A recent World Health Organization (WHO) report on global trans-fat elimination states that globally, five billion people are not protected from harmful trans-fat, increasing their risk of coronary heart disease and death.

Background Information:

Trans fatty acids (TFA) [also known as Trans-fat]: Geometric isomers of monounsaturated and polyunsaturated fatty acids having at least one carbon-carbon double bond with hydrogens on opposite sides of the double bond (trans configuration).

Industrial TFAs, formed by partial hydrogenation of vegetable oils, can be consumed at high levels and are consistently associated with higher Coronary Heart Disease, as well as sudden death. Industrial TFAs have advantages for commercial deep frying, baking, and shelf stability for packaged snacks and shortening. However, TFA also have uniquely adverse effects on blood lipid and lipoproteins, raising LDL-C, apo B, triglycerides, and lipoprotein (a) and lowering HDL-C and apo A1. 

TFAs also have nonlipid adverse effects, promoting inflammation, endothelial dysfunction, insulin resistance, visceral adiposity, and arrhythmia, although strength of evidence for these nonlipid effects varies.

Industrially produced trans fat (also called industrially produced trans-fatty acids) is commonly found in packaged foods, baked goods, cooking oils and spreads.

WHO first called for the global elimination of industrially produced trans fat in 2018 – with an elimination target set for 2023.

Key Messages:

Increased intake of trans fat (>1% of total energy intake) is associated with increased risk of coronary heart disease mortality and events.

Trans fat intake is responsible for up to 500 000 premature deaths from coronary heart disease each year around the world.

Best-practices in trans fat elimination policies follow specific criteria established by WHO and limit industrially produced trans fat in all settings. There are two best-practice policy alternatives:

1. mandatory national limit of 2 grams of industrially produced trans fat per 100 grams of total fat in all foods (2% trans-fat); and
2. mandatory national ban on the production or use of partially hydrogenated oils (a major source of trans fat) as an ingredient in all foods.

Population coverage of best-practice policies has increased almost six-fold since 2018. Forty-three countries have now implemented best-practice policies for tackling trans fat in food, with 2.8 billion people protected globally.

Despite substantial progress, however, this still leaves 5 billion worldwide at risk from trans fat’s devastating health impacts with the global goal for its total elimination in 2023 remaining unattainable at this time.

Currently, 9 of the 16 countries with the highest estimated proportion of coronary heart disease deaths caused by trans fat intake do not have a best-practice policy. They are

1. Australia,
2. Azerbaijan,
3. Bhutan,
4. Ecuador,
5. Egypt,
6. Iran (Islamic Republic of),
7. Nepal,
8. Pakistan, and
9. Republic of Korea.

The WHO developed the REPLACE trans-fat action package to eliminate trans-fat by 2023.

Useful Links:

Link to the WHO news release:

https://www.who.int/news/item/23-01-2023-five-billion-people-unprotected-from-trans-fat-leading-to-heart-disease

Link to the related WHO Report:

https://www.who.int/publications/i/item/9789240067233

Link to REPLACE action plan:

https://www.who.int/teams/nutrition-and-food-safety/replace-trans-fat