I recently attended the public hearing of New York City's Department of Health and Mental Hygiene ("Department") regarding their Intention to add §81.08 to Article 81 of the New York City Health Code.  This Amendment covers two proposals made to the Board of Health in September 2006 as follows:

1. Partial phase-out of artificial trans fat in all New York City restaurants; and
2. Restaurants that already make calorie content publicly available on or after March 1, 2007 must also publish it on their menus and menu boards.

In this post I am going to explain the two proposals, provide an explanation of trans fat and share comments from a few of the over 70 speakers who registered to provide hearing and written testimony to the Department.  I am including information about the Amendment on this web site because naturally it fits in with the themes that I have been discussing.  This is an important debate for all readers--the issue is not as simple as it may seem. Think about the following:

• Realize that if an ingredient is banned it will need to be replaced with something, but what?; and
• To what extent should the government be involved in these issues?; and
• How will this effect New York City's food pantries and soup kitchens?;and balance all of that with
• The very severe problem of obesity and diabetes especially in low income NYC neighborhoods.

PROPOSAL 1-- RESTRICTING ARTIFICIAL TRANS FATS:

The Department of Health and Mental Hygiene enforces provisions of the New York City Health Code intended to protect the wholesomeness of food served directly to the consumer throughout the City.  This includes food commercially prepared and sold or distributed for free by restaurants, caterers, food pantries, soup kitchens and mobile food vendors.

Restaurants provide an estimated one-third of the daily caloric intake of New Yorkers and almost half of their food dollars and assuring that the food is safe is a public health priority.  Trans fats are included as an ingredient in many dishes especially baked goods and most frequently found in fast food, ethnic restaurants and mom and pop type establishments.  Patrons have no real way of knowing exactly which dishes contain these unhealthy fats and therefore cannot choose to avoid them.  Thus, The Board of Health has been asked to amend the Health Code to restrict the service and sale of products containing trans fats.

It should be noted that in June 2005 the Department asked all New York City food service establishments covered by this amendment to voluntarily remove trans fats from their menus.

It has been reported that in 2004, 23,000 New Yorkers died from heart disease and scientific evidence supports a clear link between the increased consumption of foods containing trans fats and coronary disease. These studies also have demonstrated that cholesterol levels decrease and therefore so do coronary events when the trans fats are replaced with healthy alternatives.

Trans fats increases the risk of heart disease by increasing the bad cholesterol (LDL) and lowering the good cholesterol (HDL).  Trans fats are seen as even worse by doctors and scientists than saturated fat because of this effect.  Examples of saturated fats are butter, coconut oil, breast milk, meat, cow milk and other dairy products.  Trans fat is found in partially hydrogenated vegetable oil (PHVO) that has been chemically modified by adding hydrogen to the oil. 80 percent of trans fat is found in commercially produced PHVO used in fried and baked foods most of which are already highly processed such as pre-fried French fries, fried chicken, taco shells and donuts, hamburger buns, pizza dough, cookies, pies and pancake and hot chocolate mixes, breakfast cereals, potato chips, corn chips, margarine and some candy.

Now the issue is that trans fat can be replaced with healthier alternatives, but what?  Denmark has successfully dealt with the same problem by limiting industrially produced trans fat content to 2% of total calories from fat with no noticeable change in flavor.  Options to trans fats for Americans are currently non-hydrogenated oils such as canola, corn and olive which are also known as mono and poly unsaturated fats.  Safflower and sunflower oils are also options. Detractors of this Amendment such as the National Restaurant Association will argue that these newer oils are more expensive and therefore, not an option for ethnic and mom and pop owned establishments.  Restaurants that have already moved away from using the artificial trans fats will attest to the fact that they recover the slight increase in cost  by the longer "fry lives" of the non-hydrogenated oils.

What do consumers think?  There has been a 12% increase in national sales of products labeled "no trans fat" in a 52 week period ending October 2004.  Somewhat unfortunately, nutrition ranks second after taste in determining what consumers buy.  Education can change this trend, but economics and big business make it difficult for the message to get through.

PROPOSAL 2 -- CALORIE CONTENT OF MENU ITEMS MADE CLEAR TO CONSUMERS AT TIME OF ORDERING:

By requiring NYC food establishment to publish caloric content of menu items at the time of ordering, individuals will be able to make better choices that can help decrease the risks of obesity and its negative health effects.  The National Health and Nutrition Examination Survey has reported in 2003-2004 that US adults suffer a rate of obesity of 32.2%.  Compare that to NYC residents where 50% of the adults are overweight and one in six are obese and 21% of kindergarten children are obese.  The weight factor contributes to an increased risk of diabetes, heart disease, high blood pressure, arthritis and cancer.  Diabetes has more than doubled over the last 10 years and now effects 750,000 New Yorkers.  Consider those statistics when thinking about health care and prescription drug costs in this country. And recall that it has been reported that New Yorkers eat one-third of their calories outside of the home.

The federal Nutritional Labeling and Education Act of 1994 made nutrition information available on packaged foods in retail outlets, but exempted restaurants.  75% of US adults report using this information when market shopping and nearly 50% report changing their purchases after reading the labeling information.  Some restaurants do make this information available now, but place it on the internet or on brochures, placemats or food wrappers that easily get obscured, thrown away or available after an item is purchased.  The information needs to be available at the point of ordering.  Studies have shown that 9 out of 10 people underestimate calorie content of less healthy choices by more than 600 calories.  When labeling was available, consumers chose high caloric items 24%-37% less often.   This proves the results of six different studies that 62% to 87% of Americans support requiring restaurants to include caloric labeling for menu choices.

This is a great proposal, but unfortunately will only cover those establishments that have made or will in the future make caloric information available for standardized (portion size, formulation and ingredients) menu items.  The information will be posted on menu boards and menus next to each item. The font size will need to be at least as large as the price or menu item name. This proposal will in fact pertain therefore to only 10% of food establishments in NYC.

So there you have the two proposals in two rather large nutshells.  In the following section I will include comments from a couple of the speakers who gave oral testimony.  I will tell you in advance that most speakers agree with and support the two proposals.  Three Restaurant Associations gave oral testimony specifically disagreeing with the Trans Fat proposal. 

EDITOR'S NOTE--Considerable appreciation needs to be extended to the Department of Health and Mental Hygiene of New York City's Board of Health for preparing background material from which we borrowed to draft this post.