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Denmark has experienced a remarkable reduction in CVD mortality over recent decades. The scale of the health contribution from the Danish regulation on industrially produced trans fatty acid (ITFA) has therefore long been of interest. Thus the objective was to determine health and equity benefits of the Danish regulation on ITFA content in Danish food, by quantifying the relative contributions of changes in ITFA intake, other risk factors and treatments on coronary heart disease (CHD) mortality decline from 1991 to 2007 in Denmark, stratified by socioeconomic group. To evaluate the effects of the ITFA ban (Danish Order no. 160 of March 2003) the Danish IMPACTSEC model was extended to quantify reductions in CHD deaths attributable to changes in ITFA (%E) intake between 1991–2007. Population counts were obtained from the Danish Central Office of Civil Registration, financial income from Statistics Denmark and ITFA intake from Dan-MONICA III (1991) and DANSDA (2005–2008). Participants were adults aged 25–84 years living in Denmark in 1991 and 2007, stratified by socioeconomic quintiles. The main outcome measure was CHD deaths prevented or postponed (DPP). Mean energy intake from ITFA was decimated between 1991 and 2007, falling from 1.1%E to 0.1%E in men and from 1·0%E to 0·1%E in women. Approximately 1,191 (95% CI 989–1,409) fewer CHD deaths were attributable to the ITFA reduction, representing some 11% of the overall 11,100 mortality fall observed in the period. The greatest attributable mortality falls were seen in the most deprived quintiles. Adding ITFA data to the original IMPACTsec model improved the overall model fit from 64% to 73%. In conclusion: Denmark's mandatory elimination of ITFA accounted for approximately 11% of the substantial reduction in CHD deaths observed between 1991 and 2007. The most deprived groups benefited the most, thus reducing inequalities. Adopting the Danish ITFA regulatory approach elsewhere could substantially reduce CHD mortality while improving health equity. [ABSTRACT FROM AUTHOR]

The trans fatty acids (TFA) quantification is required due to its harm of human health, regular consumption can increase the risk of diseases. To reduce the intake, consumers must be informed about the negative impact on their health and the TFA content labelled. Countries as the US, Canada, and Denmark impose a maximum usage of TFA in products for a consumer higher safety. The GC and IR methods are commonly used for TFA quantification, and through this review, it was highlighted the importance and the advantages of IR procedure. FT-IR is a non-invasive, rapid and powerful technique superior to other techniques in noise-signal ratio, spectral resolution, samples treatment, and detection sensitivity. The present work addresses a comprehensive review of different IR techniques, a comparison, and the election of the most efficient one. ATR-FT-IR methods turned out to be easier and faster for the trans fatty acids quantification at its specific region (991-945 cm-1). One of the main approaches of this review is the rapidity of IR methods, the analysis can be executed directly on the fat without the need for specific preparation of samples. [ABSTRACT FROM AUTHOR]

The association between dietary fat and fertility is not well studied. We evaluated intakes of total fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, trans fatty acids (TFA), ω-3 fatty acids, and ω-6 fatty acids in relation to fecundability in Danish and North American preconception cohort studies. Women who were attempting to become pregnant completed a validated food frequency questionnaire at baseline. Pregnancy status was updated bimonthly for 12 months or until pregnancy. Fecundability ratios (FR) and 95% confidence intervals were estimated using multivariable proportional probabilities regression. Intakes of total fat and saturated, monounsaturated, polyunsaturated, and ω-6 fatty acids were not appreciably associated with fecundability. TFA intake was associated with reduced fecundability in North American women (for the fourth quartile vs. the first, FR = 0.86, 95% confidence interval (CI): 0.71, 1.04) but not Danish women (for the fourth quartile vs. the first, FR = 1.04, 95% CI: 0.86, 1.25), though intake among Danish women was low. In North America, ω-3 fatty acid intake was associated with higher fecundability, but there was no dose-response relationship (among persons who did not use fish oil supplements: for the fourth quartile vs. the first, FR = 1.40, 95% CI: 1.13, 1.73); no association was found in Danish women, among whom low intake was rare. In the present study, high TFA intake and low ω-3 fatty acid intake were associated with reduced fecundity. [ABSTRACT FROM AUTHOR]

Objective: Studies have suggested that total intake of trans-fatty acids (TFA) is positively associated with changes in body weight and waist circumference, whereas intake of TFA from ruminant dairy and meat products (R-TFA) has not been associated with weight gain. However, these previous studies are limited by self-reported measures of body weight and waist circumference or by a cross-sectional design. The objective of the present study was to investigate if R-TFA intake was associated with subsequent changes in anthropometry (body weight, waist and hip circumference) measured by technicians and body composition (body fat percentage).Design: A 6-year follow-up study. Information on dietary intake was collected through diet history interviews, and anthropometric and bioelectrical impedance measurements were obtained by trained technicians at baseline (1987-1988) and at follow-up (1993-1994). Multiple regression with cubic spline modelling was used to analyse the data.Setting: Copenhagen County, Denmark.Subjects: Two hundred and sixty-seven men and women aged 35-65 years from the Danish MONICA (MONItoring of trends and determinants in CArdiovascular diseases) cohort.Results: The median R-TFA intake was 1.3 g/d (5th, 95th percentile: 0.4, 2.7 g/d) or 0.6% of the total energy intake (5th, 95th percentile: 0.2, 1.1%). No significant associations were observed between R-TFA intake and changes in body weight, waist and hip circumference or body fat percentage.Conclusions: R-TFA intake within the range present in the Danish population was not significantly associated with subsequent changes in body size, shape or composition and the 95% confidence intervals indicate that any relevant associations are unlikely to have produced these observations. [ABSTRACT FROM AUTHOR]

Introduction: The consumption of trans fat is associated with cardiovascular disease (CVD). In January 2004, Denmark became the first country in the world to regulate the content of artificial trans fat in certain ingredients in food products, which nearly eliminated artificial trans fat from the Danish food supply. The goal of this study was to assess whether Denmark's trans fat policy reduced deaths caused by CVD.Methods: Annual mortality rates in Organisation for Economic Co-operation and Development (OECD) countries from 1990 to 2012 were used to estimate the effect of Denmark's food policy on CVD mortality rates. Synthetic control methods were employed to simulate the CVD mortality trajectory that Denmark would have witnessed in the absence of the policy and to measure the policy's impact on CVD mortality rates. Analyses were conducted in 2015.Results: Before the trans fat policy was implemented, CVD mortality rates in Denmark closely tracked those of a weighted average of other OECD countries (i.e., the synthetic control group). In the years before the policy, the annual mean was 441.5 deaths per 100,000 people in Denmark and 442.7 in the synthetic control group. In the 3 years after the policy was implemented, mortality attributable to CVD decreased on average by about 14.2 deaths per 100,000 people per year in Denmark relative to the synthetic control group.Conclusions: Denmark's food policy, which restricted the content of artificial trans fat in certain ingredients in its food supply, has been followed by a decrease in CVD mortality rates. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that the intake of trans-fatty acids (TFA) plays a role in the development of obesity. The proportions of adipose tissue fatty acids not synthesised endogenously in humans, such as TFA, usually correlate well with the dietary intake. Hence, the use of these biomarkers may provide a more accurate measure of habitual TFA intake than that obtained with dietary questionnaires. The objective of the present study was to investigate the associations between the proportions of specific TFA in adipose tissue and subsequent changes in weight and waist circumference (WC). The relative content of fatty acids in adipose tissue biopsies from a random sample of 996 men and women aged 50–64 years drawn from a Danish cohort study was determined by GC. Baseline data on weight, WC and potential confounders were available together with information on weight and WC 5 years after enrolment. The exposure measures were total trans-octadecenoic acids (18 : 1t), 18 : 1 Δ6-10t, vaccenic acid (18 : 1 Δ11t) and rumenic acid (18 : 2 Δ9c, 11t). Data were analysed using multiple regression with cubic spline modelling. The median proportion of total adipose tissue 18 : 1t was 1·52 % (90 % central range 0·98, 2·19) in men and 1·47 % (1·01, 2·19) in women. No significant associations were observed between the proportions of total 18 : 1t, 18 : 1 Δ6-10t, vaccenic acid or rumenic acid and changes in weight or WC. The present study suggests that the proportions of specific TFA in adipose tissue are not associated with subsequent changes in weight or WC within the exposure range observed in this population. [ABSTRACT FROM PUBLISHER]

ObjectiveIndia has proposed legislating an upper limit of trans fat in partially hydrogenated vegetable oils and mandating trans fat labelling in an effort to reduce intakes. The objective of the present study was to examine the complexities of regulating trans fat in India by examining the policy processes involved and the perceived implementation challenges.DesignSemi-structured interviews (n 18) were conducted with key informants from various sectors. Interviewees were asked about sources of trans fat in the food supply, existing policies that may influence trans fats and perceived challenges related to the proposed trans fat regulation, in addition to questions tailored to their area of expertise. Interview data were organised based on common themes.SettingInterviews were conducted in India.SubjectsInterviewees were key informants from various sectors including agriculture, trade, industry and health.ResultsSeveral themes were identified related to the complexity of regulating trans fat in India. A lack of trans fat awareness, the large unorganised retail sector, a need for suitable alternative products that are both acceptable to consumers and affordable, and a need to build capacity were crucial factors affecting India's ability to successfully regulate trans fat. The limited number of food inspectors will create an additional challenge in terms of enforcement of trans fat regulation.ConclusionsAlthough India will face challenges in regulating trans fat, legislating an upper limit of trans fat in partially hydrogenated vegetable oils will likely be the most effective approach to reducing it in the food supply. Ongoing engagement with industry, agriculture, trade and processing sectors will prove essential in terms of product reformulation. [ABSTRACT FROM AUTHOR]

The susceptibility of trans-fat to the human health risk prompted the Food and Agriculture Organization (FAO) and World Health Organization (WHO) to prepare regulations or compulsory claims for trans-fatty acids (TFA) in edible oils and fats. In this study, analysis of fatty acid composition and TFA content in edible oils and fats along with the possible intake of trans-fat in Indian population was carried out. The analysis was carried out as per the Assn. of Official Analytical Chemists (AOAC) methodology and the results were statistically analyzed. The average TFA content in nonrefined mustard and refined soybean oils exceeded by 1.16- to 1.64-fold as compared to the Denmark limit of 2% TFA in fats and oils destined for human consumption. In branded/nonbranded butter and butter oil samples, average TFA limit exceeded by 4.2- to 9.5-fold whereas hydrogenated vegetable oil (HVO) samples exceeded the limit by 9.8-fold, when compared to Denmark standards. The probable TFA intake per day through different oils in Indian population were found to be less than WHO recommendation. However Punjab having highest consumption of HVO (-15 g/d) showed 1.09-fold higher TFA intake than the WHO recommendation, which is alarming and may be one of the factors for high cardiovascular disease mortality rate that needs further elucidation. Thus there is a need to prescribe TFA limit for edible oil, butter, and butter oil in India and to reduce the already proposed TFA levels in HVO to safeguard the health of consumers. Practical Application: The probable daily intake of trans-fatty acid (TFA) especially through hydrogenated vegetable oil (HVO) was assessed. In absence of any specification for TFA and fatty acid composition for edible oils, butter, and butter samples, a pressing need was felt to prescribe TFA limit in India. The study indicates that TFA intake through HVO consumption is higher in States like Punjab than the recommended daily intake prescribed by WHO. Hence, strategies should be adopted to either decrease the consumption of HVO or to modify the industrial processing method of HVO with less content of TFA to safeguard the health of consumers. [ABSTRACT FROM AUTHOR]

This article discusses the implementation and diffusion of mandatory and voluntary food safety regulations from a marketing systems perspective, and specifically applies this framework to an analysis of the antecedents and implications of the Danish 2003 ban on trans-fatty acids (TFAs). The analysis is based on reviews of published material and on interviews with food marketers, nutrition experts, and policy makers. It is established that the ban was implemented due to scientific proof of health risks associated with the intake of TFAs but also as a result of aligned interests and efforts of the major stakeholders in the Danish food marketing system. Adding to the literature on diffusion of regulatory initiatives, the analysis shows that the Danish ban on trans-fats had—and still has—an important impact on trans-fat regulation in other European and overseas countries. In the final section, insights from the analysis are used as a starting point for a discussion of how public authorities, food marketers, and macromarketing researchers can apply the marketing systems perspective when designing, managing, and studying future cases of food safety regulation. [ABSTRACT FROM AUTHOR]

Background/Objectives:An association between biomarkers of trans fat intake and greater risk of preeclampsia has been reported, but research in this area is scant. Thus, we examined the association of second trimester intake of trans fats with risk of preeclampsia and severe preeclampsia.Subjects/Methods:We followed 67 186 pregnancies of women participating in the Danish National Birth Cohort between 1998 and 2003. Diet was assessed with a food frequency questionnaire at gestation week 25, and preeclampsia diagnosis was obtained by linkage with the Danish National Patient Registry.Results:There were 1804 cases of preeclampsia and 402 cases of severe preeclampsia identified in the cohort. Intake of trans fats decreased during the study period as a consequence of a reduction in industrial trans fat intake. Second trimester intake of trans fats was unrelated to risk of preeclampsia or severe preeclampsia. The relative risk (95% confidence interval; P, trend) of preeclampsia and severe preeclampsia comparing top to bottom quintiles of trans fat intake were 0.95(0.81; 1.11, 0.33) and 1.07 (0.78; 1.48, 0.92), respectively.Conclusion:Second trimester intake of trans fats is unrelated to risk of preeclampsia within the intake range observed in a period of gradual reduction of industrial trans fats from the Danish food supply. [ABSTRACT FROM AUTHOR]

Selected foods sampled from Australian supermarkets and fast food outlets were analyzed for trans fat (TF) content. The product with the highest amount of TF (6.3 g/100 g product) was a household shortening. The TF contents in spreads were remarkably low (average 0.5, range 0.2-1.3 g/100 g product) with only 3 out of 15 exceeding the maximum level (2.0 g/100 g fat) permitted in Denmark. Ready-to-eat French fries purchased from all but one (1.5 g/100 g product) fast food outlet contained generally low levels of TF (average 0.4, range 0.3-0.7 g/100 g product), and the majority of the outlets appeared to have used non-hydrogenated vegetable oils for frying. Frozen French fries and ready-to-eat potato chips purchased from supermarkets were also low in TF (average 0.1 and 0.2 g/100 g product, respectively). So were the bakery products (biscuits, cakes, bread, cake and muffin mixes) except for croissants. However, 9 out of the 103 products tested would have been prohibited from sale in Denmark, while 25 and 12 products would have failed to qualify for 'trans fat-free' claims according to the mandatory labeling regulations currently in force in Canada the USA, respectively. [ABSTRACT FROM AUTHOR]

Legislation has, within a few years, virtually eliminated the intake of industrially produced trans fatty acids (IP-TFA) in Denmark, by banning any food with an IP-TFA content greater than 2% of total fat. This accomplishment has been obtained without noticeable effects on the availability, price or quality of foods previously containing high amounts of IP-TFA. Various public health organizations, including the World Health Organization, have recommended reducing the consumption of IP-TFA, and efforts have been made in several countries to comply, through the mandatory TFA labelling of prepackaged food, societal pressure and industrial initiatives to lower the content of IP-TFA in foods. Yet still, high concentrations of IP-TFA are found in popular foods in several countries including Norway and Sweden. This indicates that millions of people currently have intakes of IP-TFA that increase their risk of coronary heart disease. The Danish experience demonstrates that this risk can be eliminated. [ABSTRACT FROM AUTHOR]

Abstract: A high intake of industrially produced trans fatty acids (IP-TFA) is associated with increased risk of coronary heart disease (CHD), and a daily intake as low as possible is required to minimize health risks. To achieve this at the individual level in Denmark, legislation limited IP-TFA in foods to a maximum of 2% of fat content from 2004. We assessed the potential exposure of consumers to IP-TFA by analysing popular foods in Denmark, and in 25 other countries. Fifty-five servings of French fries and chicken nuggets, 87 packages of microwave popcorn, and 393 samples of biscuits/cakes/wafers with “partially hydrogenated vegetable fat” listed high on the food label were bought between November 2004 and February 2006. The content of IP-TFA was analysed by standardized methodology. We defined a “high trans menu” as a large size serving of French fries and nuggets, 100g of microwave popcorn, and 100g of biscuits/wafers/cakes. The amounts of IP-TFA in a “high trans menu” was 30g in 2001 in Denmark, but was reduced to less than 1g in 2005. By contrast, a “high trans menu” provided more than 20g in 17 out of 18 countries, with Hungary, Czech Republic, Poland, Bulgaria, and USA, ranking highest with 42, 40, 38, 37, and 36g, respectively. The legislation in Denmark has reduced the exposure of IP-TFA at the individual level without noticeable effect on availability, price, and quality of foods previously containing high amounts of IP-TFA. The findings of high concentrations of IP-TFA in popular foods outside Denmark suggest that millions of people inside and outside EU have intakes of IP-TFA that may increase their risk of CHD. The Danish experience demonstrates that this risk can be eliminated. [Copyright &y& Elsevier]

Abstract: The content of trans fatty acids (TFA) in Danish food has been monitored for the last 30 years. In margarines and shortenings the content of TFA has steadily declined from about 10g/100g margarine in the seventies to practically no TFA in margarines in 1999. In order to efficiently reduce the health risk related to TFA, Denmark decided to impose a maximum level of 2g/100g fat on industrially produced TFA (IP-TFA) with the Danish Order no. 160 of March 2003, as labelling was deemed insufficient to protect the consumers, especially risk groups like children or people with high intake of fast foods. A broader range of food was monitored with 253 samples in 2003 and 148 samples in 2005 after the Danish regulation was in effect. The investigations show that the TFA content has been reduced or removed from the products with high TFA content originally, like French fries, microwave oven popcorn and various bakery products, so IP-TFA are now without any significance for the intake of TFA in Denmark. [Copyright &y& Elsevier]

Abstract: The Danish story started with the publication of Willett''s Lancet paper in 1993, and ended when industrially produced trans fatty acids (IP-TFA) were reduced at the Danish market following a ban in 2003. The Danish Nutrition Council, established in 1992, was the driving force behind a campaign that convinced Danish politicians that IP-TFA could be removed from foods without any effect on taste, price or availability of foods. The Nutrition Council argued that as no positive health effect of IP-TFA had ever been reported, then just the suspicion that a high intake exerts harmful effects on health could justify a ban. The Danish success story might be interesting for other countries where this unnecessary health hazard could be eliminated from their foods. [Copyright &y& Elsevier]

Objective:To estimate the intake of ruminant trans fatty acids (TFA) in the Danish population aged 1–80 years.Design:Descriptive study.Subjects:A sex- and age-stratified random sample drawn from the Danish Civil Registration System. A total of 3098 participants (51% female) aged 1–80 years were included. The participation was 66%.Dietary information:A 7-day dietary record.Results:The estimated median intake of ruminant TFA was 1.4 g/day with the 80% central range being from 0.9 to 2.1 among children aged 1–6 years and 1.6 g/day (1.0–2.4) among children aged 7–14 years. The median TFA intake was 1.8 g/day (0.9–2.9) among adults aged 15–29 years and among adults aged 30–80 years. The intake expressed as percentage of energy intake was 0.8, 0.6, 0.7, and 0.7, respectively. Dairy products were the main source of ruminant TFA.Conclusions:The median intake of ruminant TFA in the Danish population aged 1–80 years is estimated to be 1.7 g/day (0.9–2.7), corresponding to 0.7% of energy intake (0.5–1.0), with dairy products being the main source of ruminant TFA.Sponsorship:The Danish Heart Foundation (Grants 02-2-9-8-22010 and 03-2-9-4-22087) and the Female Researchers in Joint Action (FREJA) programme from the Danish Medical Research Council.European Journal of Clinical Nutrition (2006) 60, 312–318. doi:10.1038/sj.ejcn.1602316; published online 19 October 2005 [ABSTRACT FROM AUTHOR]

The authors argue that a total ban on industrially produced trans fatty acids (TFA) should be implemented globally. They cite the health risks associated with TFA consumption, such as cardiovascular diseases, systemic inflammation, insulin resistance and diabetes. They describe the outcome of legislative efforts in Denmark and New York City to eliminate industrial TFA, along with the issues surrounding legislation on TFA removal. The authors further argue that a legislation is needed to globally remove industrial TFA and save lives.

Background: Little is known about the causes of childhood cancer, partly as not many children develop cancer, although childhood cancer is a leading cause of death by disease in the young. The young age of the children suggests that risk factors for childhood cancer may be present during pregnancy. Previous studies have shown that exposure to trans-fat, a type of unsaturated fat common in industrially produced foods (iTFA), has adverse health effects in adults, including the risk of developing cancer. Haematopoietic neoplasms are the most common cancer types among European children under the age of 15 years. This study will bring new knowledge as to whether trans-fat and other fatty acids may also increase the risk of developing haematopoietic neoplasms during childhood., Methods: We will investigate if the Danish iTFA legislation ban, which radically reduced the use of iTFA in foodstuffs, influenced the risk of childhood haematopoietic neoplasms in children born either before or after the change in legislation, adjusting for relevant secular trends. Further, in a case-control study, we will examine if levels of fatty acids in dried blood spots from newborns can predict the risk of developing childhood haematopoietic neoplasms. Permission from the Danish Data Protection Agency and the Ethical Committee has been granted., Discussion: The results from this study will provide important information about fatty acids in the mother's diet as a contributor to development of haematopoietic neoplasms during childhood, which may result in relevant preventive action., Trial Registration: Not relevant.