Chronic disease accounts for 70% of deaths globally and causes substantial economic burdens. Research indicates diet can significantly reduce the risk of many chronic diseases. Governments regulate health claims that can inform consumers of foods’ health attributes and encourage them to consume healthy diets. This paper evaluates how the health status of North Americans has changed over time and after the approval of health claims in Canada and the United States.
Data were obtained from the OECD Health Statistics database. A logarithmic health status function with country fixed-effects for Canada and the USA is used to evaluate changes in life expectancies over time.
The findings indicate the health claims significantly affected female but not male life expectancies. However, both female (0.303%/year) and male (0.611%/year) life expectancies improved over the period, suggesting they are responsive to external health information.
This paper provides insights and discusses policy options regarding the efficacy of specific health claims in Canada and the USA at nudging consumers to improve health outcomes.
Les maladies chroniques représentent 70 % des décès dans le monde, ainsi qu’un fardeau économique important. Selon les études, le régime alimentaire peut considérablement réduire le risque de nombreuses maladies chroniques. Les gouvernements réglementent les allégations santé qui informent les consommateurs des attributs de santé de leurs aliments et les encouragent à adopter un régime sain. Nous avons cherché à déterminer si l’état de santé des Nord-Américains a changé au fil du temps et après l’approbation des allégations santé au Canada et aux États-Unis.
Nos données proviennent de la base de données de statistiques sur la santé de l’OCDE. Une fonction logarithmique de l’état de santé, à effets fixes par pays pour le Canada et les États-Unis, a permis d’évaluer les changements dans l’espérance de vie au fil du temps.
Selon nos constatations, les allégations santé ont eu des effets significatifs sur l’espérance de vie des femmes, mais pas sur celle des hommes. Cependant, tant l’espérance de vie des femmes (0,303 %/année) que celle des hommes (0,611 %/année) se sont améliorées au cours de la période, ce qui donne à penser qu’elles sont sensibles aux informations sur la santé venant de l’extérieur.
Notre article apporte des éclaircissements et analyse des options stratégiques concernant l’efficacité potentielle de certaines allégations santé au Canada et aux États-Unis lorsqu’il s’agit d’encourager les consommateurs à améliorer leurs résultats de santé.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
A list of the approved disease risk reduction claims can be found in the Appendix.
A list of the approved NLEA, FDAMA, and qualified health claims are in the Appendix.
Similar health claims were approved in the USA in 1993. However, due to limited data availability before 1990, only the impacts of the Canadian health claims are evaluated.
The models also were estimated with health claims affecting only the intercept term and the intercept and slope terms. However, the models did not produce meaningful results. The models with health claims that affected the slopes were selected as they provided the most meaningful and statistically significant results.
With the exception of the interaction terms, the main results from Model 1 and Model 4 are discussed in more detail since the signs, significance, and magnitudes were substantially similar between Model 1 and Model 2 for males and Model 3 and Model 4 for females.
Adhikari, M., Paudel, L., Houston, J. E., Paudel, K. P., & Bukenya, J. (2006). The impact of cholesterol information on meat demand: application of an updated cholesterol index. Journal of Food Distribution Research, 37(2), 60–69.
Agriculture and Agri-Food Canada (AAFC). (2012). Canada’s regulatory system for foods with health benefits – an overview of industry. Ottawa: Agriculture and Agri-Food Canada.
Agriculture and Agri-Food Canada (AAFC). (2014). Opportunities and challenges facing the Canadian functional foods and natural health products sector. Ottawa: Agriculture and Agri-Food Canada.
Amuta-Jimenez, A. O., Lo, C., Talwar, D., Khan, N., & Barry, A. E. (2019). Food label literacy and use among US adults diagnosed with cancer: results from a national representative study. Journal of Cancer Education, 34(5), 1000–1009.
Anand, S., & Bärnighausen, T. (2004). Human resources and health outcomes: cross-country econometric study. The Lancet, 364(9445), 1603–1609.
Behrman, J. R., & Wolfe, B. L. (1984). The socioeconomic impact of schooling in a developing country. The Review of Economics and Statistics, 66(2), 296–303.
Berger, M. C., & Messer, J. (2002). Public financing of health expenditures, insurance, and health outcomes. Applied Economics, 34(17), 2105–2113.
Berhaupt-Glickstein, A., Nucci, M. L., Hooker, N. H., & Hallman, W. K. (2014). The evolution of language complexity in qualified health claims. Food Policy, 47, 62–70.
Brunello, G., Fort, M., Schneeweis, N., & Winter-Ebmer, R. (2016). The causal effect of education on health: what is the role of health behaviors? Health Economics, 25(3), 314–336.
Canadian Food Inspection Agency (CFIA). (2016a). Specific Nutrient Content Claim Requirements – Energy and Calorie Claims. http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/nutrient-content/specific-claim-requirements/eng/1389907770176/1389907817577?chap=0. Accessed July 4, 2017.
Canadian Food Inspection Agency (CFIA). (2016b). Foods Always Exempt from Carrying a Nutrition Facts Table. http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/nutrition-labelling/exemptions/eng/1389198015395/1389198098450?chap=1. Accessed September 4, 2017.
Centers for Disease Control and Prevention (CDC). (2016). Heart Disease Fact Sheet. https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm. Accessed July 7, 2017.
Centers for Disease Control and Prevention (CDC). (2017a). Chronic Disease Overview. http://www.cdc.gov/chronicdisease/overview/index.htm. Accessed June 20, 2017.
Centers for Disease Control and Prevention (CDC). (2017b). Health Effects of Cigarette Smoking. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm. Accessed January 7, 2017.
Cowburn, G., & Stockley, L. (2005). Consumer understanding and use of nutrition labelling: a systematic review. Public health nutrition, 8(1), 21–28.
Crémieux, P.-Y., Ouellette, P., & Pilon, C. (1999). Health care spending as determinants of health outcomes. Health Economics, 8(7), 627–639.
De Boer, A., & Bast, A. (2015). International legislation on nutrition and health claims. 2015. Food Policy, 55, 61–70.
Dietz, W. H., Douglas, C. E., & Brownson, R. C. (2016). Chronic disease prevention: tobacco avoidance, physical activity, and nutrition for a healthy start. JAMA, 316(16), 1645–1646.
European Commission. (2006). Questions and Answers on Health and Nutrition Claims. https://ec.europa.eu/commission/presscorner/detail/en/MEMO_06_200. Accessed January 3, 2020.
Farrell, J., Ries, N. M., Kachan, N., & Boon, H. (2009). Food Policy, 34(4), 388–392.
Fayissa, B., & Gutema, P. (2005). Estimating a health production function for Sub-Saharan Africa (SSA). Applied Economics, 37(2), 155–164.
Filmer, D., & Pritchett, L. (1999). The impact of public spending on health: does money matter? Social Science & Medicine, 49(10), 1309–1323.
Hawkes, C. (2004). Nutrition labels and health claims: the global regulatory environment. Geneva: World Health Organization.
Health Canada. (2000). ARCHIVED – Health Canada scientific summary of the U.S. health claim regarding fruits, vegetables and cancer. https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/health-claims/assessments/scientific-summary-health-claim-regarding-fruits-vegetables-cancer.html. Accessed September 15, 2017.
Health Canada. (2009). Guidance document for preparing a submission for food health claims. Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch. https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fn-an/alt_formats/hpfb-dgpsa/pdf/legislation/health-claims_guidance-orientation_allegations-sante-eng.pdf. accessed April 17, 2017.
Health Canada. (2010). Nutrition Claims. http://www.hc-sc.gc.ca/fn-an/label-etiquet/nutrition/cons/claims-reclam/index-eng.php. Accessed April 17, 2016.
Health Canada. (2016). Health Claims. http://www.hc-sc.gc.ca/fn-an/label-etiquet/claims-reclam/index-eng.php. Accessed 17 Apr 2017
Health Canada. (2017). Health Claim Assessments. http://www.hc-sc.gc.ca/fn-an/label-etiquet/claims-reclam/assess-evalu/index-eng.php. Accessed February 12, 2019.
Herath, D., Cranfield, J., & Henson, S. (2008). Who consumes functional foods and nutraceuticals in Canada? Results of cluster analysis of the 2006 survey of Canadians’ demand for food products supporting health and wellness. Appetite, 51(2), 256–265.
Hobbs, J. E., Malla, S., Sogah, E. K., & Yeung, M. T. (2014). Regulating health foods: policy challenges and consumer conundrums. Cheltenham: Edward Elgar Publishing Limited.
Hoek, G., Krishnan, R. M., Beelen, R., Peters, A., Ostro, B., Brunekreef, B., & Kaufman, J. D. (2013) Long-term air pollution exposure and cardiorespiratory mortality: A review. Environmental health, 12 (43), 1-15.
Joumard, Isabelle, Christophe André, Chantal Nicq, & Olivier Chatal. (2008). Health status determinants: lifestyle, environment, health care resources and efficiency. OECD Economics Department Working Paper No. 627.
Mackie, Alexander, Ivan Haščič, & Miguel Cárdenas Rodríguez. (2016). Population exposure to fine particles: methodology and results for OECD and G20 countries. OECD Publishing.
Miller Jr., R. D., & Frech, H. E. (2000). Is there a link between pharmaceutical consumption and improved health in OECD countries? Pharmacoeconomics, 18, 33–45.
Milner, J. A. (1999). Functional foods and health promotion. Journal of Nutrition, 129(7), 1395S–1397S.
Moors, E. H. M. (2012). Functional foods: regulation and innovations in the EU. Innovation: The European Journal of Social Science Research, 25(4), 424–440.
Nettleton, J. A., Brouwer, I. A., Geleijnse, J. M., & Hornstra, G. (2017). Saturated fat consumption and risk of coronary heart disease and ischemic stroke: a science update. Annals of Nutrition and Metabolism, 70(1), 26–33.
Nichele, V. (2003). Health information and food demand in France. In W. S. Chern, K. Rickertsen, & Inc NetLibrary (Eds.), Health, nutrition and food demand. Wallingford: CABI Pub.
Nocella, G., & Kennedy, O. (2012). Food health claims: what consumers understand. Food Policy, 37(5), 571–580.
OECD. (2016). OECD health statistics (database).
Or, Zeynep. (2001). Exploring the effects of health care on mortality across OECD countries. OECD Labour Market and Social Policy Occasional Papers, No. 46. OECD Publishing: Paris.
Public Health Agency of Canada. (2014). Economic Burden of Illness in Canada, 2005–2008. Catalogue HP50–1/2013E-PDF, Publication No. 130148. Minister of Health.
Rehm, J., Baliunas, D., Borges, G. L. G., Graham, K., Irving, H., Kehoe, T., Parry, C. D., et al. (2010). The relation between different dimensions of alcohol consumption and burden of disease: an overview. Addiction, 105(5), 817–843.
Reisch, L. A., Sunstein, C. R., & Gwozdz, W. (2017). Viewpoint: beyond carrots and sticks: Europeans support health nudges. Food Policy, 69, 1–10.
Shaw, J. W., Horrace, W. C., & Vogel, R. J. (2005). The determinants of life expectancy: an analysis of the OECD health data. Southern Economic Journal, 71(4), 768–783.
Stahre, Mandy, Jim Roeber, Dafna Kanny, Robert D. Brewer, and Xingyou Zhang. (2014). Peer reviewed: contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Preventing Chronic Disease 11.
Statistics Canada. (2015. The 10 Leading Causes of Death. http://www.statcan.gc.ca/pub/82-625-x/2014001/article/11896-eng.htm. Accessed June 30, 2017.
Stockwell, T., Zhao, J., Panwar, S., Roemer, A., Naimi, T., & Chikritzhs, T. (2016). Do “moderate” drinkers have reduced mortality risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality. Journal of Studies on Alcohol and Drugs, 77(2), 185–198.
Thompson, A. K., & Moughan, P. J. (2008). Innovation in the foods industry: functional foods. Innovation, 10(1), 61–73.
Thornton, J. (2002). Estimating a health production function for the US: some new evidence. Applied Economics, 34(1), 59–62.
Tonsor, G. T., Mintert, J. R., & Schroeder, T. C. (2010). U.S. meat demand: household dynamics and media information impacts. Journal of Agricultural and Resource Economics, 35(1), 1–17.
U.S. Food and Drug Administration (FDA). (2013a). Guidance for Industry: A Food Labeling Guide (8. Claims). http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm064908.htm. Accessed August 2, 2016.
U.S. Food and Drug Administration (FDA). (2013b). Guidance for industry: a food labeling guide (11. Appendix C: Health Claims). http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm064919.htm. Accessed July 28, 2016.
U.S. Food and Drug Administration (FDA). (2016a). Dietary Supplements. http://www.fda.gov/Food/DietarySupplements/. Accessed October 5, 2016.
U.S. Food and Drug Administration (FDA). (2016b). Label Claims for Conventional Foods and Dietary Supplements. https://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/ucm111447.htm. Accessed July 4, 2017.
U.S. Food and Drug Administration (FDA). (2018a). Authorized Health Claims That Meet the Significant Scientific Agreement (SSA) Standard. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm2006876.htm
U.S. Food and Drug Administration (FDA). (2018b). Qualified Health Claims: Letters of Enforcement Discretion. https://www.fda.gov/Food/LabelingNutrition/ucm072756.htm. Accessed February 15, 2019.
van Trijp, H. C. M., & van der Lans, I. A. (2007). Consumer perceptions of nutrition and health claims. Appetite, 48(3), 305–324.
Veeman, M. (2002). Policy development for novel foods: issues and challenges for functional food. Canadian Journal of Agricultural Economics/Revue Canadienne d’agroeconomie, 50(4), 527–539.
Wansink, B., & Cheney, M. M. (2005). Leveraging FDA health claims. Journal of Consumer Affairs, 39(2), 386–398.
World Health Organization (WHO). (2003). Diet, nutrition, and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation (Vol. 916). Geneva: World Health Organization.
World Health Organization (WHO). (2015). Alcohol. http://www.who.int/mediacentre/factsheets/fs349/en/. Accessed February 15, 2018.
World Health Organization (WHO). (2017). NCD mortality and morbidity. http://www.who.int/gho/ncd/mortality_morbidity/en/. Accessed July 7, 2017.
World Health Organization (WHO). (2018). Diet. http://www.who.int/topics/diet/en/. Accessed 15 Feb 2019.
Conflict of interest
The authors declare that they have no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
List of Disease Risk Reduction Claims in Canada and the United States
Eicosapentaenoic Acid, Docosahexaenoic Acid, and Triglyceride Lowering (2016)
Polysaccharide Complex (Glucomannan, Xanthan Gum, Sodium Alginate) and Cholesterol Lowering (2016)
Vegetables and Fruit and Heart Disease (2016)
Soy Protein and Cholesterol Lowering (2015)
Ground Whole Flaxseed and Blood Cholesterol Lowering (2014)
Sugar-Free Chewing Gum and Dental Caries Risk Reduction (2014)
Barley Products and Blood Cholesterol Lowering (2012)
Unsaturated Fat and Blood Cholesterol Lowering (2012)
Psyllium Products and Blood Cholesterol Lowering (2011)
Oat Products and Blood Cholesterol Lowering (2010)
Plant Sterols (Phytosterols) (2010)
Calcium and Osteoporosis (2000)
Fruits, Vegetables and Cancer (2000)
Dietary Fat, Saturated Fat, Cholesterol, Trans Fatty Acids and Coronary Heart Disease (2000)
Sodium and Hypertension (2000)
Source: Health Canada (2017)
NLEA Authorized Health Claims (2018)
Calcium, Vitamin D, and Osteoporosis (2008)
Stanols/Sterols and Risk of Coronary Heart Disease (2000)
Soy Protein and Risk of Coronary Heart Disease (1999)
Soluble Fiber from Certain Foods and Risk of Coronary Heart Disease (1997)
Dietary Non-cariogenic Carbohydrate Sweeteners and Dental Caries (1996)
Folic Acid and Neural Tube Defects (1996)
Dietary Lipids (Fat) and Cancer (1993)
Dietary Saturated Fat and Cholesterol and Risk of Coronary Heart Disease (1993)
Fiber-containing Grain Products, Fruits and Vegetables and Cancer (1993)
Fruits and Vegetables and Cancer (1993)
Fruits, Vegetables and Grain Products that contain Fiber, particularly Soluble fiber, and Risk of Coronary Heart Disease (1993)
Sodium and Hypertension (1993)
Source: FDA (2018a)
FDAMA Authorized Health Claims (2013)
Whole Grain Foods and Risk of Heart Disease and Certain Cancers
Whole Grain Foods with Moderate Fat Content and Risk of Heart Disease
Potassium and the Risk of High Blood Pressure and Stroke
Fluoridated Water and Reduced Risk of Dental Caries
Saturated Fat, Cholesterol, and Trans Fat, and Reduced Risk of Heart Disease
Source: FDA (2013b)
Qualified Health Claims (2018)
100% Whey-Protein Partially Hydrolyzed Infant Formula and Reduced Risk of Atopic Dermatitis
Green Tea and Risk of Breast Cancer and Prostate Cancer
Selenium and a Reduced Risk of Site-specific Cancers
Antioxidant Vitamins C and E and Reduction in the Risk of Site-Specific Cancers
Tomatoes and Prostate, Ovarian, Gastric, and Pancreatic Cancers
Tomatoes and Prostate Cancer
Calcium and Colon/Rectal Cancer and Calcium and Colon/Rectal Polyps
Selenium and Certain Cancers
Antioxidant Vitamins and Risk of Certain Cancers
Oleic Acid and Coronary Heart Disease (Corbion Biotech Petition)
Folic Acid, Vitamin B6, and Vitamin B12 and Vascular Disease
Macadamia Nuts and Reduced Risk of Coronary Heart Disease
Walnuts and Coronary Heart Disease
Nuts and Coronary Heart Disease
Omega-3 Fatty Acids and Reduced Risk of Coronary Heart Disease
Soybean Oil and Reduced Risk of Coronary Heart Disease
Corn Oil and Corn Oil-Containing Products and a Reduced Risk of Heart Disease
Unsaturated Fatty Acids from Canola Oil and Reduced Risk of Coronary Heart Disease
Monounsaturated Fatty Acids from Olive Oil and Coronary Heart Disease
Phosphatidylserine and Cognitive Dysfunction and Dementia
High-Amylose Maize Starch and Reduced Risk Type 2 Diabetes Mellitus
Psyllium Husk and a Reduced Risk of Type 2 Diabetes
Whole Grains and a Reduced Risk of Diabetes Mellitus Type 2
Chromium Picolinate and a Reduced Risk of Insulin Resistance, Type 2 Diabetes
Eicosapentaenoic Acid and Docosahexaenoic Acid and Reduction of Blood Pressure in the General Population
Calcium and Hypertension, Pregnancy-Induced Hypertension, and Preeclampsia
Folic Acid and Neural Tube Defects
Ground Peanuts and Reduced Risk of Developing Peanut Allergy
Source: FDA (2018b)
About this article
Cite this article
Presseau, T., Malla, S. & Klein, K.K. Health claim regulations on foods: impacts on life expectancy in Canada and the United States. Can J Public Health 111, 705–715 (2020). https://doi.org/10.17269/s41997-020-00314-5
- Health claims
- Functional foods
- Population health
- Health nudges
- Allégations santé
- Aliments fonctionnels
- Santé des populations
- Encouragements santé