"How We Won the Fight to Ban Trans Fat"
There are three broad approaches to mediating the ruin of risky choices:
inform people (like using labeling),
nudge people (for example, by offering financial incentives),
or directly intervene to make the activity less harmful.
Which do you think prevented more car fatalities:
mandating driver education, labeling cars about crash risk,
or removing the human element altogether by just making sure
air bags are installed?
There are public education nutrition campaigns from "sugar pack" ads
on public transit, informing consumers how much sugar is in soft drinks,
to "Hot Dogs Cause Butt Cancer" billboards, educating about the link
between processed meat and colorectal cancer.
But is there a way to make products nutritionally safer in the first place?
The ban on trans fats offers a useful lesson.
In 1993, the Harvard Nurses Study found that high intake of trans fat
may increase the risk of heart disease by 50%.
That's where the trans fat story started in Denmark,
and it ended a decade later
with a ban on added trans fats there in 2003.
It took another 10 years, though, before the U.S. even started
considering a ban. All the while, trans fats were killing an estimated
tens of thousands of Americans every year,
resulting in as many years of healthy life lost as conditions
like meningitis, cervical cancer, and multiple sclerosis.
If so many people were suffering and dying,
why did it take so long for the U.S. to even suggest taking action?
One can look at a fight over New York City's trans fat ban
for a microcosm of the national debate.
Opposition came down hard from the food industry, complaining
about government intrusion, likening the city to a "nanny state."
Since trans fats can be naturally found in meat and dairy,
the livestock industry echoed the Institute of Shortening's
"everything-in-moderation" argument.
Critics styled such proposals as the rise of food fascism.
But it was the restaurant and food industries that limited consumer choice
by so broadly fouling the food supply with these dangerous fats.
If food zealots get their wish in banning added trans fats—
another argument went— what's next?
Vested corporate interests tend to rally around these kinds of slippery slope
arguments to try to distract from the very real fact that people are dying.
I mean what if the government tries to make us eat broccoli?
This actually came up in a Supreme Court case over Obamacare.
Chief Justice Roberts suggested Congress could start
ordering everyone to buy vegetables,
a fear Justice Ginsburg dubbed the broccoli horrible.
Technically, Congress could compel the American public to eat more plant-based,
Justice Ginsburg wrote, yet one can't offer the hypothetical
and unreal possibility of a vegetarian state as a credible argument.
As one legal scholar put it, "Judges and lawyers live on the slippery slope
of analogies; they're not supposed to ski it to the bottom."
New York City finally won its trans fat fight,
preserving its status as a public health leader.
For example, New York banned lead paint 18 years before federal action
was taken, despite decades of unequivocal evidence of its harm.
Comparing stroke and heart attack rates before and after the rollout of
the trans fat ban in different New York counties, researchers estimate it
successfully reduced cardiovascular death rates by about 5%.
This then became the model for the nationwide ban years later.
How was the public health community able to triumph
when attempts in the past to regulate the food industry failed?
If you would have asked me about the odds of a national trans fat ban,
I would have said, "fat chance."
In Denmark, as a leading Danish cardiologist put it,
"Instead of warning consumers about trans fats and telling them
what they are, we've simply removed them."
But we're Americans! As they say here:
"You can put poison in the food if you label it properly."
If people know the risks, the argument goes,
then they should be able to eat whatever they want.
But that's assuming they've been given all the facts,
which isn't always the case,
given the food industry's model of systemic dishonesty,
as one health ethics professor put it.
Given the predilection for predatory deception and manipulation,
government intervention was deemed necessary,
but how are you going to get it passed?
First, there was a labeling requirement.
Manufacturers had to start adding trans fat content to products'
nutrition facts labeling. Ostensibly this was to influence consumers,
but it may have had a bigger impact on producers.
Now that they had to divulge the truth, companies scrambled
to reformulate their products to gain a "no trans fat" competitive edge.
Within years of the mandatory disclosure, more than 5,000 products
were introduced touting low or zero trans fats on their labels.
Kentucky Fried Chicken went from being sued for having some of the highest
trans fat levels to running an ad campaign where mom tells dad
in front of kids that KFC now has zero grams of trans fat,
and the father yells, "Yeah, baby! Whoooo!!"
and begins eating fried chicken by the bucketful.
That was the secret to passing the ban.
Once the major food industry players had already reformulated their products
and bragged about it, once there wasn't so much money at stake,
then there was insufficient political will to block the ban
and added trans fats were taken off the playing field.