Heart disease has reigned as the leading cause of death in the United States for over 60 years. Chronic destruction and blockage of coronary arteries have devastating effects, often leaving the heart beyond repair. With over three million cases in the U.S. each year, and over 600,000 deaths, this problem is anything but a little heartache.
Risk factors such as smoking (and secondhand smoke), high levels of fats and “bad” cholesterol, high blood pressure, and high levels of sugar (secondary to insulin-resistance or diabetes) are to blame. Exercise and a healthy lifestyle are protective against coronary heart disease (CHD).
It reads like a first-world problem on paper, the consequence of too much tasty food, the luxury of cigarettes and alcohol, topped with a notoriously sedentary lifestyle. But the World Health Organization reports CHD (also termed ischemic heart disease) as a leading cause of death worldwide, closely followed by stroke, which has identical risk factors. About 7.4 million deaths annually are due to CHD, another 6.7 million due to stroke.
You may not have known the numbers, but we all know the bad foods: processed snacks and baked goods, fast foods and fried foods. McDonald’s as the Sunday hangover cure—after a 2:00 a.m. drunken Taco Bell run—has even the healthiest college student feeling guilty and greasy for a few days. While our age group isn’t particularly at risk for CHD, the lifestyle choices we make become habits we carry into adulthood.
One of the primary culprits is trans fat, which was popularized for processed foods in the 1950s, and saturated fat, found naturally in animal products and prepared foods, like frozen pizza, ice cream and sausage. The advent of fast food shares the date with the first year that heart disease was the leading cause of death: 1921. Correlation does not imply causation, but research continually proves that processed foods and fast foods are to blame for the narrowing American artery.
Trans fat is found in practically anything produced industrially. That guilt-free granola bar in your back pocket also boasts trans fat and added sugars, even if it isn’t listed on the label (actually, if it’s under 0.5 gram, it’s listed as “0”). The American Heart Association recommends a maximum of two grams of trans fat and 13 grams of saturated fat per day – unattainable if we are analyzing the standard American diet. A Big Mac alone has 1.3 grams trans fat and eight grams saturated fat, not taking into account breakfast and dinner.
Is it fair to blame or regulate the food industry? It is up to us, after all, whether we opt for an apple in the morning or a donut (a donut from Dunkin’ Donuts boasts the same amount of saturated fat as a Big Mac). Still, since 2003, the food industry has reduced trans fat use by 86 percent due to pressure from the Food and Drug Administration (as well as statewide measures from New York and California, among others). The FDA is once again taking steps to regulate trans fat in the American diet. We are eager, it seems, to kiss the cherub-cheeked American goodbye, and embrace the lean yogi.
Under new regulations, partially hydrogenated oils (PHOs)—which have been shown to raise “bad” LDL cholesterol—will not be permitted for use in food unless otherwise authorized by the FDA. On June 16, the administration announced that trans fat must be removed from prepared foods within a three-year timeline. Some industries are attempting to prove that their additives are not harmful, but I find these regulations necessary for our nation’s health.
In the clinic, we see patients as young as 29 on a long list of medications. ACE inhibitors for high blood pressure, metformin for type II diabetes, beta-blockers for heart disease, among countless others. How do informed Americans still fall prey to preventable diseases?
Not surprisingly, our food choices are often linked to income. If we can afford a Whole Foods splurge, we are less likely to indulge in fast food dollar menus. Similarly, if we have a family of six to feed, and we are living beneath the poverty level, crafting a kale salad is likely low on the priority list. This assumes that socioeconomic status is directly predictive for health, but in my opinion, it’s not. It is, however, linked to health choices. We don’t have time to hit the gym if we are working a double shift just to put bread on the table. Whether that processed bread has trans fat or not is largely up to the FDA. I am not so gullible to believe income alone is to blame. It is true that some people are simply lazy or incapable, reaching for the frozen pizza night after night. But they are still Americans and they are still at risk.
The health trends in this country in recent years will not go unnoticed. How many independent bloggers post healthy recipes online, complete with lists of gluten-free, totally vegetarian options? What about the upsurge of yoga, cardio or weight training? We are all aware of the evils of sugars, fats and additives. We are more conscious than ever, as a nation, of what we put in our mouths. We are generally well informed, sometimes too informed.
The FDA is on the right track, though this is a small step for prevention. The truth is, no matter what we know or how well we know it, Americans everywhere will opt for a processed-something in times of need, laziness or exhaustion. I consider myself moderately healthy, I exercise, and I stay away from my ultimate weaknesses (apple pie and ice cream). But I’d be lying if I said I didn’t have a few Oreos last week between patients, guilt-ridden and all.
Regulation of the food industry is an undeniable necessity for healthy Americans. Just as federal regulation of the tobacco industry aims to reduce preventable disease, so too will federal regulation of unhealthy additives. The trans fat ban is especially pertinent for those Americans who cannot afford vegetables and fruits every week, or are simply uninformed about the dangers of poor food choices. The benefits are an estimated $140 million over 20 years from lower health care spending.
Some may say the FDA is biting off more than they can chew, but if these regulations save just one American from a preventable heart attack some day, they’ll be well worth it.
Sarah Jawhari is a biweekly columnist for the Observer.