High trans fatty acid content in common Indian fast foods

Association of Specific Dietary Fatty Acids with Asthma in Urban School Children and Adolescents: Inferences from a Cross-Sectional Multicentric Study From India

OBJECTIVE

To assess the association of dietary fatty acids with asthma in Indian school children.

METHODS

Children aged 6-16 years were enrolled from randomly selected urban schools in 10 cities. The International Study on Asthma and Allergies in Childhood Phase III Questionnaire was used to assess the prevalence of asthma. Three-day dietary intake data was obtained using 24-hr dietary recall method. Intake of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA) and trans fatty acids (TFA) was calculated using DIETSOFT software.

RESULTS

Between April 2019 and February 2020, 2428 participants were recruited (49.8% males) from 60 schools. The prevalence of asthma was 2.4% (95 % CI 1.8, 3.1). The mean (SD) intake of various FA (g per kg) were 0.19 (0.22) for SFA,18 (0.22) for MUFA, 0.17 (0.18) for PUFA and 0.003 (0.005) for TFA. SFA intake in those with asthma was 0.35 (0.34) as compared to 0.18 (0.21) without asthma (P value < 0.001). On unconditional logistic regression, dietary intake of TFA was associated with asthma in children [OR 2.16 (95% CI 1.27, 3.68)].

CONCLUSION

Dietary intake of SFA and TFA is associated with asthma in children.

Total fat and fatty acid profile including TFA content of Indian fried foods versus the oils used for frying

Due to deleterious health effects, consumption of trans fat containing fried foods is a major concern. The present study has assessed total fat, SFA, cis-UFA and TFA content of Indian fried foods-French fries, Poori, Potato chips, Bread Pakora and Mathri (on dry weight basis), at varying number of frying cycles/temperatures as well as composition of the oils extracted from the foods and the oils used for frying. Total fat in the food items was significantly higher at 32nd (x̄27.4%) versus the 1st frying cycle (x̄22.5%; p < 0.05). Progressive frying cycles (1st vs. 32nd)/temperatures demonstrated declining levels of cis-UFAs (at 180 °C: x̄16.33% vs. x̄11.29%; at 160 °C: x̄19.54% vs. x̄13.81%) with concomitant increase in SFA (at 180 °C: x̄4.97% vs. x̄14.97%; at 160 °C: x̄5.19% vs. x̄13.79%) and TFA content (at 180 °C: x̄0.05% vs. x̄0.89%; at 160 °C: x̄0.04% vs. x̄0.17%). Compared to the unheated oil, at 32nd frying cycle (irrespective of the frying temperatures), oils extracted from fried foods registered a significant decrease in cis-UFA (x̄17.41%) coupled with an increase in SFA (x̄63.74%) and an exponential increase in TFA (39-301 folds); however, the change was slightly lesser in oils used for frying (cis-UFA: x̄15.06%; SFA: x̄53.75%; TFA: 20-264 folds). To curb TFA in fried foods, necessary regulations are needed for restricting the number of frying cycles as well as the frying temperatures along with awareness generation regarding appropriate frying practices.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13197-024-05989-z.

Fatty acid profiling of 75 Indian snack samples highlights overall low trans fatty acid content with high polyunsaturated fatty acid content in some samples

Diet-derived fatty acids have well-proven varying effects on human health. In particular, trans fatty acids (TFA) are associated with high risk of cardiovascular diseases whereas, polyunsaturated fatty acids (PUFA) are considered to be beneficial to the human health. In this study, we report fatty acid profiling of 75 food samples from India belonging to three broad categories, viz., perishable deep-fried, non-perishable deep-fried and bakery. Lipids were extracted from the snacks and fatty acids converted into methyl esters and analysed by gas chromatography. Thirty-seven detected fatty acids were classified into four categories: saturated (SFA), monounsaturated (MUFA), PUFA, and TFA, of which SFA represented the most abundant class in two-third of the samples. The highest average proportions of TFA and SFA of 3.26% and 56.1%, respectively, in total fatty acids were found in the bakery products; whereas, that of PUFA (38%) in the perishable deep-fried products. Principal Component Analysis depicted clustering of many samples according to the above-mentioned categories and helped predict the oil usage. Lower TFA content in all the samples and high proportion of PUFA in a quarter of the samples is suggestive of a better trend as compared to earlier studies.

Association of trans fatty acids with lipids and other cardiovascular risk factors in an Indian industrial population

Objective

Trans-fat, an invariable component of industrial fat is considered as one of the major dietary factors associated with CVD. Although the use of trans-fat is completely banned in some of the high-income countries where the CVD epidemic is declining, it is widely used in LMIC. We aimed to investigate the association of trans fatty acid in serum with risk markers of CVD in an industrial population in India. Participants were randomly selected from a study conducted in an industrial setting among employees and their family members. Information related to their demographic profile, anthropometric measurements, oil intake were recorded. Fasting samples were collected and stored at − 80 °C for analysis. Their lipid profile and hs CRP were measured and fatty acids analyzed using gas chromatography (GC) with flame ionization detector (FID).

Results

Complete data was available for 176 participants. Among trans fatty acids, mono trans fatty acid was significant predictor of serum triglycerides [Unadjusted β (95% CI) 22.9 (2.6, 43.2); Adjusted β (95% CI) 20.4 (3.5, 37.3)]. None of the other trans fatty acids either individually or in group correlated with any of the biochemical markers studied.

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4352-7) contains supplementary material, which is available to authorized users.

Food environment and policies in private schools in Kolkata, India

School food policies and services have the potential to influence the food practices and eating behaviours of adolescents which in turn may affect their lifestyles and health in adulthood. The aim of this qualitative investigation was to describe the opinions of adolescents, their parents, nutrition educators and school principals about the prevailing food environment and canteen policies in Indian schools. Fifteen adolescents aged 14-15 years, 15 parents, 12 teachers and 10 principals from 10 private schools in Kolkata, India participated in semi-structured interviews. The interview questions were primarily based on the existing literature related to school food environments and policies. Audio recordings were transcribed verbatim and assessed thematically. Throughout the 52 interviews, a number of inadequacies of the school food environment and policies were revealed. These included the absence of written food policies, the widespread supply of unhealthy foods, inadequate provision of healthy foods, misleading messages about food communicated by school authorities, lack of cleanliness in the school canteen and the high cost of canteen food. Current school food environments do not appear to promote healthy eating among adolescents. Therefore, it is important to upgrade the quality of food services in Indian schools through adoption of healthy eating policies.

Urbanized South Asians' susceptibility to coronary heart disease: The high-heat food preparation hypothesis

OBJECTIVE

Known risk factors do not fully explain the comparatively high susceptibility to coronary heart disease (CHD) in South Asians (Indian, Pakistani, Bangladeshi, and Sri Lankan populations in South Asia and overseas). The search for explanatory hypotheses and cofactors that raise susceptibility of South Asians to CHD continues. The aim of this study was to propose "the high-heat food preparation hypothesis," where neo-formed contaminants (NFCs) such as trans-fatty acids (TFAs) and advanced glycation end-products (AGEs) are the cofactors.

METHODS

We reviewed the actions of AGEs and TFAs, the burden of these products in tissues and blood in South Asians, the relationship between these products and CHD, the effects of preparing food and reheating oils at high temperatures on NFCs, and the foods and mode of preparation in South Asian and Chinese cuisines.

RESULTS

Animal and human studies show NFCs increase the risk for CHD. Evidence on the consumption and body burden of these products across ethnic groups is not available, and comparable data on the NFC content of the cuisine of South Asians and potential comparison populations (e.g., the Chinese with lower CHD rates) are limited. South Asians' cuisine is dominated by frying and roasting techniques that use high temperatures. South Asian foods have high TFA content primarily through the use of partially hydrogenated fats, reheated oils, and high-heat cooking. Reheating oils greatly increases the TFA content. In comparison, Chinese cuisine involves mostly braising, steaming, and boiling rather than frying.

CONCLUSION

We hypothesize that South Asians' susceptibility to CHD is partly attributable to high-heat treated foods producing high NFCs. Research to accrue direct evidence is proposed.

Unhealthy Fat in Street and Snack Foods in Low-Socioeconomic Settings in India: A Case Study of the Food Environments of Rural Villages and an Urban Slum

OBJECTIVE

To describe the food environment in rural villages and an urban slum setting in India with reference to commercially available unbranded packaged snacks and street foods sold by vendors, and to analyze the type and quantity of fat in these foods.

DESIGN

Cross-sectional.

SETTING

Two low-income villages in Haryana and an urban slum in Delhi.

PARTICIPANTS

Street vendors (n = 44) were surveyed and the nutritional content of snacks (n = 49) sold by vendors was analyzed.

MAIN OUTCOME MEASURES

Vendors' awareness and perception of fats and oils, as well as the type of snacks sold, along with the content and quality of fat present in the snacks.

ANALYSIS

Descriptive statistics of vendor survey and gas chromatography to measure fatty acid content in snacks.

RESULTS

A variety of snacks were sold, including those in unlabeled transparent packages and open glass jars. Mean fat content in snacks was 28.8 g per 100-g serving in rural settings and 29.6 g per 100-g serving in urban settings. Sampled oils contained high levels of saturated fats (25% to 69% total fatty acids) and trans fats (0.1% to 30% of total fatty acids).

CONCLUSIONS AND IMPLICATIONS

Interventions need to target the manufacturers of oils and fats used in freshly prepared products to improve the quality of foods available in the food environment of low-socioeconomic groups in India.

The need for multisectoral food chain approaches to reduce trans fat consumption in India

BACKGROUND

The World Health Organization (WHO) recommends virtually eliminating trans fat from the global food supply. Although several high-income countries have successfully reduced trans fat levels in foods, low- and middle-income countries such as India face additional challenges to its removal from the food supply. This study provides a systems analysis of the Indian food chain to assess intervention options for reducing trans fat intake in low-income consumers.

METHODS

Data were collected at the manufacturer, retailer and consumer levels. Qualitative interviews were conducted with vanaspati manufacturers (n = 13) and local food vendors (n = 44). Laboratory analyses (n = 39) of street foods/snacks sold by the vendors were also conducted. Trans fat and snack intakes were also examined in low-income consumers in two rural villages (n = 260) and an urban slum (n = 261).

RESULTS

Manufacturers of vanaspati described reducing trans fat levels as feasible but identified challenges in using healthier oils. The fat content of sampled oils from street vendors contained high levels of saturated fat (24.7-69.3 % of total fat) and trans fat (0.1-29.9 % of total fat). Households were consuming snacks high in trans fat as part of daily diets (31 % village and 84.3 % of slum households) and 4 % of rural and 13 % of urban households exceeded WHO recommendations for trans fat intakes.

CONCLUSIONS

A multisectoral food chain approach to reducing trans fat is needed in India and likely in other low- and middle-income countries worldwide. This will require investment in development of competitively priced bakery shortenings and economic incentives for manufacturing foods using healthier oils. Increased production of healthier oils will also be required alongside these investments, which will become increasingly important as more and more countries begin investing in palm oil production.

Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study

BACKGROUND

Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes.

METHODS

A household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented.

RESULTS

Almost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not.

CONCLUSIONS

Pregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in providing effective nutrition counselling should be explored given the overburdened public health system.

The feasibility of multisectoral policy options aimed at reducing trans fats and encouraging its replacement with healthier oils in India

INTRODUCTION

The World Health Organization recommends replacement of trans fat with polyunsaturated fat to reduce cardiovascular disease risk. Although several high-income countries have been successful in reducing trans fat in the food supply, low- and middle-income countries such as India may face additional contextual challenges such as the large informal sector, lack of consumer awareness, less enforcement capacity and low availability and affordability of healthier unsaturated fats. The objective of this study was to examine the feasibility and acceptability of multisectoral policy options aimed at supporting trans fat reduction and its replacement with polyunsaturated fats in India.

METHODS

Multisectoral policy options examined in this study were identified using food supply chain analysis. Semi-structured interviews (n = 17) were conducted with key informants from agriculture, trade, finance, retail, industry, food standards, non-governmental organizations and the health professions to gain their views on the feasibility and acceptability of the policy options. Purposive sampling was used to identify key informants. Data were coded and organized based on key themes.

RESULTS

There was support for policies aimed at improving the quality of seeds, supporting farmer co-operatives and developing affordable farming equipment suited to smallholders to improve the production of healthier oils. Increasing the role of the private sector to improve links among producers, processors and retailers may help to streamline the fats supply chain in India. Blending healthier oils with oils high in saturated fat, which are currently readily available, could help to improve the quality of fat in the short term. Improving consumer awareness through mass media campaigns and improved labelling may help increase consumer demand for healthier products.

CONCLUSIONS

Reorienting agricultural policies to support production of healthier oils will help increase their uptake by industry. Policy coherence across sectors will be critical to reduce trans fat intakes and could be improved by increasing engagement among researchers, the private sector and government.

Aligning food-processing policies to promote healthier fat consumption in India

India is undergoing a shift in consumption from traditional foods to processed foods high in sugar, salt and fat. Partially hydrogenated vegetable oils (PHVOs) high in trans-fat are often used in processed foods in India given their low cost and extended shelf life. The World Health Organization has called for the elimination of PHVOs from the global food supply and recommends their replacement with polyunsaturated fat to maximize health benefits. This study examined barriers to replacing industrially produced trans-fat in the Indian food supply and systematically identified potential policy solutions to assist the government in encouraging its removal and replacement with healthier polyunsaturated fat. A combination of food supply chain analysis and semi-structured interviews with key stakeholders was conducted. The main barriers faced by the food-processing sector in terms of reducing use of trans-fat and replacing it with healthier oils in India were the low availability and high cost of oils high in polyunsaturated fats leading to a reliance on palm oil (high in saturated fat) and the low use of those healthier oils in product reformulation. Improved integration between farmers and processors, investment in technology and pricing strategies to incentivize use of healthier oils for product reformulation were identified as policy options. Food processors have trouble accessing sufficient affordable healthy oils for product reformulation, but existing incentives aimed at supporting food processing could be tweaked to ensure a greater supply of healthy oils with the potential to improve population health.

Content of trans fatty acids in human cheek epithelium: comparison with serum and adipose tissue

Studies pertaining to trans fatty acids (TFA), which have been implicated in development of chronic diseases, are more relevant in developing countries where nutrition transition is changing traditional habits and practices. Measuring TFA is an arduous task because of the need for fat biopsies. This study identifies a tissue, which can be easily accessed for analytical measurement of trans fatty acid. In this cross-sectional study, fatty acid in adipose tissue, cheek epithelium, and blood samples were assessed by gas chromatography. Spearman correlation coefficient was computed to study the correlation of fatty acid distribution among the three tissues. The correlation coefficient of total trans fatty acid between cheek epithelium and serum was 0.30 (P < 0.02) and between cheek epithelium and adipose tissue was 0.33 (P < 0.019). This study is the first to report trans fatty acid profile in cheek epithelium giving scope for utilizing the cheek epithelium as a tissue for objective assessment of trans fatty acid intake.

Overweight, obesity and related non-communicable diseases in Asian Indian girls and women

The prevalence of obesity is rising globally and in India. Overweight, obesity and related diseases need to be delineated in Asian Indian women. A literature search was done using key words like 'obesity', 'Asian Indian women', 'body fat distribution', 'type 2 diabetes', 'fertility', 'polycystic ovarian disease', metabolic syndrome', 'cardiovascular disease', 'non-alcoholic fatty liver disease', 'gender', 'sex' and 'prevalence' up to September 2012 in Pubmed and Google Scholar search engines. This review highlights the Asian Indian body composition with regards to obesity and provides a collated perspective of gender-specific prevalence of the co-morbidities. Recent data show that women (range of prevalence of overweight and obesity from different studies 15-61%) have higher prevalence of overweight and obesity as compared with men (range of prevalence of overweight and obesity from different studies 12-54%) in India and that obesity is increasing in the youth. The prevalence of overweight and obesity in both men and women steeply rose in a Punjabi community from Jaipur. Importantly, prevalence of abdominal obesity has been consistently higher in women than in men. The lowest prevalence (6.0%) of type 2 diabetes mellitus in women is reported from South India (rural Andhra Pradesh; 2006) and the highest (14.0%) by the National Urban Diabetes Survey (2001). Although the clustering of cardiovascular disease risk factors was generally high, it increased further in post-menopausal women. There are a number of factors that predispose Indian women to obesity; sedentary behaviour, imbalanced diets, sequential and additive postpartum weight gain and further decrease in physical activity during this period and cultural issues. In view of these data, preventive measures should be specifically targeted to Indian women.

The effectiveness of policies for reducing dietary trans fat: a systematic review of the evidence

OBJECTIVE

To systematically review evidence for the effectiveness of policies, including self-regulation, aimed at reducing industrially produced trans fatty acids (TFAs) in food.

METHODS

The Medline, Embase and Cinahl databases were searched to identify peer-reviewed articles examining the effect of TFA policies. In addition, the first 20 pages of Google searches were examined for articles from the grey literature. A study was included if: (i) it was empirical and conducted in a "real-world" setting (i.e. modelling studies were excluded); (ii) it examined a TFA policy involving, for example, labelling, voluntary limits or bans; and (iii) it examined a policy's effect on TFA levels in food, people's diets, blood or breast milk.

FINDINGS

Twenty-six articles met the inclusion criteria: 5 involved voluntary self-regulation; 8, labelling alone; 4, labelling and voluntary limits; 5, local bans and 4, national bans. Overall, the TFA content of food decreased with all types of policy intervention. In general, saturated fat levels increased or decreased, depending on the product type, and total fat content remained stable. National and local bans were most effective at eliminating TFAs from the food supply, whereas mandatory TFA labelling and voluntary TFA limits had a varying degree of success, which largely depended on food category.

CONCLUSION

Policies aimed at restricting the TFA content of food were associated with significant reductions in TFA levels, without increasing total fat content. Such policies are feasible, achievable and likely to have an effect on public health.

From Denmark to Delhi: the multisectoral challenge of regulating trans fats in India

OBJECTIVE

India has proposed legislating an upper limit of trans fat in partially hydrogenated vegetable oils and mandating trans fat labelling in an effort to reduce intakes. The objective of the present study was to examine the complexities of regulating trans fat in India by examining the policy processes involved and the perceived implementation challenges.

DESIGN

Semi-structured interviews (n 18) were conducted with key informants from various sectors. Interviewees were asked about sources of trans fat in the food supply, existing policies that may influence trans fats and perceived challenges related to the proposed trans fat regulation, in addition to questions tailored to their area of expertise. Interview data were organised based on common themes.

SETTING

Interviews were conducted in India.

SUBJECTS

Interviewees were key informants from various sectors including agriculture, trade, industry and health.

RESULTS

Several themes were identified related to the complexity of regulating trans fat in India. A lack of trans fat awareness, the large unorganised retail sector, a need for suitable alternative products that are both acceptable to consumers and affordable, and a need to build capacity were crucial factors affecting India's ability to successfully regulate trans fat. The limited number of food inspectors will create an additional challenge in terms of enforcement of trans fat regulation.

CONCLUSIONS

Although India will face challenges in regulating trans fat, legislating an upper limit of trans fat in partially hydrogenated vegetable oils will likely be the most effective approach to reducing it in the food supply. Ongoing engagement with industry, agriculture, trade and processing sectors will prove essential in terms of product reformulation.

Trans fats-sources, health risks and alternative approach - A review

Trans fatty acids have the presence of one or more double bonds in the trans configuration instead of the usual cis configuration. They are desired by Vanaspati industry as they impart firmness to margarines and plasticity as well as emulsion stability to shortenings. Research has proved the direct connection of trans fatty acids with cardiovascular diseases, breast cancer, shortening of pregnancy period, risks of preeclampsia, disorders of nervous system and vision in infants, colon cancer, diabetes, obesity and allergy. In light of these new findings trans fatty intake should be zero and new technology of hydrogenation of oils is to be developed which produce zero trans fatty acids at the same time preserve the desirable properties contributed by trans fatty acids to the hydrogenated oils. Presently in India there is no system to monitor and regulate the amount of trans fats in processed foods and hence a stringent food law is immediately required.

Overview of trans fatty acids: biochemistry and health effects

Trans fatty acids (TFA) are unsaturated fatty acids that contain at least one non-conjugated double bond in the trans configuration, resulting in a straighter shape. TFA present in our diet can either be industrially produced and ruminant or natural. The major process contributing to formation of industrial TFA is hydrogenation of vegetable oils. Thermal processes such as edible oil refining and frying also lead to the formation of TFA while, ruminant/natural TFA is formed in the rumen of ruminant animals through bio-hydrogenation. Industrial TFA poses severe effects on our health like cardiovascular problems, insulin resistance, infertility in women, compromised fetal development and cognitive decline. There are strict regulations for limiting/removing the TFA content from food supply across the world. However in India, there is scarcity of data on TFA content in foods and their consumption levels. Given the alarmingly rising trend of diabetes and cardiovascular disease in India, removal of TFA from the food supply along with generating awareness among the masses in this regard is of immense importance.