You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View
Latest Type 2 Issues Articles
Popular Type 2 Issues Articles
Highly Recommended Type 2 Issues Articles
Send a link to this page to your friends and colleagues.
A food ingredient long regarded as a "silent killer" may be brought to justice next spring.
The U.S. Food and Drug Administration (FDA) is recommending that trans fatty acids—also known as trans fats—be sentenced to appear on the nutrition facts panel of food labels. This comes after a July 11, 2002, Institute of Medicine (IOM) report found that there is no safe level of trans fats in the diet. The IOM, which is a branch of the National Academy of Sciences (an independent organization chartered by Congress to advise the government on scientific matters), undertook the study after the FDA began to address the issue of whether trans fats should be listed on food labels.
Found Even in 'Low-Fat' Foods
Trans fats are created through the process of hydrogenation, which solidifies liquid oils. Hydrogenation, according to the FDA, increases the shelf life and flavor stability of the oils and foods that are processed in this manner.
Trans fat levels are currently not listed on nutrition facts panels. Nevertheless, even products labeled "low-fat" are allowed to contain trans fats.
Trans fats can be found in numerous food items, including:
The 'Biggest Food-Processing Disaster in U.S. History'
In November 1999, the FDA first proposed that nutrition facts panels list trans fat levels. The FDA arrived at this decision after studies indicated that consumption of trans fats contributes to increased LDL ("bad") cholesterol and decreased HDL ("good") cholesterol, which heighten the risk of coronary heart disease.
In the March 3, 2001, issue of USA Weekend, Walter C. Willett, MD, DrPH, chair of the Department of Nutrition at Harvard Medical School in Boston, Massachusetts, blamed trans fats for at least 30,000 premature deaths a year. Willet called the introduction of trans fats in the 1940s the "biggest food-processing disaster in U.S. history."
According to the American Diabetes Association (ADA), the FDA previously estimated that listing trans fats on food labels would save between 2,000 and 5,600 lives a year, either as a result of people choosing healthier foods or as a result of manufacturers improving their recipes to omit these fats.
Joy Pape, RN, BSN, CDE, WOCN, and president of EnJoy Life! LLC, in Columbia, Missouri, agrees that trans fats increase LDL cholesterol, triglycerides and lipoprotein (a) and decrease HDL cholesterol. Pape says they also make platelets—the parts of the blood cell that have to do with blood clotting—"stickier."
"Put these together, and we have even greater increased risk for heart disease for people with diabetes."
Marion J. Franz, MS, RD, CDE, of Nutrition Concepts by Franz, Inc., believes that people with diabetes should be aware of trans fats. She also stresses that the focus on trans fats should not override the concern for saturated fats.
"Thirteen percent of our calories come from saturated fat," says Franz. "Clearly, it is more important to focus on saturated fats. Furthermore, because trans fats are added to foods, the food industry is in the process of cutting back or eliminating their use, while saturated fats are found naturally in foods, [which makes it] much harder to reduce intake."
Tips for Lowering Trans Fat Intake
Hope Warshaw, MMSc, RD, CDE, and author of "The Diabetes Food and Nutrition Bible," published by the ADA, advises that people can lower their intake of trans fats by taking the following steps:
"Especially lower fat intake from commercial foods—margarine, fried fast foods, cookies, crackers, etc. This is where the trans fats are."
"We know that saturated fat intake represents a higher percent of fat intake than trans fats. We also know that saturated fat is deleterious in raising LDL cholesterol. If [people] decrease saturated fat, they are also decreasing trans fats because there are some trans fats in meats and dairy foods. Use lean meats, and choose low- or no-fat dairy foods."
"Purchase a trans-fat-free margarine, and perhaps take advantage of some other trans-fat-free products out there. Use more healthy fats (monounsaturated fats)—olive oil, olives, avocado, some nuts, canola oil, etc."
Keeping It Simple
Since it considers no amount safe, the Institute of Medicine declined to list an upper limit for trans fats in the diet. Instead, it simply recommends "that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet."
The ADA's 2002 Clinical Practice Recommendations contain no recommendation for a safe intake level of trans fats, beyond advising that the "intake of trans-unsaturated fatty acids should be minimized."
Pape advises her patients to avoid trans fats altogether, "understanding that living in the real world, people will not be able to totally avoid them when eating in restaurants, etc."
Trans Fats and Type 2 Diabetes Study Outlines Associative Risk
While Harvard University researchers suggest that total fat intake as well as saturated and monounsaturated fatty acid intakes are not associated with the risk of type 2 diabetes in women, they agree that trans fatty acid intake is.
According to a study presented in the June 2001 issue of the American Journal of Clinical Nutrition, researchers from the Departments of Nutrition and Epidemiology at the Harvard School of Public Health examined the relationship between dietary fat intakes and the risk of type 2 diabetes.
The study observed 84,204 women, ages 34 to 59, who had no diabetes, cardiovascular disease or cancer in 1980. Detailed dietary information was assessed at the beginning of the study and updated in 1984, 1986 and 1990.
During follow-up, 2,507 incident cases of type 2 diabetes were documented.
"Total fat intake," write the researchers, "compared with equivalent energy intake from carbohydrates, was not associated with risk of type 2 diabetes." In addition, "intakes of saturated or monounsaturated fatty acids were also not significantly associated with the risk of diabetes."
However, they found that for a 2 percent increase in energy from trans fatty acids, there was a 1.39 relative risk of developing type 2 diabetes.
"We estimated that replacing 2 percent of energy from trans fatty acids with polyunsaturated fat would lead to a 40 percent lower risk."
Obesity Culprits to Reduce or Eliminate Trans Fats From Some Foods
In a September 3, 2002, company news release, McDonald's USA announced it would significantly reduce trans fatty acid levels in its fried menu items with the introduction of "improved cooking oil" in all of its 13,000 restaurants.
The new oils—which the company plans to use to prepare its french fries, hash browns, Chicken McNuggets, Filet-O-Fish and crispy chicken sandwiches—will not change total fat levels but will reduce trans fatty acid levels by 48 percent, decrease saturated fat by 16 percent and increase polyunsaturated fat by 167 percent.
Two weeks later, Frito-Lay one-upped McDonald's by announcing it will eliminate trans fatty acids from its salty snacks, including Doritos, Tostitos and Cheetos.
According to a September 24, 2002, press release from PepsiCo (Frito-Lay's parent company), trans fatty acids will be eliminated by early next year and replaced with corn oils.
Dec 1, 2002
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.