiring that trans fats be noted on food labels and then setting a limit for trans fat content.

And third, because diet science is often a moving target. One of the most insightful pieces in this regard was a 2013 NPR story by Dan Charles. Like Dennis, Charles picked up on the fact that trans fats were actually thought to be the healthier option well into the 1980s. Charles tracked down David Schleifer, a sociologist at the New York-based group Public Agenda. He has written extensively about the history of trans fats in the food supply and attempts to regulate trans fats. Schleifer provided a counterintuitive take on trans fats, including a must-read for people tuned into the trans fat discussion, A Perfect Solution: How Trans Fats Became the Healthy Replacement for Saturated Fats. Schleifer wrote:

In the 1980s, responding to the connection that medical authorities made between saturated fats and heart disease, CSPI and another activist organization, the National Heart Savers Association (NHSA), campaigned vigorously against corporations’ use of saturated fats, endorsing trans fats as a healthy, or healthier, alternative. Many contemporaneous medical authorities shared the view that trans fats were healthier than saturated fats. But endorsing trans fats as a replacement for saturated fats was hardly a shot in the dark. Growers, oil suppliers, and academic and government scientists had been working since the early twentieth century to commercialize soybeans and develop the partial-hydrogenation process, and by the 1980s partially hydrogenated soybean oil was to some extent already in use. When activists targeted manufacturers for “poisoning America . . . by using saturated fats,” nearly all targeted firms responded by replacing saturated fats with trans fats.

In Charles’ piece, Schleifer gave the example of one of the biggest targets for healthy food advocates: McDonald’s:

McDonald’s, Schleifer says, previously used beef tallow for frying. “People freaked out about beef tallow because it had saturated fat, and McDonald’s responded to that public outcry by replacing beef tallow with trans fat,” he says.

This kind of background is essential for creating a better understanding of how a regulatory action like this takes shape. Yet, in all of the stories cited above, there was no analysis of the quality of the evidence behind the ban. This is in part because the science is a little hard to find. The FDA devotes many pages on its website to trans fats but no academic citations. You have to go to the Federal Register to read the FDA’s report, “The Tentative Determination Regarding Partially Hydrogenated Oils; Request for Comments and for Scientific Data and Information.” There the agency cites 66 different statements, guidelines, and studies to back up its action.

Over a few posts, we will break down some of the key trans fats studies to explain what went into the FDA’s decision.

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Comments (4)

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Jay Wiener

June 19, 2015 at 5:55 pm

Excellent post. I write a diet and fitness blog specialize in combining hard science with humor, to keep people interested – and found this site while researching for my next post. Good luck.

Dr Gayle Eversole

June 22, 2015 at 12:41 pm

The problem with all of this is that the “allowed” substitute is canola oil. For those who do not understand oils then you might wish to know that canola oil is a trans fat as a result of manufacturing and it is too mono-unsaturated for health. Clearly FDA is in bed with Big AG on this one.

Micki

June 22, 2015 at 1:44 pm

There is an aspect of trans fats that is missing in this discussion: the effect of hydrogenation of high phylloquinone (vitamin K1) oils – such as soy and canola oils – on vitamin K.
Turns out that hydrogenating a high vitamin K1 oil makes an aberrant form of vitamin K called dihydrophylloquinone (dK). dK does not optimally activate vitamin K-dependent proteins and it inhibits biosynthesis of MK-4 (menaquinone-4) in tissues throughout the body, two extremely important and more recently appreciated functions of vitamin K.
Only recently have the widespread tissue locations and types of vitamin K-dependent proteins been fully appreciated. Historically, we have known about the K-dependent proteins involved in coagulation, but now it is realized that matrix gla protein, osteocalcin, Gas6, periostin, TGFBI, Gla rich protein and others are found in arteries, in bones, in the brain, in the pancreas and pretty much all over. If they remain inactivated, many detrimental health effects crop up and this can occur via insufficient vitamin K and also impaired vitamin K actions such as MK-4 synthesis or K-dependent proteins activation.

http://ajcn.nutrition.org/content/90/4/889.short
Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging? (2009)

And the biosynthesis of MK-4, the only menaquinone that is not made by fermentation, is also only recently being appreciated. dK inhibits this synthesis.
These findings imply that we have contributed to atherosclerosis, osteoporosis, diabetes, and dementia and quite possibly more via this aberrant form of vitamin K, though more studies are needed.
I have even spoken to Fred Kummerow two times on the phone about this and yet this aspect of hydrogenation remains largely unspoken and unshared with the general public.
The folks at Tufts Vitamin K Lab, funded by the USDA, have figured that the ban on trans fats will eliminate the dK issues, but it seems disingenuous to not admit that these mechanisms of dK have not been more freely shared and discussed.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321250/
Vitamin K: food composition and dietary intakes (2012)

Let me offer some articles about dear dihydrophylloquinone and why we want to steer clear of it, but to truly present all the data would be excessive for this comment, so look into it more.

http://www.sciencedirect.com/science/article/pii/S0889157515000502
Changes in the content and forms of vitamin K in processed foods (2015)

http://ajcn.nutrition.org/content/74/6/783.short
Effects of a hydrogenated form of vitamin K on bone formation and resorption (2001)

http://jn.nutrition.org/content/134/11/3100.full.pdf">
Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study (2004)

http://jn.nutrition.org/content/137/7/1763.full.pdf+html
Excretion of the Urinary 5C- and 7C-Aglycone
Metabolites of Vitamin K by Young Adults
Responds to Changes in Dietary Phylloquinone
and Dihydrophylloquinone Intakes (2007)

http://www.endocrine-abstracts.org/ea/0037/ea0037EP554.htm
Enzymes of the vitamin K cycle and progression of calcification in the vessel wall (2015)

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125737
Functional Characterization of the Vitamin K2 Biosynthetic Enzyme UBIAD1

No single publication has taken on dK nor its effects on MK-4 biosynthesis nor its inhibition of activation of vitamin K-dependent proteins, so multiple articles and investigations must be assimilated.
Those trans fats are representative of an aberrant form of vitamin K. This form, dK, impairs many vital vitamin K actions and leads to weak bones, impaired insulin sensitivity, atherosclerosis, and more.
Maybe banning trans fats will help, as noted how the dK content of foods in the US have declines since 2006, but we need to look at the actions of vitamin K in the common chronic diseases and investigate how to optimize them and also what impairs them. dK impairs them.

Beverly

June 23, 2015 at 9:15 am

Thank you for this fine post and the links. I look forward to reading the rest of the series.