Health groups hunger for prompt label change
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* Martin Smith

Health Canada’s latest attempt at reforming the nation’s nutrition-labelling system for prepackaged foods is half-baked, said experts at an online public health nutrition seminar.

The proposed changes “are weak,” said Bill Jeffery, national coordinator of the Centre for Science in the Public Interest (CSPI) Canada, which sponsored the Apr. 23 seminar that attracted 130 participants worldwide.

Health Canada is in the midst of regulatory reform to improve the quality and effectiveness of the nutritional information on prepackaged foods. The federal government is expected to propose draft regulations based on Health Canada’s proposal by July 2015, although those regulations likely won’t be implemented before the Oct. 19 federal election.

Jeffery cited numerous examples from the government recommendations that don’t do enough to reduce the burden of health problems stemming from poor nutrition labelling. Examples given in [a joint response](http://cspinet.org/canada/pdf/sept-2014.ngo-joint-statement.health\_canada_food_label_proposal.pdf) from 20 health groups — including the CSPI, the Canadian Cancer Society, the Heart and Stroke Foundation and the Childhood Obesity Foundation — include stressing minor details (such as formatting on the Nutrition Facts table), adding changes that negate other changes (such as the addition of percent daily value for total sugars, which will defeat the purpose of including grams of added sugars) and a marginal reduction in the daily amount of sodium (from 2400 mg to 2300 mg).

Health Canada said it looked at sodium values recommended by the Institute of Medicine and the World Health Organization in deciding to propose an upper limit of 2300 mg. “This decision was made based on the fact that Health Canada determined the [daily value] should be consistent with the long-term public health goal of minimizing risk to the health of Canadians,” a spokesperson for Health Canada told *CMAJ*.

The joint response also called for mandatory front-of-package labelling. Jeffery said this is a significant omission in the proposal. But Health Canada’s spokesperson said the proposed changes focus on information that is currently regulated: the Nutrition Facts table on the back of the pack.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/187/9/E273/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/187/9/E273/F1)

Experts say proposed reforms to Canada’s nutrition-labelling system don’t go far enough.

Image courtesy of jaminwell/iStock

Jeffery’s call for front-of-package labelling was echoed by guest speaker Mary L’Abbé, chair of the Department of Nutritional Sciences at the University of Toronto. It has the potential to improve diets, reduce diet-related chronic disease, help consumers choose healthier foods and give manufacturers an incentive to come up with healthier products, said L’Abbé.

There are now 158 different front-of-package labels used on prepacked goods in Canada, which makes it difficult for consumers to make an informed choice, says L’Abbé.

## Other labelling systems

Canadian policy-makers should look to food-labelling systems in other countries that have proven to be effective, added Jeffery. Guest speakers presented examples of international labelling schemes in the United Kingdom and United States.

Dr. Peter Scarborough of the British Heart Foundation talked about the British experience with the traffic-light labelling system. It uses colour codes to indicate nutritional information so consumers can tell at a glance if the food has high (red), medium (amber) or low (green) amounts of salt, sugars and saturated fats. More greens indicate healthier choices.

Today, 93% of UK food retailers with house brands use traffic-light labels, but very few other manufacturers have taken it up. Scarborough noted the efficacy of the system hasn’t been rigorously proven.

David Katz, founder and director of the Prevention Research Center at the Yale School of Medicine provided an overview of the commercial NuVal food-labelling scheme, now used by 1700 US grocery stores. Katz calls it “the world’s most sophisticated nutrient profiling system.”

NuVal uses the Overall Nutritional Quality Index, a complex algorithm that ranks foods by relative healthfulness. In the end, consumers see one numeric value between 1 and 100, with a higher score indicating better nutritional value. In contrast to the UK traffic-light, front-of-package system, NuVal scores are affixed to the shelf, usually directly below the product.

The US Food and Drug Administration rejected NuVal and suggested that Katz take it to the private sector, which he did.

What’s next for Canada? A combination of the NuVal shelf tag and traffic-light, front-of-package labelling may be best, says Jeffery, but research and independent review is vital before adopting a model for Canada. And until Health Canada embeds standardized, universal front-of-package labelling into the appropriate legislation, these types of discussions are informative but ultimately academic, he maintains. “Health Canada appears very entrenched in its original July 2014 proposal, except [it is] mandating serving sizes instead of keeping them voluntary.”