Non-communicable diseases in general and cardiovascular diseases in particular are a leading cause of death globally. Trans-fat consumption is a significant risk factor for cardiovascular diseases. The World Health Organization’s ‘REPLACE’ action package of 2018 aims to eliminate it completely in the global food supply by 2023. Legislative and other regulatory actions (i.e., banning trans-fat) are considered as effective means to achieve such a goal. Both wealthier and poorer countries are taking or considering action, as shown by the United States food regulations and Cambodian draft food legislation discussed in this paper. This paper reviews these actions and examines public and private stakeholders’ incentives to increase health-protecting or health-promoting standards and regulations at home and abroad, setting the ground for further research on the topic. It focuses on the potential of trade incentives as a potential driver of a ‘race to the top’. While it has been documented that powerful countries use international trade instruments to weaken other countries’ national regulations, at times these powerful countries may also be interested in more stringent regulations abroad to protect their exports from competition from third countries with less stringent regulations. This article explores practical and principled considerations on how such a dynamic may spread trans-fat restrictions globally. It argues that trade dynamics and public health considerations within powerful countries may help to promote anti-trans-fat regulation globally but will not be sufficient and is ethically questionable. True international regulatory cooperation is needed and could be facilitated by the World Health Organization. Nevertheless, the paper highlights that international trade and investment law offers opportunities for anti-trans-fat policy diffusion globally.

中文翻译：

---

全球反脂肪斗争：国际贸易和法律的潜在作用

非传染性疾病，特别是心血管疾病，是全球范围内主要的死亡原因。食用超脂是心血管疾病的重要危险因素。世界卫生组织2018年的“ REPLACE”行动计划旨在到2023年在全球粮食供应中彻底消除这一问题。立法和其他监管行动（例如，禁止反脂肪）被认为是实现这一目标的有效手段。如本文讨论的美国食品法规和柬埔寨食品法规草案所示，较富裕国家和较贫穷国家都在采取或考虑采取行动。本文回顾了这些行动，并研究了公共和私人利益相关者在国内外提高健康保护或健康促进标准和法规的动机，为对该主题的进一步研究打下基础。它着重于贸易激励措施作为“最高竞争”的潜在驱动力的潜力。尽管有文献记载，强国利用国际贸易手段削弱其他国家的国家法规，但有时这些强国也可能对更严格的国外法规感兴趣，以保护其出口免受那些不那么严格的法规的第三国的竞争。本文探讨了有关这种动态因素如何在全球范围内传播反式脂肪限制的实用和原则性考虑。它认为，强国内部的贸易动态和公共卫生方面的考虑因素可能有助于在全球范围内促进反反脂肪监管，但是这还不够，在道德上存在疑问。真正的国际监管合作是必要的，世界卫生组织可以为之提供便利。然而，本文强调指出，国际贸易和投资法为反反胖政策在全球范围内的传播提供了机会。