The impact of policies to reduce trans fat consumption: A systematic review of the evidence

The consumption of industrially produced trans fatty acids (TFA) has been associated with an increased risk of heart disease. In recognition of this, countries, states and cities worldwide have implemented TFA policies (e.g., mandatory or voluntary limits, labeling) aimed at reducing their availability in the food supply. This study builds on a previously published review that examined the impact of TFA policies worldwide from 2000–2013. A systematic literature search of the peer reviewed and grey literature was conducted to identify additional studies examining the impact of TFA policies published between 2013 and 2016. Studies that were: 1) empirical, 2) examined a TFA policy and 3) examined the effect of the policy on TFA levels/availability pre and post policy intervention were included. Modelling studies examining the impact of TFA policies were also included. A total of 13 studies published between 2013 and 2016 were included in the review, including seven modelling and six studies examining ‘real world’ TFA policies. Overall, the modelling studies indicated that TFA bans would reduce heart disease risk, would benefit socioeconomically disadvantaged populations the most and would be cost saving. The ‘real world’ TFA policy studies all reported reductions in TFA. When combined with the findings of the previous review which included a total of 15 studies, there is strong evidence to suggest that mandatory TFA bans lead to the largest reductions in TFA levels and that whilst labelling policies also lead to reductions in TFA levels/intakes additional progress could still be made given that high levels of TFA remain in some products. The combined studies also show that reformulation of products to reduce TFA has had variable effects on saturated fat levels in these foods – in some cases saturated fat levels increased, in others they decreased and for some products they remained the same. Policies aimed at reducing TFA in the food supply are effective and will likely reduce the burden of diet‐related disease, particularly among the most vulnerable socioeconomic groups. Moving forward, national, regional or global approaches to reducing TFA should be adopted in order to further reduce the levels of TFA in the food supply.Support or Funding InformationNational Heart Foundation of Australia