Data collection
Data collection involved several stages/procedures as described in the sampling protocols for rapid assessment of TFA in edible oils and foods, which are modules in the WHO REPLACE package[
7]. These stages include selection of neighborhoods, selection of food outlet types, selection of specific food outlets, selection of food sectors, selection of food categories, selection of food/edible oil item and brands and finally sample collection, storage, and shipping.
The study area was Dar es Salaam, and all neighborhoods within the city were identified, categorized and selected based on the sampling protocols for rapid assessment of TFA in edible oils and foods, described in the WHO REPLACE package[
7]. Except for a purposeful inclusion of neighborhoods with informal food markets, all other procedures were in accordance with the REPLACE package protocols. Two neighborhoods from each of the two social economic status groups (SES) (High/middle and low SES neighborhoods) were visited for sample collection.
- 2.
Food Outlet Type Selection
For edible oils and fats, popular supermarkets and shops selling edible oils/fats in the selected neighborhoods were selected. For street foods, popular informal markets where street foods are sold were selected from the selected neighborhoods.
- 3.
Specific Food Outlet Selection
Criteria described in the REPLACE package protocols were used to identify popular supermarkets/shops/grocery stores and informal food markets that are commonly visited in the four selected neighborhoods. For fast foods, three popular outlets were selected since fast food outlets are usually located in high and middle SES areas.
- 4.
Food Sector Selection
We assessed trans-fat content in popular edible oils/fats and fried street and fast foods. Various edible oils and fats are used for baking, frying, cooking, and spreads. Therefore, edible oils could represent the trans-fat content of a wide variety of foods that are consumed in Dar es Salaam. Street foods (from street food vendors) are also commonly consumed in Tanzania and were another food sector included in the sampling. In addition, consumption of food from fast food restaurants is rapidly increasing. Commonly consumed fast foods were sampled and profiled for trans-fat.
- 5.
Food Categories Selection
Based on review of both published and grey literature supplemented by the Tanzania food composition tables[
19], oils/fats that are commonly used for baking, frying and as spreads are potentially high in trans-fat. All the available brands of potentially partially hydrogenated oils (PHO) (margarine and cooking fat) and all the edible oils/fats that were mentioned as popular, were included. These were purchased from selected outlets and processed for trans-fat assessment. For margarine and the top three popular oils, one sample was purchased from each of the supermarkets/stores in both the SES neighborhood categories (four samples for each brand). Fried foods from street food vendors and formal fast-food restaurants are also potentially high in fats and trans-fat. We selected fried foods that are commonly used as breakfast and lunch from informal markets (street foods) and popular fried fast foods from fast-food restaurants.
- 6.
Food Item and Brand Selection
To select appropriate brands of edible oils/fats for each category from outlets (supermarkets/shops/grocery stores), we reviewed sales information and interviewed owners, managers/employees of respective outlets. This was important to ensure appropriate selection of brands/items that are commonly purchased for each of the three edible oils/fats categories (frying, cooking, baking and spreads).
- 7.
Sample Collection, Storage and Shipping
Sample collection, storage and shipping procedures were designed and implemented following the Sampling Protocol for Rapid Assessment of trans-Fatty Acids in edible oils and foods[
17,
18]. The protocol was strictly adhered to throughout the study to ensure consistency and reliability of the data obtained. Field researchers were trained on the sampling procedures and quality control measures prior to the commencement of the study.
- A.
Collection of Fats and Oils:
Different categories and brands of edible oils/fats were collected/purchased from supermarkets/shops. From each outlet, a minimum of three different brands of consumer-sized oils/fats packages were collected/purchased for each edible oil/fat category (frying, baking, cooking and spreads). Additionally, at least one brand that is potentially low in TFA (liquid vegetable oils) was collected from each outlet, based on results from interviews conducted at the food stores. This was important to identify edible oils/fats that can be used as healthy alternatives.
The purchased items were processed, packaged, labeled, and stored according to the procedures described in the sampling protocols for rapid assessment of TFA in edible oils and foods [
17,
18].
- B.
Collection of Fried Foods from Street Vendors and Fast-food Outlets:
To maximize the possibility of sampling foods that are potentially higher in iTFA with limited resources, sampling was limited to fried foods. Three fried items/foods commonly used for breakfast and three for lunch were collected/purchased from street food vendors and fast-food joints. To identify commonly purchased street foods, a short survey was conducted using a modified version of the sample questionnaire for food sampling at informal food markets, from the REPLACE package[
7]. For fast foods, outlet managers were interviewed, and sales records were reviewed to confirm the foods that were commonly purchased from selected fast-food outlets.
Due to limited resources, the three items for a single category (breakfast or lunch) were collected from the same vendor. However, to account for possible variabilities within vendors, a single item/food (likely French fries/chips) was collected from 5 different vendors. Items from the two targeted categories (breakfast and lunch) were collected from two different vendors who happen to be using different edible oils. This approach allowed for a targeted, but a more complete analysis of TFA within a narrow food category, with a limited budget.
From each outlet, three 100 g portions of food samples for each of the two subcategories (breakfast and lunch) were collected. The same procedures were followed for selected fast-food outlets.
In summary, sample collection, storage and shipping procedures were implemented with strict adherence to the Sampling Protocol for Rapid Assessment of trans-Fatty Acids in edible oils and foods. The procedures ensured the collection of a representative sample of different categories and brands of edible oils/fats, and a targeted but complete analysis of TFA within a narrow food category, with a limited budget. The collected samples were properly labelled, stored, and transported to the laboratory for analysis.
- 8.
Sample collection and preparation
Samples were collected in triplicate and packaged in sterile containers. The samples were then transported to the laboratory for analysis.
- 9.
Laboratory analysis
The analysis of trans fatty acids (TFAs) was conducted using gas chromatography with flame ionization detector (GC-FID) with a 100-meter GC column. Due to the unavailability of a laboratory with the required capabilities in Tanzania and nearby countries, the samples were shipped to the laboratory at the Harvard T.H. Chan School of Public Health (HSPH) in Boston, USA. The selection of the HSPH laboratory was based on the guidance on selection of appropriate laboratory to conduct analysis of food samples present in the WHO, REPLACE package. Before the analysis, the laboratory at HSPH was inspected by a consultant to ensure it met the WHO standards.
- 10.
Data analysis
Descriptive statistics were used to present the fatty acid profile data. Frequency distribution tables and charts, including bar and pie charts, were used to present the different fatty acid content of different foods and oils/fats. Mean, modes, and proportion were used to compare the TFA content of different oils/fats and foods.
- 11.
Data management and ethical considerations
Unique identification (code) was assigned to each sample, which was linked to the edible oils/fats and foods database for ease of identification. The codes were placed on the samples that were shipped to the US for laboratory analysis to ensure that those conducting the analysis were blinded to the type and brands of edible oil and foods, thereby controlling for analysis bias. The coding also ensured data security and confidentiality before official dissemination.
Ethical review was sought from the National Institute of Medical Research (NIMR) since the study involved the collection of food samples from various markets and supermarkets. The study involved minimal human contact, and all interviewed volunteers signed informed consent forms after agreeing to participate in the surveys. All necessary authorities were consulted, and necessary procedures were followed accordingly.