New York City Trans Fat Restriction - Preventing Heart Disease by Changing the Food Environment

Cardiovascular disease is the leading killer in New York City, causing over 25,000 deaths each year. Trans fat is a significant risk factor for coronary heart disease (CHD). It is estimated that substitution of 2% of caloric intake from trans fat with healthier oils could lower CHD events by 6-23%.

Chronic diseases have traditionally been viewed as products of individual risk, with individuals bearing personal responsibility for improvement of health risk factors. However, environmental factors play a large role in the incidence of chronic diseases such as cardiovascular disease.

In 2005, the DOHMH began an educational campaign about the risks of trans fats, encouraging restaurants and consumers to “make an oil change.” Trans fat use by restaurants for frying, cooking, baking or in spreads was surveyed before and after the campaign and no significant change was observed.

A regulatory approach was therefore pursued through the NYC Health Code. After a period of public comments, in December, 2006, the Board of Health approved the measure, mandating that all food service establishments in New York City severely restrict their use of artificial trans fat over an 18-month period.

The NYC Board of Health has regulated food service establishments and food safety for over two centuries through its Health Code and associated enforcement. Using the Health Code and food safety authority to address a preventable risk factor for chronic illness is a novel approach to local government action, with potential for significant impact on coronary heart disease events.