Cholesterol Control Beyond the Clinic: New York City's Trans Fat Restriction
Cholesterol Control Beyond the Clinic: New York City's Trans Fat Restriction
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DOI：
10.7326/0003-4819-151-2-200907210-00010
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发表时间：
2009-07-21
影响因子：
39.2
通讯作者：
Bassett, Mary T.
中科院分区：
文献类型：
--
作者：
Angell, Sonia Y.;Silver, Lynn Dee;Bassett, Mary T.
在确定了关键的可改变风险因素几十年后，心血管疾病仍然是可预防死亡的主要原因，只有四分之一的高胆固醇患者达到了建议的控制水平。控制胆固醇的努力主要集中在消费者教育和医疗上。一个强有力的补充方法是改变食物的构成，纽约市卫生和心理卫生署（New York City Department of Health and Mental Hygiene）在餐馆限制人工反式脂肪（一种会导致冠心病的物质）时，就采取了这条路线。该部门首先开展了一项自愿运动，但这一努力并没有减少使用人工反式脂肪的餐馆的比例。2006年12月，卫生委员会要求逐步停止在餐馆食品中使用人工反式脂肪。为协助执行，本署向食肆提供技术援助。到2008年11月，这一限制在纽约市所有餐馆全面生效，据估计，餐馆在煎炸、烘焙、烹饪或涂酱中使用人工反式脂肪的比例已从50%降至不到2%。初步分析表明，人工反式脂肪的替代导致产品中含有更健康的脂肪酸。例如，在主要的连锁餐厅中，炸薯条中的饱和脂肪和反式脂肪总量减少了50%以上。两年来，数十家全国连锁店已经取消了人工反式脂肪，包括加州在内的13个司法管辖区也通过了类似的法律。公共卫生努力改变食物成分，使默认选择更健康，使消费者能够更成功地满足饮食建议，降低心血管风险。
Decades after key modifiable risk factors were identified, cardiovascular disease remains the leading cause of preventable death, and only one quarter of persons with high cholesterol levels have attained recommended levels of control. Cholesterol control efforts have focused on consumer education and medical treatment. A powerful, complementary approach is to change the makeup of food, a route the New York City Department of Health and Mental Hygiene took when it restricted artificial trans fat-a contributor to coronary heart disease-in restaurants. The Department first undertook a voluntary campaign, but this effort did not decrease the proportion of restaurants that used artificial trans fat. In December 2006, the Board of Health required that artificial trans fat be phased out of restaurant food. To support implementation, the Department provided technical assistance to restaurants. By November 2008, the restriction was in full effect in all New York City restaurants and estimated restaurant use of artificial trans fat for frying, baking, or cooking or in spreads had decreased from 50% to less than 2%. Preliminary analyses suggest that replacement of artificial trans fat has resulted in products with more healthful fatty acid profiles. For example, in major restaurant chains, total saturated fat plus trans fat in French fries decreased by more than 50%. At 2 years, dozens of national chains had removed artificial trans fat, and 13 jurisdictions, including California, had adopted similar laws. Public health efforts that change food content to make default choices healthier enable consumers to more successfully meet dietary recommendations and reduce their cardiovascular risk.