Recently the FDA took steps that will eventually lead to the banning of trans fats in food in the United States. I think that's a great idea. Not long ago the city of New York tried to ban sodas of a certain size in restaurants. I think that's a terrible idea. How can both of these things be true? That's the topic of this week's Healthcare Triage.

(Intro)

Getting rid of all trans fats is not a trivial thing. For a long time they existed in many of our processed foods, both because they made foods last longer, and partially because they helped with the taste. Also, not too long ago we thought trans fats were actually healthier for us than more traditional animal fats. Now it turns out that they do make food last longer, and it turns out that they often taste and feel great in your mouth. But they're not healthy.

In fact, lots of studies have shown that trans fats are significantly more likely to lead to heart disease or even death than other kinds of fats. In 2006 the FDA mandated that all foods now had to print exactly how much trans fats were in each of them. This is because it turned out that the recommended daily amount of them was almost zero, or about two grams per day. Anything above that was considered unsafe, and in fact they got such a bad rap that most restaurants and foods started banning them voluntarily. Today about 75 percent of companies have already removed trans fats from the foods that they produce.

What the FDA did recently is decide that companies now have to make a case for including trans fats in the foods that they produce. Given that they are so unhealthy and unnecessary and in fact must be produced in a lab, it's very unlikely that any companies are going to try to do so. 

This will not come free. It's estimated that it will cost somewhere between 12 and 14 billion dollars over the next 20 years to remove trans fats from all the foods we eat. But there's no doubt that it'll make us much healthier. 

But recently, the city of New York tried to ban sodas above 16 ounces in restaurants for the same reason: they think it'll make us healthier. Why isn't that a good idea?

It's not that they don't have a good case. Sodas can have a lot of sugar in them. A big soda today can have 275 calories or more. In the 1950s the average meal had about seven ounces of soda. Today that same meal might contain 42 ounces of soda.

This could be one of the reasons why Americans are, on average, about 25 pounds heavier than they were back then.

The reason I think banning sodas of a certain size is a bad idea is because it's cherry-picking: We've picked one source of sugar delivered one way and decided to restrict that in certain places. But without a holistic way to attack the entire obesity problem, this just doesn't seem to make much sense.

For instance, the ban applies to restaurants and movie theaters but not to vending machines or supermarkets or convenience stores. Why just that one place ? And why just a 16-ounce size? In other words, if you get a 12-ounce soda which is unlimited and can be refilled as much as you like, that's okay; but having one 16-ounce soda, that's a bad idea.

Research shows that people might be more likely just to buy two 12-ounce sodas than the one 16-ounce soda they might have gotten, just to make sure that they have 'enough.' In other words, this kind of thing could actually backfire.

And why is it okay to go to the Cheesecake Factory and get a Farmhouse Cheeseburger at 1530 calories and follow it up with a piece of Ultimate Red Velvet Cheesecake for 1540 calories, but you're gonna ban the 250-calorie soda that might come along with it? I mean, in that case you've already consumed 3000 calories before you've touched a french fry, and it had nothing to do with the soda, but that's the only that we're gonna choose to ban.

It's not just cheap food, either. A Porterhouse at Morton's with mashed potatoes and half a side of creamed spinach has over 2500 calories with 85 grams of saturated fat and almost 3000 milligrams of sodium. That's the same as eight pieces of Original Recipe Kentucky Fried Chicken plus mashed potatoes with gravy, coleslaw, and four biscuits --with an extra one-and-a-half days of fat on the side.

Now if you want to come up with some holistic way to try to reduce peoples' calorie consumption overall, maybe I'd be in support of that. If you wanted to find a way to try to attack certain nutrients --say, sugar --by coming up with a tax on sugar, I'd be willing to look at economic analyses to see if that kind of thing would work. But cherry-picking one delivery source of calories while leaving everything else untouched just doesn't seem to make much sense and it isn't going to work.

Trans fats are artificial; they're made in a lab; and adding them to our food has been hurting us. It makes a lot of sense to stop doing that. Banning sodas of a certain size in a certain place is not a holistic solution to the obesity epidemic. It's totally rational to oppose the ban on sodas while supporting the FDA's ban on trans fats, and I'll continue to do so.