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Global Surveillance of trans-Fatty Acids
PUBLIC HEALTH PRACTICE BRIEF — Volume 16 — October 31, 2019
PEER REVIEWED
Figure 1.
Pareto analysis on the estimated number of deaths from coronary heart disease attributable to high intake of trans-fatty acids (TFAs) (defined by Wang et al [8] as >0.5% of total energy intake), top 30 countries. Pareto charts are used to describe the countries in descending order of the total estimated number of CHD deaths worldwide (9). In this chart, bars indicate the estimated number of CHD deaths attributable to high TFA intake, the curved line indicates cumulative percentages, and the dashed line indicates the 15 countries that account for 80% of total CHD deaths attributable to high TFA intake worldwide according to the Pareto principle (the 80/20 rule). Data source: Wang et al (8).
| Country | Annual No. of CHD Deaths Due to High Intake of trans Fatty Acids | Percentage | Cumulative Percentage | Ranking by No. of CHD Deaths |
|---|---|---|---|---|
| United States | 96,611 | 18.11 | 18.11 | 1 |
| India | 63,243 | 11.86 | 29.97 | 2 |
| Egypt | 44,257 | 8.3 | 38.27 | 3 |
| China | 42,356 | 7.94 | 46.21 | 4 |
| Pakistan | 40,239 | 7.54 | 53.75 | 5 |
| Russia | 29,480 | 5.53 | 59.28 | 6 |
| Mexico | 18,732 | 3.51 | 62.79 | 7 |
| Brazil | 18,576 | 3.48 | 66.27 | 8 |
| Iran | 14,398 | 2.70 | 68.97 | 9 |
| Canada | 13,901 | 2.61 | 71.58 | 10 |
| Ukraine | 12,980 | 2.43 | 74.01 | 11 |
| Germany | 10,916 | 2.05 | 76.06 | 12 |
| Bangladesh | 8,137 | 1.53 | 77.59 | 13 |
| Indonesia | 5,760 | 1.08 | 78.67 | 14 |
| Japan | 5,271 | 0.99 | 79.66 | 15 |
| Poland | 5,133 | 0.96 | 80.62 | 16 |
| United Kingdom | 4,712 | 0.88 | 81.50 | 17 |
| Turkey | 3,973 | 0.74 | 82.24 | 18 |
| Belarus | 3,561 | 0.67 | 82.91 | 19 |
| Italy | 3,381 | 0.63 | 83.54 | 20 |
| France | 3,084 | 0.58 | 84.12 | 21 |
| Philippines | 3,067 | 0.57 | 84.69 | 22 |
| Netherlands | 2,881 | 0.54 | 85.23 | 23 |
| Romania | 2,591 | 0.49 | 85.72 | 24 |
| Uzbekistan | 2,535 | 0.48 | 86.20 | 25 |
| Thailand | 2,517 | 0.47 | 86.67 | 26 |
| Iraq | 2,475 | 0.46 | 87.13 | 27 |
| Colombia | 2,215 | 0.42 | 87.55 | 28 |
| Nepal | 2,178 | 0.41 | 87.96 | 29 |
| Sri Lanka | 2,162 | 0.41 | 88.37 | 30 |
Figure 2.
Countries with policies or regulations on industrially produced (artificial) TFAs. Data source: World Health Organization (14). Abbreviation: PHO, partially hydrogenated oil; TFA, trans-fatty acid.
| Country | Policy |
|---|---|
| Afghanistan | No or unknown TFA policy |
| Albania | No or unknown TFA policy |
| Algeria | No or unknown TFA policy |
| American Samoa | No or unknown TFA policy |
| Andorra | No or unknown TFA policy |
| Angola | No or unknown TFA policy |
| Anguilla | No or unknown TFA policy |
| Antarctica | No or unknown TFA policy |
| Antigua and Barbuda | No or unknown TFA policy |
| Argentina | Restriction of TFAs AND mandatory TFA labeling |
| Armenia | Restriction of TFA only |
| Aruba | No or unknown TFA policy |
| Australia | No or unknown TFA policy |
| Austria | Restriction of TFA only |
| Azerbaijan | No or unknown TFA policy |
| Bahamas | No or unknown TFA policy |
| Bahrain | Mandatory TFA labeling only |
| Bangladesh | No or unknown TFA policy |
| Barbados | No or unknown TFA policy |
| Belarus | Restriction of TFA only |
| Belgium | No or unknown TFA policy |
| Belize | No or unknown TFA policy |
| Benin | No or unknown TFA policy |
| Bermuda | No or unknown TFA policy |
| Bhutan | No or unknown TFA policy |
| Bolivia | Mandatory TFA labeling only |
| Bonaire, Saint Eustatius, and Saba | No or unknown TFA policy |
| Bosnia and Herzegovina | No or unknown TFA policy |
| Botswana | No or unknown TFA policy |
| Bouvet Island | No or unknown TFA policy |
| Brazil | Restriction of TFAs AND mandatory TFA labeling |
| British Indian Ocean Territory | No or unknown TFA policy |
| Brunei Darussalam | No or unknown TFA policy |
| Bulgaria | No or unknown TFA policy |
| Burkina Faso | No or unknown TFA policy |
| Burundi | No or unknown TFA policy |
| Cambodia | No or unknown TFA policy |
| Cameroon | No or unknown TFA policy |
| Cameroon/Nigeria | No or unknown TFA policy |
| Canada | Banning of PHOs AND mandatory TFA labeling |
| Cape Verde | No or unknown TFA policy |
| Cayman Islands | No or unknown TFA policy |
| Central African Republic | No or unknown TFA policy |
| Chad | No or unknown TFA policy |
| Chile | Restriction of TFAs AND mandatory TFA labeling |
| China | Mandatory TFA labeling only |
| China/India | No or unknown TFA policy |
| China/Taiwan, Province of China | No or unknown TFA policy |
| Christmas Island | No or unknown TFA policy |
| Cocos (Keeling) Islands | No or unknown TFA policy |
| Colombia | Restriction of TFA only |
| Comoros | No or unknown TFA policy |
| Congo | No or unknown TFA policy |
| Congo, Democratic Republic of the | No or unknown TFA policy |
| Cook Islands | No or unknown TFA policy |
| Costa Rica | No or unknown TFA policy |
| Cote D’Ivoire | No or unknown TFA policy |
| Croatia | No or unknown TFA policy |
| Cuba | No or unknown TFA policy |
| Curacao | No or unknown TFA policy |
| Cyprus | No or unknown TFA policy |
| Czech Republic | No or unknown TFA policy |
| Denmark | Restriction of TFA only |
| Djibouti | No or unknown TFA policy |
| Dominica | No or unknown TFA policy |
| Dominican Republic | No or unknown TFA policy |
| Ecuador | Restriction of TFAs AND mandatory TFA labeling |
| Egypt | No or unknown TFA policy |
| El Salvador | No or unknown TFA policy |
| Equatorial Guinea | No or unknown TFA policy |
| Eritrea | No or unknown TFA policy |
| Estonia | No or unknown TFA policy |
| Ethiopia | No or unknown TFA policy |
| Falkland Islands (Malvinas) | No or unknown TFA policy |
| Faroe Islands | No or unknown TFA policy |
| Fiji | No or unknown TFA policy |
| Finland | No or unknown TFA policy |
| France | No or unknown TFA policy |
| French Guiana | No or unknown TFA policy |
| French Polynesia | No or unknown TFA policy |
| French Southern Territories | No or unknown TFA policy |
| Gabon | No or unknown TFA policy |
| Gambia | No or unknown TFA policy |
| Georgia | No or unknown TFA policy |
| Germany | No or unknown TFA policy |
| Ghana | No or unknown TFA policy |
| Gibraltar | No or unknown TFA policy |
| Golan Heights | No or unknown TFA policy |
| Greece | No or unknown TFA policy |
| Greenland | No or unknown TFA policy |
| Grenada | No or unknown TFA policy |
| Guadeloupe | No or unknown TFA policy |
| Guam | No or unknown TFA policy |
| Guatemala | No or unknown TFA policy |
| Guernsey | No or unknown TFA policy |
| Guinea | No or unknown TFA policy |
| Guinea-Bissau | No or unknown TFA policy |
| Guyana | No or unknown TFA policy |
| Haiti | No or unknown TFA policy |
| Heard Island and McDonald Islands | No or unknown TFA policy |
| Holy See (Vatican City State) | No or unknown TFA policy |
| Honduras | No or unknown TFA policy |
| Hungary | Restriction of TFA only |
| Iceland | Restriction of TFA only |
| India | Restriction of TFAs AND mandatory TFA labeling |
| Indonesia | No or unknown TFA policy |
| Iran, Islamic Republic of | Restriction of TFA only |
| Iraq | No or unknown TFA policy |
| Ireland | No or unknown TFA policy |
| Isle of Man | No or unknown TFA policy |
| Israel | Mandatory TFA labeling only |
| Italy | No or unknown TFA policy |
| Jamaica | No or unknown TFA policy |
| Japan | No or unknown TFA policy |
| Jersey | No or unknown TFA policy |
| Jordan | No or unknown TFA policy |
| Kazakhstan | Restriction of TFA only |
| Kenya | No or unknown TFA policy |
| Kiribati | No or unknown TFA policy |
| Korea, Democratic People’s Republic of | No or unknown TFA policy |
| Korea, Republic of | Mandatory TFA labeling only |
| Kosovo | No or unknown TFA policy |
| Kuwait | Mandatory TFA labeling only |
| Kyrgyzstan | Restriction of TFA only |
| Lao People’s Democratic Republic | No or unknown TFA policy |
| Latvia | Restriction of TFA only |
| Lebanon | No or unknown TFA policy |
| Lesotho | No or unknown TFA policy |
| Liberia | No or unknown TFA policy |
| Libya | No or unknown TFA policy |
| Liechtenstein | No or unknown TFA policy |
| Lithuania | Restriction of TFA only |
| Luxembourg | No or unknown TFA policy |
| Macedonia, the Former Yugoslav Republic of | No or unknown TFA policy |
| Madagascar | No or unknown TFA policy |
| Malawi | No or unknown TFA policy |
| Malaysia | No or unknown TFA policy |
| Maldives | No or unknown TFA policy |
| Mali | No or unknown TFA policy |
| Malta | No or unknown TFA policy |
| Marshall Islands | No or unknown TFA policy |
| Martinique | No or unknown TFA policy |
| Mauritania | No or unknown TFA policy |
| Mauritius | Mandatory TFA labeling only |
| Mayotte | No or unknown TFA policy |
| Mexico | No or unknown TFA policy |
| Micronesia, Federated States of | No or unknown TFA policy |
| Moldova, Republic of | No or unknown TFA policy |
| Monaco | No or unknown TFA policy |
| Mongolia | No or unknown TFA policy |
| Montenegro | No or unknown TFA policy |
| Montserrat | No or unknown TFA policy |
| Morocco | No or unknown TFA policy |
| Mozambique | No or unknown TFA policy |
| Myanmar | No or unknown TFA policy |
| Namibia | No or unknown TFA policy |
| Nauru | No or unknown TFA policy |
| Nepal | No or unknown TFA policy |
| Netherlands | No or unknown TFA policy |
| New Caledonia | No or unknown TFA policy |
| New Zealand | No or unknown TFA policy |
| Nicaragua | No or unknown TFA policy |
| Niger | No or unknown TFA policy |
| Nigeria | No or unknown TFA policy |
| Niue | No or unknown TFA policy |
| Norfolk Island | No or unknown TFA policy |
| Northern Mariana Islands | No or unknown TFA policy |
| Norway | Restriction of TFA only |
| Oman | No or unknown TFA policy |
| Pakistan | No or unknown TFA policy |
| Palau | No or unknown TFA policy |
| Palestinian Territory, Occupied | No or unknown TFA policy |
| Panama | No or unknown TFA policy |
| Papua New Guinea | No or unknown TFA policy |
| Paraguay | Mandatory TFA labeling only |
| Peru | Restriction of TFAs AND mandatory TFA labeling |
| Philippines | Mandatory TFA labeling only |
| Pitcairn | No or unknown TFA policy |
| Poland | No or unknown TFA policy |
| Portugal | No or unknown TFA policy |
| Puerto Rico | No or unknown TFA policy |
| Qatar | No or unknown TFA policy |
| Reunion | No or unknown TFA policy |
| Romania | Restriction of TFAs AND mandatory TFA labeling |
| Russian Federation | Restriction of TFA only |
| Rwanda | No or unknown TFA policy |
| Saint Barthelemy | No or unknown TFA policy |
| Saint Helena | No or unknown TFA policy |
| Saint Kitts and Nevis | No or unknown TFA policy |
| Saint Lucia | No or unknown TFA policy |
| Saint Martin | No or unknown TFA policy |
| Saint Pierre and Miquelon | No or unknown TFA policy |
| Saint Vincent and the Grenadines | No or unknown TFA policy |
| Samoa | No or unknown TFA policy |
| San Marino | No or unknown TFA policy |
| Sao Tome and Principe | No or unknown TFA policy |
| Saudi Arabia | Restriction of TFAs AND mandatory TFA labeling |
| Senegal | No or unknown TFA policy |
| Serbia | No or unknown TFA policy |
| Seychelles | No or unknown TFA policy |
| Sierra Leone | No or unknown TFA policy |
| Singapore | Restriction of TFAs AND mandatory TFA labeling |
| Sint Maarten (Dutch Part) | No or unknown TFA policy |
| Slovakia | No or unknown TFA policy |
| Slovenia | Restriction of TFA only |
| Solomon Islands | No or unknown TFA policy |
| Somalia | No or unknown TFA policy |
| South Africa | Restriction of TFAs AND mandatory TFA labeling |
| South Georgia and the South Sandwich Islands | No or unknown TFA policy |
| Spain | No or unknown TFA policy |
| Sri Lanka | No or unknown TFA policy |
| Sudan | No or unknown TFA policy |
| Suriname | No or unknown TFA policy |
| Suriname/Guyana | No or unknown TFA policy |
| Svalbard and Jan Mayen | No or unknown TFA policy |
| Swaziland | No or unknown TFA policy |
| Sweden | Restriction of TFA only |
| Switzerland | Restriction of TFA only |
| Syrian Arab Republic | No or unknown TFA policy |
| Taiwan, Province of China | No or unknown TFA policy |
| Tajikistan | No or unknown TFA policy |
| Tanzania, United Republic of | No or unknown TFA policy |
| Thailand | Restriction of TFA only |
| Timor-Leste | No or unknown TFA policy |
| Togo | No or unknown TFA policy |
| Tokelau | No or unknown TFA policy |
| Tonga | No or unknown TFA policy |
| Trinidad and Tobago | No or unknown TFA policy |
| Tunisia | No or unknown TFA policy |
| Turkey | No or unknown TFA policy |
| Turkmenistan | No or unknown TFA policy |
| Turks and Caicos Islands | No or unknown TFA policy |
| Tuvalu | No or unknown TFA policy |
| Uganda | No or unknown TFA policy |
| Ukraine | No or unknown TFA policy |
| United Arab Emirates | No or unknown TFA policy |
| United Kingdom | No or unknown TFA policy |
| United States | Banning of PHOs AND mandatory TFA labeling |
| Uruguay | Mandatory TFA labeling only |
| Uzbekistan | No or unknown TFA policy |
| Vanuatu | No or unknown TFA policy |
| Venezuela | No or unknown TFA policy |
| Viet Nam | No or unknown TFA policy |
| Virgin Islands, British | No or unknown TFA policy |
| Virgin Islands, US | No or unknown TFA policy |
| Wallis and Futuna | No or unknown TFA policy |
| Western Sahara | No or unknown TFA policy |
| Yemen | No or unknown TFA policy |
| Zambia | No or unknown TFA policy |
| Zimbabwe | No or unknown TFA policy |
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.