Egypt to limit harmful trans fats in food after WHO warning

Egypt — one of the highest trans fat consumers in the world — is working to limit the dangerous fat in food in line with World Health Organisation standards, officials told The National after a warning this week on the dire health impact.

The WHO on Monday warned that 5 billion people are being exposed to higher rates of heart disease due to trans-fatty acids despite efforts to eliminate trans fats globally by 2023.

But Egypt's National Food Safety Authority chairman Dr Tareq El Houby said that a bill signed last year should bring the country in line with international standards.

Under the decree from the NFSA published in the country's official gazette last October, manufacturers and importers will be limited to two grams of trans fat per 100 grams of total fat in all food within 12 months.

The changes would bring Egypt in line with WHO advice on safer levels of trans fats - which are commonly found in margarine, fried foods, sweets, packaged goods and fast food items, and increase the risk of heart disease and death.

Manufacturers are also prohibited from using partially hydrogenated oils, a major source of trans fat.

“I think a year is enough for [manufacturers and importers] to make the necessary arrangements,” Dr El Houby told The National.

“This is not a choice — it’s an obligation.”

Egypt has the world’s highest percentage of coronary heart disease deaths due to trans fats and has not yet implemented a best practice policy, the WHO said on Monday.

The WHO report, produced with the non-profit organisation Resolve to Save Lives, found that five billion people globally are exposed to the harmful fat.

The WHO issued an appeal in 2018 for industrially produced fatty acids in foods to be eliminated worldwide by 2023.

An estimated 8.39 per cent of Egypt’s coronary heart disease deaths are due to trans fat intake, followed by the US at 7.57 per cent and Iran at 6.96 per cent.

Nine of the 16 countries with the highest proportion of coronary heart disease deaths caused by trans fats do not have a best-practice policy. They are Australia, Azerbaijan, Bhutan, Ecuador, Egypt, Iran, Nepal, Pakistan and South Korea.

Dr Tom Frieden, president of Resolve to Save Lives and former director of the US Centres for Disease Control and Prevention, said Egypt's move to remove trans fat shows change is on the horizon.

“We commend the government of Egypt for taking decisive action to eliminate trans fat and are very encouraged that, if implemented, Egypt will meet the WHO target of becoming trans-fat-free by the end of 2023,” he told The National.

The WHO report said that supporting the policy process in Egypt “will be a priority for WHO and partners in the next year”.

Commitment to eliminate trans fat

In the Mena region, only Oman and Saudi Arabia have best-practice policies.

The UAE, Bahrain, Iran and Kuwait have some trans fat limits. Jordan, Tunisia and Qatar have implemented other complementary measures.

Egypt, Lebanon and Morocco have expressed a national policy commitment to eliminate trans fat, the WHO report said.

In 2017, Egypt’s five-year national plan for the prevention and control of non-communicable diseases set a goal to “replace trans fats and saturated fats with unsaturated fats through reformulation, labelling and fiscal and agricultural policies”.

Non-communicable diseases, including cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, account for around 85 per cent of all deaths in the country.

Egypt established the NFSA in 2017 to protect consumers’ health and interests by ensuring that food consumed, distributed, marketed or produced in Egypt meets the highest standards of food safety and hygiene.

Resolve to Save Lives has worked with and supported the WHO's Eastern Mediterranean office since 2018, with “Egypt as one of the priority countries”, Dr Frieden said.

This included technical support to develop trans fat regulations and measure trans fat content in foods.

“It took a long time to be able to develop a system of risk assessment and traceability,” said Dr El Houby.

A third of foods exceed limit

A 2021 study published in the scientific journal Nutrients examined the trans fat content of 208 commonly consumed food items in the Egyptian market and found that 34 per cent of the products exceeded the trans fat limit.

The authors, who included Egyptian medical academics and WHO representatives, referred to it as “the first steps in the trans fatty acid elimination road map”.

The categories included fats and oils, milk and milk products, confectioneries, canned and frozen items, fast-food items and sweets.

The fast-food group had the largest proportion of products rich in trans fat, with half of the items exceeding the limit.

Meat sambousek, a deep-fried savoury pastry, had the highest trans fat content of 5.4 per cent, followed by falafel and mixed meat grills.

Frying foods with used oils had a major impact on the trans fat content, with falafel and potatoes made with used oils having more than four times the content of those prepared with new oil.

Some traditional Egyptian meat items, such as frozen kebbah and kofta, had trans fat content that exceeded those of Western items such as chicken nuggets and luncheon meat.

Sweets such as basbousa and zalabia had a trans fat content three times higher than doughnuts.

Poverty a factor

Some of the challenges in limiting or eliminating trans fat in Egypt include resistance towards regulations by the food industry, as well as the higher cost of healthier alternatives for the manufacturers and consumers, the authors of the study said.

Egypt’s poverty rate of about 30 per cent and an illiteracy rate of around 25 per cent are also contributing factors.

Low-income customers are more likely to consume products with higher trans fat content since they are often cheaper and those who are illiterate are unable to read nutrition labels.

The study recommended that the Egyptian government collaborate with the food and beverage industry to reformulate their products, enforce the relevant legal reforms and empower consumers through educational interventions and consumer-friendly nutrient labels.

Dr El Houby said the NFSA is working on nutrient label guidelines, so that the trans fat percentage is clear to consumers.

Regulation of trans fat content will start with the industrial sector, followed by the so-called “loose market”, such as food stalls.

“That will be the second stage. We can't achieve everything all at once,” Dr El Houby said.