RESUMO
Recent research studies have highlighted that the consumption of industrially produced trans-fatty acids (TFAs) causes detrimental effects on human health. The World Health Organization (WHO) has recommended the elimination of TFA from diets to reduce the risk of non-communicable diseases (NCDs). In this paper, we use WHO's REPLACE framework for a situation analysis of TFAs in Pakistan's context by reviewing the literature on its dietary and industrial sources along with the legislative and regulatory context surrounding TFA related affairs in Pakistan. To maintain the authenticity of the data and the various actions implemented in Pakistan, we interviewed government officials, experts and researchers engaged in this field. By combining this information with a review of effective policies and best practices applied for TFA elimination around the world, we have prepared recommendations for policymakers in the country. The primary dietary sources of TFA in Pakistan are vanaspati ghee (partially hydrogenated vegetable oil), kinds of margarine, bakery shortenings and fat spreads. Whereas, their main producers are the edible oil, margarine, bakery and confectionary industries. Federal and provincial governments have introduced TFA regulations, but these vary across jurisdictions, complicating enforcement. Lack of credible penalties for violation of regulations, low public awareness and capacity and data gaps among regulators also inhibit TFA elimination. We recommend multi-stakeholder efforts for harmonization of mandatory TFA limits and labeling, replacement of traditional vanaspati ghee, communication efforts for behavioral change, promotion of replacement oils and strengthening regulators' assessment capacities.