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Objective To minimise the intake of industrially produced trans fat (I-TF) and decrease the risk of coronary heart disease, several countries have implemented a legislative restriction on I-TF in foods. The objective of this study was to investigate the presence of I-TF in biscuits/cakes/wafers in 15 countries of the former Soviet Union that all have a high coronary mortality rate compared with countries in Western Europe. Methods Three large supermarkets in 15 capitals were visited in 2015 or 2016. Prepackaged biscuits/cakes/wafers were bought if the list of ingredients disclosed that the product contained more than 15 g of fat per 100 g of product and if partially hydrogenated fat or a similar term, including margarine, refined fat or confectionery fat, were mentioned. Samples of the foods were subsequently analysed for total fat and TF. Results Some 994 products contained more than 2% total fat as I-TF (illegal in Denmark). In Armenia, 91 different products had a mean value (SD) of 21 (11)% fat as I-TF. In Estonia, there were eight products with 14 (10)% fat as I-TF. The other 13 countries had values between those of Armenia and Estonia. In several countries, a major portion of the products was imported from Russia and Ukraine. The mean shelf life (SD) of 673 packages was 218 (75) days. The % TF in the fat of the products produced in Russia and in Ukraine in relation to the date of production both declined by approximately 10% points during the 2-year collection period. Conclusions The findings suggest that I-TF is used in popular foods in all 15 countries of the former Soviet Union. Therefore, these findings indicate a possible way for some reduction of the high coronary mortality rate in these countries.

Objective: To minimise the intake of industrial artificial trans fat (I-TF), nearly all European countries rely on food producers to voluntarily reduce the I-TF content in food. The objective of this study was to investigate the effect of this strategy on I-TF content in prepackaged biscuits/cakes/wafers in 2012–2013 in 20 European countries. Design: The I-TF content was assessed in a market basket investigation. Three large supermarkets were visited in each capital, and in some countries, three additional ethnic shops were included. Results: A total of 598 samples of biscuits/cakes/ wafers with ‘partially hydrogenated vegetable fat’ or a similar term high on the list of ingredients were analysed, 312 products had more than 2% of fat as I-TF, exceeding the legislatively determined I-TF limit in Austria and Denmark; the mean (SD) was 19 (7)%. In seven countries, no I-TF was found, whereas nine predominantly Eastern European countries had products with very high I-TF content, and the remaining four countries had intermediate levels. Of the five countries that were examined using the same procedure as in 2006, three had unchanged I-TF levels in 2013, and two had lower levels. The 18 small ethnic shops examined in six Western European countries sold 83 products. The mean (SD) was 23 (12)% of the fat as I-TF, all imported from countries in Balkan. In Sweden, this type of food imported from Balkan was also available in large supermarkets. Conclusions: The findings suggest that subgroups of the population in many countries in Europe still consume I-TF in amounts that increase their risk of coronary heart disease. Under current European Union (EU) legislation, the sale of products containing I-TF is legal but conflicts with the WHO recommendation to minimise the intake of I-TF. An EU-legislative limit on I-TF content in foods is expected to be an effective strategy to achieve this goal.

Objective: To minimise the intake of industrially produced trans fat (I-TF) and thereby decrease the risk of coronary heart disease (CHD), nearly all European countries rely on food producers to voluntarily reduce the I-TF content in food. The objective of this study was to monitor the change in presence of I-TF in biscuits/cakes/wafers in six countries in South-eastern Europe from 2012 to 2014, including two members of the European Union (Slovenia and Croatia).Design: Three large supermarkets were visited in each of the six capitals in 2012. Pre-packaged biscuits/cakes/wafers were bought if the products contained more than 15 g of total fat per 100 g of product and if partially hydrogenated oil or a similar term was disclosed at the beginning of the ingredients list. These same supermarkets were revisited in 2014 and the same collection procedure was followed. All foods were subsequently analysed for total fat and trans fat in the same laboratory.Results: The number of packages bought in the six countries taken together was 266 in 2012 and 643 in 2014. Some were identical, and therefore only 226 were analysed in 2012 and 434 in 2014. Packages with less than 2% of fat from I-TF went up from 69 to 235, while products with more than 2% (illegal in Denmark) doubled from an average of 33 to an average of 68 products for the six countries, with considerable variation across countries. The per cent of I-TF in total fat decreased slightly, from a mean (SD) of 22 (13) in 2012 to 18 (9) in 2014.Conclusions: The findings suggest that voluntary reduction of I-TF in foods with high amounts is an ineffective strategy in several European countries. Alternative strategies both within and outside the European Union are necessary to protect all subgroups of the populations against an increased risk of CHD.

Objectives To minimise the intake of industrial trans fatty acids (I-TFA) some countries have introduced labelling, while others have introduced legislative limits on the content of I-TFA in food. However, most countries still rely on food producers to voluntarily reduce the I-TFA content in food. The objective of the present study was to investigate the efficiency of these strategies in the EU. Design The potential consumption of I-TFA was assessed in a market basket investigation by analysing the I-TFA content in popular foods. Setting A standardised purchase methodology was used in 16 EU countries in 2005 and again in 2009. Samples Seventy servings of French fries and chicken nuggets, 90 packages of microwave popcorn, and 442 samples of biscuits/cakes/wafers with ‘partially hydrogenated vegetable fat’ listed high on the list of ingredients were analysed. A high- trans menu was defined as a large serving of French fries and nuggets, 100 g of microwave popcorn and 100 g of biscuits/wafers/cakes. Results In 2005, a high- trans menu provided above 30 g of I-TFA in five EU countries in Eastern Europe and 20–30 g in eight EU countries in Western Europe. In 2009 the values in Hungary, Poland and the Czech Republic remained high between 10 and 20 g, whereas they were less than 2 g in Germany, France and the UK. Conclusions In 2009 contents of I-TFA in popular foods in Western Europe appear low but, in spite of some reduction, still high in Eastern European EU countries. These findings suggest that millions of people in the EU still consume I-TFA in amounts that substantially increase their risk of coronary heart disease.

Background Filaggrin proteins are located in the skin and prevent epidermal water loss and impede the entry of micro-organisms, allergens and chemicals. Filaggrin null mutations are strongly associated with ichthyosis vulgaris and atopic dermatitis. Objective The authors aimed to investigate the association between filaggrin null mutations, atopic dermatitis and diabetes. Design A random sample of 3335 adults from the general population in Denmark was filaggrin-genotyped for R501X and 2282del4 null-mutations and questioned about atopic dermatitis and diabetes. Furthermore, two independent study populations of patients with type 1 (n=104) or 2 (n=774) diabetes were genotyped. Results In a crude data analysis, a positive association was detected between the filaggrin null genotype and, respectively, subjects from the general population who reported diabetes (p=0.04) and patients with established type 2 diabetes (p=0.073). Adjustment for age and gender resulted in significant associations for patients with type 2 diabetes (p=0.048) and subjects with self-reported diabetes (p=0.032). Conclusions Adult Danes with a filaggrin null genotype had a significantly increased prevalence of self-reported diabetes. This finding was replicated when an independent sample of Danish patients with established type 2 diabetes was compared with control subjects from the general population., Article summary Article focus A few studies have suggested the existence of an inverse association between atopic dermatitis and type 1 diabetes. The existence of a specific endotype of asthma that is not driven by sensitisation but rather driven by skin barrier dysfunction was recently suggested. It is unknown whether a putative impairment of the skin barrier may increase the propensity to low-grade inflammation in other organs as well. Key messages Data from a general population study suggested that the prevalence of filaggrin null mutations was higher in adult Danes who reported diabetes than in non-diabetics. This finding was replicated when an independent sample of Danish patients with type 2 diabetes was compared with participants from the general population who did not report diabetes and who had normal fasting plasma-glucose and glycated haemoglobin (HbA1c) levels. Strengths and limitations of this study Two independent samples were investigated and showed similar results. The question on self-reported diabetes was not validated in the general population allowing for misclassification.