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Heart Attack Prevention

From the Current Issue

Bringing Trans Fats Into the Open
These heart-harmful fats won’t stay hidden for long, thanks to new food labeling required by the FDA.

Trans fatty acids—also known as trans fats—are formed when food manufacturers add hydrogen atoms to unsaturated vegetable oils (a process called hydrogenation) to make them more saturated and therefore more solid and shelf-stable. These synthetic trans fats are found in nearly all commercially prepared foods. In addition to margarines, trans fats are often found in frozen dinners, dry mixes, snack foods (including chips, crackers, and baked goods), and fried fast food. Trans fats also occur naturally, primarily in dairy products, beef, and pork. About a quarter of the trans fats in the diet are from natural sources; the remainder are synthetic.

Why Are Trans Fats So Bad?

Trans fats not only raise low-density lipoprotein (LDL) cholesterol, but they also lower high-density lipoprotein (HDL) cholesterol levels. A 2004 study in the Journal of Nutrition found that recent heart attack victims had significantly more trans fats in their fat tissue than did healthy people. In addition, people who reported the highest intake of trans fats were more than twice as likely to have a heart attack as people who reported the lowest.

The research on trans fats and heart disease is so convincing that one expert from the U.S. Food and Drug Administration (FDA) estimated that removing all trans fats from margarine and just 3% of trans fats from baked items would prevent more than 17,000 heart attacks and more than 5,000 deaths related to coronary heart disease (CHD) a year. In fact, Denmark recently banned hydrogenated fats from all foods sold in that country.

Reading Labels

Prepared foods currently list the types of oils they contain and whether any oils have been hydrogenated, but there is no requirement to list the amount of trans fats. The FDA recently altered this policy, however.

In the biggest change to food labeling since 1993, all food manufacturers will be required to list the amount of trans fats per serving by January 1, 2006. Some manufacturers are already including this listing, while others have removed trans fats from their manufacturing processes.

The amount of trans fats in a food product will be listed below the amount of saturated fats (see the sample nutrition label above). A “% Daily Value” is not indicated for trans fats because they are not recommended at all. A recent report from the Institute of Medicine concluded that there is no safe level of trans fat intake, so it’s important to limit your consumption of trans fats as much as possible.

The new labeling will make it easier to choose products that have no trans fats—or have very few. But foods with less than 0.5 g of trans fats can round down to 0. Therefore, if a single serving of cookies contains 0.4 g of trans fats, and you eat a whole box (the equivalent of 10 servings), you will have consumed not 0 g of trans fats, but a total of 4 g.

Even foods that contain no trans fats still have calories, which all add up and can lead to weight gain, so it’s important to eat in moderation. Remember that all fat is equally high in calories, and saturated fat is also detrimental to your health. Keep daily saturated and trans fat intake to 20 g or less. People with CHD, diabetes, or elevated LDL cholesterol levels should aim even lower, getting less than 15.5 g of saturated and trans fats a day.

Don’t Wait for the Labeling Changes

Although the amount of trans fats is not yet included on most nutrition labels, you can limit them in your diet by:

• Avoiding stick margarine. Instead, use tub or liquid products like olive oil, which contain fewer hydrogenated oils.

• Checking ingredient lists for fully or partially hydrogenated vegetable oils and for shortening—all of these foods contain trans fats. The higher they are on the ingredient list, the more plentiful they are in the food.


The Heart Bulletin is a quarterly publication that presents the latest information available to help you make informed decisions about your cardiac care.
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