Trans fatty acid elimination policy in member states of the Eurasian Economic Union: Implementation challenges and capacity for enforcement

Trans fatty acids and saturated fatty acids in margarines and spreads in Kazakhstan: Study period 2015-2021

Oil and other fat rich products such as some processed foods can contain unhealthy amounts of trans fatty acids (TFA) and saturated fatty acids (SFA). Diets rich in TFA have been linked to coronary artery disease. It is necessary to quantify and police the type of fat in foods to assess its risk. For the first time, this study quantifies the TFA content in margarines and spreads sold in the Kazakhstan markets in the period from 2015 to 2021. Fatty acid composition, and importantly TFA levels, were determined in 6 brands of margarines and 5 brands of spreads used in the food industry and by consumers directly in 2015-2017, and in 23 brands of margarines and 23 brands of spreads from 2018 to 2021. The study margarines and spreads had 20.0 ± 0.02 % TFA on average until 2018. In contrast, in the period 2018-2021, the TFA average content was 14.2 ± 0.06 % in margarines, and 10.6 ± 0.05 % in spreads, which is still 7.4 and 6 times higher than the regulatory requirements of the Customs Union (Kazakhstan, Russia, Belarus, Kyrgyzstan) and the EU, respectively. The strong cause effect between TFA and cardiovascular diseases urges Kazakhstan and other countries to reduce TFA in commercial products. It also encourages research and implementation of technical measures to provide healthy food products that effectively comply with national and international regulations regarding TFA content. The aim of the study was to analyze changes in the quality of solid fat products produced in Kazakhstan over time, particularly after the Technical Regulations of the Customs Union came into effect on January 1, 2018.

Projecting cardiovascular deaths averted due to trans fat policies in the Eurasian Economic Union

OBJECTIVE

To demonstrate the potential impact on population health if policies designed to reduce population trans fatty acid (TFA) intake are successfully implemented in the Eurasian Economic Union (EAEU) in line with the WHO's guidelines to lower intake of TFA as a percentage of total energy intake to less than 1 %.

DESIGN

A projection exercise was conducted to estimate reductions in CVD-related deaths in countries of the EAEU if TFA policies are implemented in the EAEU. Plausibly causal, annual effects (in %) of Denmark's TFA policy on the evolution of CVD mortality rates were applied to project the potential effects of recently announced TFA policies in Armenia, Belarus, Kazakhstan, Kyrgyzstan and the Russian Federation under three TFA exposure scenarios.

SETTINGS

Member States of the EAEU: Armenia, Belarus, Kazakhstan, Kyrgyzstan and the Russian Federation.

PARTICIPANTS

Data used for the projection exercise were based on estimates from natural experimental evidence from Denmark. National CVD mortality rates used were from WHO and the Organisation for Economic Cooperation and Development datasets.

RESULTS

In all countries and in all scenarios, deaths averted were ≤ 5 deaths/100,000 in year 1 and rose in years 2 and 3. The highest projected impacts in the high-exposure scenario were seen in Kyrgyzstan (39 deaths/100 000), with the lowest occurring in Armenia (24 deaths/100 000).

CONCLUSION

This study demonstrates the potential population health gains that can be derived from effective policies to reduce TFA in line with WHO guidance. Monitoring and surveillance systems are needed to evaluate the effectiveness of the TFA reduction policies in a national context.

Sugar-sweetened beverage taxes in Europe: learning for the future

Background

Sugar-sweetened beverage (SSB) taxes are recommended globally as part of measures to prevent diet-related NCDs. However, their uptake in the World Health Organization (WHO) European Region has been limited. The aim of this study was to inform strategic, cross-sectoral, public health policy engagement to support the uptake and effective implementation of SSB taxation.

Methods

We conducted a policy analysis of SSB taxes in the WHO European Region, drawing on theories of policy making and diffusion of innovation. Data were collected from policy documents and media, secondary contextual sources and qualitative interview data (n = 20) to analyze factors influencing the adoption of taxes in 10 countries.

Results

Belgium, Finland, France, Hungary, Ireland, Latvia, Monaco, Norway, Portugal and the UK had current SSB taxes, but Monaco was excluded from the findings due to its unique taxation context. All countries were characterized by policy priority for NCD prevention, and in many there was a fiscal imperative to raise revenue. The taxes took the form of excises or levies, and the tax base and rate varied between countries. SSB taxation was fostered by constructive engagement between health and fiscal policy makers, but also influenced by external industry and public health stakeholders. Policy learning from national and international experience was evident in all countries.

Conclusions

This study points to the value of ongoing policy learning for improving tax design, and the importance of constructive collaboration between finance and health policy makers. It also suggests regional bodies could play a greater role in supporting SSB taxation.

Trans Fat Free by 2023-A Building Block of the COVID-19 Response

COVID-19 has brought to center stage the most important health issue of our era, largely ignored by policymakers and the public to date: non-communicable diseases (NCDs), the cause of 71% of deaths per year worldwide. People living with NCDs, and particularly those living with cardiovascular disease (CVD), are at higher risk of severe symptoms and death from COVID-19. As a result, the urgent need for policy measures to protect cardiovascular health is more apparent than ever. One example of "low-hanging fruit" in the prevention of CVD is the elimination of industrially-produced trans fatty acids (iTFA). Their removal from the global food supply could prevent up to 17 million deaths by 2040 and would be the first time an NCD risk factor has been eliminated.