Hello and welcome to Nutrition Facts. I’m your host, Dr. Michael Greger. Today, we’re going to explore smart nutrition choices based, naturally, on facts. Whenever there’s a new drug or surgical procedure, you can be assured that you and your doctor will probably hear about it because there’s a corporate budget driving its promotion; but, what about advances in the field of nutrition? That’s what this podcast is all about.

A lot of junk food comes loaded with trans fats which, when consumed in nearly any quantity, may raise our bad “LDL” cholesterol. These killer fats can be found in hydrogenated vegetable oils like margarine and shortenings, as well as in meat and dairy.

The food industry fought tooth and nail to retain partially hydrogenated oils, even though they were killing an estimated 50,000 Americans every year. Here’s the story.

In 1993, the Harvard Nurses’ Study found that high intake of trans fats may increase the risk of heart disease by 50%. That’s where the trans fat story started, in Denmark, ending a decade later with a ban on added trans fats there in 2003. It took another 10 years, though, before the U.S. even started considering a ban. All the while, trans fats were killing tens of thousands of Americans every year. Why, if so many people were dying, did it take so long for the U.S. to suggest taking action?

One can look at the fight over New York City’s trans fat ban for a microcosm of the national debate. “Opposition came,” not surprisingly, “from [the food] industry,” complaining “about government intrusion,” likening the city to a “nanny state.” “Are trans fat bans…the road to food fascism?” Yes, a ban on added trans fats might save 50,000 American lives every year, which might save the country tens of billions of dollars in healthcare costs. Not so fast, though. If people eating trans fat die early, think how much we could save on Medicare and Social Security. That’s why “smokers [may] actually cost society less than nonsmokers, because smokers die earlier.” So, “we should be careful about making claims about the potential cost savings of trans fat bans.” “More research is needed on the effects of these policies.” Yes, we might save 50,000 lives a year, but you have to think about “the effects on the food industry.”

How about just “education and product labeling,” rather than the “extreme measure of banning” trans fats? As the leading Danish cardiologist put it, when we discover a food additive that’s dangerous, we don’t label it, we simply remove it. But, we’re Americans! “As they say in North America: ‘You can put poison in food if you label it properly.’” But look, people who are informed and know the risks should be able to eat whatever they want. But that’s assuming they’re given all the facts, which doesn’t always happen, “due to deception and manipulation” by the food industry.

And, not surprisingly, it’s the unhealthiest of foods that are most commonly promoted, using deceptive marketing. It’s not because junk food companies are evil, or want to make us sick. “The reason is one of simple economics—[processed foods simply] offer higher profit margins and are shelf-stable, unlike fresh foods, such as fruit[s] and vegetables.” So, their “model of systemic dishonesty,” some argue, “justifies some minimal level of governmental intervention.”

But what about the slippery slope? “Today, trans fats; tomorrow, hot dogs.” Or the reverse, what if they make us eat broccoli? This actually came up in a Supreme Court case over Obamacare. As Chief Justice Roberts said, Congress could start ordering everyone to buy vegetables, a concern Justice Ginsburg labeled “the broccoli horrible.” Hypothetically, Congress could compel the American public to go plant-based; yet, one can’t “offer the ‘hypothetical and unreal possibilit[y]…of a vegetarian state as a credible [argument].” As one legal scholar put it, “Judges and lawyers [may] live on the slippery slope of analogies, [but] they are not supposed to ski it to the bottom.”

If anything, what about “the slippery slope of inaction”? “Government initially defaulted to business interests in the case of tobacco and pursued weak and ineffective attempts at education” to try to counter all the tobacco industry lies, and look what happened. The unnecessary deaths could be counted in the millions. “The U.S. can ill-afford to repeat this mistake with diet.”

After the trans fat oil ban, the only major sources of trans fat remaining will be from meat and dairy.

The years of healthy life lost due to our consumption of trans fats is “comparable to the impact of” conditions like meningitis, cervical cancer, and multiple sclerosis. But, if food zealots get their wish in banning added trans fats, what’s next? “[V]ested corporate interests” rally around these kinds of “slippery slope” arguments to distract from the fact that people are dying.

New York Mayor Bloomberg was decried as a “meddling nanny” for his trans-fat ban and attempt to cap soft drink sizes. How dare he try to manipulate consumer choice? But, isn’t that what the industry’s done? In 1950, “[a] twelve-ounce soda…was [the] king-sized” option. Now, that’s like the kiddie size.

Similarly, with trans fats, it was the industry that limited our choice by putting trans fats in everything without even telling us. So, who’s the nanny now?

New York City finally won its trans-fat fight, preserving its status as a public health leader. “For example, it took decades to achieve a national prohibition of lead paint, despite unequivocal evidence for harm.” But New York led the way, banning it “18 years before federal action.”

There’s irony in the slippery slope argument that first, they came for your fries; next, they’ll come for your burger. After the trans fat-oil ban, one of the only sources of trans fat left will be in the meat itself. “Trans fats naturally exist in small amounts in the fat in meat and milk,” as I’ve talked about before. Animal products only used to provide about a fifth of America’s trans-fat intake, but since the U.S. trans fat-ban exempts animal products, they will soon take over as the leading source.

In Denmark, for example, now that added trans fats are banned, the only real trans fat exposure left is from animal products found in U.S. dairy, beef, chicken fat, turkey meat, lunch meat, hot dogs—with trace amounts in vegetable oils, due to the refining process.

The question is: are animal trans fats as bad as processed food-trans fats? A compilation of randomized interventional trials found that they both make bad cholesterol go up; they both make good cholesterol go down; and so, they both make the ratio of bad to good go up, which is bad. So, all trans fats cause negative effects, “irrespective of their origin.” They suspect that removing natural trans fats from the diet too could prevent tens of thousands of heart attacks. But, unlike processed foods, you can’t remove trans fats from milk and meat, because trans fats are there naturally.

The livestock industry suggests a little bit of their trans fats might not be too bad. But you saw the same everything-in-moderation-argument coming from the “Institute of Shortening” after industrial trans fats were first exposed as a threat. The bottom line is that “all sources of trans fat should [probably] be minimized.” The trans fat in processed foods can be banned, and just adhering to the current dietary guidelines to restrict saturated fat intake, which is primarily found in meat and dairy as well, would kind of automatically cut trans fat intake from animal fats.

The reason no progress may have been made on animal trans fat reduction in Denmark is because The Nutrition Council that pushed for the trans fat ban was a joint initiative of “The Medical Association and The Dairy Board.” They recognized that “the economic support from The Dairy Council could be perceived as problematic” from a scientific integrity point of view. But not to worry, the medical association expanded the board and funding members to include “the Danish pork industry, the Danish meat industry, The Poultry and Egg Council”, as well as Big Margarine.

About half of America’s trans fat intake now comes from animal products. Here’s the story.

Trans fats are bad, increasing one’s risk of heart disease, sudden death, and diabetes; even, perhaps, aggression. Trans fat intake has been associated with overt aggressive behavior, impatience, and irritability.

Trans fats are basically only found one place in nature—animal fat. The food industry, however, found a way to synthetically create these toxic fats by hardening vegetable oil in a process called hydrogenation, which rearranges their atoms to make them behave more like animal fats.

Although most of America’s trans fat intake has traditionally come from processed foods containing partially hydrogenated oils, a fifth of the trans fats in the American diet used to come from animal products—1.2 grams out of the 5.8 total consumed daily, on average. But, now that trans fat labeling has been mandated, and places like New York City banned the use of partially hydrogenated oils, the intake of industrially-produced trans fat is down to about 1.3. So, that means about 50% of America’s trans fat intake now comes from animal products.

According to the official USDA Nutrient Database, cheese, milk, yogurt, burgers, chicken fat, turkey meat, bologna, hot dogs contain up to about between 1 to 5% trans fats. They also found small amounts of trans fats in non-hydrogenated vegetable oils, due to steam deodorization or stripping during the refining process.

Now, is getting a few percent trans fats a problem, though? The most prestigious scientific body in the United States, the National Academies of Science, concluded that the only safe intake of trans fats is zero. In their report condemning trans fats, they couldn’t even assign a Tolerable Upper Daily Limit of intake because “any incremental increase in trans fatty acid intake increases [coronary heart disease] risk.”

There’s been controversy, though, as to whether the trans fats naturally found in animal products are as bad as the synthetic fats in partially hydrogenated junk food. The latest “study supports the notion that [trans fat] intake, irrespective of source [animal or industrial] increases [cardiovascular disease] risk.” Especially, it appears, in women.

“Because trans fats are unavoidable on ordinary, nonvegan diets,” getting down to zero percent trans fats “would require significant changes in patterns of dietary intake.” One of the authors of the report, the Director of Harvard’s Cardiovascular Epidemiology Program, famously explained why—despite this—they did not recommend a vegan diet: “We can’t tell people to stop eating all meat and all dairy products,” he said. “Well, we could tell people to, become vegetarians,” he added. “If we were truly basing this only on science, we would, but it is a bit extreme.” Wouldn’t want scientists basing anything on science now, would we? “Nevertheless,” the report concludes, “it is recommended that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet.”

Even eating vegan, though, there’s a loophole in labeling regulations, that allows foods with trans fats that contain up to 0.5 grams per serving to be listed as having, you guessed it, zero grams of trans fat. “This labeling is misguiding the public by allowing foods to be labeled as ‘trans fat free’ when they are, in fact, not.”

So, to avoid all trans fats, avoid meat and dairy, refined oils, and anything that says “partially hydrogenated” in the ingredients list—regardless of what it says on the nutrition facts label.

To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts podcast landing page. There, you’ll find all the detailed information you need plus links to all the sources we cite for each of these topics.

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Thanks for listening to Nutrition Facts. I’m Dr. Michael Greger.

This is just an approximation of the audio content, contributed by Allyson Burnett.