Last week, US consumers received the good news that the US Food and Drug Administration (FDA) will require manufacturers to remove artificial trans fat from food products within three years. From a domestic perspective, the public health benefits of the FDA’s move are irrefutable. Through a global lens however, the impacts are less clear. Often, transnational companies respond to public health regulation in developed countries by dumping unhealthy products and expanding their markets in the developing world. In light of mounting national bans and increasing consumer awareness of the dangers of trans fat, it is timely to ask whether industry will take the opportunity to reformulate products destined for developing countries and improve health outcomes for everyone.
Trans fats are used in processed foods and in cooking to lengthen shelf-life, enhance flavor, and provide texture. They gained popularity in the 1940s, as a cheaper alternative to lard and butter. By the 2000s however, “it was clear beyond doubt that trans fats increase the risk of coronary heart disease.” In the United States, mounting concerns about the safety of trans fats led to a decrease in consumption of about 80 percent between 2003 and 2012. Despite the decrease, the FDA states that Americans still eat about one gram of trans fat each day, and “further reduction in the amount of trans fat in the American diet could prevent an additional 20,000 heart attacks and 7,000 deaths from heart disease each year.”
Ideally, the FDA’s move, which follows successful bans in several countries and US cities (e.g., Denmark, New York City), would further encourage governments around the world to protect their populations from “the biggest food processing disaster ever.” Indeed, the removal of artificial trans fats from the food supply has been identified by the World Health Organization as a “best-buy” public health intervention for low- and middle-income countries, meaning that bans provide high returns on investment in terms of health gains. Nonetheless, regulation is lacking or poorly enforced in many countries.
In the absence of adequate trans fat regulations, transnational corporations should voluntarily reformulate food products destined for all countries—whether high, middle, or low income—and whether or not required under domestic law. History, however, tells a different story. When unhealthy products or additives are banned, regulated, or fall out of favor among health-conscious consumers in higher income countries, corporations look to new markets—typically in low- and middle-income countries—to offload unhealthy products, rebuild sales figures, or stabilize profit margins. For example:
- Tobacco companies have responded to tobacco control laws and declining tobacco use in the United States and other western countries by aggressively targeting developing markets including Russia and Indonesia. Tobacco companies continue to employ deceptive marketing tactics that have been banned elsewhere, and promote high tar and high nicotine products.
- Poultry producers have sought and created new markets for turkey tails, a highly-fatty cut that is disliked by American consumers, in Samoa, Micronesia, and other low and middle-income countries.
- Transnational corporations continue to promote infant formula in developing countries, in breach of decades-old intergovernmental and industry codes that recommend restrictions on the promotion of breastmilk substitutes.
In addition, though “[m]any transnational companies have made commitments to remove trans fats and reduce levels of salt, sugar, and fat content in foods in wealthy countries… in most cases, these nutritional improvements are not being applied in low- and middle-income markets.”
While history suggests that industry will promote and perhaps increase marketing of trans fat laden products in developing countries, mounting national bans and increasing consumer awareness present a different, ethical option—to reformulate products destined for all countries and improve health outcomes globally.