The Food and Drug Administration’s recent decision to phase out partially hydrogenated oils, the source of most trans fat in the U.S. food supply, serves as the final nail in the coffin for the artificial ingredient in the American food industry.

The decision has sparked little controversy – surprising, given that bans of large sodas, cigarettes and Styrofoam can generate thousands of protests. However, trans fats have been widely criticized for years, and have long been on the way out in the food industry. “Trans fats were relatively easy to ban because the evidence for their harm is substantial and substitutes are available,” says Marion Nestle, a food studies professor at New York University.

Once hailed as the healthy alternative to animal fats and butter, health advocacy groups have been working to ban trans fats since the early 1990s. The FDA implemented a rule in 2006 requiring manufacturers list trans fat on nutrition labels. One year later, New York City banned the use of partially hydrogenated vegetable oils and spreads– the bulk of trans fat in food– in restaurants. In 2012, trans fats in school lunches were severely diminished under new guidelines issued by the Department of Agriculture.

A 2012 report of fast-food chains’ lunch receipts revealed that the average trans fat content of customers’ meals dropped from about three grams to 0.5 grams after the New York City ban was enacted.

Of course, traces of trans fat are still apparent in some of the food we eat. The most common culprits for trans fat include popcorn, canned frosting, coffee creamers and baked goods. With many of these products, consumers may not even know they’re eating trans fat; the FDA allows products with under 0.5 grams of trans fat to be classified as having zero grams trans fat on their nutrition labels.

“This is problematic as those half grams can add up – like when you eat two servings of packaged cookies or one serving of cookies with a cup of coffee with packaged coffee creamer,” says Beth Vallen, a professor at Fordham Schools of Business specializing in consumer goals and self-control in consumer health.

The FDA predicts that banning trans fats for good would prevent up to 20,000 cases of health disease and 7,000 deaths every year.

While trans fat’s demise has been met with little resistance, the question remains: what does this mean for other unhealthy foods?

“I have no idea what the FDA is working on, but I sure hope they are planning to label added sugars,” says Nestle.

Vallen says it is possible similar bans could follow. “As we understand more about the effects of [preservatives and additives] on our health, it’s certainly possible that other items may go the way of trans fats.”

I yield to no one in my anger around the performance of some of the websites where far too many people are enduring deep frustration to sign up for coverage on the new health care exchanges. But there is an obvious danger of over-interpreting this unfortunate, time-limited episode.

Perhaps I should address this post to people over 45 (I’m almost 58… eeks!), but can we get a little historical perspective here in at least two dimensions, with the second being most important?

First, the introduction of big, complex policies like this always invoke big implementation challenges. I well remember the numerous delays to the rollout of the Medicare Prescription drug program, a benefit that is now highly valued by its recipients. Back when we introduced Medicare, we were sending forest rangers out into the woods to enroll hermits.

But the larger point is this: many of us have literally been working on health care reform for decades — three decades, in my case. With the passage of the Affordable Care Act, advocates in particular and the nation in general scored a milestone victory. That’s not saying the law is perfect by a long shot (it’s too complex for one, a function of embracing an architecture that avoids single payer).

But its structure meets the fundamental requirements of reform: an individual mandate to ensure a large risk pool, and subsidies to ensure that economically disadvantaged households can meet the mandate.

Of course, these rotten, horribly timed glitches should be fixed ASAP. Especially in this political climate, the idea that progressives would score an “own goal” on this is absolutely unconscionable.

But no one should let a few weeks or even a few months of computer glitches undermine a legislative victory that was so many years in the making.

A final thought, just on the mechanics of government. In my tenure, I learned that presidential administrations are not designed for optimal implementation of anything complicated. A tax or formula change, no problem. But a Recovery Act, financial market reform, ACA — much tougher. At that level, you put all your energy into program design and then the legislative fight. Once you win or lose the votes, you’re on to landing all the other airplanes that were circling while you were otherwise engaged.

The tendency is to shove off the implementation on the agencies, who then cascade it down the line, in the case of the ACA, to private contractors who demonstrably weren’t up to the task.

The key, at least in my limited experience, is to put someone in charge of the process who’s willing to ride herd at the most granular level. I saw VP Biden do that close up on the Recovery Act. I mean, the dude had weekly calls with governors and mayors, making sure stuff got done, and with high levels of accountability and transparency.

In an important way, I’m sure building the ACA websites was harder to oversee than the Recovery Act, because while the VP knew what it meant to have fiscal relief get to states or to get construction projects underway, high-level administrators can’t be expected to understand database architecture. But knowing of implementation-risk at this level of government should have led those involved to provide more oversight.

Still, it’s good to see that the screw-ups have gotten administrators’ full attention and they clearly understand the urgency of the moment. And let’s not lose sight of the fact that both the Medicaid expansions and the state-run exchanges appear to be going well. In his speech yesterday, the president pointed out the absolutely remarkable result that the Medicaid expansion in Oregon “…helped cut the number of uninsured people by 10 percent just in the last three weeks. Think about that. That’s 56,000 more Americans who now have health care.”

Most importantly, as Kentucky’s Gov. Beshear advises here, let’s take a deep breath (be sure to watch this). With the construction of the exchanges, we’ve built what I believe will come to be seen as a uniquely effective shopping center. It’s just that the road to get there in a bunch of states is fraught with potholes or worse. That can and will be fixed.

In the meantime, for the majority of us who are not rabid haters of the program, let’s remember the decades it took us to get here. Fixing a website, while obviously essential, unquestionably pales beside that accomplishment.

Photo: Thinkstock

We all know the telltale signs of aging: crow’s feet, wrinkles, age spots. But those are just on the surface. What really matters for your long-term health is how your body is aging on the inside. Keep an eye out for these red flags.

Cotton Mouth

Cotton mouth in the morning may be a sign of sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts. To figure out if you have it, determine your “snore score” by answering the following questions. For every “yes” answer, give yourself a point:

• Do you snore?
• Do you wake up groggy or with a headache?
• Do you feel constantly tired or fatigued during the day?
• Do you fall asleep reading, watching TV, or driving?
• Do you have problems with memory or concentration?

If you answered yes to two or more of these questions, you’re at risk for sleep apnea and you should see your doctor. In the mean time, be sure to sleep on your side. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway. Taping a tennis ball under your back or placing a pillow between your legs can be helpful way to ensure a safer night’s sleep by ensuring you stay on your side the entire night.

Red Eyes
Inflamed eyes could be a sign of arthritis, the painful inflammation and stiffening of joints. The same cellular process that causes inflammation in your joints can cause inflammation in your eyes, turning them red.

Studies have shown that the sooner you treat arthritis, the better the long-term results, so visit your doctor at the first sign of trouble. To help stave off or relieve arthritis, try taking feverfew, a plant with a long history of use in traditional and folk medicine. Available at health food stores, feverfew has great anti-inflammatory properties; take 1 to 2 capsules per day.

Graying Skin
If your skin doesn’t seem to “glow” in the way it used to, it may be a red flag for kidney problems. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney failure reaches an advanced stage, dangerous levels of fluid, electrolytes, and wastes can accumulate in your body. The “good news” is that kidney problems can cause anemia, which will lead to a gray-skin warning sign. If you notice your skin looking duller than usual, be sure to check in with your doctor.

Loss of Smell
Losing your sense of smell may be an early warning sign of Parkinson’s disease. The degenerative nerve disorder usually starts slowly and worsens over time, leading with muscle tremors to slowness of voluntary movements, muscle stiffness, imbalance, changes in speech, and dementia.

Catch this debilitating disease early by testing your sense of smell. Start by holding an open rubbing-alcohol swab by your belly button and slowly raising it to your nose. If you can smell the swab 8 to 12 inches away from your nose, your sense of smell is normal. But if you only start to smell it 4 inches away, it indicates a loss of smell.

There are other reasons your sense of smell may be lacking, and alpha-lipoic acid may be able to help in some of those cases. Made naturally in the body and available from food sources like spinach, broccoli, and yeast, alpha lipoic acid has been used for decades in Europe to treat nerve conditions. Try taking just 600 mg daily.

By THE EDITORIAL BOARD of the NYTimes.com,  Published: March 23, 2013

Republican leaders in Congress regularly denounce the 2010 Affordable Care Act and vow to block money to carry it out or even to repeal it. Those political attacks ignore the considerable benefits delivered to millions of people since the law’s enactment three years ago Saturday. The main elements of the law do not kick in until Jan. 1, 2014, when many millions of uninsured people will gain coverage. Yet it has already thrown a lifeline to people at high risk of losing insurance or being uninsured, including young adults and people with chronic health problems, and it has made a start toward reforming the costly, dysfunctional American health care system.

EXPANDING COVERAGE Starting in 2010, all insurers and employers that offer dependent coverage were required to offer coverage to dependent children up to age 26. An estimated 6.6 million people ages 19 through 25 have been able to stay on or join their parents’ plans as result, with more than 3 million previously uninsured young adults getting health insurance. The law requires private health insurers to provide free preventive care, without co-pays or deductibles. Some 71 million Americans have received at least one free preventive service, like a mammogram or a flu shot, and an additional 34 million older Americans got free preventive services in 2012 under Medicare.

Private insurers are now required to cover children with pre-existing conditions, which means that an estimated 17 million such children have been protected against being uninsured.

And more than 107,000 adults have enrolled in a federally run insurance plan for people with pre-existing conditions. The law also bars insurers from canceling policies on sick people; previously, 10,000 people a year had their policies rescinded.

The law appropriated $11 billion over five years to build and operate community health centers, a major factor in increasing the annual number of patients served to 21 million, a rise of 3 million from previous levels. Some $5 billion has been put into a reinsurance program that has encouraged employers to retain coverage for retirees and their families; 19 million people benefited with reduced premiums or cost-sharing.

SAVING CONSUMERS MONEY Private insurers are required by the law to spend at least 80 to 85 percent of their premium revenues on medical claims or quality improvements, or they must pay a rebate to consumers. In 2012, insurers had to pay $1.1 billion in rebates, an average of $151 per family. Although Republicans contend the law will drive up insurance premiums, thus far it seems to have reduced them. Any insurer that wants to increase its premiums by 10 percent or more for people who buy their own policies must justify the increase to state or federal officials. As a result, the proportion of rate filings that sought increases of 10 percent or more fell from 75 percent in 2010 to 34 percent in 2012, and it is expected to be even lower this year. The average premium increase in 2012 was 30 percent lower than in 2010.

The law also provides for prescription drug discounts to Medicare beneficiaries. More than 6.3 million older or disabled people have already saved more than $6.1 billion on prescription drugs since 2010 and will save even more as a gap in coverage, known as the doughnut hole, is filled in by 2020. And the law ended lifetime dollar limits on services covered by private plans, a matter of great importance to people with very high medical costs. Annual limits on what plans will pay are being phased out.

REINING IN HEALTH CARE COSTS Sharp declines in the annual growth rate in overall health care spending and in Medicare’s cost per beneficiary have eased the pressure on federal budgets and on private insurance premiums. The main factor was presumably the recession, which made people reluctant to spend on health care, but it is possible that the focus on reform has led many providers to act more frugally. The law has reduced unjustified overpayments to private Medicare Advantage plans, which enroll more than a fifth of all beneficiaries, and despite fears to the contrary, Medicare Advantage premiums have fallen by 10 percent and enrollment has risen by 28 percent since the law was passed.

BETTER QUALITY OF CARE One of the most promising aspects of the health reform act is its focus on improving quality. The percentage of Medicare patients requiring readmission to the hospital within 30 days of discharge dropped from an average of 19 percent over the past five years to 17.8 percent in the last half of 2012, an improvement due in large part to penalties imposed by Medicare for poor performance and financial incentives paid by Medicare to providers to encourage better coordination of care after a patient leaves the hospital.

A number of pilot programs in Medicare and Medicaid have been started to reward quality, to encourage doctors and hospitals to coordinate care, and to lower costs. If enough of these experiments pan out, they could transform not only Medicare but the entire health care system.