The EVIPNet webinar series offer a platform for network members to exchange on best practices, lessons learned, and latest innovation in evidence-informed decision-making and knowledge translation for health policy and practice.
Three questions to presenter Elif Islek, RN, PhD, TÜSEB Turkish Health Policies Institute (TÜSPE)
How did you identify dietary trans fats as a persisting public health issue in Turkey?
Trans fat are unsaturated fats which occur naturally in small quantities, but are also found in fried, packaged, or processed fast food products as a result of hydrogenating vegetable oils into semi-solid form. In Turkey, potential sources of trans fats include bakery products, cookies, biscuits, bagels (simit & poğaça), or cakes, which are sold without clear indication on packaging and labels and are an important part of dietary habits in every age group.
Because trans fats are known to contribute to cardiovascular diseases, hypertension, obesity, cancer, infertility and diabetes, reducing or completely eliminating the consumption of these fats are a priority goal of the current WHO strategic plan, and considered an effective and cost-effective public health policy measure. In Turkey, trans fats were identified as a major health risk in two multi-stakeholder meetings in 2018. In 2019, the Turkish Institute for Health Policies (TÜSPE), in close collaboration with WHO EVIPNet Europe, the WHO Country Office in Turkey, the WHO Regional Office for Europe, and the Ministry of Health and the Presidency of the Republic of Turkey started working on an Evidence Brief for Policy (EBP) brief outlining possible policy options to address the problem.
How did the EVIPNet Evidence Brief for Policy (EBP) process help you to mobilize the best available evidence and engage strategic stakeholders at country level?
We kicked-off our EBP at a workshop in late 2019, for which we received hands-on training and technical support by WHO Europe’s EVIPNet team. We then defined a work plan and timeline, identified key informants and composed a steering committee, before appraising and synthesizing relevant research evidence on the problem. Speaking to key informants helped us to understand and detail local implementation considerations and reflect global research evidence alongside local insights. At that time, the Health and Food Policies Council put trans fats on its agenda, which created an opportunity for us to hold a policy dialogue meeting and present the EBP to representatives from the Ministry of Health, Ministry of Agriculture and Forestry, several Universities, non-government organizations, and the food industry.
Which policy options did you consider in your EBP, and how did the process help drive evidence to policy?
Based on our evidence review, the key informant interviews, and the policy dialogues, we discussed
establishing mandatory limits on trans fats, labelling trans fat-free foods, and introducing incentives to replace them with healthier oils as three possible policy options. In Turkey, considering cultural factors that affect eating habits, or providing incentives for smaller-scale producers to reformulate their products, are also important factors to reducing the trans fat contents in products.
Drafting this evidence brief for policy and organizing a policy dialogue first and foremost helped raise new awareness about the negative health effects of trans fats among a broader public in Turkey. There were several thematic reports and interviews in newspapers and on national television. The Presidency’s Health and Food Policies Council putting trans fats on its agenda provided an additional boost and helped us organize a dedicated policy dialogue meeting. Via this forum, the EBP directly contributed to accelerating the new regulation enacted by Ministry of Agriculture and Forestry establishing mandatory limits on trans fats in food products Turkey.