Hidden killer

It's trans fat. It's dangerous. And it's in food you eat every day.

Kim Severson, Chronicle Staff Writer

Wednesday, January 30, 2002

Phantom fat is hiding in your cereal bowl. It's the bad boy in your bag of

microwave popcorn. It lurks in those low-fat cookies and even in that

energy bar. The stuff is called trans fat, created when ordinary

vegetable oil is processed into partially hydrogenated oil. It's why Crisco

stays solid at room temperature and what makes cakes moist, cookies fresh

and crackers crisp.

Partially hydrogenated oil is in about 40 percent of the food at the

grocery store, including some products most consumers regard as healthy. A

generation ago, when cardiologists waved Americans off saturated fats like

butter and beef tallow, partially hydrogenated oils became a preferred

alternative. Now, in an about-face, researchers have determined that trans

fat can grease the way to a heart attack faster than a cup of lard.

Some of the nation's leading medical researchers, including many in the Bay

Area, also believe that the trans fat that marbles the modern American diet

may be why kids are so fat, diabetes is at record levels and why some

people develop cancer. They say trans fat is a big player in Syndrome X, a

cluster of health problems characterized by a beer belly, high blood

pressure and out-of-whack blood fats and sugars.

"There should be a warning on food made with this stuff like there is on

nicotine products. It's that bad for you," says Dr. Jeffrey Aron, a

University of California at San Francisco professor of

medicine and one of the nation's leading experts on fatty acids and their

effects on the body.

But there is no warning label. Trans fat amounts aren't regulated at all,

so manufacturers and fast food operators don't have to list it on nutrition

labels. That means there's no easy way to know how much you're

eating. And chances are, it's a lot more than you think. Virtually

every fast-food or family restaurant french fry is cooked in trans

fat-filled grease. Almost half of all cereals, both cold and hot, contain

it, according to the Food and Drug Administration. So do 70 percent of

cake mixes, 75 percent of chips and other salty snacks, 80 percent of

frozen breakfast foods like waffles, and 95 percent of cookies.

Even products people buy when they want to eat healthier -- granola, power

bars and low-fat cookies and crackers -- are made with partially

hydrogenated vegetable oil. During a recent informal survey of 140

varieties of crackers on a typical supermarket shelf, only three brands had

no partially hydrogenated oil. Because trans fat flies under the radar,

food labeled "low in saturated fat," "cholesterol-free" or "made with 100

percent vegetable oil" can have so much trans fat that consumers focused on

heart-healthy food wouldn't touch many of these products -- if they knew.

The FDA, which could decide by September whether to require trans fat on

food labels, estimates that listing it could prevent as many as 5,600 heart

disease deaths a year -- not only because people would be able to choose

healthier foods but also because manufacturers would choose to reduce the

amount of trans fat rather than put it on the label. "The labels on food

say how much fat but not what kinds of fat," Aron explains. "It's

insidious and we're nowhere near the level of awareness we need to be."

WHAT IT IS

Trans fat is the byproduct of the hydrogenation process patented in 1903 by

chemist William Normann. He discovered a way to turn relatively healthy

liquid vegetable oil into something that stays solid at room temperature

and improves shelf life. However, it also blocks arteries just as readily

as saturated fat. Crisco was soon introduced with an advertising campaign

that called it "a scientific discovery which will affect every kitchen."

But partially hydrogenated oil didn't really catch on until World War II,

when people turned to margarine and shortening as alternatives to rationed

butter. As convenience foods started to hit the market in the 1960s and

'70s, more hydrogenated oil was used. Consumption rose significantly in

the 1980s and 1990s when the public embraced the connection between heart

disease and saturated fats. Fast food restaurants replaced the beef fat in

the fryers with partially

hydrogenated oils. Food manufacturers began to tout products that were

free of saturated fats but that had plenty of trans fat instead.

Now, in light of new research, those changes don't seem like such great

ideas. An American Heart Association study released last July showed that

foods cooked with trans fat might clog arteries quicker than food cooked in

animal-based saturated fat. Like beef fat, trans fat also raises the

level of bad cholesterol (LDL), which can lead to strokes and heart

attacks. But trans fat goes one step further, scrubbing away good

cholesterol (HDL) that keeps arteries clean.

SYNDROME X

The ongoing Nurses' Health Study of 80,000 women, conducted by Harvard

Medical School and the Brigham and Women's Hospital in Massachusetts,

showed that for each 2 percent increase in the amount of calories from

trans fat, a woman's coronary risk jumps by 93 percent. And the New

England Journal of Medicine reported in 1998 that women who want to reduce

their risk of heart disease would be better off if they replaced saturated

and trans fats with unhydrogenated mono- or polyunsaturated fats than if

they cut down on the total amount of fat they eat.

But heart disease may be only one of trans fat's threats to health. A

growing number of doctors say it plays a starring role in something more

prevalent and ultimately worse -- Syndrome X. Former Stanford University

director of endocrinology Dr. Gerald Reaven named Syndrome X in 1988 after

he observed a collection of health problems ultimately linked to cells'

inability to

process insulin.

Also called metabolic syndrome or, more commonly, beer belly syndrome, the

prevalence of the condition has increased along with the amount of refined

foods and partially hydrogenated oil

Americans eat. "Forty years after it's been in the food system on such a

large scale, what is becoming clear is that this is dangerous stuff," says

Jack Challem, a Tucson-based nutrition expert and author of "Syndrome X:

The Complete Nutritional Program to Prevent and Reverse Insulin Resistance."

Even though Americans' saturated fat intake has dropped by 10 percent

across the board, diabetes rates and obesity have gone up, researchers

say. The cases of diabetes alone climbed 33 percent in the 1990s, and

doctors point to lifestyle changes as part of the problem. It's not so

much Crisco in pie crusts that's raising trans fat levels, but rather

prepared foods and popular

fried restaurant food. Average Americans now get a third of their calories

from food they haven't prepared themselves. The nation's children eat 40

percent of their meals at fast food restaurants.

CLOGGING THE WORKS

Trans fatty acids make up a small part of the average daily diet --

somewhere between 3 to 8 percent of the total daily caloric intake. But

even a handful of grams a day is enough to gum up the workings of a cell,

says Aron, author of "Gut-Check: Your Prime Source for Bowel Health and

Colon Cancer Prevention." Picture the cell as a Swiss watch, he

says. Sprinkle a few very fine grains of sand in that watch and it will

continue to tick, but after awhile it won't keep time. Eventually it won't

work. That's how trans fat works in the body, he says. It changes how the

cell membranes work -- how they talk to each other and function.

Trans fat can help make cells resistant to insulin, and when you have

resistance to insulin you have obesity. Researchers at the Centers for

Disease Control earlier this month released estimates that showed at least

47 million Americans, more than 20 percent, have Syndrome X. Other

Syndrome X experts say that estimate is conservative and put the figure as

high as 70 million. Trans fat is such a hidden part of the American diet,

people have no idea that it contributes to their illness. "One of the

defining moments for me came when I looked at a box of breakfast bars,"

says nutrition expert Challem, who urges people to read labels for clues to

hidden trans fat (see sidebar). "This is in everything. Trans fatty acids

are like a wild card. It's as if you're screwing up how the body processes

food."

HOW DO YOU KNOW?

The fight to put trans fat on food labels has been a difficult one, in part

because adding trans fat would be the first change to the national

nutrition facts panel since labels became mandatory in 1993. Margo Wootan,

a scientist with the Center for Science in the Public Interest, the health

advocacy group that first petitioned the FDA to add trans fat to labels in

1994, says consumers won't see an FDA decision on trans fat until after the

results of a sweeping nutrition study by the National Academy of Sciences

is released this summer. And even then, it could take another year or more.

A NEW BREED OF OIL

Meanwhile, food manufacturers are rushing to find new ways to deliver the

taste people want in baked goods and snacks without using as much trans

fat. "As the science has evolved related to trans fat, of course the

industry is looking to different sources and re-engineering and

reformulating products," says Bob Earl, senior director for nutrition

policy and regulatory affairs for the National Food Processors

Association. New, lower-fat margarines are being marketed as trans

fat-free. Oil processors are mixing super-hard, trans-free hydrogenated

oils with liquid oil to make a suitable replacement.

Nutritionists are revisiting tropical palm and coconut oils, which may not

be as bad as once thought and could actually have cancer-fighting

properties. Healthier canola and sunflower oils that remain stable at high

temperatures are coming onto the market. New seed oil crops are

being bred to produce oils that don't need hydrogenation. "Biotechnology

holds great promise for us," Earl says.

Some natural food companies, like Barbara's Bakery and Newman's Own

Organics, have begun to use alternatives to hydrogenated oil. Peter

Meehan, CEO of Newman's Own Organics, says palm oil has almost half the

saturated fat of regular palm kernel oil and is a breakthrough for baked

products that have required partially hydrogenated oils. Finding that

substitute was key to Newman-O's, the company's chocolate sandwich cookie,

introduced last year.

Still, eliminating so-called "bad fat" is likely impossible for a nation

with a taste for shelf-stable cakes, crunchy snacks and fast food. "If

you were to get rid of saturated and hydrogenated fats, bread would not

have the same flavor, crackers wouldn't have the crumble, pie crusts

wouldn't be tender. We need these fats to maintain taste and performance,"

Earl notes. He and others in the food business warn against trans-fat

hysteria in a culture where exercise has declined and fast food consumption

has increased. In other words, don't blame the food for a fatter, lazier

public.

It's an intersection where food manufacturers and some health advocates

actually agree. "At this point I'm not convinced trans fat is poison

people shouldn't eat. They should just eat less of it," says Wootan. "I

would hate to see them get trans fat out of their diets at the risk of

raising saturated fat levels again." You can find the FDA proposal on

trans-fat labeling at:

How much bad fat do you really eat? On the standard American food label,

trans fat content is invisible. Only three types of fat -- unhealthy

saturated fat and, in cases when certain health claims are made, poly- and

monounsaturated fats -- must be listed under the total fat content. But

there are some tricks to figuring out if food has trans fat.

-- -- Figure out how much fat you need every day. For an average healthy

person who eats 2,500

calories a day, about 30 percent or less should come from fat. That

translates to about 80 grams a day. And of that, only about 25 grams

should be saturated or trans fat.

-- Look for the words hydrogenated, partially hydrogenated or fractionated

in the list of ingredients. Trans fat comes from hydrogenation. The

higher up partially hydrogenated oil is on the list of ingredients, the

more trans fat the product has.

-- Note the amount of total fat listed and compare it to the breakdown of

specific fats on the label. The results may surprise you. A box of

reduced-fat Triscuits, for example, has 3 grams of fat per 7-cracker

serving. Saturated fats make up 1/2 gram and monounsaturated fats 1

gram. The crackers have no polyunsaturated fats, so the remaining 1 1/2

grams must be the only other kind of dietary fat -- trans fat.

One study, by the Center for Science in the Public Interest, showed that

foods with partially hydrogenated oils in the ingredient list contained 1

gram of hidden trans fat for each gram of saturated fat. That means that

Chips Ahoy cookies, for example, with 2 grams of saturated fat per serving

also contain 2 additional grams of trans fat.

Know your fats

There are only four kinds of fats in our diet -- monounsaturated,

polyunsaturated, saturated and trans.

-- -- Mono- and polyunsaturated fats. These are considered "good"

fats. They do not clog arteries and, in moderation, can contribute to a

healthy diet. They include olive, canola, peanut and walnut oils.

-- Saturated fat. This is mainly animal fat, the kind found in beef,

butter, lard, the skin of chicken, whole milk, whipped cream, egg yolks and

other products that come from animals. Coconut and palm oils are also

saturated. Too much raises the level of artery-clogging cholesterol.

-- Trans fat (trans-fatty acids). These are formed when oil is

hydrogenated. Some naturally occurring trans fats can be found in small

amounts in animal products. Like saturated fat, trans fat

raises the level of harmful blood cholesterol (LDL) as well as the ratio of

LDL to the more beneficial HDL cholesterol. Some researchers believe it

changes how cells process insulin -- which can lead to diabetes -- and have

linked it to cancer. Trans fat is found in many processed, convenience and

fast foods -- french fries, fried chicken, doughnuts, pastries, cookies,

crackers and some breakfast cereals.

-- Partially hydrogenated oil. This manufacturing process creates trans

fat. A hydrogen atom is mixed with non-saturated liquid oil from plants

like corn or soy to make fat such as shortening and

margarine that stay solid at room temperature.

-- Fractionated oil. This type of oil is created by a manufacturing process

that uses high

temperatures or solvents to separate hydrogenated oil into liquid and solid

parts. When listed on food labels, it indicates the presence of trans fat.

Two brands top trans fat-free margarine rating

To most cooks, and certainly to The Chronicle Food staff, margarine never

has been a good substitute for butter. But there comes a time when the

saturated fat in butter needs to be avoided. And now, it turns out that

trans fat -- the stuff that makes most margarines stay solid at room

temperature -- is worse for the body than saturated fat. As a result, new

lower-calorie, trans fat-free margarines are hitting the market. For

people who have made a decision to eat less of both kinds of bad dietary

fat, the Food staff tasted eight of them. The bad news is, most were so

bad that we can't recommend them. The good news is we found two to

recommend. Keep in mind that these are margarines we suggest for people

who need to restrict their intake of saturated and

trans fat.

-- SMART BALANCE (16 OUNCES, $1.99 at many markets). This was the best of

the lot. It contains 80 calories per tablespoon, along with 2.5 grams of

saturated fat. The selling point is its lack of trans fat and a claim that

the balance of good to bad fats makes it better for blood cholesterol. It

had the mildest, least oily taste. It is a very pale product and very

stiff, which put some tasters off. But the clean, non-oily taste made it a

winner.

-- BRUMMEL & BROWN (16 OUNCES, $1.89 at many markets). This spread was the

second

favorite. Made with yogurt to give it a slight dairy tang, it has 45

calories per tablespoon and one gram of saturated fat. The texture is very

creamy and the flavor just slightly salty. It is a lower-fat

alternative to Smart Balance.

If you want a trans fat alternative that tastes more like butter, make up a

batch of "Better Butter." The recipe below is adapted from a recipe by

Laurel Robertson, author of "Laurel's Kitchen" (Bantam Books, 1981). It

does contain saturated fat from the butter, but can be a good alternative

for people who don't want to use a processed spread. This keeps well in

the

refrigerator. Oil and butter alone will work, but the other ingredients

help it stay firm longer. Even when cold, it spreads easily. It liquefies

if left at room temperature, but will solidify when refrigerated.

INGREDIENTS

1 cup butter ( 1/2 pound) at room temperature

1 cup light olive oil or other light oil, such as canola

2 tablespoons soy milk, skim milk or reconstituted dry milk (optional)

1/2 teaspoon salt (optional)

1/4 teaspoon lecithin (optional)

INSTRUCTIONS

Place all the ingredients in a blender or food processor. Process until

smooth. Pour into containers and store in the refrigerator. Yields a

little more than 2 cups.

PER TABLESPOON:

110 calories, 0 protein, 0 carbohydrate, 13 g fat (4 g saturated), 16 mg

cholesterol, 59 mg sodium, 0 fiber.

Ferreting out the fat

Partially hydrogenated oils are more prevalent than you might think. Since

only total fat and saturated fat are required to be on food labels, you

have to be a fat detective to figure out if trans fat is in the product. A

trip through a supermarket and a quick read of ingredient lists found the

surprises below.

Product / Total fat content per serving / Saturated fat / Unsaturated fat /

"Hidden" trans fat / Clues

Safeway Select Healthy Advantage Blueberry Breakfast Bars

3 grams 1/2 gram O 2 1/2 grams

Hydrogenated soybean and cottonseed oil are high on the ingredient list.

Healthy Choice Low-fat Microwave Popcorn

2 1/2 grams 0 not listed ?

Partially hydrogenated oil is the third ingredient.

Quaker 100% Natural Low Fat Granola With Raisins

3 grams 1 gram 1 1/2 grams 1/2 gram

Partially hydrogenated cottonseed and soybean oils are listed.

Gerber Graduates Arrowroot Cookies For Toddlers

1 gram 0 not listed 1 ?

Partially hydrogenated soybean oil is the third ingredient listed.

Jiffy Cornbread Mix

4 grams 1 1/2 grams not listed 2 1/2 ?

The fourth ingredient listed is shortening.

Maruchan Instant Lunch Pork Flavor

12 grams 6 grams not listed 6 ?

Partially hydrogenated vegetable oil is the second ingredient listed.

Ortega White Corn Taco Shells

4 1/2 grams 1 gram 2 1/2 1 gram

Fried in partially hydrogenated vegetable oil.