IMACE Q&A on trans fatty acids Brussels, April 2016

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1 IMACE Q&A on trans fatty acids Brussels, April 2016 What are trans fatty acids? Trans fatty acids (TFA) are a specific type of unsaturated fatty acids with at least one double bound in the trans configuration. They can be found in foods, either from ruminant sources or non-ruminant sources. What are ruminant TFA? Ruminant TFA are produced in the stomach of ruminants (cows, sheep, etc.) and are present in milk, cheese, butter, other milk products, meat and meat products. Dairy fat contains up to 4-6% TFA. The quantity and composition of ruminant TFA depend on the season and the feeding practices of ruminant animals. For example, grass-fed ruminants produce more TFA and the TFA content in milk is higher during summer. What are non-ruminant TFA? Non-ruminant TFA are found in partially hydrogenated vegetable oils and fats, resulting from the partial hydrogenation process (as opposed to the full hydrogenation process, which does not produce TFA). The quantity and composition of non-ruminant TFA depend on the process parameters (e.g.: temperature, time, pressure, type of oil, etc.). Can we technically differentiate between the two TFA sources? Both in animal and vegetable fat sources, there is not a single TFA type present, but always a mixture of different TFA. The TFA in animal and vegetable fat sources are the same, but they differ in their respective quantities. Non-ruminant TFA Ruminant TFA Isomeric distribution of trans fatty acids in non-ruminant and ruminant trans fat (mean weight percent) of trans-18:1 fatty acids, adapted from Wolff et al.

2 If a food product contains a mix of both sources of TFA, how can I know the contribution of ruminant vs. non-ruminant TFA? It is very complex to exactly differentiate between ruminant and non-ruminant TFA. As a consequence, the contribution of each TFA source in a final end-product is technically very difficult to measure. Why are TFA a health concern? TFA consistently raise the level of bad LDL-cholesterol, lower good HDL cholesterol, and as a consequence increase the ratio total to HDL-cholesterol (TC/HDL) in blood (1;2;3;4, and as specified in the European Food Safety Authority s (EFSA) Scientific Opinions in 2004 and 2010). This is associated with an increased risk of cardiovascular diseases. TFA have adverse effects on the blood cholesterol risk profile as compared with carbohydrates and other dietary fatty acids, including saturated fatty acids (SFA). The Food and Agriculture Organisation of the United Nations and the World Health Organisation (FAO/WHO) expert consultation concluded that there is convincing evidence that TFA raise LDL cholesterol and TC/HDL ratio compared to SFA, cis-monounsaturated fatty acids (cis-mufa) or cispolyunsaturated fatty acids (cis-pufa) (5). Do all TFA have the same health effect? According to EFSA, although most evidence relates to non-ruminant TFA, ruminant and non-ruminant TFA have the same adverse effects on health and on the risk of coronary heart disease, when consumed in equal quantities (1;2). A recent study showed that in equal amounts, the main ruminant TFA, vaccenic acid, is as bad for LDL cholesterol as non-ruminant TFA (6). What about CLA? According to the Codex Alimentarius definition, all types TFA, including both non-ruminant TFA and ruminant TFA, are seen as trans fat, except conjugated linoleic acid (CLA) 1. Regarding the possible positive health effects of CLA, further research is needed as there is no general scientific consensus on this question. EFSA, when assessing potential health claims for CLA, concluded that a cause and effect relationship has not been established between the consumption of CLA and potential health benefits (17). What are the official recommendations on TFA intake? The FAO/WHO expert consultation on fats and fatty acids has set an upper limit of 1% of the total daily energy from TFA (1%EN) in 2008 (8). The recommendation of <1%EN TFA includes both non-ruminant 1 The Codex Alimentarius for regulatory and food labelling purposes defines TFA as all the geometrical isomers of monounsaturated and polyunsaturated fatty acids having non-conjugated, interrupted by at least one methylene group, carbon-carbon double bonds in the trans-configuration (16).

3 % Value TFA and ruminant TFA for adults, but ruminant TFA are exempted from the <1%EN for infants and children up to 18 years (5). EFSA concluded that all TFA intake should be as low as possible (15). Who is still at risk for a too high intake of TFA in Europe? Although TFA intake substantially decreased in Western Europe, the decline of TFA in foods has been slower in some Eastern European countries. It is likely that subgroups of the European population still consume TFA in amounts that significantly increase their risk of coronary heart disease (7;8). What strategies were taken to lower the intake of non-ruminant TFA? After the discovery that TFA have adverse effects on the blood cholesterol risk profile for cardiovascular diseases, a number of countries have taken steps to reduce population TFA intakes. Some strategies that have been implemented are voluntary self-regulation by the industry; obligatory labelling; and local or national legal limitations on the use of partial hydrogenated vegetable oils (PHVO) or TFA in the food supply chain (9). What was the result of the voluntary self-regulation of the margarine sector? As early as in the 90s, the European margarine sector, represented by IMACE, has worked on the reduction of TFA levels in its margarines and vegetable oil spreads. In retail margarines and spreads those sold to the final consumers non-ruminant TFA levels are now well below 2% on fat basis (or below 1% on product basis), as recommended by public authorities (WHO, EFSA) Reduction of trans fatty acids (TFA) in retail margarines onwards Trans fatty acids (TFA) Source: IMACE Internal data

4 % Value The average non-ruminant TFA content in margarines and fat formulations sold as ingredients for other food products (B2B Business-to-business margarines) also decreased to well below 2% on fat basis. Reduction of trans fatty acids (TFA) in Business-to-business margarines Average TFA level (on fat basis) Source: IMACE Internal data What is the current TFA intake in Europe? The two major contributors to total TFA intakes are PHVO and ruminant fat. Until 1995, PHVO was the major source of TFA in Europe. However, due to reformulation and use of alternatives for PHVO in foods (including fat spreads, sweet bakery products and fast food), the intake of TFA in the EU has over the past decade(s) decreased to below the widely recommended maximum intake of 1% EN (2). Because of the steep reduction in the production and intake of non-ruminant TFA, ruminant fats are now the major source of TFA in most EU countries (10). Intake data from 2008 show that TFA intakes in France were on average 1% EN in adults, including 0.6% EN ruminant TFA and 0.4% EN non-ruminant TFA (11). In the UK, TFA intakes were estimated in at on average 0.8% EN. Similar to France, the major contributors to TFA intake in the UK were meat and meat products, milk and milk products and cereal and cereal products (12). In Germany, in 2009 already, 67% of TFA intake came from ruminant TFA (25% from butter, 24% from other milk products and 16% from meat and meat products) (13). In Spain, 2016 data shows that the average content of TFA in all groups was less than 0,6 g / 100 g of product, with the sole exception for butter in which a content of 2,0 g TFA/ 100 g was found (17).

5 Sources of TFA intake in Western Europe (average) 35% ruminant TFA 65% nonruminant TFA Source: IMACE Internal data Who is still at risk for a too high intake of non-ruminant TFA in Europe? Although TFA intake substantially decreased in Western Europe, the decline of TFA in foods has been slower in Eastern European countries. It is likely that subgroups of the European population still consume non-ruminant TFA in amounts that significantly increase their risk of coronary heart disease (7;8). What options exist to keep the ruminant TFA intake at low levels? Intakes of ruminant TFA are not perceived as a major health problem, even though ruminant and nonruminant TFA have the same adverse effects on blood lipids. However, daily consumption diets include a regular consumption of ruminant-tfa containing foods (butter, dairy, meat, etc.). It is not possible to technically lower the levels of ruminant TFA in dairy or meat products: they are always present at levels up to 5-6% on fat basis. Controlling the intake of ruminant TFA cannot be done by setting a regulatory upper TFA limit (as it is currently proposed for the non-ruminant TFA). It means that other means need to be applied to control the intake of ruminant TFA. This is important as ruminant TFA are currently the predominant TFA source in Western Europe. The following two options are possible: Labelling of the ruminant TFA content on dairy and meat products, allowing consumers to be informed about the ruminant TFA presence and to make informed healthy choices; Dietary guidelines to reduce intake of butter, full-fat dairy and high-fat meat, reducing the SFA intake and keeping the ruminant TFA intake as low as possible (due to lower ruminant fat intake). *******

6 Key references 1. EFSA opinion of the scientific panel on dietetic products, nutrition and allergies on a request from the Commission related to the presence of trans fatty acids in foods and the effects on human health of the consumption of trans fatty acids (Request EFSA-Q ), adopted on 8 July EFSA Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA Journal 2010; 8(3):1461. [107 pp.] doi: /j.efsa Mensink RP, Zock PL, Kester ADM, 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 metaanalysis of 60 controlled trials. American Journal of Clinical Nutrition 2003;77: Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. New England Journal of Medicine 2006;354: Foods and Agricultural Organization and World Health Organization. Fats and fatty acids in human nutrition. Report of an expert consultation Gebauer S et al. (2015), Vaccenic acid and trans fatty acid isomers from partially hydrogenated oil both adversely affect LDL cholesterol: a double-blind, randomized controlled trial. American Journal of Clinical Nutrition, 2015; doi: /ajcn Stender S, Astrup A, Dyerberg J. A trans European Union difference in the decline in trans fatty acids in popular foods: A market basket investigation. BMJ Open 2012;2. 8. Stender S, Astrup A, Dyerberg J. Tracing artificial trans fat in popular foods in Europe: A market basket investigation. BMJ Open 2014;4. 9. Downs SM, Thow AM, Leeder SR. The effectiveness of policies for reducing dietary trans fat: A systematic review of the evidence. Bulletin of the World Health Organization 2013;91: Brouwer IA, Wanders AJ, Katan MB. Effect of Animal and Industrial Trans Fatty Acids on HDL and LDL Cholesterol Levels in Humans: a quantitative review. PLOS ONE 2010; 5(3): e AFSSA (Agence Française de Sécurité Sanitaire des Aliments). Avis de l'agence française de sécurité sanitaire des aliments sur l'estimation des apports en acides gras trans de la population française. Request 2007-SA Ref Type: Report.

7 12. Pot GK, Prynne CJ, Roberts C et al. National Diet and Nutrition Survey: Fat and fatty acid intake from the first year of the rolling programme and comparison with previous surveys. British Journal of Nutrition 2012;107: German Federal Risk Institute BfR (June 2013), Höhe der derzeitigen trans- Fettsäureaufnahme in Deustchland ist gesundheitlich unbedenklich. Stellungnahme 028/2013 des BfR vom 6. Juni EFSA Panel on Dietetic Products NaAN. Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA Journal 2010;8: Codex Alimentarius. Guidelines on nutrition labelling. CAC/GL Codex International Food Standards. Ref Type: Report. 16. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the substantiation of health claims related to conjugated linoleic acid (CLA) isomers and contribution to the maintenance or achievement of a normal body weight (ID 686, 726, 1516, 1518, 2892, 3165), increase in lean body mass (ID 498, 731), increase in insulin sensitivity (ID 1517), protection of DNA, proteins and lipids from oxidative damage (ID 564, 1937), and contribution to immune defences by stimulation of production of protective antibodies in response to vaccination (ID 687, 1519) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;8(10): Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Health Ministry, Contenido de ácidos grasos trans en los alimentos en España, Madrid, 2016

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