August 30, 2021
By Dr Sundeep Mishra
Even as the ongoing pandemic takes a toll on the health and well-being of the world, the other silent epidemic of non-communicable diseases (NCDs) including cardio-vascular diseases, stroke, cancer, and diabetes continue to kill 41 million people annually. Cardiovascular account for nearly half of all NCD deaths and many of these deaths are in people under 70 years of age, and most occur in low- and middle-income countries. Research has revealed that consumption of high levels of trans fatty acids (TFA) increases the risk of coronary heart disease and death. World over, approximately half a million people die of CHD that can be directly linked to TFA consumption. In India, this number is at least as high as 72,000 people annually.
WHO has called for elimination of TFA from the global food supply by 2023.It is considered a health best buy – a policy measure that will positively impact several million lives. In the last few decades, India has witnessed a significant rapid change in dietary patterns that has led to the rise of NCDs and related comorbidities in young children, adolescents, young adults, and the elderly. A series of international and national research papers have directly linked TFA to coronary heart diseases (CHD). According to Hyderabad-based National Institute of Nutrition (NIN), the daily intake of TFA should not exceed 1 per cent of energy intake. Doctors and researchers have also found that TFA causes a rise in LDL cholesterol levels (Bad cholesterol) and lowers good cholesterol (HDL). It also increases risk of developing heart disease, stroke and is associated with a higher risk of causing type 2 Diabetes.
According to the World Health Organization (WHO), ‘replacement of TFA with unsaturated fatty acids decreases the risk of CHD, in part, by eliminating the negative effects of TFA on blood lipids. Besides the harmful effect on lipid profile, there are indications that TFA may also increase inflammation and endothelial dysfunction’ as well. The recently launched REPLACE report 2020 by WHO emphasizes on the elimination of TFA from food supply chains as one of the most effective public health interventions and one of the ‘Best Buys’ for NCDs. This can be efficiently done by promoting the replacement of industrial TFA with healthier fats and oils.
But countries like India face huge challenges to trans-fat reduction as there is a prominent presence of the informal food sector which includes the small manufacturing enterprises and small traders and service providers, legal and illegal activities and a wide array of small traders. These factors reduce capacity for enforcing compliance with policies and regulations within the system.
In India, the main source of trans-fat is Vanaspati, a form of vegetable ghee that is a Partially Hydrogenated Vegetable Oil (PHVO). It has an important role in India’s edible oil economy with a production of about 1.2 million tonnes annually (around 10% share of the edible oil market). With rising consumption of edible oil; from 9.7 million tons in 2000–01 to 14.3 million tons during 2007–08, it can be inferred that edible oil consumption is rising, but the pace of Vanaspati consumption rising cannot be clearly stated, which poses a serious threat.
In 2013, India implemented a mandatory limit of 10% trans-fat in specific fats/oils. In 2017, the mandatory limit was reduced to 5% in fats/oils. In 2018, India made a commitment to reduce TFA in foods and oils to 3% by 2021 and 2% by 2022. While the Food Safety and Standards Authority of India released a draft regulation seeking to limit the amount of TFA in edible oils in 2019, the same has not been notified. Further, no progress has been on the same commitment for the entire food system.
Eliminating trans-fat from food supply chains is one of the most effective public health interventions to reduce NCDs as they are non-essential dietary components. Many countries globally have achieved success in TFA reduction through combined efforts like compulsory trans-fat labelling, public awareness campaigns, and engagement with industry to reformulate products and regulation of levels of trans- fats nationally and locally for most effective outcomes.
The intensive battle against the meanest fats in our food and health systems is a long one as the way forward is full of challenges. Concerted actions with relevant stakeholders at the ground level in partnerships with international agencies and private corporates can help in achieving healthier outcomes by creating a safer food system and reducing the disease burden in India.(ET HealthWorld).
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