Editorial | Taking aim at trans fats

Most of the coverage of Christopher Tufton’s report on the state of Jamaica’s health focused on his announcement that the Government had retrieved ownership of the brand Jamaica Moves, the highly popular, globally endorsed and regionally copied national exercise programme to help reduce lifestyle diseases – among them diabetes, hypertension, and their handmaiden, obesity. Which, perhaps, was to be expected, given the salacious context to the discovery that the name was in the hands of the health ministry’s marketing company, Market Me.

The problem is that people missed, or ignored, the health minister’s remarks on his latest, and related, initiative to promote healthier lifestyles: an assault on trans fats and a front-of-package labelling of the ingredients in foods. Yet, these are matters worthy of robust public discussions, which Dr Tufton should engage in as a refocus on this worsening health crisis and as part of his strategy for the lowering, over the long term, of the cost of healthcare. At the same, he should report on his initiative to have food manufacturers reduce the sugar content of their products, an initiative that petered out in a whimper.

Trans fats (trans-unsaturated fatty acids) are what you get when hydrogen is added to vegetable oils in a process called hydrogenation. The result is solid or semi-solid food substances that are used in foods. They are especially popular with food processors. They enhance the shelf life of products and add to taste.

The downside is that trans fats, when consumed beyond very limited amounts, are bad for people’s health. They increase bad cholesterol, that is, fats that move throughout the body in the blood, and reduce the good ones. High cholesterol often leads to blocked arteries and hypertension, which sometimes result in strokes and other coronary heart diseases (CHD). CHDs are the leading cause of deaths in Jamaica, accounting for about a third of mortality annually. This is followed by diabetes at around 12 per cent.

Indeed, as Dr Tufton pointed out in his parliamentary report, approximately 34 per cent of Jamaicans are hypertensive, 12 per cent suffer from diabetes, 15 per cent have chronic kidney problems, and two per cent have heart attacks. Moreover, of the people who die each year, half (51 per cent) have hypertension, 36 per cent are diabetic, and 10 per cent suffer from chronic kidney disease – even if these conditions are not the direct causes of their deaths.

“Our bodies and what we do with it and what we put in it over the years had a significant impact on how we responded to the COVID-19 virus. The foods we eat, our physical activity programme, rest and relaxation, and pollutants in the environment are all contributors to our personal health,” Dr Tufton said.

THE VILLAINS OF NEW CAMPAIGN

Whereas in the past excess salt and sugar were in the minister’s cross hairs, trans fats are the villains of his new campaign, especially with respect to foods consumed by children. He is taking aim at the food industry.

A baseline study done last year by the University of Technology (UTech) for the health ministry showed that 39 per cent of the commonly consumed foods contained trans fats above the recommended levels, including 83 per cent of confectionery, 71 per cent of cooking oils, 56 per cent of desserts, and half of dairy products. Most also had more salt than was recommended for the specific foods for the categories.

While Jamaica’s standards law requires that food processors list the ingredients of their product, most consumers remain in the dark about what they eat. Labels are not easy to read. The print is often fine. And the information is usually complex and technical.

It is against this backdrop that Dr Tufton wants new labelling standards – information where it is easily seen and in language that is readily understood.

He said “... In the coming year, we will continue our drive to educate consumers on the dangers of unhealthy foods and push for lower levels of salts and sugars in our diets, and, over time, the elimination of trans fats. We will also be pushing for labelling requirements that are clear and easy to understand, including front-of-package labelling, in the interests of protecting consumers’ right to know and for good health.”

That makes sense. But the Government must be specific in its demands, which should be the result of robust scientific research and clearly articulated to consumers and manufacturers. The process of discussion has to begin now rather than later, and the administration must be certain about its intended mode of enforcement, whether by legislative or voluntary compliance.

BETTER ECONOMICS

In other words, Minister Tufton must avoid the pitfalls of 2017-18, when he placed on the agenda the problem of sugar in foods, especially drinks and snacks consumed by children. At one point he floated the idea of a tax on sugary drinks, as was the case in countries like Mexico, Britain and regional partners Barbados and Dominica.

Dr Tufton, however, did not find too much support among his Cabinet colleagues. Neither was the food industry welcoming of a proposal that might increase prices and decrease consumption of their products. That, the Government feared, might cost jobs and negatively impact economic growth.

There was talk of voluntary compliance and suggestions for the reduction of portion sizes. Some of that may have happened, but without specific, or enforceable, undertakings. Unfortunately, there has been no review or analysis of what was done, or if sugar consumption has changed over the three years. Neither is there any data on what was achieved with the mandate to schools to eliminate or reduce the sale or serving of sugary foods and drinks in schools’ cafeterias and tuck shops.

Dr Tufton did not provide an update in his recent remarks, but in 2019 he highlighted studies that showed that Jamaica, over the next 15 years, would lose up to J$47 billion in labour output because of cardiovascular disease and diabetes alone. The medical costs of treating these diseases would be another J$30 billion. That combined J$77 billion is more than three and half per cent of Jamaica’s current GDP. That is a lot of money. Clearly, it is better economics to have a healthy country.