Our estimate of approximately 4700 fewer CVD deaths following trans fat elimination is also reassuringly close to the 7000 quoted in a recent BMJ editorial.10 The benefit for individuals and ethnic groups with insulin resistance may be even greater.10,15 In Denmark, legislation passed in 2004 banning industrial trans fats resulted in a rapid drop to zero consumption.13 After initial opposition, the EU slowly relented and subsequently discussed a ban across Europe.27 Following Denmark, several countries, including Austria, Canada, Iceland and Switzerland (and several US cities and states), have recently taken steps to reduce or ban industrial trans fats in food.10 Canada was the first country to require that the trans fats levels in pre packaged foods be included on the mandatory nutrition facts table. Though less powerful, labelling regulations inform consumers, motivate industry to reformulate its products and favourably influence social norms. Many manufacturers have now reduced trans fat content.28 In Seattle, a programme to phase out industrial trans fats in fast food outlets encountered surprisingly little opposition from commercial interests; most stakeholders apparently considered it a logical step.29.
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