Denmark鈥檚 world-leading ban on artificial trans fats in food has considerably reduced the number of people dying from heart disease, particularly in disadvantaged groups.
鈥淚t鈥檚 an excellent lesson showing that when governments put high standards in place around food, it can have a really important population health impact,鈥� says at Deakin University in Melbourne, Australia.
Trans fats are mostly artificially made by adding hydrogen to vegetable oils to make them solid. They became popular in the 20th century due to their low cost and long shelf life.
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Their main uses have been in margarine and processed bakery goods, such as biscuits, cakes, doughnuts and pies. Trans fats are also often found in deep-fried fast foods due to partially hydrogenated vegetable oil needing to be changed less regularly than other oils, hence their use in some deep fryers. Small amounts of trans fats also naturally occur in some meat and dairy products.
In 1993, a landmark study showed a link between . Denmark was quick to respond. In 1994, its local margarine producers agreed to reduce trans fats in their products, and in 2003, the Danish government banned all foods containing more than trace amounts of artificial trans fats.
The country has since recorded one of the steepest declines in deaths from heart disease in Europe, but how much of this is to do with cutting out artificial trans fats has been unclear.
To find out, at Bispebjerg and Frederiksberg Hospital in Denmark and her colleagues analysed data on Danish mortality rates, dietary habits, other risk factors like smoking and the effects of healthcare advances over time.
They found that deaths from coronary heart disease in Denmark declined by 74 per cent between 1991 and 2007. About 11 per cent of this drop could be attributed to cutting out artificial trans fats, equating to around 1200 lives saved.
The most lives saved appear to be in lower-income groups, since they were previously the biggest consumers of trans fats. 鈥淩egulating food composition tends to be more equitable than strategies like food labelling because it benefits the whole population, not just those who have the motivation and resources to make change,鈥� says Sacks.
Forcing food manufacturers to ditch cheap trans fats may have slightly increased the price of some foods, but only those 鈥渓ike pies and pastries that you want people to eat less of anyway, so that鈥檚 probably a good thing鈥�, says at the University of South Australia.
Several countries have since followed Denmark鈥檚 lead in banning artificial trans fats, including the US in 2018 and the rest of the European Union in 2021. Others, including the UK and Australia, have stopped short of banning them, but have encouraged voluntary phase-outs. The World Health Organization is working with policy-makers around the world to try to .
Eliminating trans fats is the 鈥渓ow-hanging fruit鈥� of food regulation because they can be easily swapped for healthier fats, says Sacks. Regulating things like sugar and salt is more challenging because we can鈥檛 cut them out entirely, since they naturally occur in most foods and are important for palatability.
However, governments could place mandatory limits on their quantities to prevent excess consumption, he says. 鈥淚 think this demonstrates that you can achieve population-wide health benefits with regulation.鈥�
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