Advertisement

Canadian Journal of Public Health

, Volume 108, Issue 4, pp 409–413 | Cite as

Policy recommendations for front-of-package, shelf, and menu labelling in Canada: Moving towards consensus

  • Kim D. RaineEmail author
  • Alexa R. Ferdinands
  • Kayla Atkey
  • Erin Hobin
  • Bill Jeffery
  • Candace I. J. Nykiforuk
  • Lana Vanderlee
  • Ellen Vogel
  • Barbara von Tigerstrom
Commentary
  • 5 Downloads

Abstract

Greater availability of low nutritional quality foods and decreased consumption of nutrient-dense foods have negatively impacted the nutrient profile of the Canadian diet. Poor diet is now the leading risk factor for chronic disease and premature death in Canada. To help consumers choose healthful foods, nutrition labelling is one policy tool for communicating relevant nutrition information. However, there are notable shortcomings with current nutrition labelling systems, which make it difficult for Canadians to navigate the complex food environment. Government action on nutrition labelling systems, including front-of-package (FOP), shelf, and menu labelling, is required. In May 2016, we hosted a consensus conference with experts from research, policy and practice to review available evidence, share experiences and come to consensus regarding the next best steps for action on nutrition labelling in Canada. In this paper, we examine the evidence, opportunities and challenges surrounding FOP, shelf, and menu labelling. We outline recommendations, emphasizing FOP, shelf, and menu labelling as part of a standardized, coordinated and multi-pronged strategy supported by a robust, evidence-based nutrition profiling system. Recommendations for monitoring adherence to regulations and participation of stakeholders to avoid conflict of interest in policy development, implementation and evaluation are included. Within a comprehensive strategy, these recommendations can help to improve the nutrition information environment for Canadians.

Key words

Food labelling consensus policy obesity chronic disease 

Mots Clés

Étiquetage des aliments consensus politique (principe) obésité maladie chronique 

Résumé

La disponibilité accrue d’aliments de faible qualité nutritionnelle et la baisse de la consommation d’aliments riches en nutriments ont des impacts négatifs sur le profil nutritionnel du régime canadien. La mauvaise alimentation est maintenant le principal facteur de risque de maladies chroniques et de décès prématurés au Canada. Pour aider les consommateurs à choisir des aliments sains, l’étiquetage nutritionnel est un outil stratégique de communication de l’information nutritionnelle pertinente. Les systèmes d’étiquetage nutritionnel actuels comportent toutefois des lacunes notables, d’où la difficulté pour les Canadiens de s’y retrouver dans un environnement alimentaire complexe. Une action gouvernementale est nécessaire en ce qui a trait aux systèmes d’étiquetage nutritionnel, notamment l’étiquetage sur le devant de l’emballage (étiquetage de face), l’étiquetage sur les tablettes et l’étiquetage des menus. En mai 201 6, nous avons tenu une conférence de concertation avec des spécialistes de la recherche, des politiques et des pratiques pour examiner les données probantes disponibles, partager les expériences de chacun et parvenir à un consensus quant aux meilleures mesures à prendre maintenant pour agir sur la question de l’étiquetage nutritionnel au Canada. Nous présentons ici les données probantes, les possibilités et les défis concernant l’étiquetage de face, l’étiquetage sur les tablettes et l’étiquetage des menus. Nous formulons des recommandations, qui abordent l’étiquetage de face, l’étiquetage sur les tablettes et l’étiquetage des menus dans le cadre d’une stratégie standardisée et coordonnée à plusieurs volets, soutenue par un système de profilage nutritionnel robuste et fondé sur les preuves. Nous incluons des recommandations visant à surveiller le respect de la réglementation et la participation des acteurs pour éviter les conflits d’intérêts dans l’élaboration, l’application et l’évaluation de politiques. Dans le cadre d’une stratégie globale, ces recommandations peuvent contribuer à améliorer l’environnement d’information nutritionnelle des Canadiens.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Statistics Canada. Canadians Spending More on Eating Out. Ottawa, ON: Statistics Canada, 2006. Available at: http://www41.statcan.gc.ca/2006/0163/ceb0163_002-eng.htm (Accessed August 26, 2016).Google Scholar
  2. 2.
    Moubarac J-C, Batal M, Martins APB, Claro R, Levy RB, Cannon G, et al. Processed and ultra-processed food products: Consumption trends in Canada from 1938 to 2011. CanJDiet PractRes 2014;75(1):15–21. PMID: 24606955. doi: 10.3148/75.1.2014.15.Google Scholar
  3. 3.
    Garriguet D. Diet Quality in Canada. Catalogue, no. 82-003-X. Ottawa, ON: Statistics Canada, 2009. Available at: http://www.statcan.gc.ca/pub/82-003-x/2009003/article/10914-eng.pdf (Accessed November 21, 2016).Google Scholar
  4. 4.
    Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA: IHME, University of Washington, 2016. Available at: http://vizhub.healthdata.org/gbd-compare/ (Accessed October 24, 2016).Google Scholar
  5. 5.
    Raine, KD. Addressing poor nutrition to promote heart health: Moving upstream. Can J Cardiol 2010;26:21C–24C. PMID: 20847988. doi: 10.1016/ S0828-282X(10)71078-3.CrossRefGoogle Scholar
  6. 6.
    Campos S, Doxey J, Hammond D. Nutrition labels on pre-packaged foods: A systematic review. Public Health Nutr 2011;14(8):1496–506. PMID: 21241532. doi: 10.1017/S1368980010003290.CrossRefGoogle Scholar
  7. 7.
    Hobin E, Shen-Tu G, Sacco J, White C, Bowman C, Sheeshka J, et al. Comprehension and use of Nutrition Facts tables among adolescents and young adults in Canada. Can J Diet Pract Res 2016;77(2):59–65. PMID: 26771281. doi: 10.3148/cjdpr-2015-042.CrossRefGoogle Scholar
  8. 8.
    Canadian Food Inspection Agency. List of Ingredients and Allergens Requirements. Ottawa, ON: CFIA, 2016. Available at: http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/list-of-ingredients-and-allergens/eng/1383612857522/1383612932341?chap=1 (Accessed December 6, 2016).Google Scholar
  9. 9.
    Schermel A, Emrich TE, Arcand J, Wong CL, L’Abbé MR. Nutrition marketing on processed food packages in Canada: 2010 Food Label Information Program. Appl Physiol Nutr Metab 2013;38(6):666–72. PMID: 23724885. doi: 10.1139/apnm-2012-0386.CrossRefGoogle Scholar
  10. 10.
    World Health Organization. Guideline: Sugars Intake for Adults and Children. Geneva, Switzerland: WHO, 2015. Available at: http://apps.who.int/iris/bitstream/10665/149782/1/9789241549028_eng.pdf?ua=1 (Accessed December 15, 2016).Google Scholar
  11. 11.
    Morestin F, Hogue M-C, Jacques M, Benoit F. Public Policies on Nutrition Labelling: Effects and Implementation Issues — A Knowledge Synthesis. Québec City, QC: National Collaborating Centre for Healthy Public Policy, 2011. Available at: http://www.ncchpp.ca/docs/Synthesis_nutrition_labelling_EN.pdf (Accessed January 4, 2016).Google Scholar
  12. 12.
    Hawley KL, Roberto CA, Bragg MA, Liu PJ, Schwartz MB, Brownell, KD. The science on front-of-package food labels. Public Health Nutr 2013;16(3):430–39. PMID: 22440538. doi: 10.1017/S1368980012000754.CrossRefGoogle Scholar
  13. 13.
    Health Canada. Toward Front-of-Package Nutrition Labels for Canadians. Consultation Document. Ottawa, ON: Health Canada, 2016. Available at: https://www.canada.ca/content/dam/canada/health-anada/migration/health-system-systeme-sante/consultations/labels-nutrition-etiquetage/alt/labels-nutri tion-etiquetage-eng.pdf (Accessed February 24, 2017).Google Scholar
  14. 14.
    Krieger J, Saelens B. Impact of Menu Labeling on Consumer Behavior: A 2008–2012 Update. Princeton, NJ: Robert Woods Johnson Foundation, 2013. Available at: http://healthyeatingresearch.org/research/impact-of-menu-labeling-on-consumer-behavior-a-2008-2012-update-an-issue-brief/ (Accessed January 4, 2016).Google Scholar
  15. 15.
    POWER UP! Evidence Synthesis: Exploring the Impact of Front-of-Package, Shelf, and Menu Labelling for Obesity and Chronic Disease Prevention. Edmonton, AB: POWER UP! 2016. Available at: http://abpolicycoalitionforprevention.ca/portfolio-posts/evidence-synthesis-exploring-the-impact-of-front-of-package- shelf-and-menu-labelling-for-obesity-and-chronic-disease-prevention/ (Accessed February 25, 2017).Google Scholar
  16. 16.
    Institute of Medicine. Front-of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. Washington, DC: IOM, 2012.Google Scholar
  17. 17.
    Hobin E, Sacco J, Vanderlee L, Hammond D, L’Abbé M, Rosella L, et al. The impact of the Guiding Stars on-shelf nutrition labelling system on the nutritional quality of food purchases in supermarkets in Canada. International Society for Behavioral Nutrition and Physical Activity Annual Meeting, Cape Town, South Africa, June 8–11, 2016.Google Scholar
  18. 18.
    Cecchini M, Warin L. Impact of food labelling systems on food choices and eating behaviours: A systematic review and meta-analysis of randomized studies. Obes Rev 2016;17(3):201–10. PMID: 26693944. doi: 10.1111/obr.12364.CrossRefGoogle Scholar
  19. 19.
    Koehler K, Hersey JE, Wohlgenant KC, Kosa KM, Arsenault JE, Muth, MK. Policy Research for Front of Package Nutrition Labeling: Environmental Scan and Literature Review. Washington, DC: U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation, 2011.Google Scholar
  20. 20.
    Hersey JC, Wohlgenant KC, Arsenault JE, Kosa KM, Muth, MK. Effects of front-of-package and shelf nutrition labeling systems on consumers. Nutr Rev 2013;71(1):1–14. PMID: 23282247. doi: 10.1111/nure.12000.CrossRefGoogle Scholar
  21. 21.
    Scrinis G. Reformulation, fortification and functionalization: Big Food corporations’ nutritional engineering and marketing strategies. J Peasant Stud 2015;43(1):17–37. doi: 10.1080/03066150.2015.1101455.CrossRefGoogle Scholar
  22. 22.
    Roy R, Kelly B, Rangan A, Allman-Farinelli M. Food environment interventions to improve the dietary behavior of young adults in tertiary education settings: A systematic literature review. J Acad Nutr Diet 2015; 115(10):1647–81.e1. PMID: 26271691. doi: 10.1016/j.jand.2015.06.380.CrossRefGoogle Scholar
  23. 23.
    Robles-Valcarcel P. An update on the status of front-of-package labelling regulations in Latin America. Public Health Nutr 2017;20(5):948–49. PMID: 27995835. doi: 10.1017/S1368980016003359.CrossRefGoogle Scholar
  24. 24.
    Long MW, Tobias DK, Cradock AL, Batchelder H, Gortmaker, SL. Systematic review and meta-analysis of the impact of restaurant menu calorie labeling. Am J Public Health 2015;105(5):e11-24. PMID: 25790388. doi: 10.2105/AJPH. 2015.302570.Google Scholar
  25. 25.
    Swartz JJ, Braxton D, Viera, AJ. Calorie menu labeling on quick-service restaurant menus: An updated systematic review of the literature. Int J Behav Nutr Phys Act 2011;8:135. PMID: 22152038. doi: 10.1186/1479-5868-8-135.CrossRefGoogle Scholar
  26. 26.
    Littlewood JA, Lourenço S, Iversen CL, Hansen, GL. Menu labelling is effective in reducing energy ordered and consumed: A systematic review and meta-analysis of recent studies. Public Health Nutr 2016;19(12):2106–21. PMID: 26714776. doi: 10.1017/S1368980015003468.CrossRefGoogle Scholar
  27. 27.
    Gortmaker SL, Wang YC, Long MW, Giles CM, Ward ZJ, Barrett JL, et al. Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Affairs 2015;34(11):1932–39. PMID: 26526252. doi: 10.1377/hlthaff.2015.0631.Google Scholar
  28. 28.
    Kaczorowski J, Campbell NR, Duhaney T, Mang E, Gelfer M. Reducing deaths by diet: Call to action for a public policy agenda for chronic disease prevention. Can Fam Physician 2016;62(6):469–70. PMID: 27302998.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Dietitians of Canada. Nutrition Labelling. Toronto, ON: DC, 2016. Available at: http://www.dietitians.ca/Dietitians-Views/Food-Regulation-and-Labelling/Nutrition-Labelling.aspx (Accessed August 26, 2016).Google Scholar
  30. 30.
    Canadian Diabetes Association. Canadian Diabetes Association: Sugars Position Statement. Toronto, ON: CDA, 2016. Available at: http://www.diabetes.ca/getmedia/9d0baffb-6268-4762-acc7-e52575c40c55/cda-position-on-sugars.pdf.aspx (Accessed August 26, 2016).Google Scholar
  31. 31.
    Government of Canada. Archived — Government of Canada Announces Proposed New Nutrition Labels and Tools to Promote Healthier Food Choices. Ottawa, ON: Government of Canada, 2015. Available at: http://news.gc.ca/web/article-en.do?nid=987069 (Accessed January 14, 2017).Google Scholar
  32. 32.
    Centre for Health Science and Law. Statement: Health Canada’s Unambitious First Step to Update Food Labels Systematically Understates Levels of Salt, Sugar. Ottawa, ON: Centre for Health Science and Law, 2016. Available at: http://healthscienceandlaw.ca/wp-content/uploads/2016/12/FINAL.CHSL_.14Dec2017.Comment.NutritionLabel-Regulations-1.pdf (Accessed January 4, 2017).Google Scholar
  33. 33.
    Standing Senate Committee on Social Affairs, Science and Technology. Obesity in Canada: A Whole-of-Society Approach for a Healthier Canada. Ottawa, ON: Senate of Canada, 2016. Available at: http://www.parl.gc.ca/content/sen/committee/421/SOCI/Reports/2016-02-25_Revised_report_Obesity_in_Canada_e.pdf (Accessed November 21, 2016).Google Scholar
  34. 34.
    Government of Canada. Government of Canada Finalizes Changes to the Nutrition Facts Table and List of Ingredients on Packaged Foods. Ottawa, ON: Government of Canada, 2016. Available at: http://news.gc.ca/web/article-en.do?nid=1169379 (Accessed December 20, 2016).Google Scholar
  35. 35.
    Government of Ontario. Regulation Under the Healthy Menu Choices Act, 2015. Toronto, ON: Government of Ontario, 2016. Available at: http://www.ontariocanada.com/registry/view.do?postingId=19762 (Accessed August 10, 2016).Google Scholar
  36. 36.
    Health Canada. Healthy Eating Strategy. Ottawa, ON: Health Canada, 2016. Available at: http://healthycanadians.gc.ca/publications/eating-nutrition/healthy-eating-strategy-canada-strategie-saine-alimentation/index-eng.php (Accessed November 1, 2016).Google Scholar
  37. 37.
    World Health Organization. Nutrient Profiling. Geneva, Switzerland: WHO, 2017. Available at: http://www.who.int/nutrition/topics/profiling/en/ (Accessed February 24, 2017).Google Scholar
  38. 38.
    Sodium Working Group. Sodium Reduction Strategy for Canada. Ottawa, ON: Health Canada, 2010. Available at: http://www.hc-sc.gc.ca/fn-an/nutrition/sodium/related-info-connexe/strateg/reduct-strat-eng.php (Accessed December 12, 2016).Google Scholar

Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  • Kim D. Raine
    • 1
    Email author
  • Alexa R. Ferdinands
    • 1
  • Kayla Atkey
    • 1
  • Erin Hobin
    • 2
  • Bill Jeffery
    • 3
    • 4
    • 5
  • Candace I. J. Nykiforuk
    • 1
  • Lana Vanderlee
    • 6
  • Ellen Vogel
    • 7
  • Barbara von Tigerstrom
    • 8
  1. 1.School of Public HealthUniversity of AlbertaEdmontonCanada
  2. 2.Public Health OntarioTorontoCanada
  3. 3.Centre for Health Science and LawOttawaCanada
  4. 4.International Association of Consumer Food OrganizationsOttawa/London/WashingtonCanada
  5. 5.Geneva Global Health Hub (G2H2)GenevaSwitzerland
  6. 6.Department of Nutritional SciencesUniversity of TorontoTorontoCanada
  7. 7.Faculty of Health SciencesUniversity of Ontario Institute of TechnologyOshawaCanada
  8. 8.College of LawUniversity of SaskatchewanSaskatoonCanada

Personalised recommendations