WHO Director General Dr Tedros Adhanom Ghebreyesus Can the World Health Organization Actually Ban Deadly Trans Fats? Alanna Shaikh, MPH May 17, 2018 By: Alanna Shaikh, MPH on May 17, 2018 This week, the World Health organization called for the elimination of trans fats by 2023. To make this happen, the organization has released a step-by-step guide for the elimination of industrially-produced trans-fatty acids from the global food supply. The key question now is whether countries around the world will adopt this plan as their own. Trans fatty acids, or trans fats, are produced in an industrial process that adds hydrogen molecules to fat. The resulted hydrogenated fats stay more solid at room temperature, and can be fried at high temperatures without burning. As a result, they are a popular ingredient for commercial baking and deep frying. The problem is, consuming trans fats raises the risk of heart disease, stroke, and diabetes. (A few trans fatty acids occur naturally in animal fats, but they appear in minimal quantities and are not the focus of the plan, known as “REPLACE.”) These dangerous fats are responsible for half a million deaths a year due to cardiovascular disease, and, as WHO points out, they can be released by healthier alternatives at almost no additional cost. REPLACE is an acronym that provides six strategic actions to ensure the prompt, complete, and sustained elimination of industrially-produced trans fats from the food supply. These actions are based on tracking the production and consumption of trans fats, passing laws to eliminate the fats, and then enforcing compliance. REview dietary sources of industrially-produced trans fats and the landscape for required policy change. Promote the replacement of industrially-produced trans fats with healthier fats and oils. Legislate or enact regulatory actions to eliminate industrially-produced trans fats. Assess and monitor trans fats content in the food supply and changes in trans fat consumption in the population. Create awareness of the negative health impact of trans fats among policy makers, producers, suppliers, and the public. Enforce compliance of policies and regulations. Replacing trans fats has been proven to be possible. Trans fats have no known health benefit, and the cost of eliminating them from use is minimal. This is a public health intervention with almost no downside. The US Food and Drug Administration tried to ban trans fats in the whole United States in 2004 and was defeated by food industry lobbyists – not on the basis of health impact. But other localities have successfully banned the substance. New York City began phasing out tans fats in 2007 and has seen reductions in cardiovascular disease in subsequent years. Denmark banned trans fats in 2004 and saw cardiovascular disease plummet. Taking such a big stand on a chronic disease issue – poor quality fats that lead to heart disease – is in many ways a new step for WHO. Powerful corporate and government interests have made it difficult to develop and enforce strict stances on the products that lead to chronic disease. The WHO has had difficulty formulating a firm stance on sugar and health, for example, in the face of powerful agricultural interests. No one benefits when children get measles, while a whole network of businesses and individuals benefit from the sale of processed sugar. This web of financial interests makes addressing the causes of chronic illness far more difficult than advocating for, say, increased immunization or access to HIV drugs. REPLACE could be a sign of a WHO that is ready to take a stronger stance against corporate interests. This is the very first time the WHO has called for a total global ban on the use of a food ingredient. An effective stand against trans fats in food will be a win in the fight against heart disease, and also serve as an example for other efforts to reduce chronic disease. The challenge that REPLACE will face is in implementation. The WHO has no enforcement capacities. It can provide technical assistance in developing new policies and legislation and use its influence to advocate for change, but that is the extent of its abilities. It cannot pass laws or act on its own. It is an organization made of member states, and those member states will have to act upon the REPLACE action package. Having developed REPLACE, WHO will now have to convince member states to act. Bonus: Listing to the Global Dispatches Podcast interview with Dr. Thomas Frieden, former director of the US Centers for Disease Control and Prevention who is currently working with the WHO and its member states to help implement trans fats bans.