[Adopted 6-1-2010 by L.L. No. 7-2010]
This article shall be known as "The Rockland County Healthy
Heart Act."
A.
Coronary heart disease (CHD), sometimes called "ischemic heart disease,"
refers to atherosclerosis of the arteries that supply the heart muscle.
Atherosclerosis is a disease condition that can occur throughout the
arterial circulation. It is a broad term that refers to the thickening
and hardening of the arteries. Insufficiency of blood supply may result
from a reduction of blood flow through one or more of these arteries.
Heart cells are dependent on blood flow through these arteries to
provide oxygen and to carry away metabolic products. Without an adequate
flow of blood, these cells can become injured or die. When this occurs,
immediate emergency treatment is necessary to stop the injury from
widening, killing additional heart cells, and increasing the risk
of complications or death. Facts about CHD:
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1.
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Age-adjusted CHD mortality in New York for ages 35 and over
is highest in the nation.
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2.
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Most of the excess in New York's CHD mortality occurs for ages
65 and over.
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3.
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CHD is the single largest killer of New York State residents.
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4.
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Heart attack is the leading cause of death among women in New
York.
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5.
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26% of the deaths in the United States in 2006 were caused by
CHD, the single largest killer in the United States.
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B.
Scientific evidence demonstrates a clear association between increased
trans fat intake and the risk of coronary heart disease. Most dietary
trans fat is found in partially hydrogenated vegetable oil (PHVO),
oil that has been chemically modified. Scientific studies which examine
the change in cholesterol levels when trans fat is replaced with currently
available heart-healthy alternatives conservatively estimate a reduction
of 6% in coronary heart disease events such as heart attacks (Mozaffarian
D. Katan MB. Ascherio A. Stampfer MJ. Willett WC. Trans Fatty Acids
and Cardiovascular Disease. New England Journal of Medicine. April
13, 2006. 354;15:1601-13). Even in the most conservative estimates,
based on replacing trans fat primarily by saturated fat, an unlikely
outcome given the widespread trend to healthier fats by food producers,
a significant although smaller reduction in coronary heart disease
events is still expected. Other scientific studies, based upon observing
large groups of people over time, estimate that up to 23% of coronary
heart disease events could be avoided by replacing trans fat with
healthy alternatives. Because an estimated one third of dietary trans
fat comes from foods purchased in restaurants (Guthrie JF. et al.
Role of Food Prepared Away from Home in the American Diet, 1977-78
Versus 1994-96: Changes and Consequences. Society for Nutrition Education
2002; 34:140-150), the continued presence of PHVO in restaurant foods
represents an important contribution to cardiovascular risk for diners.
(1)
Dietary trans fat increases the risk of heart disease by elevating
LDL ("bad") cholesterol, and lowering HDL ("good") cholesterol (Ascherio
A. Katan MB. Zock PL. Stampfer MJ. Willett WC. Trans fatty acids and
coronary heart disease. New England Journal of Medicine. 1999; 340:1994-1998).
Because of its negative effect on "good cholesterol," trans fat appears
to be even worse than saturated fat. The Institute of Medicine (IOM)
reviewed the scientific evidence and concluded that there is "a positive
linear trend between trans fatty acid intake and total and LDL concentration,
and therefore increased risk of coronary heart disease" (Panel on
Macronutrients, Institute of Medicine. Letter report on dietary reference
intakes for trans fatty acids drawn from the Report on dietary reference
intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol,
protein, and amino acids. 2002. Washington, DC, Institute of Medicine,
Page 14). The 2005 Dietary Guidelines for Americans, issued by the
United States Department of Agriculture (USDA), recommends that dietary
intake of trans fat be "as low as possible" (Dietary Guidelines Advisory
Committee. King J, et al. Dietary Guidelines for Americans 2005. January
12, 2005.) and the American Heart Association guidelines issued in
June 2006 recommend that trans fat intake be kept below 1% of total
energy intake (American Heart Association Nutrition Committee. Lichtenstein,
A. et al. Diet and lifestyle recommendations revision 2006: a scientific
statement from the American Heart Association Nutrition Committee.
Circulation. 2006 July 4;114[1]e27). In January of 2006, the FDA's
mandatory listing of trans fat content on the nutrition facts labels
of packaged foods came into effect.
(2)
Approximately 80% of dietary trans fat is found in industrially produced
PHVO, which is used for frying and baking and is present in many processed
foods. Approximately 20% is naturally occurring and is found in small
amounts in dairy and meat products from ruminant animals.
(3)
The artificial trans fat found in PHVO is produced when hydrogen
is added to vegetable oil in a process called "hydrogenation." Common
food service establishment sources of artificial trans fat include:
foods fried in partially hydrogenated vegetable oils; margarine and
vegetable shortening; prepared foods such as pre-fried French fries,
fried chicken, taco shells and donuts; baked goods such as hamburger
buns, pizza dough, crackers, cookies, and pies; and pre-mixed ingredients
such as pancake and hot chocolate mix.
C.
The major source of dietary trans fat, found in PHVO, can be replaced
with currently available heart-healthy alternatives. Denmark has recently
successfully removed artificial trans fat by limiting industrially
produced trans fat content in food to 2% of total calories from fat.
In addition, in June 2006 the Canadian Trans Fat Task Force issued
a report recommending that Canada limit trans fat in food service
establishments to 2% of total fat content in margarines and vegetable
oils and 5% of total fat content in all other food ingredients. "Zero
grams" trans fat packaged foods in the US, both new products and those
already in production, have been extensively marketed since the labeling
requirement for packaged foods became effective in January of 2006.
Many manufacturers have formulated a number of their existing products
that are now widely available as "zero grams" trans fat (defined by
the FDA as less than 0.5 gram per serving) on supermarket shelves.
A recent New England Journal of Medicine article reports that industry
and government representatives agreed that the restriction of trans
fat in Denmark "did not appreciably affect the quality, cost or availability
of food." This experience demonstrates that artificial trans fat can
be replaced without consumers noticing an effect. Acceptable healthier
alternatives to PHVOs include traditional mono- and polyunsaturated
vegetable oils (e.g., canola, corn, olive, etc.) that have not been
hydrogenated, as well as newly developed oils such as those made from
specially cultivated varieties of soybeans, safflowers, and sunflowers.
Further, many of the newer trans-fat-free oils have long "fry lives"
and other favored characteristics of PHVOs. Educational and enforcement
efforts will seek to promote a shift to healthier fats. In response
to increased demand, US companies are expanding production of products
that will increase the market supply of alternatives to hydrogenated
oils.
D.
Owners of many food service establishments in Rockland County, acknowledging
the health risks caused by artificial trans fats and recognizing the
availability of tasty, healthy alternatives, have already voluntarily
gone "trans-fat free." Hopefully, through this article and the widespread
dissemination thereof, individuals and commercial owners who are not
subject to its restrictions will also become better educated and make
healthier choices for themselves and their patrons.
E.
The purpose of this article is to safeguard the health and well-being
of all Rockland County residents by prohibiting the use of artificial
trans fat in any food item prepared or served at a food establishment
within the County of Rockland in order to dramatically reduce the
risks of CHD.
As used in this article, the following terms shall have the
meanings indicated:
A food shall be deemed to contain artificial trans fat if
the food is labeled as, lists as an ingredient, or has vegetable shortening,
margarine (not including trans-fat-free or cholesterol-lowering margarine)
or any kind of partially hydrogenated vegetable oil. However, a food
whose nutrition facts label or other documentation from the manufacturer
lists the trans fat content of the food as less than 0.5 gram per
serving shall not be deemed to contain artificial trans fat.
The County of Rockland, New York.
A place where food is prepared and intended for individual
portion service and includes the site at which the individual portions
are provided, whether consumption occurs on or off the premises. The
term excludes food processing establishments, retail food stores,
private homes where food is prepared or served for family consumption,
and food service operations where a distinct group mutually provides,
prepares, serves, and consumes the food such as a "covered-dish supper"
limited to a congregation, club or fraternal organization.
[Amended 12-6-2011 by L.L. No. 1-2012]
A.
No foods
containing artificial trans fat, as defined in this article, shall
be stored, distributed, held for service, used in preparation of any
menu item, or served in any food service establishment within the
County of Rockland, except food that is being served directly to patrons
in a manufacturer's original sealed package.
B.
Foods
that are received as donations from businesses or members of the public
that are then distributed by food service establishments organized
and run by not-for-profit organizations are exempt from this prohibition.
A.
Original labels. Food service establishments shall maintain on site
for two years the original labels for all food products:
(1)
That are, or that contain, fats, oils or shortenings; and
(2)
That are, when purchased by such food service establishments, required
by applicable federal and state law to have labels; and
(3)
That are currently being stored, distributed, held for service, used
in preparation of any menu items, or served by the food service establishment,
or by the mobile food unit commissary.
B.
Documentation instead of labels. Documentation acceptable to the
Department of Health, from the manufacturers of such food products,
indicating whether the food products contain vegetable shortening,
margarine or any kind of partially hydrogenated vegetable oil, or
indicating trans fat content, may be maintained instead of original
labels. Said documentation shall be available for inspection upon
demand by the Department of Health.
C.
Documentation required when food products are not labeled. If baked goods or other food products restricted pursuant to § 267-20 that are or that contain fats, oils or shortenings are not required to be labeled when purchased, food service establishments and mobile food commissaries shall obtain and maintain documentation acceptable to the Department of Health, from the manufacturers of the food products, indicating whether the food products contain vegetable shortening, margarine or any kind of partially hydrogenated vegetable oil, or indicating trans fat content.
Any person who violates the provisions of this article shall
be subject to the imposition by the Rockland County Department of
Health of a civil penalty pursuant to Section 1.25 of the Rockland
County Sanitary Code. No civil penalty shall be imposed by the Department
of Health as provided for herein unless the alleged violator has received
notice of the charge against him or her and has had an opportunity
to be heard pursuant to the normal procedures of the Department of
Health. Prior to the imposition of the first civil penalty on an alleged
violator, the Department of Health shall make a good-faith effort
to issue a warning to the alleged violator and shall make a good-faith
effort to educate the alleged violator about the provisions of this
article.
The Department of Health shall promulgate and make available
information regarding the dangers of trans fats and the availability
of healthier alternatives, in such manner as may be reasonably determined
by the Commissioner of Health, or his or her designees.
This article shall apply to any and all actions occurring on
or after the effective date of this article.
This article shall take effect on January 1, 2011.
