Journal Club 埼玉医科大学 総合医療センター 内分泌・糖尿病内科 Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University 松田 昌文 Matsuda, Masafumi 2012 年 7 月 26 日 8:30-8:55 ８階 医局 Angell SY, Cobb LK, Curtis CJ, Konty KJ, Silver LD. Change in Trans Fatty Acid Content of Fast-Food Purchases Associated With New York City's Restaurant Regulation: A Pre-Post Study. Ann Intern Med Jul 17;157(2):81-6.

朝日新聞（ 2 月 20 日 39 面）、京都新聞（ 2 月 20 日 24 面）、産経新聞（ 2 月 20 日 22 面）、日本経済新聞（ 2 月 20 日 34 面）、毎日新聞（ 2 月 20 日 31 面）および読売新 聞（ 2 月 20 日 35 面）に掲載。フジテレビにても放映あり。 GPR120 is a member of the rhodopsin family of G protein-coupled receptors (GPRs) (Fredriksson et al., 2003). GPR120 has also been shown to mediate the anti- inflammatory and insulin- sensitizing effects of omega 3 fatty acids. GPR120 、 GPR40 は α- リノレン酸 (α-LA) などの長鎖不飽和脂肪酸をリガンド. とす る G タンパク質共役型受容体であり、類 似する薬理特性を持っている。

日本の食品成分表示 Cis double bonds produce a bend in the molecule that impairs crystallization and keeps the oil liquid. To convert vegetable and marine oils into fats of various degrees of plasticity, manufacturers of edible fat straighten out cis unsaturated fatty acids by converting them to trans isomers or saturated fatty acids in a process called hydrogenation.

油脂の加工・精製でできるもの

Ann Intern Med. 2012;157: the New York City Department of Health and Mental Hygiene, New York, New York

The U.S. Food and Drug Administration mandated in 2003 that trans fat content be listed on the Nutrient Facts panel of packaged foods by In 2005, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) took the bold step of calling for a voluntary reduction in the use of partially hydrogenated fat by commercial food establishments. The first phase required elimination of partially hydrogenated fat from spreads and products used in frying, pan-frying (saute´ing), and grilling unless the product contained less than 0.5 g of trans fat per serving. The second phase required that no food contain partially hydrogenated vegetable oil, shortening, or margarine with more than 0.5 g of trans fat per serving. After several unsuccessful legal challenges, the first phase went into effect in July 2007 and the second phase in July 2008.

Background: Dietary trans fat increases risk for coronary heart disease. In 2006, New York City (NYC) passed the first regulation in the United States restricting trans fat use in restaurants. Objective: To assess the effect of the NYC regulation on the trans and saturated fat content of fast-food purchases.

Design: Cross-sectional study that included purchase receipts matched to available nutritional information and brief surveys of adult lunchtime restaurant customers conducted in 2007 and 2009, before and after implementation of the regulation. Setting: 168 randomly selected NYC restaurant locations of 11 fast-food chains. Participants: Adult restaurant customers interviewed in 2007 and Measurements: Change in mean grams of trans fat, saturated fat, trans plus saturated fat, and trans fat per 1000 kcal per purchase, overall and by chain type.

Study Design In 2007, we randomly sampled 300 locations from all 1625 NYC licensed restaurant locations of 13 chains. These 13 chains represented almost 90% of all eligible restaurants, defined as chain restaurants that have more than 15 locations nationally, have available nutritional information, and are not ice cream chains. Of the 300 identified restaurant locations, 25 were excluded because they had closed or were in an airport or a shopping mall. For 9 weeks from March through June 2007, we recruited patrons exiting the 275 sampled fast-food locations for participation in the study. They were asked to provide their receipts after exiting and to take a brief survey to describe their purchase, confirm that it was for only 1 person, and answer a few additional questions. During the same time frame in 2009, we approached the same restaurant locations for a repeated survey of patrons. Of the original 275 locations, 22 had either closed or would not allow data collection and were therefore replaced in our sample by outlets of the same chain in the same neighborhood or a neighboring ZIP code.

Results: The final sample included 6969 purchases in 2007 and 7885 purchases in Overall, mean trans fat per purchase decreased by 2.4 g (95% CI, － 2.8 to － 2.0 g; P ＜ 0.001), whereas saturated fat showed a slight increase of 0.55 g (CI, 0.1 to 1.0 g; P ＜ 0.011). Mean trans plus saturated fat content decreased by 1.9 g overall (CI, － 2.5 to － 1.2 g; P ＜ 0.001). Mean trans fat per 1000 kcal decreased by 2.7 g per 1000 kcal (CI, － 3.1 to － 2.3 g per 1000 kcal; P ＜ 0.001). Purchases with zero grams of trans fat increased from 32% to 59%. In a multivariate analysis, the poverty rate of the neighborhood in which the restaurant was located was not associated with changes. Limitation: Fast-food restaurants that were included may not be representative of all NYC restaurants.

Conclusion: The introduction of a local restaurant regulation was associated with a substantial and statistically significant decrease in the trans fat content of purchases at fast-food chains, without a commensurate increase in saturated fat. Restaurant patrons from high- and low-poverty neighborhoods benefited equally. However, federal regulation will be necessary to fully eliminate population exposure to industrial trans fat sources. Primary Funding Source: City of New York and the Robert Wood Johnson Foundation Healthy Eating Research program.

What have we learned from NYC’s trans fat ban? Public health measures work and, when well-planned and well implemented, do not result in adverse consequences. The benefit seems to be widespread and not limited to subsets of the population. Nevertheless, these new data represent a sliver of the commercially prepared foods available from a narrow segment of food outlets. Caution must be used when interpreting the data. What have we not learned from NYC’s trans fat ban? The major public health challenge in the United States is excess energy intake, and the question remains about whether the trans fat–free designation confers an undeserved “health halo” for foods that are high in energy and low in nutrient density. Vigilance in this area is essential. What NYC’s trans fat ban has done is make the default option for foods prepared outside of the home a bit healthier. The final assessment of this public health effort awaits additional evaluation; however, the data so far suggest that the mission has been accomplished. Alice H. Lichtenstein, DSc Tufts University Boston, MA New York City Trans Fat Ban: Improving the Default Option When Purchasing Foods Prepared Outside of the Home Editorial Ann Intern Med. 2012;157:144-5.

Message ニューヨーク市内のファストフードチェーン 168 店を利用した成人へのインタビューから、 2006 年のトランス脂肪酸使用規制の効果を横断的研究 で評価。規制後、購入 1 回当たりのトランス脂肪 酸の平均量は 2.4g 低下し（ P ＜ ）、飽和 脂肪は 0.55g 増加した。飽和脂肪を増やさずト ランス脂肪酸が統計的有意に低下と示唆された。 米国全体での規制強化になれば 日本でも必ず議 論になると思われる。