Trans Phat

What Denmark taught me (and the rest of Philadelphia) about loving junk food again.

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People say that I am careful about my food. I buy armloads of organic produce and fresh breads from my local farmer’s market every week. I drive 45 minutes into southern New Jersey all summer to pick buckets of berries, cherries, and peaches. Until my children came along, I grew heirloom tomatoes, eggplant, and cucumbers at the community garden. I like to serve my family and friends wholesome, homemade foods that don’t come out of a bag or a box.

When people say that I am careful, what they really mean is that I am “too careful.” They conveniently overlook the possibility that as someone who writes about medicine for a living, maybe I am just trying to stay healthy. They get annoyed because I won’t grant that convenience foods are a necessary part of modern life. They think, and none too subtly, that I spend too much time in the kitchen preparing food, that I make too many food shopping trips every week, and that I put too much emphasis on serving homemade dinners to my family and friends.

But what most people don’t know is that I have, hidden in my past, what I consider to be a shameful history of ridiculous and none-too-healthy food obsessions (case in point: my senior year in college I existed almost solely on frozen yogurt and bagels), and that I have a secret place in my heart for unwholesome sweets and fast food. Perhaps it is because I grew up in a house located just two blocks from a place called Vic’s that sold the world’s best milkshakes and hot dog sandwiches. When I was older and had a boyfriend who worked there, he would drop off pints of my favorite ice cream — mocha chip — on his way home from work. Perhaps it is because my volleyball team in high school habitually prepared for practices and games with a visit to the nearby Taco Bell, McDonald’s, or Dairy Queen. Or perhaps it is because, during high school summers, I sold soft, sweet, heavy cookies from a bakery cart in the mall. Chocolate chip, butterscotch, peanut butter, and oatmeal, three for $1.25 — some people dropped in every day to take advantage of that deal. I know I did, even after I quit selling the cookies.

As I grew older, I dropped the junk food habit. The change started during my college years, when I was stuck as the slightly chunky chick among a group of skinny, smart girls. Yes, sure, some of them did have eating disorders, but I think most just ate more salads than I did. College was in Los Angeles, and everybody wore short shorts and bikinis and constantly talked about dieting. I eventually even swore off beer and its empty calories, but that didn’t last.

In any case, in trying to be thin, I learned to stay away from most junk food, and it was no big deal for years and years. But then I had kids. When they were younger, it was easy. In fact, our babysitter is usually exasperated when she opens our pantry. “This house has like the healthiest food ever,” she sighs. “There’s nothing to eat in here.” But now they’re getting older, and they’ve learned about things like frosted doughnuts with sprinkles or a Happy Meal with a plastic-wrapped toy. It kills me to admit this, but now if they wheedle and plead loudly enough and long enough, I sometimes give in — hey, Grandma doesn’t get to be the only one who spoils my kids now and then. Suddenly — I’m almost too embarrassed to admit — junk food is once again back in my life.

The slippery junk food slope reached its nadir a few weeks ago while I was on a working vacation in Denmark. One day, I ate a cinnamon pastry and a jelly pastry for breakfast, an order of chicken nuggets and French fries for lunch, a chocolate bar and some packaged cookies for an afternoon snack, and fried fishcakes for dinner. It was a stressful day of travel, and there was even an ice cream sundae after dinner that disappeared somewhere. Yet despite this flagrant quantity of fat and calories, I didn’t feel too bad about what I ate.

This was because a day earlier, while doing research for my job as the science writer for a major medical journal, I had sat down with Steen Stender, MD, a physician and biochemist at Copenhagen County Hospital in Gentofte and member of the Danish Nutrition Council, who told me that food in Denmark contains practically no trans fat. Denmark, in 2004, was the first nation in the world to ban trans fats. Had I eaten my Danish vacation menu in my hometown of Philadelphia I would have ingested at least 30 grams of trans fat, a “completely unnatural” level of trans fat consumption, Stender said.

Before the ban, trans fats were practically unavoidable in Denmark, just as they are in the United States. After all, Denmark is the home of the “Danish” pastry (though Danes call it Wienerbrod.) And though they’re loath to admit it, Danes love fried fast food and frozen pizzas, crackers and microwave popcorn, as well as cookies, margarine, and vegetable shortening, just like in the United States. All, of course, are manufactured foods enhanced by the long-lasting, stable, and semisolid quality of industrially produced, partially hydrogenated oil, the main source of trans fats.

Today, just about everyone knows that trans fats are bad. But most people don’t realize just how bad they are; I know I didn’t. Consider that just five grams a day is believed to increase the risk of heart disease by 20 percent, and perhaps you can understand why indulging in junk food in Denmark isn’t such a bad idea. Scientists also believe that this fake fat puts people at greater risk for diabetes and cancer. Research even suggests a link between trans fats consumption and the rising incidence of asthma in children. “Industrially produced trans fat, introduced on a widespread scale into foods in the mid-20th century, has been the biggest dietary disaster in the past 200 years,” Stender told me.

Eliminating industrially produced trans fats in the United States would prevent more than 200,000 cases of coronary heart disease every year, according to research from Harvard University published last year in the New England Journal of Medicine. Data from Denmark seems to bear this good news out: Mortality by ischemic heart disease has decreased 20 percent in the past five years, and while various factors such as increased statin use probably contributed to this drop, the removal of trans fat from the Danish diet surely accounts for some of it, too, Stender said.

Scientific evidence about the health risks associated with trans fats has been mounting since the late 1970s, but it wasn’t until the groundbreaking Danish legislation banning them that other industrialized countries were forced to face up to the facts. The funny thing, Stender said, was how smoothly the whole switch to alternative fats went. There was hardly any opposition. Chocolate makers and pastry chefs reported that the switch was no big deal. Even international food giants like McDonald’s and Burger King, which have franchises in Denmark, hardly bothered to complain.

Things are changing here in the United States, too. Various franchises like Dunkin’ Donuts, Starbucks, Wendy’s, and Kentucky Fried Chicken have pledged to remove trans fats from their foods. Many packaged foods, whose labels must now list trans fat amounts, have been altered to contain zero grams. Meanwhile, New York City has passed legislation banning trans fats.

Now, so has my city of Philadelphia.

In fact, when I returned home from Denmark, Philadelphia was just days away from implementing the first stage of its trans fat ban. In addition to checking for cleanliness and cockroaches, health inspectors are now expected to make sure that restaurants are not serving foods cooked or prepared with trans-fatty oils or spreads (a ban on trans fats in bakeries begins next fall). With my extensive personal research experimenting with consuming trans fat-free junk food in Denmark, I already knew that I would hardly notice the difference, except I might feel a little less guilty eating French fries now and then.

Indeed, some people have asserted that banning trans fats just gives people license to feel good about eating junk food. Others have wondered if banning trans fat will just mean that people will end up eating more of the unhealthy saturated fats. And still others have complained that laws shouldn’t be made to save people from themselves.

But I know that the legislation was important, because while it might seem logical that companies would remove this ingredient that people don’t want to eat, food labeling only goes so far to protect consumers. The Philadelphia ban would ideally apply beyond restaurants and bakeries and into supermarkets where lots of trans fats still lurk.

Vulnerable urban populations in places like Philadelphia will benefit from the protection of an official trans fats ban. Stender noted that the working poor and the uneducated face fewer food options, often cannot properly read labels, and are forced to rely on fast food for daily meals. Some of the highest levels of industrially produced trans fat is found in inexpensive foods, and levels of trans fat consumption are growing in poorer, less industrialized nations. Similarly, Stender’s research has shown that heart disease rates are occurring at younger and younger ages in these areas of the world.

It doesn’t have to be this way. “Why is trans fat only harmful for Danes? Of course it is harmful for everyone, and should be banned. Trans fat is so easy to remove that there is no excuse for not doing it,” Stender said. It’s nice to know that more and more restaurants and bakeries and supermarket foods are doing just that.

It’s also nice, in a way, to feel vindicated for being careful about my food (at least most of the time). Over the years, I’ve been sensitive about people suggesting that I’m fussy when I make my own salad dressings, soups, pasta sauces, and cookies, when I overstock the fridge with fruits and vegetables, and when I buy loaves of bread that need to be sliced and go stale in just a day.

Granted, it’s been as much about taste for me as about healthfulness. But now I know that I’ve had good reason to be suspect of artificial foods, and I don’t feel so defensive. Of course this also raises a fresh concern. Ten years ago we didn’t know what trans fat was. Who knows what other industrially created ingredients we’ll soon discover threatening our health. • 14 September 2007

Jennifer Fisher Wilson is the science reporter for Annals of Internal Medicine. Her stories are available at www.annals.org.

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