Press Release January

Abu Dhabi – Sheikh Khalifa Medical City (SKMC) , managed by Cleveland Clinic, announces the initial elimination of trans fatty acids from its main campus and facilities, becoming the first facility of any kind in the Gulf and MENA region to launch the ban of artificial trans fat from food production and distribution areas, inpatient and cafeteria menus. Trans fat has been linked to cancer risk and increases in the development of and death from heart disease. In moving to start eliminating artificial trans fat from SKMC’s food services, SKMC is taking the lead in an important health issue that is gaining national momentum, providing those it serves with a standard for healthy living and wellness.

The Trans Fat Free Zone policy was signed by Dr. Kenneth Ouriel, SKMC CEO with the presence of the CEO of the American Dietetic Association, Mr. Ron Moen during his visit to SKMC on the 24^th of February 2008.

The signed policy defines the Trans Fat Free Zone as an area where food items are not prepared or distributed when containing Trans fats. The purpose of the policy is to identify food products containing trans fats, ban the use of food items containing more than 0.5 grams trans fats per serving at SKMC facilities and to enforce trans fat free zone procedures at SKMC facilities. It provides directions for alternate food items for food products containing trans fats.

“As a health care leader in the community, SKMC is committed to creating a healthy environment for the entire population,” said Dr. Ouriel. “Eliminating Trans fat food items on our campuses is a key step in this process. We are appreciative of the support we have received from our vendors and contractors thus far. But the elimination of trans fats on our campuses is only a first step. Our hope is that this will encourage healthy dietary habits among our employees and their families at home, and that this education will spread to the population of Abu Dhabi at large.”

Ellen Edwards RD LD, Head of Department, Clinical Dietetics pointed out that “As the transformation to a Trans Fat Free Zone takes time to all the vendors and contractors to comply with the policy, the implementation process will include three phases which are the Trans Fat Free Zone Launch Phase – the phase that we implemented with the signing of the policy today which will be communicated to the vendors and contractors and along with the research for alternative food items in the market. The next phase is the Trans Fat Free Zone Phase I which affirms no usage of partially hydrogenated vegetable oils, shortenings, or margarines for frying, pan-frying (sautéing), or grilling, or as a spread, unless confirmation by a label or other documents from the manufacturer showing that these ingredients contain less than 0.5 grams of trans fat per serving. Spreads are included in this ban. However, continuance of the use of trans fat-containing oils and shortenings for deep frying cake batter and dough until 1 July 2008 will be allowed.

She then pointed on the third phase and stated “Trans Fat Free Zone Phase II will include the ban of storage, use and service at SKMC of Foods containing partially hydrogenated vegetable oils, shortenings, or margarines with 0.5 grams or more trans fat per serving. Exempt foods will be foods served in the manufacturer’s original, sealed packaging such as a package of crackers until 1 January 2009.”

“The change needs education to all parties, therefore the Clinical Food Service section of Clinical Dietetics provides a service to venders, contractors, patients and staff to identify trans fat containing food items and to assist in appropriate alternative selections. Moreover, enforcement and audits will be conducted thru the Clinical Dietetics Department in order to maintain SKMC Trans Fat Free Zone status continuously ” she concluded.

About the Clinical Dietetics Department at SKMC

The Clinical Dietetics Department at SKMC provides specialty services for nutritional disorders and for healthy eating. Nutrition services are provided for breast feeding support, weaning diet or DFA advice in the infant, cystic fibrosis, pediatric and adult diabetes, constipation, disorders of the colon, tube feeding monitoring, failure to thrive, pediatric and adult renal nutritional care, cardiac, cholesterol control, food allergies, celiac disease, oncology care, weight management, metabolic diseases, inflammatory bowel disease, cleft palate, nutrition support, nutrition in developmental delayed patients, wound healing and care for various medical conditions.

SKMC Clinical Dietetics staff monitors patients admitted to the hospital, renal unit, home health care patients, and clinic patients for ongoing medical nutritional therapy. Patients are screened for nutritional risk and an assessment of the patient’s nutritional status is conducted, education and an ongoing monitoring plan are provided. The department provides nutrition education for medical and nursing staff to provide access to scientifically supported medical nutrition therapy.

About SKMC

Sheikh Khalifa Medical City (SKMC), located in Abu Dhabi, UAE, operates under the management of Cleveland Clinic, named one of the top three hospitals in the USA by U.S. News and World Report . The Medical City is the flagship institution for the public health system in Abu Dhabi and has several 'Centers of Excellence,' and aspires to practice contemporary medicine comparable to the best hospitals and medical centers in the world. SKMC provides comprehensive health care services in all of the disciplines relevant to the needs and priorities of the community to attain the highest levels of patient satisfaction.

SKMC consists of a 550-bed Acute Care Hospital, a 120-bed Behavior Sciences Pavilion and the 90-bed Abu Dhabi Rehabilitation Center, in addition to more than 12 specialized outpatient clinics and ten primary healthcare centers around the city of Abu Dhabi.

About SEHA

SEHA is health in Arabic. The Abu Dhabi Health Services Company – whose corporate identity is SEHA – is an independent, public joint stock company created to manage and develop the curative activities of the public hospitals and clinics of the Emirate of Abu Dhabi. SEHA is committed to providing quality, cost effective healthcare on par with international standards measured through accessibility, affordability, choice and satisfaction. SEHA manages 8 hospital systems totaling 14 facilities, 2,472 licensed beds, more than 55 Primary Health Clinics and 14,350 employees.

2. Hydrogenated fatty acids- Hydrogenation is a process of adding hydrogen to oil, in order to turn liquid oils (mono or polyunsaturated fats) into solids (saturated fats). In liquid oils, the molecules are bent. The molecules cannot be packed closely which is what makes the oil soft, or liquid. Hydrogenation increases the shelf life and flavor stability of foods containing these fats.

3. Partially hydrogenated fatty acids- Oil molecules that are basically straight, but with a slight kink, pack more closely together and the oil becomes semi-solid. The oil molecules are twisted into a new shape and no longer shaped like the original fat. These twisted oil molecules are called trans fats.

Ø trans fats- are manufactured through a chemical procedure made when processing fats into partially hydrogenated vegetable oils, spreads, margarine and shortenings. Trans fat has no known health benefits, and there is no harmless level of artificial trans fat consumption. Trans fats are not found in fully hydrogenated vegetable oils. A small amount of trans fat is found naturally in some animal based foods. Foods that contain less than 0.5 grams per serving may be labeled as: Trans Fat 0 grams. Small amounts of trans fats contribute to risk of heart disease, obesity and diabetes. Trans fats raise the "bad" cholesterol called low density lipoproteins (LDL), and lower the "good"; cholesterol, high-density lipoprotein (HDL). There are currently no safe levels of trans fat. Trans fats are found primarily in these foods and food groups:

§ Margarine - stick margarine or spreadable. All margarines will be considered to contain trans fats unless stated in the contents as a “trans fat 0” item or labeled as a trans fat free product.

§ All fried foods unless labeled as a “trans fat 0” or trans fat free item.

4. Saturated fatty acids- are fats that pack the fat molecule with hydrogen making the oil hard or separable. Saturated fats raise the "bad" cholesterol, low-density lipoprotein (LDL) levels in blood. Areas that were bent on the molecule are broken allowing the additional hydrogen to bond. It no longer contains twisted or bent molecules- or trans fats. Saturated fats are generally solid or waxy at room temperature and are found primarily in animal products. There are also some plant-derived foods that contain saturated fat. High saturated fats products include:

Ø hot dogs, bacon and high-fat luncheon meats, such as salami, bologna and mortadella

Ø desserts, donuts, pastries and sweets made with lard, butter or tropical oils

5. Monounsaturated fats- are fats that have an opening on the molecule which enhances the ability to lower the “bad” cholesterol or LDL. Monounsaturated fats are generally liquid at room temperature. Monounsaturated fats do not lower triglyceride levels or raise HDL levels Some good food sources of monounsaturated fat include:

6. Polyunsaturated fats- are fats that have several openings on the molecule that allows one to lower the “bad” cholesterol or LDL. Polyunsaturated fats stay liquid at room and in the refrigerator. When substituted for saturated or trans fats, polyunsaturated fats can lower LDL cholesterol. Good sources of polyunsaturated fats include:

Þ omega-3 fatty acids are polyunsaturated fats that have additional protective benefits against cardiovascular disease, including lowering triglycerides, protecting against irregular heartbeats, decreasing your risk of a heart attack and lowering blood pressure. Good sources include

Þ fish — especially cold-water fish like sea bass, tuna, mackerel, salmon, herring and sardines.

7. Low Density Lipoproteins (LDL) A complex of fats and proteins, with greater amounts of lipid than protein, which transports cholesterol in the blood. High levels are associated with an increased risk of atherosclerosis and coronary heart disease.

8. High Density Lipoproteins (HDL) A complex of fats and proteins in approximately equal amounts that functions as a transporter of cholesterol in the blood. High levels are associated with a decreased risk of atherosclerosis and coronary heart disease.


Press Release, February 25, 2008
For immediate release
*During the visit of the American Dietetic Association CEO to SKMC* The CEO of Sheikh Khalifa Medical City Signs the policy to transform SKMC to become a Trans Fat Free Zone Abu Dhabi – Sheikh Khalifa Medical City (SKMC) , managed by Cleveland Clinic, announces the initial elimination of trans fatty acids from its main campus and facilities, becoming the first facility of any kind in the Gulf and MENA region to launch the ban of artificial trans fat from food production and distribution areas, inpatient and cafeteria menus. Trans fat has been linked to cancer risk and increases in the development of and death from heart disease. In moving to start eliminating artificial trans fat from SKMC’s food services, SKMC is taking the lead in an important health issue that is gaining national momentum, providing those it serves with a standard for healthy living and wellness. The Trans Fat Free Zone policy was signed by Dr. Kenneth Ouriel, SKMC CEO with the presence of the CEO of the American Dietetic Association, *Mr. Ron Moen* during his visit to SKMC on the 24^th of February 2008. The signed policy defines the Trans Fat Free Zone as an area where food items are not prepared or distributed when containing Trans fats. The purpose of the policy is to identify food products containing trans fats, ban the use of food items containing more than 0.5 grams trans fats per serving at SKMC facilities and to enforce trans fat free zone procedures at SKMC facilities. It provides directions for alternate food items for food products containing trans fats. “As a health care leader in the community, SKMC is committed to creating a healthy environment for the entire population,” said Dr. Ouriel. “Eliminating Trans fat food items on our campuses is a key step in this process. We are appreciative of the support we have received from our vendors and contractors thus far. But the elimination of trans fats on our campuses is only a first step. Our hope is that this will encourage healthy dietary habits among our employees and their families at home, and that this education will spread to the population of Abu Dhabi at large.” Ellen Edwards RD LD, Head of Department, Clinical Dietetics pointed out that “As the transformation to a Trans Fat Free Zone takes time to all the vendors and contractors to comply with the policy, the implementation process will include three phases which are the Trans Fat Free Zone Launch Phase – the phase that we implemented with the signing of the policy today which will be communicated to the vendors and contractors and along with the research for alternative food items in the market. The next phase is the Trans Fat Free Zone Phase I which affirms no usage of partially hydrogenated vegetable oils, shortenings, or margarines for frying, pan-frying (sautéing), or grilling, or as a spread, unless confirmation by a label or other documents from the manufacturer showing that these ingredients contain less than 0.5 grams of trans fat per serving. Spreads are included in this ban. However, continuance of the use of trans fat-containing oils and shortenings for deep frying cake batter and dough until 1 July 2008 will be allowed. She then pointed on the third phase and stated “Trans Fat Free Zone Phase II will include the ban of storage, use and service at SKMC of Foods containing partially hydrogenated vegetable oils, shortenings, or margarines with 0.5 grams or more trans fat per serving. Exempt foods will be foods served in the manufacturer’s original, sealed packaging such as a package of crackers until 1 January 2009.” “The change needs education to all parties, therefore the Clinical Food Service section of Clinical Dietetics provides a service to venders, contractors, patients and staff to identify trans fat containing food items and to assist in appropriate alternative selections. Moreover, enforcement and audits will be conducted thru the Clinical Dietetics Department in order to maintain SKMC Trans Fat Free Zone status continuously ” she concluded. About the Clinical Dietetics Department at SKMC The Clinical Dietetics Department at SKMC provides specialty services for nutritional disorders and for healthy eating. Nutrition services are provided for breast feeding support, weaning diet or DFA advice in the infant, cystic fibrosis, pediatric and adult diabetes, constipation, disorders of the colon, tube feeding monitoring, failure to thrive, pediatric and adult renal nutritional care, cardiac, cholesterol control, food allergies, celiac disease, oncology care, weight management, metabolic diseases, inflammatory bowel disease, cleft palate, nutrition support, nutrition in developmental delayed patients, wound healing and care for various medical conditions. SKMC Clinical Dietetics staff monitors patients admitted to the hospital, renal unit, home health care patients, and clinic patients for ongoing medical nutritional therapy. Patients are screened for nutritional risk and an assessment of the patient’s nutritional status is conducted, education and an ongoing monitoring plan are provided. The department provides nutrition education for medical and nursing staff to provide access to scientifically supported medical nutrition therapy. About SKMC Sheikh Khalifa Medical City (SKMC), located in Abu Dhabi, UAE, operates under the management of Cleveland Clinic, named one of the top three hospitals in the USA by U.S. News and World Report . The Medical City is the flagship institution for the public health system in Abu Dhabi and has several 'Centers of Excellence,' and aspires to practice contemporary medicine comparable to the best hospitals and medical centers in the world. SKMC provides comprehensive health care services in all of the disciplines relevant to the needs and priorities of the community to attain the highest levels of patient satisfaction. SKMC consists of a 550-bed Acute Care Hospital, a 120-bed Behavior Sciences Pavilion and the 90-bed Abu Dhabi Rehabilitation Center, in addition to more than 12 specialized outpatient clinics and ten primary healthcare centers around the city of Abu Dhabi. *About SEHA* SEHA is health in Arabic. The Abu Dhabi Health Services Company – whose corporate identity is SEHA – is an independent, public joint stock company created to manage and develop the curative activities of the public hospitals and clinics of the Emirate of Abu Dhabi. SEHA is committed to providing quality, cost effective healthcare on par with international standards measured through accessibility, affordability, choice and satisfaction. SEHA manages 8 hospital systems totaling 14 facilities, 2,472 licensed beds, more than 55 Primary Health Clinics and 14,350 employees. *Fats Types* 1. Fatty acids-Fats are energy essential for normal body function 2. Hydrogenated fatty acids- Hydrogenation is a process of adding hydrogen to oil, in order to turn liquid oils (mono or polyunsaturated fats) into solids (saturated fats). In liquid oils, the molecules are bent. The molecules cannot be packed closely which is what makes the oil soft, or liquid. Hydrogenation increases the shelf life and flavor stability of foods containing these fats. 3. Partially hydrogenated fatty acids- Oil molecules that are basically straight, but with a slight kink, pack more closely together and the oil becomes semi-solid. The oil molecules are twisted into a new shape and no longer shaped like the original fat. These twisted oil molecules are called trans fats. Ø *trans fats- are manufactured through a chemical procedure made when processing fats into partially hydrogenated vegetable oils, spreads, margarine and shortenings. Trans fat* has no known health benefits, and there is no harmless level of artificial trans fat consumption. Trans fats are not found in fully hydrogenated vegetable oils. A small amount of trans fat is found naturally in some animal based foods. Foods that contain less than 0.5 grams per serving may be labeled as: Trans Fat 0 grams. Small amounts of trans fats contribute to risk of heart disease, obesity and diabetes. Trans fats raise the "bad" cholesterol called low density lipoproteins (LDL), and lower the "good"; cholesterol, high-density lipoprotein (HDL). There are currently no safe levels of trans fat. Trans fats are found primarily in these foods and food groups: § Any food that contains partially hydrogenated oils § Margarine - stick margarine or spreadable. All margarines will be considered to contain trans fats unless stated in the contents as a “trans fat 0” item or labeled as a trans fat free product. § All fried foods unless labeled as a “trans fat 0” or trans fat free item. 4. Saturated fatty acids- are fats that pack the fat molecule with hydrogen making the oil hard or separable. Saturated fats raise the "bad" cholesterol, low-density lipoprotein (LDL) levels in blood. Areas that were bent on the molecule are broken allowing the additional hydrogen to bond. It no longer contains twisted or bent molecules- or trans fats. Saturated fats are generally solid or waxy at room temperature and are found primarily in animal products. There are also some plant-derived foods that contain saturated fat. High saturated fats products include: Ø beef, lamb, veal, and fatty poultry Ø hot dogs, bacon and high-fat luncheon meats, such as salami, bologna and mortadella Ø high-fat dairy products milk, laban, cheese and labna Þ unless labeled as a low fat product Ø butter and lard Ø sauces and gravies made from animal fat Ø most fried foods and fast foods Ø bacon fat Ø tropical oils - palm, palm kernel and coconut Ø desserts, donuts, pastries and sweets made with lard, butter or tropical oils 5. Monounsaturated fats- are fats that have an opening on the molecule which enhances the ability to lower the “bad” cholesterol or LDL. Monounsaturated fats are generally liquid at room temperature. Monounsaturated fats do not lower triglyceride levels or raise HDL levels Some good food sources of monounsaturated fat include: Þ olive oil and olives Þ canola Þ avocados Þ peanut butter 6. Polyunsaturated fats- are fats that have several openings on the molecule that allows one to lower the “bad” cholesterol or LDL. Polyunsaturated fats stay liquid at room and in the refrigerator. When substituted for saturated or trans fats, polyunsaturated fats can lower LDL cholesterol. Good sources of polyunsaturated fats include: Ø Corn oil, safflower oil, soy oil and sunflower oils. Þ omega-3 fatty acids are polyunsaturated fats that have additional protective benefits against cardiovascular disease, including lowering triglycerides, protecting against irregular heartbeats, decreasing your risk of a heart attack and lowering blood pressure. Good sources include Þ fish — especially cold-water fish like sea bass, tuna, mackerel, salmon, herring and sardines. Þ flaxseeds, walnuts, soybeans and canola oil 7. Low Density Lipoproteins (LDL) A complex of fats and proteins, with greater amounts of lipid than protein, which transports cholesterol in the blood. High levels are associated with an increased risk of atherosclerosis and coronary heart disease. 8. High Density Lipoproteins (HDL) A complex of fats and proteins in approximately equal amounts that functions as a transporter of cholesterol in the blood. High levels are associated with a decreased risk of atherosclerosis and coronary heart disease.

For immediate release