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Health claim regulations on foods: impacts on life expectancy in Canada and the United States

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

  1. 1.

    A list of the approved disease risk reduction claims can be found in the Appendix.

  2. 2.

    A list of the approved NLEA, FDAMA, and qualified health claims are in the Appendix.

  3. 3.

    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.

  4. 4.

    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.

  5. 5.

    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.

References

  1. 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.

    Google Scholar 

  2. 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.

    Google Scholar 

  3. 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.

    Google Scholar 

  4. 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.

    PubMed  Article  Google Scholar 

  5. Anand, S., & Bärnighausen, T. (2004). Human resources and health outcomes: cross-country econometric study. The Lancet, 364(9445), 1603–1609.

    Article  Google Scholar 

  6. 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.

    Article  Google Scholar 

  7. Berger, M. C., & Messer, J. (2002). Public financing of health expenditures, insurance, and health outcomes. Applied Economics, 34(17), 2105–2113.

    Article  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    PubMed  Article  Google Scholar 

  10. 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.

  11. 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.

  12. 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.

  13. Centers for Disease Control and Prevention (CDC). (2017a). Chronic Disease Overview. http://www.cdc.gov/chronicdisease/overview/index.htm. Accessed June 20, 2017.

  14. 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.

  15. Cowburn, G., & Stockley, L. (2005). Consumer understanding and use of nutrition labelling: a systematic review. Public health nutrition, 8(1), 21–28.

    PubMed  Article  Google Scholar 

  16. Crémieux, P.-Y., Ouellette, P., & Pilon, C. (1999). Health care spending as determinants of health outcomes. Health Economics, 8(7), 627–639.

    PubMed  Article  Google Scholar 

  17. De Boer, A., & Bast, A. (2015). International legislation on nutrition and health claims. 2015. Food Policy, 55, 61–70.

    Article  Google Scholar 

  18. 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.

    PubMed  Article  Google Scholar 

  19. 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.

  20. Farrell, J., Ries, N. M., Kachan, N., & Boon, H. (2009). Food Policy, 34(4), 388–392.

    Article  Google Scholar 

  21. Fayissa, B., & Gutema, P. (2005). Estimating a health production function for Sub-Saharan Africa (SSA). Applied Economics, 37(2), 155–164.

    Article  Google Scholar 

  22. Filmer, D., & Pritchett, L. (1999). The impact of public spending on health: does money matter? Social Science & Medicine, 49(10), 1309–1323.

    CAS  Article  Google Scholar 

  23. Hawkes, C. (2004). Nutrition labels and health claims: the global regulatory environment. Geneva: World Health Organization.

    Google Scholar 

  24. 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.

  25. 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.

  26. 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.

  27. Health Canada. (2016). Health Claims. http://www.hc-sc.gc.ca/fn-an/label-etiquet/claims-reclam/index-eng.php. Accessed 17 Apr 2017

  28. 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.

  29. 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.

    PubMed  Article  Google Scholar 

  30. 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.

    Book  Google Scholar 

  31. 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.

  32. 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.

  33. Mackie, Alexander, Ivan Haščič, & Miguel Cárdenas Rodríguez. (2016). Population exposure to fine particles: methodology and results for OECD and G20 countries. OECD Publishing.

  34. 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.

    PubMed  Article  Google Scholar 

  35. Milner, J. A. (1999). Functional foods and health promotion. Journal of Nutrition, 129(7), 1395S–1397S.

    CAS  PubMed  Article  Google Scholar 

  36. 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.

    Google Scholar 

  37. 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.

    CAS  PubMed  Article  Google Scholar 

  38. 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.

    Google Scholar 

  39. Nocella, G., & Kennedy, O. (2012). Food health claims: what consumers understand. Food Policy, 37(5), 571–580.

    Article  Google Scholar 

  40. OECD. (2016). OECD health statistics (database).

  41. 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.

  42. 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.

  43. 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.

    PubMed  PubMed Central  Article  Google Scholar 

  44. Reisch, L. A., Sunstein, C. R., & Gwozdz, W. (2017). Viewpoint: beyond carrots and sticks: Europeans support health nudges. Food Policy, 69, 1–10.

    Article  Google Scholar 

  45. 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.

    Article  Google Scholar 

  46. 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.

  47. 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.

  48. 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.

    PubMed  PubMed Central  Article  Google Scholar 

  49. Thompson, A. K., & Moughan, P. J. (2008). Innovation in the foods industry: functional foods. Innovation, 10(1), 61–73.

    Article  Google Scholar 

  50. Thornton, J. (2002). Estimating a health production function for the US: some new evidence. Applied Economics, 34(1), 59–62.

    Article  Google Scholar 

  51. 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.

    Google Scholar 

  52. 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.

  53. 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.

  54. U.S. Food and Drug Administration (FDA). (2016a). Dietary Supplements. http://www.fda.gov/Food/DietarySupplements/. Accessed October 5, 2016.

  55. 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.

  56. 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

  57. 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.

  58. van Trijp, H. C. M., & van der Lans, I. A. (2007). Consumer perceptions of nutrition and health claims. Appetite, 48(3), 305–324.

    PubMed  Article  Google Scholar 

  59. 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.

    Article  Google Scholar 

  60. Wansink, B., & Cheney, M. M. (2005). Leveraging FDA health claims. Journal of Consumer Affairs, 39(2), 386–398.

    Article  Google Scholar 

  61. 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.

    Google Scholar 

  62. World Health Organization (WHO). (2015). Alcohol. http://www.who.int/mediacentre/factsheets/fs349/en/. Accessed February 15, 2018.

  63. World Health Organization (WHO). (2017). NCD mortality and morbidity. http://www.who.int/gho/ncd/mortality_morbidity/en/. Accessed July 7, 2017.

  64. World Health Organization (WHO). (2018). Diet. http://www.who.int/topics/diet/en/. Accessed 15 Feb 2019.

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Correspondence to Stavroula Malla.

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Appendix

Appendix

List of Disease Risk Reduction Claims in Canada and the United States

Canada (2017)

  • Polysaccharide Complex (Glucomannan, Xanthan Gum, Sodium Alginate) and a Reduction of the Post-Prandial Blood Glucose Response (2016)

  • 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)

United States

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)

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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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Keywords

  • Health claims
  • Functional foods
  • Population health
  • Health nudges

Mots-clés

  • Allégations santé
  • Aliments fonctionnels
  • Santé des populations
  • Encouragements santé