Abstract
Objectives
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.
Methods
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.
Results
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.
Conclusion
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.
Résumé
Objectifs
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.
Méthode
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.
Résultats
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.
Conclusion
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.
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Notes
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.
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Appendix
Appendix
List of Disease Risk Reduction Claims in Canada and the United States
Canada (2017)
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Eicosapentaenoic Acid, Docosahexaenoic Acid, and Triglyceride Lowering (2016)
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Polysaccharide Complex (Glucomannan, Xanthan Gum, Sodium Alginate) and Cholesterol Lowering (2016)
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Vegetables and Fruit and Heart Disease (2016)
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Soy Protein and Cholesterol Lowering (2015)
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Ground Whole Flaxseed and Blood Cholesterol Lowering (2014)
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Sugar-Free Chewing Gum and Dental Caries Risk Reduction (2014)
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Barley Products and Blood Cholesterol Lowering (2012)
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Unsaturated Fat and Blood Cholesterol Lowering (2012)
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Psyllium Products and Blood Cholesterol Lowering (2011)
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Oat Products and Blood Cholesterol Lowering (2010)
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Plant Sterols (Phytosterols) (2010)
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Calcium and Osteoporosis (2000)
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Fruits, Vegetables and Cancer (2000)
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Dietary Fat, Saturated Fat, Cholesterol, Trans Fatty Acids and Coronary Heart Disease (2000)
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Sodium and Hypertension (2000)
Source: Health Canada (2017)
United States
NLEA Authorized Health Claims (2018)
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Calcium, Vitamin D, and Osteoporosis (2008)
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Stanols/Sterols and Risk of Coronary Heart Disease (2000)
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Soy Protein and Risk of Coronary Heart Disease (1999)
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Soluble Fiber from Certain Foods and Risk of Coronary Heart Disease (1997)
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Dietary Non-cariogenic Carbohydrate Sweeteners and Dental Caries (1996)
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Folic Acid and Neural Tube Defects (1996)
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Dietary Lipids (Fat) and Cancer (1993)
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Dietary Saturated Fat and Cholesterol and Risk of Coronary Heart Disease (1993)
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Fiber-containing Grain Products, Fruits and Vegetables and Cancer (1993)
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Fruits and Vegetables and Cancer (1993)
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Fruits, Vegetables and Grain Products that contain Fiber, particularly Soluble fiber, and Risk of Coronary Heart Disease (1993)
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Sodium and Hypertension (1993)
Source: FDA (2018a)
FDAMA Authorized Health Claims (2013)
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Whole Grain Foods and Risk of Heart Disease and Certain Cancers
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Whole Grain Foods with Moderate Fat Content and Risk of Heart Disease
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Potassium and the Risk of High Blood Pressure and Stroke
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Fluoridated Water and Reduced Risk of Dental Caries
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Saturated Fat, Cholesterol, and Trans Fat, and Reduced Risk of Heart Disease
Source: FDA (2013b)
Qualified Health Claims (2018)
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100% Whey-Protein Partially Hydrolyzed Infant Formula and Reduced Risk of Atopic Dermatitis
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Green Tea and Risk of Breast Cancer and Prostate Cancer
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Selenium and a Reduced Risk of Site-specific Cancers
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Antioxidant Vitamins C and E and Reduction in the Risk of Site-Specific Cancers
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Tomatoes and Prostate, Ovarian, Gastric, and Pancreatic Cancers
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Tomatoes and Prostate Cancer
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Calcium and Colon/Rectal Cancer and Calcium and Colon/Rectal Polyps
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Selenium and Certain Cancers
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Antioxidant Vitamins and Risk of Certain Cancers
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Oleic Acid and Coronary Heart Disease (Corbion Biotech Petition)
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Folic Acid, Vitamin B6, and Vitamin B12 and Vascular Disease
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Macadamia Nuts and Reduced Risk of Coronary Heart Disease
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Walnuts and Coronary Heart Disease
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Nuts and Coronary Heart Disease
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Omega-3 Fatty Acids and Reduced Risk of Coronary Heart Disease
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Soybean Oil and Reduced Risk of Coronary Heart Disease
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Corn Oil and Corn Oil-Containing Products and a Reduced Risk of Heart Disease
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Unsaturated Fatty Acids from Canola Oil and Reduced Risk of Coronary Heart Disease
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Monounsaturated Fatty Acids from Olive Oil and Coronary Heart Disease
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Phosphatidylserine and Cognitive Dysfunction and Dementia
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High-Amylose Maize Starch and Reduced Risk Type 2 Diabetes Mellitus
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Psyllium Husk and a Reduced Risk of Type 2 Diabetes
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Whole Grains and a Reduced Risk of Diabetes Mellitus Type 2
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Chromium Picolinate and a Reduced Risk of Insulin Resistance, Type 2 Diabetes
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Eicosapentaenoic Acid and Docosahexaenoic Acid and Reduction of Blood Pressure in the General Population
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Calcium and Hypertension, Pregnancy-Induced Hypertension, and Preeclampsia
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Folic Acid and Neural Tube Defects
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Ground Peanuts and Reduced Risk of Developing Peanut Allergy
Source: FDA (2018b)
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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
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DOI: https://doi.org/10.17269/s41997-020-00314-5