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Healthy Food and
Nutrition Labelling
What’s happening …
Dairy Farmers of Canada Conference
Ottawa, February 5, 2015
Mary R. L’Abbé, PhD
Earle W. McHenry Professor and
Chair, Department of Nutritional Sciences
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Outline
1. Diet and Chronic disease – the Global context
2. National Policies related to diet and nutrition
3. Monitoring and surveillance
4. National Dietary Guidelines are evolving
5. Nutrition labelling changes
6. Consumer Tools and Apps
7. Global initiatives – where to next?
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1. Diet and Risk for Obesity
and Chronic Disease …
The Global Context driving
Nutrition policy
In 2011, 13.8 million people, between age of 30-70, died from NCDs:
More than 85% of these deaths occurred in developing countries
25,000,000
10%
Deaths in 2011
20,000,000
15,000,000
Communicable,
maternal, perinatal and
nutritional conditions
10,000,000
Noncommunicable
diseases
Injuries
5,000,000
0
0-29
30-69
70-80+
Source: WHO, Sept 2014
9 global targets to be attained by 2025
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3 of 6 risk factors are
food and nutrition driven
Global accountability framework to report progress to the
World Health Assembly
WHA68
2015 (2016)
WHA73
WHA78
2020 (2021)
2025 (2026)
Targets
2010 baseline
2015
WHA68
(2016)
WHA69
2017 (2018)
WHA73
2020 (2021)
Action Plan
Source: WHO, Sept 2014
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2. National Policies related to
diet and nutrition
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National Policies to reduce NCDs also
require information on the food supply
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3. Monitoring and Surveillance:
Sodium and Trans levels in
Canadian foods
Other questions – sugar, calories …
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WHO (2008) Global Strategy – Framework to monitor and evaluate implementation
Example - Pantry Breads and Rolls (2010)
41% meet 2012 target (430)

29% meet 2014 target (380)

24% exceed the
13% meet 2016 target
maximum level of
(330)


520 mg/100g
Avg Sodium/serving = 272 mg
Avg Sodium per 100 g = 447 mg
CNF level per 100 g = 532 (∆ 16%)
N=142 breads
Arcand et al, Am J Prev Med (2014)
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Proportion of Cheese Meeting HC
Benchmarks for Sodium in 2010
100%
90%
80%
70%
60%
Exceeds All
Meets 2016
Meets 2012
Meets 2010
50%
40%
30%
20%
10%
0%
Dairy Prod
(n=483)
Natural Cheese
(n=428)
Proc Cheese
(n=49)
Arcand et al, Am J Prev Med (2014)
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Data Analysis: Trans Fat
Arcand J, Scourboutakos MJ, Au JTC, L’Abbe MR, AJCN 2014
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Baseline data: the proportion of foods
meeting the trans fat limits, TFMP
versus FLIP 2010
100%
80%
60%
40%
20%
0%
Trans Fat Monitoring Program (2005 – 2009)
Food Label Information Program (2010)
Arcand et al, AJCN 2014
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4. National Dietary Guidelines
are evolving
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Away from “number of servings”
Canada's Food Guide
(2007)
 Number of servings/food group by
age/gender
 Directional statements and “info
boxes” about “healthy” choices
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To …
US ChooseMyPlate (May 2012)
 More visual approach
 Better approach to guide
appropriate quantities
 Supplemental consumer
apps and tools
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To Brazil – 10 Steps to a Healthy Diet
(Oct 2014) – Healthy Eating approach
Make natural or minimally processed foods the
basis of your diet
2. Use oils, fats, salt, and sugar in small amounts
3. Limit consumption of processed foods
4. Avoid consumption of ultra-processed foods
5. Eat regularly and carefully in appropriate
environments and, whenever possible, in company
6. Shop in places that offer a variety of natural or
minimally processed foods
7. Develop, exercise and share cooking skills
8. Plan your time to make food and eating important
in your life
9. Out of home, prefer places that serve freshly made
meals
10. Be wary of food advertising and marketing
1.
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5. Nutrition Labelling Changes
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Health Canada and US FDA Proposed
Changes to Nutrition Labelling (2014)
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Health Canada Proposed
Changes
A. Serving size declarations
B. Reference amounts
C. Daily Values
D. List of core nutrients
- Sodium and sugar controversy
E. Format of the Nutrition Facts table
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A. Proposed Guidelines for Serving Size
1.
Use Reference Amount
and corresponding
household measure, e.g.
both ¾ cup (175 g)
2.
Use household measure
closes to the reference
amount and the actual
weight
3.
Use a standardized
household measure and
corresponding actual
weight
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Thoughts to consider …
Serving size and Reference Amounts
 Inconsistent with the principle of standardized reference amounts:
•
•
Either per 100 g – i.e. Europe
Or per standardized serving size - US has had for > 20 years
 Can result in large variances
•
•
example 20 g crackers (mean HC values - 993 mg sodium /100 g)
Could be reported as 169 mg/17 g or 228 g/23 g serving (a 35% difference)
 Is there any evidence that this will be easier for consumers?
 Is proposed as Guidance not mandatory in the regulations – is this really
any improvement?
 FLIP Evidence (L’Abbe lab - unpublished data)
•
•
only 42% of packaged food products used Schedule M Reference Amounts; 23% >
Schedule M Ref Amt; but 35% < Ref Amt
Of those using the Ref Amt – 70% were in the lower half of range
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C. Daily Values
Comments
 mostly consistent with US – proposing to update RDAs
 EAR for Vitamin D – should be consistent with approach to other
nutrients?
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D. Sodium and Sugar Controversy
 Sodium – recommending changing %DV from
2400 to the UL of 2300
 Large debate
Consistent with FDA approach
• Consistent with other nutrients to limit, e.g. sat fat
• BUT many advocating for the AI recommended
amount to bring more focus on how high sodium levels
are; consumer interprets these as “recommendations”
HOWEVER, IOM report recommended using ULs for
nutrients to limit
•
 Sugar
• 3 changes proposed
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Sugars – Health Canada has
Proposed 3 Approaches
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Some thoughts on Added Sugar
 Focus on added sugars due to concerns about the added sugar
contribution to calorie intakes
 Foods high in added sugars are often those with a low nutrient density
 Support product reformulation with less added sugar (as was clearly
demonstrated with trans labelling)
 Support educational messages around “healthy” food choices, such as
those in CFG
BUT
 Analytically cannot distinguish in foods, but “audit” already frequently
used
 Need a proper definition of “added sugars” Sugars that are either
added during the processing of foods, or are packaged as such, and
include sugars…, syrups, naturally occurring sugars that are isolated
from a whole food and concentrated so that sugar is the primary
component, for example fruit juice concentrates,
 BUT LOOPHOLE for concentrated fruit juices/purees: if the fruit is
listed in the product name then it is NOT a sweetener and the "no
added sugar" claim can be used. (CFIA)
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Proposed changes to List of
Ingredients
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E. Proposed Nutrition Facts
table Format
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Proposed new format - Comments
Good
 Maintains the %DV on right
 Increased font size for Calories
 Heavy lines to separate nutrient to limit (top) and
nutrients to encourage (below)
 Adding footnote to explain %DV
BUT
 Fibre is still separated from carbs
 Where would n-3 fats go? …
 Adding footnote to explain %DV – is a very poor
form of interpretive labelling
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6. Consumer Tools and Aps
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App Development - Supporting consumer
knowledge and action
http://www.projectbiglife.ca/sodium/
Arcand et al, APNM (2013)
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Big Life Salt Calculator - A few stats
 Featured on MarketPlace – March 2013
 Over 100,000 have done their own personal salt
calculations; plus global pick-up
 Clinicians have requested a detailed version – Salt
Calculator Plus
 Other apps under development
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7. GLOBAL OVERVIEW
WHERE TO NEXT?
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What was not in the recent
Nutrition Labelling Proposals –
But happening elsewhere …
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What Canadians said they
want … (p9)
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Helping Consumers identify
“healthy foods” – Interpretative
Labelling
Healthy
Unhealthy
Nordic keyhole
UK FSA/Ofcom
model
USDA school
feeding guidelines
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Recent Examples of Interpretative
Nutrition Labelling …
UK Traffic Light System –
June 2013
FSANZ - Health Star rating system
approved 27 June 2014; mandatory Jan
2016 (Australia/New Zealand)
Nutrient Profiling Scoring Calculator
Chile – Warning labels for foods
high in fat, sodium or sugar
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Conclusions – Many food and nutrition
“hot topics” here or on the horizon
 Trans, sodium, sugar, saturated fats
 Dietary patterns and healthy eating
 Nutrition labelling
 Technology enabled consumer support tools
 “Interpretative” nutrition labelling
 Menu Labelling
 Marketing to children
 Taxes on sugar sweetened beverages
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Thank You/Questions
Funding
Acknowledgements
Research Team:
JoAnne Arcand, PhD, RD
Mary Scourboutakos, BSc
Christina Wong, PhD
Alyssa Schermel, MSc
Teri Emrich, PhD, RD
Chelsea Murray, MSc
Mavra Ahmed, MSc
Mahsa Jessri, MSc
Sheida Noorhosseini, BSc
Jodi Bernstein, MPH, RD
Mary R. L’Abbe, PhD
Department of Nutritional Sciences
Faculty of Medicine, University of Toronto
E.W. McHenry
Endowed Chair
(M. L’Abbe)
[email protected]