uring the last decade or so, a growing body of scientific evidence has validated the damaging effects of trans-fatty acids (TFAs) in dietary sources for human health. Foods with high levels of trans-fats have been proven to raise levels of low-density lipoprotein (LDL) or what is commonly known as “bad cholesterol.” At the same time, TFAs also reduce high-density lipoprotein (HDL) or “good cholesterol” in the body.

Needless to say, the compound effect of this unhealthy equation results in increasing the risk of heart disease and stroke. Trans-fats have also been associated with other ailments, including obesity, heart diseases, stroke, diabetes and Alzheimer’s disease in addition to prompting infertility in both men and women.

In simple terms, TFAs are mainly formed during the process of hydrogenation, which converts liquid oils into solid fats. TFAs have a unique chemical structure that includes one or more double bond in their fatty acid chain, with a straight structure. They can be naturally occurring in small amounts in certain animal fats, but a majority of TFAs are industrially produced through the process of partial hydrogenation of vegetable oils.

Trans-fats are normally found in processed foods, especially those made with partially hydrogenated oils. They are used to enhance the taste, texture and shelf life of food items. Unlike other types of fatty acids, TFAs have no known nutritional benefits.

Pakistan faces significant challenges in regulating and eliminating TFA from dietary sources. To begin with, the country has the second highest intake of TFAs in the WHO-EMRO region after Egypt. However, progress in introducing necessary measures to regulate TFAs presence in dietary sources has been subpar.

Pakistan’s inability to effectively regulate trans-fats is consistently contributing to the country’s burden of non-communicable diseases (NCDs), especially the heart diseases, stroke and diabetes. As per 2019 global burden of disease data, ischemic heart diseases and stroke are among the top killers of Pakistanis.

As per International Diabetes Federation (IDF) in 2021, more than 33 million people were living with diabetes. The number was set to reach 62 million by 2045 in case no policy action was taken. The IDF estimated the cost of diabetes management in Pakistan in 2021 as $2,640 million.

Countries such as Denmark, which implemented strong regulations to limit TFAs in food products to 2 percent of total fat during the early 2000s, have witnessed a substantial decrease in cardiovascular diseases. Almost half of the world’s population – living in 62 countries – is currently covered with the mandatory TFA limits. In the Asia region, several countries including India, Bangladesh and Philippine have also passed regulations to limit the trans-fatty acids in the diet to 2 percent of total fats in all foods.

Pakistan has made limited progress in eliminating trans-fatty acids from dietary sources. In 2020, Pakistan Standards and Quality Control Authority (PSQCA) set a 5 percent TFA limit for vanaspati ghee only. However, after continuous efforts by the Ministry of National Health Services, Regulations and Coordination and civil society advocates a 2 percent limit was set by the PSQCA for vanaspati, margarine, bakery fats, biscuits, rusks and bakery wares in June 2023.

Granted that this is an important step in the right direction, there are several products that are potential sources of TFAs but they have not been covered under the mandatory limits. These include deep fried street foods, several types of snacks, ultra-processed products, fast food, chocolates, ice-creams and desserts.

Historically, food safety laws have seen weak enforcement, resulting from a lack of capacity, limited resources (human, technical and financial), and limited availability of laboratories working under the national and sub national regulatory bodies.

After the decision of the Council of Common Interest in 2020, with PSQCA becoming the sole custodian of defining food standards, the process of regulating TFAs in all dietary items across Pakistan can be expedited if the PSQCA adopts the WHO-recommended limit of 2 grams of industrially produced TFA per 100 grams of total fat in all foods.

However, the passage of a uniform regulation is not the only requirement to ensure eliminating TFAs from the Pakistani diet. There are serious capacity and resource constraints at play, e.g., provincial food authorities don’t always have the resources to test TFA in the food supply.

Accordingly, Pakistan should consider a multi-pronged approach to regulate trans-fats to adopt best policy practices. First, it is essential to set mandatory limits with no more than 2 percent of industry produced TFAs of total fats that cover all food products. Another possibility could be to ban the partially hydrogenated oil through special legislation. A hybrid approach may also be adopted. It might include setting the limit of TFAs to 2 percent in all foods as well as banning partially hydrogenated oils.

Second, labelling of TFA on food packages should be made a binding requirement. Easily comprehensible front of pack labelling with warning signs is a well-established means to empower consumers to make healthy choices. This also encourages the food industry to reformulate products in a bid to meet regulated standards.

Third, public awareness campaigns should be launched to educate consumers about the risks associated with TFA consumption and the importance of opting for healthier dietary items. The awareness campaigns may be aimed at encouraging the use of healthier alternatives such as olive oil, canola oil, sunflower oil and corn oil, in moderate quantities. This can make a significant difference in reducing TFAs without compromising taste and quality.

Finally, public investment in necessary infrastructure, such as laboratories equipped to ascertain TFA levels in the food supply is absolutely essential. Granted that this will have some cost, it is the only viable way to generate critical data to refine and improve the regulatory efforts. It is also the only way to measure the effectiveness of TFA-related policies and make necessary adjustments when essential.

Regulating trans-fatty acids in Pakistani dietary sources is a crucial step towards improving public health outcomes and combating the ever-increasing incidence of non-communicable diseases. Leveraging on the positive experiences of other countries, Pakistan must decisively apply best policy practices to limit TFA consumption in the food supply chain.

By setting mandatory limits in line with WHO standards, introducing compulsory labelling, promoting healthier alternatives, and raising widespread awareness, the government can pave the way for a healthier nation. The time to act is now, and the health and well-being of millions of Pakistanis depend on it.

The writer is a development communications and advocacy specialist with experience in public health, education and gender programming. He currently serves as the communications and advocacy lead at Pakistan Youth Change Advocates