I’M one of those people who scoff at health trends, especially when a new dietary villain is found every other day. That’s because I remember when butter was bad for you and the magic bullet solution was touted to be margarine. Then they flipped on that without so much as an ‘oops’ and then we were told that margarine was the devil’s spread and to be avoided. Then it was eggs that humans have eaten for millennia but which were now the devil’s droppings and a surefire way to give yourself a heart attack. From full-fat milk to desi ghee, everything that received the alarmist treatment ended up being endorsed as actually good for you, considering the alternatives.

So, when my wife, who devours such news with the same gusto as I devour nihari, sent me an article about the dangers of trans-fatty acids (or trans-fats as they’re usually called) my first instinct was to dismiss this as yet more of that ‘West-centric wellness eat clean live love pray hippy-dippy’ grift that’s so virally popular these days.

But, to my infinite regret and a few dozen ‘see I told you so’s’, it turns out that not only are trans-fats as dangerous as they’re made out to be, they are also very much a desi problem, and not an upper-class elite desi problem but one that affects the masses more than it does others.

Trans-fats are found in just about everything we like to eat, from deep-fried street food like samosas to breakfast cereals, bakery goods, cookies, chocolates and processed foods. The main culprit seems to be partially hydrogenated oils like Vanaspati ghee and other refined oils, along with margarine and bakery shortenings, all used in food preparation in Pakistan. In fact, in the WHO’s Eastern Mediterranean region, Pakistan accounts for the second highest consumption of trans-fats, amounting to six per cent of our daily energy intake, while the recommended ‘safe’ level is meant to be less than 1pc.

Trans-fats are found in just about everything.

The consequences are deadly and can be seen all around us. Pakistan has one of the highest incidences of diabetes in the world, with an estimated 27pc of adults suffering from this disease. Then there’s heart disease, which is already a top killer in Pakistan, along with obesity and a variety of cancers — all of which are also on the rise across the country, with many going undiagnosed until it’s too late.

There’s more: take a look at the wall-chalkings in any town or city in Pakistan and you’ll see advertisements of treatments for increasing male potency (or ‘strength’ as the Urdu euphemism puts it) plastered everywhere. It’s no surprise then that excessive consumption of saturated fat is also linked to erectile dysfunction and trans-fats in particular are closely linked to male infertility. If that doesn’t get your attention, I don’t know what will.

The cost isn’t just to our health — every incidence of disease means yet more financial burden on those afflicted — this is especially worrisome considering how overburdened our healthcare system is and how stretched household finances are. The medicines required to treat these illnesses are increasing in price and many are already beyond the reach of most people. Take diabetes alone: if we continue as we are, the number of diabetics in Pakistan will likely reach 62 million by 2045. That would mean a staggering burden on those suffering; note that the International Diabetes Federation estimated that in 2021, the cost of treating diabetes in Pakistan was $2,640m.

So, what can be done? One approach is of course to spread awareness in the hope of inducing behavioural change, but this can’t be the main thrust as most people will continue the way they always have, and consume what they are already consuming, simply out of a lack of access to alternatives.

That leaves legislation and enforcement, and some progress has been made on this front: in 2020 the Pakistan Standards and Quality Control Authority imposed a limit of 5pc on trans-fatty acids in Vanaspati ghee, and then three years later set a limit of 2pc in Vanaspati ghee, margarine, bakery wares, biscuits and rusks etc. However, as always, enforcement is an issue and the industry has also successfully approached the courts to buy time. Moreover, this only covers the organised sector and cannot thus include the vast majority of the sources of trans-fats, such as street food and so on.

I realise that flagging a concern like this at a time of severe and deepening national crisis may seem a bit odd, but this is a literal time bomb that the whole nation is sitting on and, as with so many issues, it is a crisis that disproportionately affects those in a lower socioeconomic stratum. The well-to-do not only have access to more information, but also have the fiscal ability to use alternatives. The poor, as usual, are on their own.

The writer is a journalist.
X (formerly Twitter): @zarrarkhuhro

Published in Dawn, September 11th, 2023