The adverse health effects of partially hydrogenated oils (trans fats) are becoming a matter of public knowledge. Studies have shown their relationship to coronary disease, stroke, Alzheimer’s disease, and colon, breast and prostate cancers. The National Academies Institute of Medicine has stated that there is no level of ingestion that is safe. Countries have passed laws limiting its use, cities have banned it in restaurants, several states are looking at legislation to prohibit or regulate its use. Many fast-food restaurants are switching over to trans fat-free frying oils. Why then do our hospitals, nursing homes, schools and other institutions continue to cook with and serve it to their patients, students and employees?

Of all places, there, we would expect to find health-promoting foods, not poisonous ones. And yes, trans fats are poisons. Sure, they don’t make you immediately sick (except for perhaps some indigestion and a bad aftertaste), But the long-term additive effects are downright scary. So, consumer beware. Don’t count on your health institutions to serve you trans fat-free foods anytime soon. According to one administrator, “It is not going to happen overnight.” Indeed, I have been working on this topic for more than a year and have seen little change thus far.

In fact, if you go to the cafeteria in the morning and reach for the creamer that says “dairy fresh,” think twice – the one I’ve seen has no dairy at all, just trans fat. Likewise, all baked goods, sauces, gravies and fried foods should be assumed to contain trans fat unless specifically stated otherwise.

But caution, the FDA has allowed trans fat levels of less than 1 gram per serving to be reported as zero. Serving size is often listed as much less than what a person usually eats. So if you eat three servings of certain chips, for example, (the amount in some “individually sized bags”) reporting zero grams of trans fat, you can get up to three grams of trans fat without knowing it. Eat at your own risk.

So why no change? It’s economics. Institutions contract for the best deals with large food vendors that determine for the most part what foods are available. Trans fat-laden foods have longer shelf life and are cheaper to produce and process, and they may even sell better; pastries are fluffier, breads rise better, etc. Perhaps as a society we have become addicted to trans fats.

But the time has come for a change. We are in an epidemic of chronic disease (diabetes, obesity, cancer, heart disease, Alzheimer’s). It has been shown that diet and lifestyle changes can reduce this disease burden by up to 80 percent. Now that is more effective prevention and cure than any medicine I am aware of. The ultimate cost of medical care could thus be significantly reduced.

As a consumer, read the fine print on labels and request to know the ingredients of prepared foods. As a society, it’s time we legislate against trans fat consumption and find the means to provide more healthful diets for our schoolchildren, patients and employees of these institutions, starting immediately.

If our quest for wellness and-or affordable health care is to be successful, it must be founded upon a reduction of chronic disease. Dietary and lifestyle modifications are of primary importance.

Paul Potvin, M.D., practices at Pivotal Health LLC in Bangor.