Global Surveillance of trans-Fatty Acids

Abstract

Trans-fatty acid (TFA) intake can increase the risk of coronary heart disease (CHD) morbidity and mortality and all-cause mortality. Industrially produced TFAs and ruminant TFAs are the major sources in foods. TFA intake and TFA-attributed CHD mortality vary widely worldwide. Excessive TFA intake is a health threat in high-income countries; however, it is also a threat in low- and middle-income countries (LMICs). Data on TFA intake are scarce in many LMICs and an urgent need exists to monitor TFAs globally. We reviewed global TFA intake and TFA-attributed CHD mortality and current progress toward policy or regulation on elimination of industrially produced TFAs in foods worldwide. Human biological tissues can be used as biomarkers of TFAs because they reflect actual intake from various foods. Measuring blood TFA levels is a direct and reliable method to quantify TFA intake.

Figure 1

Pareto analysis on the estimated number of deaths from coronary heart disease attributable to high intake of trans-fatty acids (TFAs) (defined by Wang et al [8] as >0.5% of total energy intake), top 30 countries. Pareto charts are used to describe the countries in descending order of the total estimated number of CHD deaths worldwide (9). In this chart, bars indicate the estimated number of CHD deaths attributable to high TFA intake, the curved line indicates cumulative percentages, and the dashed line indicates the 15 countries that account for 80% of total CHD deaths attributable to high TFA intake worldwide according to the Pareto principle (the 80/20 rule). Data source: Wang et al (8).

Figure 2

Countries with policies or regulations on industrially produced (artificial) TFAs. Data source: World Health Organization (14). Abbreviation: PHO, partially hydrogenated oil; TFA, trans-fatty acid.