Transcript File - Healthy Chelsea

Healthy
Chelsea
Coalition
Chelsea
Board of
Health
Partners in a process to pass and successfully implement a trans fat free
regulation in Chelsea, Massachusetts
Obesity and Heart Disease
Risk for Chelsea Residents
Percentage of Obese Adults, 2008*
•Chelsea & Revere Data, 2008, % advised to lose weight in past year
•Data Source: BRFSS
Overweight or Obese Children in
Grades 1, 4, 7, 10, 2008-2009
Source: Massachusetts Department of Public Health, 2010; Chelsea Public Schools, 2010
Mortality: Overall & Chronic Disease
Higher than State for Heart Disease,
Stroke and Diabetes
2005*, 2006** Vital Records
*2005 Data Source: Partners Community Benefits Report
**2006 Data Source: MassCHIP CHNA Health Status Indicators Report for Chelsea
Trans fatty acids
(Trans fats)
Why did the Board of Health
propose a regulation focused on
trans fats?
Dietary Behaviors
• Increased frequency of meals eaten away from home
-- National Center for Chronic Disease and Health Promotion, Division of
Nutrition, Physical Activity, and Obesity
Types of Fat
“Good” Fats
 Monounsaturated (olive, peanut & canola oil; avocados, most nuts)
 Polyunsaturated (vegetable oils – corn, sunflower, soy, cottonseed)
 Omega 3 Fatty Acids (fatty cold water fish like salmon;
flaxseeds, flax oil, walnuts)
“Bad” Fats
 Saturated Fats (animal products – red meat, poultry, butter, whole
milk; tropical oils – coconut, palm)
 Trans Fats (partially hydrogenated vegetable oils commonly used for
frying & baked good and – margarine, shortenings)
Reprinted with permission by Boston Public Health Commission
Making Artificial Trans Fats
Vegetable Oil + Hydrogen
=
Partially Hydrogenated
Vegetable Oil
• Chemical hydrogenation
process transforms liquid
vegetable oil into a semisolid state.
• Alteration of chemical
structure creates trans
fatty acids (trans fat)
Reprinted with permission by Boston Public Health Commission
Trans Fat = Clogged Arteries =
Heart attacks and strokes
In 2007 the Harvard School of Public Health released a study
stating that people with elevated trans fat levels are three times
more likely to contract coronary heart disease.
Dietary Sources of Trans Fats
79% Artificial
Trans Fat
from partially
hydrogenated
vegetable oil
21% Natural
trans fat
from animal products
(meat and dairy)
Reprinted with permission by Boston Public Health Commission
Health Effects of Trans Fats
• Raise LDL (“bad”) cholesterol (as do saturated fats)
• Decrease HDL (“good”) cholesterol (unlike saturated
fats)
• Increase ratio of total cholesterol to HDL cholesterol
• Increase blood levels of triglycerides and other
physiological effects that relate to increased risk of
coronary heart disease (CHD)
• Promote systemic inflammatory responses
–
“Because the presence of inflammation is an independent risk factor for
atherosclerosis, sudden death from cardiac causes, diabetes, and heart
failure, the inflammatory effects of trans fats may account in part for their
effect on cardiovascular health.”
(Mozaffarian et al. Trans Fatty Acids and Cardiovascular Disease, NEJM: 2006;
354:1601-13)
Impact on Coronary Heart Disease (CHD)
100
% Change in CHD
Trans
80
60
40
Sat
20
1%E
2%E
3%E
4%E
5%E
0
-20
Mono
-40
Poly
(Hu et al. Dietary fat intake and the risk of coronary heart disease in women. NEJM; 337(21):1491-9.1997)
Reprinted with permission by Boston Public Health Commission
Impact on Diabetes
Data from Nurses Health Study showed a
positive association between trans fat
consumption and risk of diabetes 2 in
women.
 Estimate that replacing just 2% of energy
from trans fats with polyunsaturated fats is
associated with a 40% lower risk of
diabetes.
–
(Salmeron et al. Dietary fat intake and risk of type 2 diabetes in women. Am J
Clin Nutr. 2001, 73:1019-26)
Reprinted with permission by Boston Public Health Commission
Impact on Breast Cancer
In 2008 the American Journal of Epidemiology
released a study stating that women with
elevated trans fat levels are twice as likely to
develop breast cancer.
Restaurants and other Food
Service Establishments
Learning from Conversations with
Chelsea Restaurants
RESTAURANT SURVEY RESULTS
TOTAL # CHELSEA RESTAURANTS = 77
77% (59 RESPONDING as of 1/1/12)
Use of Partially Hydrogenated
Oil
Awareness of Trans Fat Health
Issues
Awareness of Trans Fat
13%
29%
33%
yes
yes
no
yes
no
71%
no
87%
67%
Awareness of Trans Fat Bans
Awareness of Use of Partially
Hydrogenated Oil
3%
29%
27%
70%
no
yes
yes
don't know
no
71%
Background for and Implications
of the Chelsea trans fat free
regulation
“Food Service Establishments”
(FSE)
Any entity that serves food or beverage for
consumption and is required to hold a permit
from the City of Boston Inspectional Service
Department (ISD). Includes:
 Restaurants
 Supermarkets
 Delis
 Schools
 Bakeries
 Child care centers
 Caterers
 Senior centers
 Mobile carts
Reprinted with permission by Boston Public Health Commission
Trans fat bans in place
Trans Fat Bans in Food Service
Establishments
Site of Ban
New York City – 8 million
Philadelphia – 1.5 million
Montgomery County, MD – 932,000
Brookline, MA – 58,000
King County, WA – 1.8 million
Nassau County, NY – 1.3 million
Westchester County, NY – 949,355
Suffolk County, NY – 1.5 million
Boston, MA – 600,000
Stamford, CT – 118,000
Cambridge, MA – 100,000
California – 36.5 million
Albany County, NY – 298,000
Broome County, NY – 200,000
Needham, MA – 30,000
Lynn, MA – 90,000
Chelsea, MA – 40,000
Also
Puerto Rico – 4 million
(not included in percentage)
United States Population: 301 Million
18% of US population resides in a
community where trans fats are
banned
FDA's nutrition labeling regulations
Stick of Margarine
Frozen Potatoes
Clarifying the distinction between prior trans
fat regulations & Chelsea’s approach
From the Boston regulation passed in March 2008
“artificial trans fat” - food or beverage that is labeled as, lists as an ingredient,
contains or is prepared with vegetable shortening, margarine or any kind of
partially hydrogenated vegetable oil. However, a food or beverage whose
nutrition facts label or other suitable documentation lists the trans fat content
of the food as less than 0.5 grams per serving shall not be deemed to contain
artificial trans fat.
From Chelsea’s regulation, passed December 2011
SECTION 1: DEFINITIONS
(A) Artificial Trans Fat – any ingredient that is partially hydrogenated. Artificial
trans fats are commonly found in vegetable oils, butter substitutes,
shortening, margarine, cake mixes and frosting.
SECTION II: PROHIBITION
“No food service establishment, vending machine, or mobile food vendor shall
store, prepare, distribute, hold for service, or serve any food or beverage
containing artificial fat in the City of Chelsea.
Role of Trans Fat in Foods
• Frying oil: Doesn’t break down as quickly
–
French fries, chicken nuggets, donuts, taco shells, chips
• Baking: Texture and longevity of baked goods harder to
achieve with liquid oils
–
cakes, crackers, pastries, cookies, pies
• Spreads
–
Margarine is a common butter alternative
• Longer shelf life than other fats
–
Pre-mixed foods: pancake mix, hot chocolate, salad dressing
However…”Trans fatty acids are not essential and
provide no known benefit to human health” *
(*Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat,
Fatty Acids, Cholesterol, Protein, and Amino Acids. National Academies Press, 2005)
Reprinted with permission by Boston Public Health Commission
Industrial Suppliers have responded
“You asked for Zero-Grams Trans Fat (ZGTF)
products that meet your highest quality
standards. We listened. Simplot ZGTF products
deliver the same flavor, texture, crispness and
stability as traditional products -- thanks to our
exclusive, specially formulated oil blend, Nutri
Blanch™. Only Simplot has it. So now there’s a
healthier alternative we can all feel good
about!”
“ With a complete line of “zero trans” products,
recipes and merchandising resources, Ventura’s
Trans Fat Free Kitchen™ makes the switch to
trans fat free foods simple. Our trans fat free
replacement products are generally equivalent
1:1 in recipes. They deliver even more than
great performance and great taste: namely,
healthy benefits for your customers—and your
business.”
TRANS FAT FREE OPTIONS
OILS
BAKING / BAKERY
 BUNGE OIL
 ABEL AND SCHAFER
 LODERS CROKLAAN
 ACH FOOD COMPANIES
 ACH/ADM (STRATAS)
 BAKE’NJOY
 BESTBRANDS
 VENTURE FOODS
 BOSTON GORMET CHEFS
 CON AGRA FOODS
 DAWN FOODS
 WESTERN PACIFIC OILS
 MIMAC
 PENNANT FOODS
 SIGNATURE
 SIMPLOT
 PIDY GOURMET
 PURATOS
Next Steps
2012 and 2013
Supporting Compliance
& Enforcement
Technical assistance to restaurants and
other food service establishments
Make the connections with new
distributors as needed
Hands-on training for inspectors,
creation of checklists and tracking
materials
Healthy Restaurant Campaign
 Use the conversation about trans fats as a jumping
off point to focus on increasing the availability and
visibility of healthy menu options
“Healthy Restaurant certificates are
popping up all over the county. When you
see one, you know the restaurant – from
fast food to fine dining – has a clean and
safe environment and offers healthy menu
choices. Check out the list of healthy
restaurants or look at a map to find the
closest healthy restaurant to you. ”
http://healthyhowardmd.org/healthy-howard/healthy-restaurants