Colleen Crawford has seen first-hand what too much cholesterol can do to people. The Wichita, Kan., nurse cares for heart failure patients.

High-fat diets cause many patients’ problems. Teaching them about nutrition using food labels can help, she said.

“I teach people how to check for fats, for sodium, so they make better choices,” Crawford said.

On Sunday, new rules on food labeling will make it easier for consumers to avoid artery-clogging trans fats, which have been linked to an increased risk of heart disease.

The labels have already had an impact. Rather than face an undesirable label, Kraft and other large food manufacturers have announced they will reduce or eliminate trans fats.

And food activists are calling for labeling in restaurants. That’s more controversial, but for Crawford, any knowledge helps.

“People need to know what they’re eating,” she said.

Trans fats are formed when hydrogen is added to vegetable oils to improve shelf life. If a product ingredient is listed as “partially hydrogenated,” that means that at least some trans fats are created in the product, though the amount can range from almost zero to a large portion of a food item’s calories.

Trans fats can wreak havoc on humans, lowering good cholesterol, raising bad cholesterol and reducing the quality of everything from testosterone to breast milk.

They are worse than saturated fats that nutritionists have long warned about. Saturated fats raise the level of bad cholesterol, but they also provide some health benefit by raising the level of good cholesterol.

Though trans fats are found in small quantities naturally in dairy products, most Americans get their trans fats through heavily processed foods such as vegetable shortening, margarine, and snack foods like deep-fried chips and packaged breads, cookies and crackers.

Laura Sansgaard, a clinical dietitian at Via Christi Regional Medical Center in Wichita, said it’s best to keep trans fat consumption “as close to zero as possible.”

In response to rising health concerns, the U.S. Food and Drug Administration set the new labeling requirements in 2003. Many food labels already contain trans fat listings; companies have rolled out their new labels as their supplies of old ones ran out.

But not every new label will be in place on Sunday, as stores use up products with old labels.

Also, some trans fat content can still receive a zero trans fat listing under the new rules, even if a hydrogenated oil is an ingredient. If a food has less than 0.5 grams of fat per serving and makes no claims about fat content, manufacturers can skip the label. If a product simply has less than 0.5 grams of trans fat, the FDA allows a company to list its trans fat content as zero.

The place to find trans fats, when they’re listed, is under the “Saturated Fat” listing, just under the “Total Fat” heading.

The idea behind the labeling is to give consumers more information they can use to make healthier choices.

Sansgaard said she applauded the move.

“I like giving people what they need to make wise choices,” she said.

Trans fat awareness has also spurred companies to remove it from their own foods, fearing that consumers won’t eat trans fatty products once they know their content. Frito-Lay and Kraft, among food companies, have dramatically reduced the number of products they sell that contain trans fats.

Restaurants have also jumped on the no-trans wagon. Panera Bread is switching from partially hydrogenated oil in its baked goods to butter and palm oil.

The effort to change labeling and reformulate food in ways that preserve quality while cutting trans fat is estimated to cost the food industry up to $854 million over 20 years.

Much of the cost will be absorbed by companies.

And the public health benefits could be great — the FDA estimated savings of between $25 billion and $59 billion in health care costs over 20 years.

Food advocate groups are pushing for more regulation. The Center for Science in the Public Interest, a Washington-based watchdog group that has roots in Ralph Nader-led advocacy, is calling for labeling of trans fat on restaurant menus — doughnuts, french fries and other popular restaurant items are also high in trans fats, and right now aren’t regulated.

Michael Jacobson, the organization’s executive director, said that short of an outright ban, restaurants that choose trans fat-laden cooking oils over healthier alternatives have to be pressured to add health information to their menus so consumers can make better choices in restaurants, too.

The problem with labeling in restaurants, said Dan Mindus, senior analyst for the Center for Consumer Freedom, a Washington-based group supported by restaurants and food companies, is that it’s tougher to give consistent information on prepared foods that vary from location to location.

Rather than the government regulating a solution, consumers can easily solve the problem by demanding information if they want it, he said.

“The ideal would be for consumer demand to dictate what kinds of foods are offered and what kind of information people receive,” he said.

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