Understanding the Complexity of Trans Fatty Acid Reduction in the American Diet
American Heart Association Trans Fat Conference 2006: Report of the Trans Fat Conference Planning Group
- History of Trans Fatty Acids in Health
- Value of Addressing Trans Fatty Acid Issues to Help Consumers
- Food Science Behind Fatty Acid Technology
- Fats and Oils for Human Consumption
- Health Sciences of Dietary Fatty Acids
- Summary of Trans Fatty Acid Alternatives Presented
- Considerations for Evaluating and Choosing Trans Fatty Acid Alternatives
- Considerations for Food Reformulation
- Use of Alternatives in Food Manufacturing (3 Case Studies)
- Use of Alternatives in Food Services (1 Supplier and 3 Case Studies)
- Key Learnings From Conference and Breakout Session
- Figures & Tables
- Info & Metrics
A 2-day forum was convened to discuss the current status and future implications of reducing trans fatty acids without increasing saturated fats in the food supply while maintaining functionality and consumer acceptance of packaged, processed, and prepared foods. Attendees represented the agriculture and oilseed industry and oil processing, food manufacturing, food service, government, food technology, and health and nutrition disciplines. Presentations included food science behind fatty acid technology, the health science of dietary fatty acids, alternatives to trans fatty acids, and the use of alternatives in food manufacturing and food service. The reduction of trans fatty acids in the food supply is a complex issue involving interdependent and interrelated stakeholders. Actions to reduce trans fatty acids need to carefully consider both intended and unintended consequences related to nutrition and public health. The unintended consequence of greatest concern is that fats and oils high in saturated fats, instead of the healthier unsaturated fats, might be used to replace fats and oils with trans fatty acids. Many different options of alternative oils and fats to replace trans fatty acids are available or in development. Decisions on the use of these alternatives need to consider availability, health effects, research and development investments, reformulated food quality and taste, supply-chain management, operational modifications, consumer acceptance, and cost. The conference demonstrated the value of collaboration between the food industry and health and nutrition professionals, and this conference model should be used to address other food development, processing, and/or technology issues.
In recent years, scientific studies, public and regulatory policy activity, and media coverage have focused extensively on issues related to trans fatty acid reduction in the American diet and potential benefits with respect to health outcomes. To discuss and address trans fatty acid reduction in the food supply with input from the agricultural and oilseed industry and oil processing and manufacturing, food manufacturing, food service, government, food technology, and health and nutrition disciplines, the American Heart Association convened the Trans Fat Conference from October 10 to 11, 2006, in Washington, DC.
The key objective of the conference was to provide an interactive and collaborative forum to discuss the current status and future implications of reducing the intake of trans fatty acids without increasing saturated fats as part of a balanced dietary approach to reduce the risk of cardiovascular disease while maintaining functionality and consumer acceptance of packaged, processed, and prepared foods.
History of Trans Fatty Acids in Health
The process of hydrogenation was first discovered around the turn of the 20th century by French chemist Paul Sabatier using a nickel catalyst. Shortly after, German chemist Wilhelm Normann developed a hydrogenation process using hydrogen gas. Modifications in the processing and formulation of hydrogenated fats continued through the mid-20th century. It was the partial hydrogenation of fats that introduced trans fatty acids (or trans fats) into fats of vegetable origin.
The use of partially hydrogenated fats accelerated in the 1960s, 1970s, and 1980s as food producers responded to public health recommendations to move away from animal fats and tropical oils. At the time, partially hydrogenated fats seemed to be a good alternative, particularly because of their stability, cost, availability, and functionality. Before the 1990s, limited data were available on the health effects of trans fatty acids, and the data often were contradictory. For example, an article published in 19571 found no significant effect between coconut oil (iodine value 9) and hydrogenated coconut oil (iodine value 5.2) on plasma cholesterol levels of 9 healthy males, probably because, independently of hydrogenation, the fat was composed of predominantly saturated fatty acids. (Iodine value is a measure of the total number of double bonds present in fats and oils. It is generally expressed in terms of number of grams of iodine that will react with the double bonds in 100 g of fats and oils.) In this same study, researchers reported that compared with coconut oil, the hydrogenated whale oil (iodine value 83) was similar in its effect on plasma cholesterol levels, whereas the nonhydrogenated whale oil (iodine value 118) was found to be hypocholesterolemic. One year later, researchers reported that within the context of a 35% butterfat diet, there was no significant difference between supplemental corn oil and hydrogenated corn oil.2
Between 1960 and 1990, numerous additional studies were published with inconsistent results. This variability is likely attributable to differences in the background diets, starting fatty acid profile of the test oil, differences in the degree and type of hydrogenation, and less-than-optimal comparison fats.
In 1990, Mensink and Katan3 compared the effect of diets rich in oleic acid, saturated fatty acids, and trans fatty acids. They reported that relative to a diet rich in oleic acid, total cholesterol and low-density lipoprotein (LDL) cholesterol levels were higher after subjects consumed diets rich in saturated or trans fatty acids. In contrast, relative to the diet rich in trans fatty acids, high-density lipoprotein (HDL) cholesterol levels were higher after subjects consumed the diets rich in saturated fatty acids or oleic acid. The differential effects on LDL and HDL cholesterol levels resulted in the least favorable total-to-HDL-cholesterol ratio after the subjects consumed the diet rich in trans fatty acids.
The negative effect of partial hydrogenation and resulting trans fatty acids on serum cholesterol levels bears out consistently in multiple research studies conducted throughout the 1990s. A 1999 study4 found that partial hydrogenation had a linear, positive relationship with LDL cholesterol levels in that increasing dietary intake of trans fatty acids increased the levels of LDL cholesterol. In contrast, HDL cholesterol levels remained relatively constant with increasing hydrogenation and decreased only with the highest level of hydrogenation, resulting in the least favorable total-to-HDL-cholesterol ratio. A recent meta-analysis of available data found that a 2% increase in energy intake from trans fatty acids was associated with a 23% increase in the incidence of coronary heart disease.5
The US Food and Drug Administration (FDA) mandated that as of January 1, 2006, the Nutrition Facts panels of all packaged food labels must indicate the quantity of trans fatty acids in a serving of the food product. Since the phasing in of this information, it appears that the regulatory action has catalyzed food manufacturers to reformulate many of their products to decrease levels of partially hydrogenated fats. This regulatory action also has resulted in an increased awareness about dietary trans fatty acids in the general public and in efforts by a number of cities and states to limit the trans fatty acid content of restaurant foods.
Value of Addressing Trans Fatty Acid Issues to Help Consumers
To address improvements in the health of the public related to trans fatty acid consumption, it is helpful to assess consumer understanding of dietary fats. The American Heart Association conducted an online consumer research survey in spring of 2006 with a national sample of 1000 adults 18 to 65 years of age. Results of this market research indicate that when asked if they had heard of the term “trans fats,” 84% of the respondents said yes. However, close to half of the respondents lacked understanding of the health effects of trans fats (Table 1).6–10
Other highlights of the survey include the following:
Fewer than half of those surveyed could identify any 1 food as typically containing trans fats, even when asked to choose from a list of foods. The top food identified as containing trans fats was doughnuts (44% of consumers). This compares with the higher knowledge that consumers exhibited regarding foods they thought contained saturated fats. Approximately 70% of consumers surveyed could correctly identify at least 3 foods containing saturated fats from the same list of foods.
Consumers were more likely to report specific “good” behaviors regarding saturated fats than regarding trans fats. For example, 50% of the respondents reported “using cooking sprays or vegetable oils instead of butter” compared with 23% who reported “reviewing information on trans fats specifically before making purchasing decisions.”
Americans are more likely to make healthy dietary changes when at home or in the supermarket than at restaurants. Most consumers (95%) surveyed did not ask about healthy food options or request nutrition information when eating out. Close to half of the respondents reported “never” or “rarely” ordering a menu item marked as being “healthy” in some way.
Food Science Behind Fatty Acid Technology
Most fats and oils consumed on a regular basis are a combination of several fatty acids. No fat or oil contains only 1 type of fatty acid. Saturated fatty acids are more stable than polyunsaturated and monounsaturated fatty acids. This stability is important in terms of the shelf life of packaged foods and the retardation of the rancidity of frying oils.
The major fatty acids found in food are palmitic, stearic, oleic, linoleic, and linolenic acids. Their structures, physical properties, functionality traits, and health effects are summarized in Table 2.
Trans fatty acids occur naturally at relatively low levels in meat and dairy products as a result of the fermentation process in the animal’s rumens. In the US diet, a large proportion of trans fatty acids (≈80%) is contributed by the partial hydrogenation of fats. Partial hydrogenation increases the shelf life and flavor stability of foods containing fats and gives the fat a higher melting point. Compared with fatty acids with cis bonds, trans fatty acids tend to be more stable in storage and during frying. Partially hydrogenated fats tend to be more solid than unsaturated fats but less solid than saturated fats. The major dietary sources of trans fatty acids are traditional vegetable shortenings and solid margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods. The actual amount coming from any of these products is changing rapidly as a result of efforts by food producers to decrease the level of trans fatty acids in their foods.
Measurement of Trans Fatty Acids
Two methods approved by the FDA for measuring fatty acid composition to declare the amount of trans fatty acids in the food on food labels are summarized next. There are advantages and disadvantages to both processes.
Gas chromatography, Association for Official Analytical Chemists method 996.06. In this process, fat is extracted from the food product and converted to fatty acid methyl esters before being injected onto a gas chromatography column ≈100 m long. It takes about 1 hour to run a sample with this process, and the method can measure individual trans fatty acid isomers to ≈0.1 g per serving. The advantage of this method is the ability to measure individual trans fatty acid isomers to as low as 0.1 g per serving, but the disadvantages are the long sample preparation and gas chromatography run times.
Attenuated total reflection–Fourier transform infrared spectroscopy (ATR-FTIR), American Oil Chemists’ Society method Cd 14d-96. In this process, fat is extracted from a food sample, and the neat (without solvent) sample is placed in an infrared cell. It takes ≈1 minute to read the sample with an accuracy of 0.5 g trans fatty acids per serving. The minimum trans fatty acid content of the sample must be 0.8% to 1% to get an accurate reading, depending on sample size. This method makes no distinction among the different trans fatty acid isomers and therefore can give a value only for the total trans fatty acids. Different trans fatty acid isomers may have different effects on health. For example, although trans fatty acids created through partial hydrogenation have been linked with an increased risk of coronary heart disease,5 vaccenic acid, a naturally occurring trans fatty acid in the fat of ruminants, is converted in human beings to rumenic acid, an isomer of conjugated linoleic acid.11 Conjugated linoleic acid has been shown to protect against some types of cancer in animals and humans.12 Therefore, the lack of sensitivity to different trans fatty acid isomers limits the usefulness of ATR-FTIR as an assessment method for other purposes. There are also limitations regarding the type of oil being measured; for example, the oil cannot contain large quantities (>5%) of conjugated unsaturated fatty acids (eg, tung oil), and the oil cannot contain functional groups around the isolated trans double bonds, all of which interfere with the ATR-FTIR measurement. The sample also must be liquid during measurement. Despite its limitations, most food manufacturers use this method because of its speed.
Fats and Oils for Human Consumption
Fats and oils for human consumption are usually separated into 3 categories: salad and cooking oils, frying oils, and solid fats. The quality issues of edible oils include oxidative stability, nutrient composition, and functionality.
Salad and Cooking Oils
Bland flavor, light color, good stability, and manufacturing processing and packaging flexibility are important for salad and cooking oils. Good choices to meet these requirements are polyunsaturated and monounsaturated oils. Less polyunsaturated fat is preferred to minimize the likelihood of rancidity and the need for refrigeration. This type of salad or cooking oils also is suitable for in-home 1-time deep frying and pan frying. The need for trans fatty acid reduction in this type of liquid oils is not an issue because most salad or in-home cooking oils on the market today do not contain trans fatty acids and cooking this type of oil in one’s kitchen does not produce trans fatty acids.
Commercial frying applications include restaurant frying such as the preparation of deep-fried foods and packaged foods such as snack chips.
Oils for commercial frying require stability related to the thermal deterioration processes of oxidation, hydrolysis, and polymerization. For consumer acceptance, the fatty acid composition of the oils needs to have 20% to 30% linoleic acid to produce a desirable full deep-fried flavor to the foods; however, higher levels of linoleic acid might introduce “off”-flavors from oxidation. For restaurant use, oils need to be stable because a long fry life is required and the oil has to withstand the high temperatures of commercial frying. Food manufacturers prefer stable oils that can also tolerate high temperatures and allow an extended shelf life for foods after they are packaged.
Stable frying oils are characterized by increased amounts of oleic acid (preferably in the moderate range of 50% to 65%), decreased amounts of linoleic acid (preferably in the 20% to 30% range), and decreased amounts of linolenic acid (preferably no more than 3%). It has been common to acquire stable commercial frying oils by changing the fatty acid composition by partial hydrogenation. Potential alternatives to partially hydrogenated oils for commercial frying include naturally stable oils such as corn, cottonseed, palm, peanut, and rice bran and modified fatty acid oils such as mid-oleic corn, high-oleic/low-linolenic canola, high-oleic sunflower, mid-oleic sunflower, low-linolenic soybean, and mid-oleic/low-linolenic soybean oils (Figure 1). In choosing trans fatty acid–free frying oils, consider the cost, availability, oxidative stability, functionality in terms of the appearance and texture, flavor, and nutrient composition of the option. Specifically, some of these oils such as animal fats and tropical oils contain high amounts of saturated fats and should not be considered as replacements.
Functionality parameters in solid fats (spreads and baking shortenings) include the melting point, lubricity, moisture barrier, and creaming ability. The parameters of fat content, emulsifiers, solid fat in blending, and melting point need to be in place before product development is begun. In the development of solid shortenings to reduce trans fatty acids, functional parameters such as plasticity for extrusion into dough and creaming properties are important. The dough should not be sticky or “oil out” (have the fats separate from the dough) at high temperatures. Solid shortenings packed in cubes need to allow handling without deformation.
Partially hydrogenated fats have been effective in achieving functionality and stability requirements in solid fats. To meet the functionality and stability requirements in solid fats while minimizing trans fatty acids, many of the current options typically include significantly increasing saturated fatty acids.
Several consumer brands of solid trans fatty acid–free margarines have become available in recent years, as have solid shortenings. The availability of these products for commercial use is uncertain at this time.
Health Sciences of Dietary Fatty Acids
Trends in Fatty Acid Supply and Intake in the United States
The US Department of Agriculture (USDA) Economic Research Service has maintained food supply data since 1909. The saturated fat content in the food supply has remained relatively stable between 1909 and 2000. Monounsaturated fats became the primary source of dietary fats in the 1950s and have shown a steady increase from 1960 through 2000. There also has been a steady increase in polyunsaturated fats in the US food supply during this same time.
In terms of per capita spread consumption, US margarine consumption was minimal before World War II, but after World War II, there was a significant increase. Margarine consumption surpassed the intake of butter during the 1960s, 1970s, and 1980s. In the 1990s, the consumption of margarine decreased, and the intake of butter remained constant. Today, there is essentially an equal intake of margarine and butter. On the basis of a proprietary analysis of AC Nielsen sales data conducted by the National Association of Margarine Manufacturers, there also has been a shift away from stick margarine to soft and liquid margarines, with soft and liquid margarines accounting for 72% of the margarine sales in 2006 compared with 46% in 1990.
The use of shortening increased steadily throughout the 20th century. Salad and cooking oils were separated from other edible oils in the USDA Census Bureau for Added Fats and Oils in the mid-1960s, and they represent the largest single source of fat in the US diet today.
World vegetable oil consumption is about 106 million metric tons, with soybean and palm oil representing ≈60% of this consumption (Table 3).13 The breakout of edible oil use in the United States is quite different. Americans consume ≈10% of all the edible oils in the world, and ≈75% of this is soybean oil.14 Key uses for soybean oil in the United States include baking and frying (44%), salad and cooking oils (44%), and margarine (7%).
Trans fatty acids have been included in the USDA National Nutrient Database for Standard Reference only since 1994,15 and only since 2002 was national randomized sampling conducted to derive trans fatty acid values. The database now contains trans fatty acid values for >800 food products, but this is only a fraction of the total products in the database. In addition, ≈50% of these 800-plus products are branded, and many of them have been reformulated since being added to the database. The rapid changes in product formulation led to challenges in maintaining accurate trans fatty acid consumption data.
A 2006 review16 showed that trans fatty acid consumption per person per day in the United States decreased from ≈10 g per person per day in 1984 to ≈4 g per person per day in 1995. Comparatively, in Denmark, the per capita consumption of trans fatty acids steadily declined through the 1980s and 1990s from slightly >2 g/d per person in 1992 to <0.5 g/d in 1999.17,18 In June 2003, Denmark introduced protection measures concerning trans fatty acids in food. As of January 2004, the level of industrially produced trans fatty acids in oil and fats intended for the consumer, either alone or as an ingredient in foodstuffs, must not exceed 2%. As a result, trans fatty acids created through partial hydrogenation have virtually been eliminated in Denmark.
Although mean values are available for per-person per-day trans fatty acid consumption, the range is high because of the variability of the trans fatty acid content in foods. For example, a review of 37 different kinds of bread, cake, and related products in the Washington, DC, area showed that the average grams of trans fatty acids (grams per 100 g fat) ranged from 0.0 to 48.8.19 The significant difference in the trans fatty acid content in products within each food category is due to differences in the type of fats and oils used in the manufacturing process.
Dietary Fatty Acids Affecting Cardiovascular Disease and Diabetes
Dietary fat profiles have a significant impact on health. Many studies have shown that trans fatty acids can adversely affect LDL and HDL cholesterol levels, and some data suggest that trans fatty acids adversely affect other outcomes.5
A meta-analysis of 60 controlled trials of dietary fats and blood lipids (Figure 2) show that as carbohydrates are replaced with polyunsaturated or monounsaturated fats, the ratios of total to HDL and LDL cholesterol decrease.20 However, when carbohydrates are replaced with trans fatty acids, the ratio of total to HDL cholesterol increases, as does LDL cholesterol. Trans fatty acids also are the only type of fats that do not raise HDL cholesterol.
Strong observational and experimental evidence also exists for the increasing risk of coronary heart disease associated with trans fatty acids. Multiple prospective studies and case-control studies have reported a positive association between trans fatty acid intake and the risk of developing coronary heart disease.21–23 A less mature data set suggests a positive association between trans fatty acid intake and type 2 diabetes and elevated inflammatory markers.24,25
The edible oil used most in North America is soybean oil, followed by canola oil and corn oil (Table 4). In 2005, of the ≈25 billion pounds of edible oils used, close to 18 billion pounds were soybean oil.
Soybean oil is commonly used because it is abundantly available, is a versatile base stock, and is cost competitive. However, liquid soybean oil is high in linolenic acid, and for rigorous applications such as commercial frying and baking, it is frequently hydrogenated to increase stability.
Alternatives to Partially Hydrogenated Fat
There are a number of alternatives to partially hydrogenated fat. Table 5 provides a summary and lists some of their advantages and drawbacks.
Summary of Trans Fatty Acid Alternatives Presented
To provide practical perspectives on the availability of quality edible oils that can be used to reduce trans fatty acids in the American food supply, representatives from 5 seed and oil processing companies spoke at the conference. They included representatives from Monsanto Company, DuPont/Pioneer Hi-Bred International, Dow AgroSciences, Archer Daniels Midland Company, and Cargill. Table 6 summarizes the trans fatty acid alternative commercial products presented at the conference.
On the basis of the estimates of the companies in Table 6, the national supply of these key trans fatty acid alternative commercial products would total ≈3.25 billion pounds in 2007, compared with the ≈9 billion pounds of partially hydrogenated oils that should be replaced in North America, as shown previously in Table 4.
Considerations for Evaluating and Choosing Trans Fatty Acid Alternatives
When evaluating alternatives to reduce trans fatty acids in the food supply, several considerations were raised in the presentations:
There are several different needs and therefore different solutions for oils. As a result, there is not one “fix” in terms of alternative oils.
There are various different applications with different attributes, including sensory needs, the level of nutrition benefit sought, and functionality.
Food companies might have brand claims or product positions that drive decisions on the oil choice.
Availability and cost considerations are paramount before a conversion can happen.
The dynamics of industrial marketing can influence the choice of commodity crops versus trait-enhanced oils. As shown in Figure 3, most (≈90%) of the soybeans and corn are currently sold as commodities for syrup (corn), meal, feed, alternative fuel, and starch.
In the meantime, trait-enhanced oils face the following challenges:
Additional costs are incurred. A grower premium is provided to farmers as an incentive for them to grow trait-enhanced beans and seeds and to compensate growers for their efforts at the segregation of trait-enhanced and commodity oilseeds. There are also additional oil processor costs related to the need to collect, crush, refine, and store the oil separately.
In the development of new varieties of oil seeds, long lead time is required. The decision about which specific seeds to grow is made several years in advance of oil delivery; thus, contract planting is necessary. The normal 4-year cycle begins with seed decisions in September of year 1 in anticipation of demand by the food industry in year 4. Seed production contracts are finalized in March of year 2. Farmers are contracted by January of year 3, with the delivery of oils in year 4. However, for seed companies that have ramped up production to address the rapidly growing market demand, the cycle could be shorter, from around 1 year to 20 months.
Some individual farmers do not want crops that require contract planting and identity preservation and are unwilling to go through the trouble of separating commodity and trait-enhanced oilseeds regardless of the grower premium provided by oilseed companies. This challenge can be magnified if the farmer can make a much higher profit by growing commodity soybean and corn for alternative fuels.
Growing demand of ethanol as an alternative fuel can drive up corn acreage and put pressure on soybean acreage.
Increasing demand for biodiesel/biofuels can drive up prices for soybean and palm, both attractive options given their historically low prices.
There are conceptually many pathways in generating alternatives for trans fatty acids. All of these pathways can lead to a significant reduction in trans fatty acids in the US food supply. Given that many pathways are available and factors of industrial marketing are at play, no perfect oil will dominate, and all of these options will be used.
Considerations for Food Reformulation
When food producers go through the time and expense for food reformulation, several issues should be considered:
There is no longer a standard all-purpose oil like partially hydrogenated soybean oil. Each product application is unique, and drop-in solutions (oil/fat ingredient with equivalent performance) are rare.
Extensive consumer testing must be conducted before the reformulated product is introduced to ensure acceptance.
The supply chain must be managed to ensure an adequate supply of new oils.
Transportation and storage are huge considerations that involve capital expense and lead time. Many manufacturing plants have only 1 storage tank, used for partially hydrogenated soybean oil. For reformulation, the plants may have to allow storage for various new oils.
Packaging must be reevaluated because reformulated products may require different packaging as a result of changes in fragility and/or shelf life.
Labels most likely need to be changed to communicate the benefits of reformulated products to consumers.
Consumer input must be obtained to clearly define the objectives for reformulation.
Reformulated products need to satisfy regulatory concerns in the United States and Canada because most food manufacturers cannot afford separate production lines for these 2 markets.
Food manufacturers should consider partnering to share research and development risks and expenses.
For many applications, food reformulation to reduce trans fatty acids is less of a technical challenge and more of a business decision. Several factors were identified that promote the reduction of trans fatty acids in the food supply: (1) leadership and commitment of corporate senior management, (2) collaboration across the supply chain and ongoing interindustry dialogue, (3) adequate supply of alternative ingredients for food reformulation, (4) increased competition in the marketplace to focus on health and wellness, (5) media coverage and consumer demand, and (6) regulation to stimulate changes.
Use of Alternatives in Food Manufacturing (3 Case Studies)
Many food manufacturers have reformulated their products in the United States to address the need for trans fatty acid reduction. (According to the Grocery Manufacturers Association and/or company press releases, as of January 2007, food manufacturers that have made significant efforts to reduce or eliminate partially hydrogenated oils/fats from their product portfolios include Campbell Soup Co, ConAgra Foods, General Mills, The Hershey Company, The J.M. Smucker Co, Johnson & Johnson, Kellogg Co, Kraft Foods, Nestle, PepsiCo, Proctor & Gamble, Sara Lee Corp, The Schwan Food Co, and Unilever.) For some companies, this change has come in the interest of public health, and for others, it is a result of the 2006 FDA labeling requirement to indicate trans fatty acid content in the nutrition label on packaged foods. The transition to “zero trans” or “low trans” products has generally taken several years and involved economic, supply, formulation, packaging, and market research considerations. This conference included case studies from Frito-Lay North America, a division of PepsiCo, and Unilever North America, 2 food manufacturers that were among the first companies to reformulate their products to reduce trans fatty acids. In addition, a representative of the American Institute of Baking International (AIB) addressed issues related to commercially baked goods and trans fatty acids.
Frito-Lay North America
Summary of Presentation by Robert Brown, PhD, MPH
With the September 2002 release of the Institute of Medicine’s “Report on Dietary Reference Intakes of Trans Fatty Acids,”9 Frito-Lay responded with a strategic decision in November 2002 to ensure that all of their oils would be “trans fat free” within the year. The company’s Nutrition and Regulatory Affairs Division had been doing research and development on options for trans fatty acid alternatives since the late 1990s, and by 2002, viable options had been identified. Frito-Lay based its decision on nutrition using a parameter of unsaturated-to-saturated or –trans fatty acid ratio, as well as considerations for flavor, stability, and cost. In 2002, corn oil was identified as a viable option, although it contributed to only 2.2% of the world supply. By July 2003, trans fatty acids had been eliminated from the company’s most popular brands, including potato chips, which had been fried in partially hydrogenated oils. Mid-oleic sunflower oil also was identified as a viable option to replace cottonseed oil used in another brand of potato chips. However, it took 4 years of working with farmers in North Dakota to plant mid-oleic instead of regular sunflower seeds to generate an adequate supply. In 2006, the mid-oleic sunflower oil was used instead of cottonseed oil to reduce saturated fats and to increase polyunsaturated fats in one of their major brands of potato chips.
Several significant challenges had to be overcome during the reformulation:
The reformulation required 7200 man-hours and involved 243 analytical tests and 25 consumer tests. This resulted in more than $25 million in expenses to transition 187 product lines in 45 plants while working with only 3 oil suppliers.
The decision to use oils with limited supplies resulted in higher raw material costs that were not passed on to consumers and the need to address oil handling, transportation, and storage issues. Because of differences in the stability of the new oils, new packaging to prevent oxidation of the products was required, along with new labeling.
Extensive testing was necessary to ensure that the end products made with the new oils tasted the same to consumers.
Frito-Lay continues to face challenges that need to be addressed:
Unreliable corn oil supply. Most of the corn is grown for sweeteners used in soft drinks, with oil being a secondary product. Although demand for ethanol could increase the corn supply, less consumption of sweetened soft drinks could decrease the supply.
The supply of mid-oleic sunflower oil continues to be limited.
The demand for trans fatty acid–free edible oils is growing rapidly and continues to put pressure on the supply chain.
Oils low in trans fatty acids and saturated fats are not widely available in Europe, where palm oil is used extensively.
The company’s cookies and crackers line is challenged with finding functional alternatives low in trans fatty acids and saturated fats because many trans fatty acid–free alternatives are high in saturated fats.
Unilever North America
Summary of Presentation by Ravinder Reddy, PhD
Unilever is a multinational company with products in the categories of nutrition, hygiene, health, and beauty. This case study focuses on spreads, of which Unilever is the world’s leading producer. With its global reach, connection with the nutrition science community, and extensive technical capabilities, Unilever was able to assess the emerging science and to act quickly to innovate. Unilever was among the first companies to reformulate spreads to reduce the amount of trans fatty acids.
Unilever has invested in research and development in nutrition and heart health for >40 years, including sponsoring independent research to examine the effects of foods on health. Unilever has expertise and proprietary knowledge in oil application technologies. In the early 1990s, scientific data emerged suggesting that trans fatty acids may have a negative impact on blood cholesterol levels. Unilever initiated an extensive research program that included sponsoring independent scientific research, and by 1993, spreads with very low trans fatty acid content had been developed. These products became readily available by 1995, made with tropical oils in Europe and Latin America. In North America, the science community and consumer groups did not favor using tropical oils to replace trans fatty acids because of concern about increasing the saturated fat content. Therefore, in North America, Unilever developed proprietary solutions using mainly nontropical oils such as soybean, canola, and sunflower oils.
Unilever developed a global position and policy on spreads to ensure that technologies be developed to minimize the combined amount of trans fatty acids and saturated fats for all Unilever products on the market in each country. Spreads and margarine are to be virtually free of trans fatty acid worldwide (<1 g/100 g or as legally defined). After reformulation, the company policy is that the combined amount of saturated fats and trans fatty acids must not exceed existing levels.
However, to make an impact on public health, the food products must be consumed. Unilever invested in research to ensure that these new products met consumer expectations. The products must be sufficiently easy to spread soon after being taken from the refrigerator. The spread must remain stable at room temperatures and have acceptable texture, “mouth feel,” and taste. To make the transition, Unilever took a step-by-step approach by screening and sourcing novel raw materials and developing partnerships with suppliers, using technologies such as rearrangement and fractionation to produce trans fatty acid–free hard fats, and using extensive processing knowledge to develop trans fatty acid–free spreads at the lowest costs.
Since the initial phase of product reformulation in 1995, Unilever has developed new fat blends and novel processes to produce trans fatty acid–free spreads that have lower saturated fat and higher unsaturated fat contents. The company continues to have a leading role in nutrition research and has a corporate strategy to provide leadership in the industry to significantly improve public health.
Summary of Presentation by Brian L. Strouts
Partially hydrogenated fats have been used extensively in commercial baking processes, resulting in high levels of trans fatty acids in commercially baked goods. AIB is primarily a research and education organization that tests and recommends shortenings and oils to food manufacturers for their baked products.
Fats and oils in baked goods serve multiple functions that are integral to the product, including tenderizing, aerating, allowing a clear definition of structure, ensuring sufficient shelf life, flavoring and flavor carrying, and emulsifying.
Typical types of shortenings include regular hydrogenated shortening, frying shortening, hard fats, emulsified hydrogenated shortening, fluid shortening, butter, and margarine. Challenges to changing from these ingredients to trans fatty acid–free solutions include the following:
Functional differences with the loss of volume, any appearance change, the development of a greasy or oily character, and different interactions with the water component of a batter.
Process issues such as achieving specific gravity in batters and cream fillings to avoid changing packaging, batter emulsification, loss of sheet-forming capability and disruption of dough film forming, and frying shortening breakdown, foaming, and darkening.
Reduction in shelf life and changes in texture, including in some products such as cakes and muffins, loss of softness, and in others, such as cookies and crackers, loss of crispness.
Flavor differences such as an off-flavor note in high-fat products, different eating quality, and flavor development from the frying process.
The AIB indicates that because of the different functional properties required for the wide variety of baked goods, many types of fats and shortenings may be needed, and the right ingredient may have to be obtained through trial and error. The challenge is especially formidable in the manufacturing of cakes, cookies, biscuits, pie crusts, pastries, and doughnuts.
As an example of the extensive and time-consuming experimentation that often is necessary, the AIB worked with a manufacturer to overcome the problem of a “flat puff pastry” by manipulating and adjusting different fractions of palm oil on the basis of performance for a brand of shortening. The resulting pastry was the same in quality as the one produced by an all-purpose partially hydrogenated puff pastry shortening (Figure 4). In the beginning of the process, the puff pastry was flat and unacceptable, just like the one produced with another no-trans alternative.
In the food service environment, restaurants and bakeries also have to go through extensive recipe reworking and product testing to ensure that their baked goods made with trans fatty acid–free oils and shortenings meet standards for taste, texture, and shelf life. Challenges appear to exist in finding trans fatty acid–free alternative shortenings without increasing saturated fats to meet the functionality requirements. In food manufacturing and food service, many companies that made a switch to trans fatty acid–free alternatives for their baked goods chose shortenings made with palm oil or butter.
Use of Alternatives in Food Services (1 Supplier and 3 Case Studies)
Although the packaged food industry has been greatly affected by the January 2006 trans fatty acid labeling requirement, the food service industry does not have a similar labeling mandate in place. However, in December 2006, the New York City Board of Health passed regulation to phase out the use of trans fatty acids in city restaurants. Legislative and regulatory efforts to ban trans fatty acids in food service also have been proposed in several other cities and states. Many notable restaurants and food service businesses have taken steps to reduce or eliminate trans fatty acids from menu items. (As of January 2007, restaurant chains and food service companies that have made public announcements of their intention to switch to trans fatty acid–free frying oils and/or trans fatty acid–free baked goods in their locations include Arby’s, Au Bon Pain, The Cheesecake Factory, Chili’s, The Compass Group, Denny’s, Disney theme parks, The Holland Inc., KFC Corp, The Kroger Co [chicken fryer], Legal Sea Foods, Loews Hotels, Olive Garden, Panera Bread, Red Lobster, Ruby Tuesday, Starbucks, Taco Bell, Universal Studios theme parks, and Wendy’s.) Three case studies showcasing the trans fatty acid reduction experiences at a regional chain (The Holland Inc.), a national chain (Ruby Tuesday), and an international food service corporation (The Compass Group) were presented.
ACH Food Companies
Summary of Presentation by Pete Friedman, MS
The session began with ACH Food Companies, a fats and oils supplier to both the consumer and food service markets. Given the importance of frying in restaurants, fry studies are conducted by food oil companies on a regular basis. Oils are evaluated during fry tests in the laboratory or in the restaurant on parameters such as color, free-fatty-acid content, polar compound concentrations, flavor, and degree of foaming and polymerization. Of the various oil evaluation parameters, ACH indicates that color is an important measure in restaurant operations because it is fairly practical to implement an oil change schedule with the help of a color testing kit. The ideal frying oil would have a low cost while maintaining a high oil quality for a long period of time. A review of oil costs found that the RBD (refined, bleached, and deodorized) soybean oil is the least costly oil on a per-unit basis, but with the 1- to 2-hour stability under high heat, it often cannot be used in restaurants. In comparison, high-oleic canola oil and high-oleic sunflower oil tend to have the highest initial costs. However, the longer fry life of high-oleic canola oil and sunflower oil is expected to offset some of the initial higher costs to restaurants. In addition, cost is a dynamic issue that tends to change frequently. ACH anticipates that once high-oleic canola and low-linolenic soybean oils reach >1 billion pounds per year, the cost differentials will be reduced.
The choice of frying oils is important to quick-service (fast food) restaurants because fried foods are predominant on their menus. Oil cost has driven many decisions. Customers do not usually ask for trans fatty acid–free oils or foods in quick-service restaurants.
Casual dining restaurants rely less on fried foods than do quick-service restaurants. The lower volume of fried foods and different cooking applications could make it easier to switch to trans fatty acid–free oils in this setting. Fine-dining establishments offer few fried foods, and trans fatty acid oil use is not a typical concern in that sector.
The Holland Inc.
Summary of Presentation by Debe Nagy-Nero, MS, RD
The Holland Inc., a regional chain of 40 quick-service restaurants in the Pacific Northwest, switched to a trans fatty acid–free frying oil in January 2006. The motivating factors were both their mission of “doing the right thing” based on literature documenting the deleterious effects of trans fatty acids and questions from their guests. The decision took 9 months to implement, starting with buying a trans fatty acid–free canola oil from an existing supplier, getting acceptance from the corporate committee, educating personnel about trans fatty acids, setting up oil testing at a pilot restaurant, deciding between current par-fried French fries containing trans fatty acids and trans fatty acid–free fries on the basis of taste, and finally laboratory testing to obtain the nutritional content of the foods. The restaurants advertise using a trans fatty acid–free oil in their kitchens at the front counter, and customer reactions are generally positive. The biggest challenge has involved training cooking staff on the appropriate time to change the frying oil. The Holland Inc. has used expertise from Dow AgroSciences to educate cooking staff about the appropriate schedule to change the frying oil to avoid changing it too quickly. Because The Holland Inc. purchases par-fried French fries containing trans fatty acids, the French fries served at the restaurants still have trans fatty acids. The chain is seeking trans fatty acid–free options for their cookies and seasonal shortcakes, which continue to contain trans fatty acids.
The additional cost of 6 cents per pound for the trans fatty acid–free oil has not been an issue with senior management and has been absorbed by the company. The customer count went up in 2006 compared with 2005. However, it is not clear whether that increase had anything to do with positive customer reactions to the oil change; there was barely any difference in the oil and French fry purchases for the first 6 months of 2006 compared with the same period in 2005.
Summary of Presentation by Julie Reid, MS
Ruby Tuesday is a national casual dining chain with >850 restaurants. In November 2003, Ruby Tuesday made a corporate decision to be the first major restaurant chain to switch from partially hydrogenated soybean oil to canola oil for frying. Several factors were behind the decision: (1) health consciousness of its chairman/president/founder, (2) the ability to publicize the use of a “healthy” oil for fried foods that were “better for you,” and (3) the likelihood that customers would ask about trans fatty acids with the upcoming mandated labeling on packaged foods. An extensive public relations campaign accompanied the oil change, and Ruby Tuesday received widespread recognition and approval from the industry and the media. However, few of its customers noticed the change, and the oil change appeared to have a negligible impact on sales.
Ruby Tuesday faced 2 challenges in making the switch to canola oil: higher costs and shorter fry life. The switch cost the chain about $1 million to implement in 2003. Regarding the fry life, many Ruby Tuesday restaurants had the practice of changing oil on Thursdays to allow fresh oil for the busy weekend. Restaurant operations staff, using color as the gauge, noted that the canola oil did not last as long.
Since 2003, the number of custom-made products that contain trans fatty acids at Ruby Tuesday has decreased from >30 to ≈10. However, its French fries still contain some trans fatty acids because Ruby Tuesday continues to purchase French fries par fried in partially hydrogenated oil. A switch to trans fatty acid–free par-fried French fries would incur an additional $1 million cost because of a surcharge from suppliers. The chain is committed to removing trans fatty acids from all of its products. It encourages all chain restaurants to collaborate in a concerted effort to demand that trans fatty acid–free products be made available from vendors to restaurants without an increased cost.
The Compass Group
Summary of Presentation by Deanne Brandstetter, MBA, RD
The Compass Group, which operates in 90 countries, is the world’s leading food service company. Its brands include Chartwells, Bon Appetit, Eurest, Canteen, Morrison, and Wolfgang Puck Catering. In the United States, The Compass Group deals with >200 distributors to provide for food service establishments, including corporate offices, hospital cafeterias, university dining halls, and sports arenas. On any given day, the company deals with thousands of different menus and faces huge challenges when making changes in ingredients.
Regarding the mission of reducing trans fatty acids in the foods served, The Compass Group decided to use a “push-pull” strategy, beginning with 3 countries: the United States, Canada, and the United Kingdom. In each market, The Compass Group uses sector innovators to “push” the trans fatty acid reduction initiative, requesting the others to be “pulled along.” For example, in 2002 to 2003, The Compass Group used Bon Appetit on the West coast and Flik International on the East coast, which served “premium” sectors such as investment banks and private college cafeterias, as pilot programs to change to trans fatty acid–free frying oils. The initiative included a cost-benefit analysis, customer education, purchasing assistance, and audits. From October 2005 to May 2006, all North American contract food sectors transitioned their frying oils to trans fatty acid–free oils. Half of the sectors transitioned to low-linolenic soybean oil, and half of the sectors transitioned to high-oleic canola oil, with the goal of all sectors moving to high-oleic canola oil by year-end 2006. The transition cost The Compass Group $2.5 million, and the company is using better frying oil management and smaller portions to keep cost increases under control. The company continues to face distribution challenges in that distributors do not always deliver the trans fatty acid–free frying oil ordered. The Compass Group indicates that the small change in the frying oil has had a big impact on trans fatty acid reduction. In a case study of 1 corporate client with 28 locations, by eliminating 5 g of trans fatty acids per 6-oz serving of French fries, the corporate client estimates that 88 990 fewer grams of trans fatty acids were consumed by its employees in a typical month.
The Compass Group plans to reduce trans fatty acids in other foods such as baked goods and snacks by 50% in 2007 in its North American outlets. Its European sectors are testing trans fatty acid–free fry oil and other products; the UK sectors are closely watching the North American efforts; and in Latin America, the company is addressing overall fat reduction in foods.
Key Learnings From Conference and Breakout Session
After the plenary sessions, participants of the Trans Fat Conference convened into 6 preassigned groups facilitated by preappointed session leaders using a common discussion guide. The forum generated significant interactions, allowing individual attendees to contribute their expertise.
Afterward, the leaders summarized their discussions and reported back to the entire audience. The summary of the discussions and some of the conference presentations are available online at http://www.americanheart.org/presenter.jhtml?identifier=3043187.
The conference generated significant interaction and information exchange among participants and presenters. The following summarizes key learnings from the conference:
Changing the food supply can produce tremendous improvements in public health. The January 2006 FDA labeling requirement to indicate trans fatty acid content on the nutrition labels of packaged foods has served as a catalyst to accelerate food reformulation.
Since mid-2006, food service companies and restaurants have accelerated their efforts to reduce trans fatty acids in their foods. With the passing of the regulation to phase out trans fatty acids in New York City restaurants in December 2006, the pressure is on restaurants to reduce trans fats in the foods they serve, either via voluntary means or through regulations likely to be proposed in areas nationwide within the next few years.
Many alternative oils and fats are available or in development to replace trans fatty acids in the food supply. However, decisions on which alternatives to use is complex and often time consuming, involving considerations in health effects, availability, research and development investments, food quality and taste, supply-chain management, operational modifications, consumer acceptance, and cost.
Effective communication efforts are needed throughout the food supply chain to help increase knowledge transfer and to reduce risks related to changes. The media should be engaged so that they can play a major role in helping to educate and inform the various audiences. In addition, stakeholder groups such as the AHA, food industry trade groups, and government can help facilitate information dissemination.
The conference showcased the value of multiple sectors and disciplines seeking solutions to improve the food supply, and conference participants showed strong support for using the conference model to tackle other issues, particularly obesity. Ongoing forums for facilitating the dialogue between nutrition, food, and agricul-ture sciences to understand challenges and to identify opportunities would be of value. The need for collaboration of all stakeholders from the beginning can serve as a lesson learned that can translate to other emerging food development, processing, and/or technology issues.26,27
↵*The American Heart Association Trans Fat Conference Planning Group was composed of Robert H. Eckel, MD, FAHA, Immediate Past President of the AHA; Susan Borra, RD, Co-Chair; Alice H. Lichtenstein, DSc, FAHA, Co-Chair; Shelley Goldberg, MPH, RD; Bill Layden; Rose Marie Robertson, MD, FAHA; Brigid McHugh Sanner; Kimberly F. Stitzel, MS, RD; and Shirley Y. Yin-Piazza, MS, MBA.
This article represents a summary of a conference sponsored by the American Heart Association. The opinions expressed in this article are those of the authors and do not necessarily represent those of the editor or the American Heart Association. The publication of these proceedings was approved by the American Heart Association Science Advisory and Coordinating Committee on February 27, 2007.
The conference focused on approaches to decrease the amount of trans fatty acids in the US food supply through reductions in the use of partially hydrogenated fats. Company-specific information is intended to reflect practical experiences and the expertise of the speakers. The presentations and subsequent information in the report do not necessarily reflect the opinions, support, or endorsement of the American Heart Association. The information is not intended to be exhaustive but to be informative of the barriers and success to the reduction of trans fatty acids in the food supply—a necessary step in the fight against cardiovascular disease.
The following speakers presented at the conference: Susan Borra, RD (International Food Information Council Foundation); Deanne Brandstetter, MBA, RD (The Compass Group); Robert Brown, PhD, MPH (Frito-Lay North America); David Dzisiak (Dow AgroSciences); Robert H. Eckel, MD (University of Colorado at Denver and Health Sciences Center); Brent D. Flickinger, PhD (Archer Daniels Midland Company); Pete Friedman, MS (ACH Food Companies); Peter D. Goldsmith, PhD, MBA (University of Illinois Urbana-Champaign); William Hitz, PhD (DuPont Pioneer Hi-Bred International); David M. Klurfeld, PhD (USDA); Michael Lefevre, PhD (Pennington Biomedical Research Center); Alice H. Lichtenstein, DSc (Tufts University); Gary List (USDA); Willie H. Loh, PhD (Cargill); Debe Nagy-Nero, MS, RD (The Holland Inc.); Ravinder Reddy, PhD (Unilever North America); Julie Reid, MS (Ruby Tuesday); Frank Sacks, MD (Harvard School of Public Health); David Stark, PhD (Monsanto Company); Brian L. Strouts (American Institute of Baking International); Kathleen Warner, PhD (USDA); Pamela White, PhD (Iowa State University); and Richard F. Wilson, PhD (USDA).
A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0326. To purchase additional reprints, call 842-216-2533 or e-mail firstname.lastname@example.org. To make photocopies for personal or educational use, call the Copyright Clearance Center, 978-750-8400.
Expert peer review of AHA Scientific Statements is conducted at the AHA National Center. For more on AHA statements and guidelines development, visit http://www.americanheart.org/presenter.jhtml?identifier=3023366.
Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml?identifier=4431. A link to the “Permission Request Form” appears on the right side of the page.
Nestel P, Clifton P, Noakes M. Effects of increasing dietary palmitoleic acid compared with palmitic and oleic acids on plasma lipids of hypercholesterolemic men. J Lipid Res. 1994; 35: 656–662.
Aro A, Jauhiainen M, Partanen R, Salminen I, Mutanen M. Stearic acid, trans fatty acids, and dairy fat: effects on serum and lipoprotein lipids, apolipoproteins, lipoprotein(a), and lipid transfer proteins in healthy subjects. Am J Clin Nutr. 1997; 65: 1419–1426.
Parthasarathy S, Khoo JC, Miller E, Barnett J, Witztum JL, Steinberg D. Low density lipoprotein rich in oleic acid is protected against oxidative modification: implication for dietary prevention of atherosclerosis. Proc Natl Acad Sci U S A. 1990; 87: 3894–3898.
National Academy of Sciences. Dietary reference intakes for energy, carbohydrates, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). 2005. Available at: http://books.nap.edu/openbook.php?record_id=10490. Accessed February 5, 2007.
Wang C, Chung M, Balk E, Kupelnick B, Jordan H, Harris W, Lichtenstein A, Lau J. n–3 fatty acids from fish or fish-oil supplements, but not α-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr. 2006; 84: 5–17.
Turpeinen AM, Mutanen M, Aro A, Salminen I, Basu S, Palmquist DL, Griinari JM. Bioconversion of vaccenic acid to conjugated linoleic acid in humans. Am J Clin Nutr. 2002; 76: 504–510.
The American Soybean Association. Available at: http://www.soystats.com/2005. Accessed February 5, 2007.
Oil Crops Situation and Outlook Yearbook. Washington, DC: Economic Research Service, USDA. Available at: http://usda.mannlib.cornell.edu/usda/current/OCS-yearbook/OCS-yearbook-03-19-2007_summary.txt. Accessed March 19, 2007.
USDA. USDA national nutrient database for standard reference. Available at: http://www.ars.usda.gov/Services/docs.htm?docid=8964. Accessed February 5, 2007.
Mensink RP, Zock PL, Kester A, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003; 77: 1146–1155.
Howard B, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil-Smoller S, Kuller LH, LaCroix AZ, Langer RD, Lasser NL, Lewis CE, Limacher MC, Margolis KL, Mysiw WJ, Ockene JK, Parker LM, Perri MG, Phillips L, Prentice RL, Robbins J, Rossouw JE, Sarto GE, Schatz IJ, Snetselaar LG, Stevens VJ, Tinker LF, Trevisan M, Vitolins MZ, Anderson GL, Assaf AR, Bassford T, Beresford SA, Black HR, Brunner RL, Brzyski RG, Caan B, Chlebowski RT, Gass M, Granek I, Greenland P, Hays J, Heber D, Heiss G, Hendrix SL, Hubbell FA, Johnson KC, Kotchen JM. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295: 655–666.
Pietinen P, Ascherio A, Korhonen P, Hartman AM, Willett WC, Albanes D, Virtamo J. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men: the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol. 1997; 145: 876–887.
Lopez-Garcia E, Schulze MB, Meigs JB, Manson JE, Rifai N, Stampfer MJ, Willett WC, Hu FB. Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction. J Nutr. 2005; 135: 562–566.
Salmerón J, Hu FB, Manson JE, Stampfer MJ, Colditz GA, Rimm EB, Willett WC. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr. 2001; 73: 1019–1026.
- History of Trans Fatty Acids in Health
- Value of Addressing Trans Fatty Acid Issues to Help Consumers
- Food Science Behind Fatty Acid Technology
- Fats and Oils for Human Consumption
- Health Sciences of Dietary Fatty Acids
- Summary of Trans Fatty Acid Alternatives Presented
- Considerations for Evaluating and Choosing Trans Fatty Acid Alternatives
- Considerations for Food Reformulation
- Use of Alternatives in Food Manufacturing (3 Case Studies)
- Use of Alternatives in Food Services (1 Supplier and 3 Case Studies)
- Key Learnings From Conference and Breakout Session
- Figures & Tables
- Info & Metrics