Frieden’s Next Act: Heart Disease and Preparing for New Epidemics

Eradicating trans fats

Trans fats should be out of our food environment. It increases bad cholesterol and decreases good cholesterol. Just as we are working to eliminate certain diseases, I think we should try to eliminate this toxic product. It wasn’t put in with bad intentions. It prolongs shelf life. But we’re more concerned about human life than shelf life.

Trans fats are hard because you have to ban it and you have to ensure the ban is being complied with. There are about 40 governments that have done that at various levels.

(In 2006, when Dr. Frieden was New York City health commissioner, he led an effort to ban trans fats in the city’s restaurants. Industry resisted.)

There was a sky-is-falling thing. Then McDonald’s came to us and said, ‘O.K., We took it out six months ago. No one can tell the difference. But please don’t tell anyone. Because if they hear it’s not there they’ll say it doesn’t taste as good.’

Dunkin’ Donuts came to me and said, ‘We can’t do it. We need another year.’ We already gave the deep-fry places another year because they had a whole supply chain to arrange. But Dunkin’ Donuts said, ‘The sprinkles keep falling off the frosting and we have to solve this!’ So we made a donut hole exemption at the last minute.

Why reducing salt is really difficult

There are two drivers for sodium in food. One is what you add and the other is what you buy in restaurants and in packaged foods. It’s different in different countries, and in different parts of countries and within different population groups. In some parts of Asia, for example, people put huge amounts of salt into their tea. In Tibet, it’s the main source of their salt — salty tea.

But the good thing is you don’t have to take it all out right away. A gradual reduction. Tastes change. You’ve got to get industry to work voluntarily to lower sodium. And you’ve got to change habits about how much salt people…

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