On Wednesday, December 6th, the New York Times, along with other media outlets, reported on the New York City Board of Health’s decision to ban trans fats in NYC restaurants (see article).
I’m sure it was just a coincidence that the news reports appeared just two days after the press broke the story of Pfizer’s decision to discontinue the company’s development of it’s cholesterol drug torcetrapib because too many people were dying in a clinical trial of the agent(see article).
But the timing of the two news stories couldn’t have been more perfect!
The drug from Pfizer raises levels of the good kind of cholesterol, and trans fat has the dubious distinction of lowering such levels (in addition to raising levels of the bad kind of cholesterol). So a drug that would help battle the menace of trans fat fails, and then NYC steps in with a restaurant ban to make sure the battle lives on. The city of Cambridge is now thinking about an anti-trans fat measure of its own (see article).
For anyone tired of hearing about trans fat, this past week was not a good one; it’s hard to go through just one day without being scared-to-death by articles about the trans fat specter. Nevertheless, both stories from this past week raise really interesting issues. Three of the more compelling ones:
1. How bad is trans fat in actuality? A NYT article in August of 2005 by Gina Kolata (see article)
says that, according to most scientists, trans fat is about as bad for you as saturated fat, but since people eat far more saturated fat than trans fat, maybe we’re too worried about the latter, and are not keeping our eye closely enough on the former.
2. How far should city public health departments go in protecting the public health? Many places have banned smoking in bars/restaurants; is the ban on trans fat any different? Or is the city of New York trying to legislate lifestyle choices? NYC also approved a measure that would force some restaurants to inform customers of the caloric content of each of their offerings. Would this have been enough? Also, is the scientific understanding of the health consequences of trans fat firm enough to make a trans fat ban desirable?
3. What does all of this say about drug development by pharmaceutical companies? I just started reading a book on this topic by Marcia Angell, the former editor-in-chief of the New England Journal of Medicine. In The Truth About Drug Companies, she argues that big pharma companies spend far more on marketing and advertising their drugs than they do on developing them, and that they actually introduce very few new, innovative drugs. I feel really bad for patients who would have benefited from torcetrapib, and hopefully other companies will develop their own drugs that will raise good cholesterol. I’m not so concerned about Pfizer’s finances, though, and the nosedive its stock has taken, because the profits still keep rolling in.
About point #2, I think public health departments have a large and important role to play in restaurants, beyond just making sure they’re clean and not infested with rodents. I agree with you, a ban just on trans fat does seem a bit narrow, considering all the other things (saturated fat, calories) that are in excess in restaurant food, but because people are eating out more and more, we need to scrutinize what restaurants are serving us. Instituting and enforcing rules about labeling and offering healthy alternatives could, little by little over time, help change dietary attitudes and habits.
I’m glad you brought up the comparison with smoking bans. I think the bans have helped change the public image of smoking and I hope, made smoking less “cool” and acceptable in society. We need to do something similar with unhealthy, high-fat, high-calorie eating habits.