Food Label Information Program Research Articles

Assessment of Packaged Foods and Beverages Carrying Nutrition Marketing against Canada's Food Guide Recommendations.

Canadians’ food purchases consist largely of packaged processed and ultra-processed products, which typically fall outside the “core” foods recommended by Canada’s Food Guide (CFG). Almost half of packaged products in Canada carry nutrition marketing (i.e., nutrient content and health claims). This study assessed whether packaged foods carrying nutrition marketing align with recommendations outlined in the 2007 CFG. Label data (n = 9376) were extracted from the 2013 Food Label Information Program (FLIP). Label components (including nutrition marketing) were classified using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) labelling taxonomy. The Health Canada Surveillance Tool (HCST) was used to assess the alignment of products to CFG. Each food or beverage was classified into one of five groups (i.e., Tier 1, Tier 2, Tier 3, Tier 4, “Others”). Products in Tier 1, 2 or water were considered “in line with CFG”. Most products in the analyzed sample were classified as Tier 2 (35%) and Tier 3 (27%). Although foods with nutrition marketing were significantly more likely to align to CFG recommendations (p < 0.001), many products not “in line with CFG” still carried nutrition marketing. This study provides important baseline data that could be used upon the implementation of the new CFG.

Assessment of the Canadian Children’s Food and Beverage Advertising Initiative’s Uniform Nutrition Criteria for Restricting Children’s Food and Beverage Marketing in Canada

Imposing governmental restrictions on the marketing of unhealthy foods and beverages to children is a demanded policy action since in Canada, this remains self-regulated by the voluntary, industry-led Canadian Children’s Food and Beverage Advertising Initiative (CAI) whose participants pledge to only advertise products that satisfy its Uniform Nutrition Criteria to children. This study evaluated the stringency of this nutrient profiling (NP) model for restricting child-directed food and beverage marketing in Canada. Data was obtained from the University of Toronto Food Label Information Program (FLIP) 2013 database, providing nutritional information for 15,342 packaged products which were evaluated using the CAI Uniform Nutrition Criteria. Products with child-directed packaging and those from CAI participating companies were identified. Of the n = 15,231 products analyzed, 25.3% would be allowed and 57.2% would be restricted from being marketed to children according to the CAI Criteria. Additionally, 17.5% of products lacked criteria by which to evaluate them. Child-directed products represented 4.9% of all products; however, 74.4% of these would be restricted from being marketed to children under CAI standards. Products from CAI participating companies represented 14.0% of all products and 33.3% of child-directed products; 69.5% of which would be restricted from being marketed to children. These results indicate that if the CAI was mandatory and covered a broader range of advertising platforms, their Uniform Nutrition Criteria would be relatively stringent and could effectively restrict children’s marketing in Canada.

A free sugars daily value (DV) identifies more “less healthy” prepackaged foods and beverages than a total sugars DV

Regulatory changes in Canada will require food labels to have a benchmark [% Daily Value, %DV] for total sugars, based on 100 g/day, while US labels will require a %DV for added sugars, based on 50 g/day. The objective of this study was to compare two labelling policies, a total sugars DV (100 g/day) and a free sugars DV (50 g/day) on food labels. This cross-sectional analysis of the Food Label Information Program database focussed on top sources of total sugars intake in Canada (n = 6924 foods). Products were categorized as “less healthy” using two sets of criteria: a) free sugars levels exceeding the WHO guidelines (≥10% energy from free sugars); and b) exceeding healthfulness cut-offs of the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (FSANZ-NPSC). The proportion of “less healthy” products with ≥15%DV (defined as “a lot” of sugars i.e. high in sugars, based on Health Canada's %DV labelling footnote and educational message for dietary guidance) were compared for each sugar labelling scenario. The free sugars DV showed better alignment with both methods for assessing “healthfulness” than the total sugars DV. The free sugars DV identified a greater proportion of “less healthy” foods with ≥15%DV, based on both the FSANZ-NPSC (70% vs. 45%, p < .0001) and WHO guidelines (82% vs. 55%, p < .0001); particularly in sweet baked goods, sugars and preserves, chocolate bars, confectionery, and frozen desserts categories. Compared to total sugars DV labelling, using a free sugars DV identified more “less healthy” foods. Findings support the adoption of free sugars labelling.

Assessing nutrition and other claims on food labels: a repeated cross-sectional analysis of the Canadian food supply

BackgroundIn 2010, nutrition claims were investigated in Canadian foods; however, many nutrition and other claims have been introduced since then. This study aimed to determine: i) the proportion of foods carrying claims in 2013, ii) the types and prevalence of nutrition claims (nutrient content claims, health claims, general health claims) and other claims displayed on labels in 2013, iii) and trends in use of nutrition claims between 2010 and 2013.MethodsRepeated cross-sectional analysis of the University of Toronto Food Label Information Program (FLIP) of Canadian foods (2010/11 n = 10,487; 2013 n = 15,342). Regulated nutrition claims (nutrient content, health claims) were classified according to Canadian regulations. A decision tree was used to classify non-regulated general health claims (e.g., front-of-pack claims). Other claims (e.g., gluten-free) were also collected. Proportions of claims in 2013 were determined and χ2 was used to test significant differences for different types of claims between 2010 and 2013.ResultsOverall, 49% of products in 2013 displayed any type of claim and 46% of foods in FLIP 2013 carried a nutrition claim (nutrient content claim, health claim, general health claim). Meal replacements and fruits/fruits juices were the categories with the largest proportion of foods with claims. At least one approved nutrient content claim was carried on 42.9% of products compared to 45.5% in 2010 (p < 0.001). Health claims, specifically disease risk reduction claims, were slightly lower in 2013 (1.5%) compared to 1.7% in 2010 (p = 0.225). General health claims, specifically front-of-pack claims, were carried on 20% of foods compared to 18.9% in 2010 (p = 0.020). Other claims, specifically gluten-free, were present on 7.3% of foods.ConclusionsNutrition and other claims were used on half of Canadian prepackaged foods in 2013. Many claims guidelines and regulations have been released since 2010; however, little impact has been seen in the prevalence of such claims in the food supply. Claims related to nutrients of public health priority, such as sugars and sodium, were not commonly used on food labels. Monitoring trends in the use of nutrition and other claims is essential to determine if their use on food labels reflects public health objectives, or instead are being used as marketing tools.

Unregulated serving sizes on the Canadian nutrition facts table \u2013 an invitation for manufacturer manipulations

BackgroundServing sizes on the Nutrition Facts table (NFt) on Canadian packaged foods have traditionally been unregulated and non-standardized. The federal government recently passed legislation to regulate the serving sizes listed on the NFt. The objective of this study was to compare the serving sizes on food product NFts to the recommendations in the 2003 Nutrition Labelling regulation (Schedule M) reference amounts, the Canadian Food Inspection Agency (CFIA) ranges, and Canada’s Food Guide recommendations. An additional objective was to determine if food and beverage products that report smaller serving sizes have a higher calorie density, compared to similar products with a larger serving size.MethodsData for 10,487 products were retrieved from the 2010 Food Label Information Program (FLIP) database and categorized according to Schedule M categories. Correlations between calorie density and manufacturer stated serving size were tested and the proportion of products meeting recommendations were tabulated.Results35% of products had serving sizes on the NFt that were smaller than the Schedule M reference amount and 23% exceeded the reference amount. 86% of products fell within the CFIA’s recommended serving size ranges; however, 70% were within the lower-half of the range. Several bread and juice categories exceeded CFG’s recommendations, while several dairy product categories were smaller than the recommendations. Of the 50 Schedule M sub-categories analyzed, 31 (62%) exhibited a negative correlation between serving size and calorie density.ConclusionWhile most products fell within the CFIA’s recommended serving size ranges, there was a tendency for products with a higher calorie density to list smaller serving sizes.

Mismatch between Probiotic Benefits in Trials versus Food Products.

Probiotic food products contain a variety of different bacterial strains and may offer different health effects. The objective was to document the prevalence and dosage of probiotic strains in the Canadian food supply and to review the literature investigating these strains in order to understand what health benefits these products may offer. The Food Label Information Program was used to identify probiotic-containing products in the food supply. PubMed, Web of Science, and Embase were searched for randomized controlled trials that tested the health effects of these strains in humans. There were six probiotic strains/strain combinations identified in the food supply. Thirty-one studies investigated these strains and found that they are associated with decreased diarrhea and constipation, improved digestive symptoms, glycemic control, antioxidant status, blood lipids, oral health, and infant breastfeeding outcomes, as well as enhanced immunity and support for Helicobacter pylori eradication. There were a limited number of studies investigating these strains. Many studies were funded by the food industry and tested dosages that were up to twenty-five times the dosage found in most food products. Probiotic food products could have health benefits not currently reported on their labels. However, many dosages are too low to provide the benefits demonstrated in clinical trials. Further research is needed to enable more effective use of these functional foods.

Total and Free Sugar Content of Canadian Prepackaged Foods and Beverages.

A number of recommendations for policy and program interventions to limit excess free sugar consumption have emerged, however there are a lack of data describing the amounts and types of sugar in foods. This study presents an assessment of sugar in Canadian prepackaged foods including: (a) the first systematic calculation of free sugar contents; (b) a comprehensive assessment of total sugar and free sugar levels; and (c) sweetener and free sugar ingredient use, using the University of Toronto’s Food Label Information Program (FLIP) database 2013 (n = 15,342). Food groups with the highest proportion of foods containing free sugar ingredients also had the highest median total sugar and free sugar contents (per 100 g/mL): desserts (94%, 15 g, and 12 g), sugars and sweets (91%, 50 g, and 50 g), and bakery products (83%, 16 g, and 14 g, proportion with free sugar ingredients, median total sugar and free sugar content in Canadian foods, respectively). Free sugar accounted for 64% of total sugar content. Eight of 17 food groups had ≥75% of the total sugar derived from free sugar. Free sugar contributed 20% of calories overall in prepackaged foods and beverages, with the highest at 70% in beverages. These data can be used to inform interventions aimed at limiting free sugar consumption.

Are foods with fat-related claims useful for weight management?

Many consumers believe that foods labelled with fat claims (e.g. low fat) are lower in calories than comparable regular foods and are therefore helpful for weight management. However, it is unknown whether such foods are actually lower in calories. Our aims were to determine 1) the relative proportion of foods carrying fat claims among various food categories within the Canadian marketplace; and 2) whether foods with fat claims are actually lower in calories than comparable foods without claims. The Food Label Information Program 2010, a database of Canadian foods developed at the University of Toronto, was used to compare the calorie content of products with and without fat claims within a given food subcategory, as defined by Schedule M of the Food and Drug Regulations. Median differences of 25% or greater were deemed nutritionally significant, as that is the minimum difference required for comparative claims such as “reduced” and “lower” in the Food and Drug Regulations. Fat claims were present on up to 68% of products in a given food subcategory. Products with fat claims were not significantly lower in both fat and calories compared to comparable products without fat claims in more than half of the subcategories (24 out of 40) analyzed. Conversely, in 16 subcategories, foods with fat claims were at least 25% lower in calories; however, for many of these foods, the absolute difference in calories was small, i.e., for 9 of the 16 subcategories, the absolute difference between foods with and without fat claims was <50 calories, even though the relative percent difference was high. This research suggests that foods with fat claims may be misleading consumers and undermining their efforts to manage body weight or prevent obesity.

An updated analysis of trans fatty acids in Canadian packaged foods

The Canadian food industry has voluntarily reduced the trans fatty acid (TFA) content of foods, however there are no updated analyses of TFA levels in Canadian foods. This study assessed TFA levels in Canadian packaged foods in 2013, compared to historical data. Data from Health Canada's Trans Fat Monitoring Program (TFMP, n=541 in 2006‐09) and the University of Toronto Food Label Information Program (n=1999 in 2010; n=2542 in 2013) were used. In 2013, 97% of foods met the TFA limits, increased from 95% in 2010 and 78% during the TFMP. The proportion of products meeting the TFA limits was below the overall average for lard (0%), coffee whiteners (67%), brownies (88%), snack puddings (92%) and garlic bread (94%). Among food categories with &gt;10% of products exceeding TFA limits in 2010, there were few significant increases in the proportion of foods meeting TFA limits in 2013 compared to 2010, including dairy free cheeses (0% to 83% meeting, p=0.002) and cakes with pudding/mousse (77% to 97%, p=0.046). When assessing TFA as a percent total fat, Mexican kits was the only category with a significant increase in mean TFA as a percent total fat (7.6±1.8% to 20.3±5.9%). Categories exceeding 20% TFA as a percentage of total fat were coffee whiteners (55.6±16.7%), frosting (23.1±9.7%), lard and shortening (22.0±17.8%), margarine (20.5±14.4%) and popcorn (37.5%). There has been an overall improvement in the proportion of packaged food products that meet the recommended TFA limits and the majority of food categories did not have increased levels of TFA. However, several categories continue to have an unacceptably high proportion of foods exceeding TFA limits, suggesting that action by the food industry and/or government is still required to ensure maximal health benefits for Canada.

Trans Fatty acids in the Canadian food supply: an updated analysis

Dietary trans fatty acids (TFAs) increase the risk of heart disease. In 2007, Canada set voluntary TFA limits for industrial TFAs added to food and encouraged substitution of TFAs with unsaturated fats during reformulation. No longitudinal follow-up assessment of TFA amounts in foods has occurred in Canada since termination of a government-led Trans Fat Monitoring Program (TFMP). The objective was to conduct an updated assessment and longitudinally evaluate TFA amounts in the food supply and to determine whether saturated fats have replaced TFAs in reformulation. This was a cross-sectional study that used 3 databases: TFMP (Health Canada, 2005-2009; n = 921), the University of Toronto Food Label Information Program (2010-2011; n = 5544), and the Restaurant Database (2010; n = 4272). Outcomes were TFAs as a percentage of fat, proportion of foods meeting TFA limits, and saturated fat amounts in foods with high or low TFAs. The proportion of foods meeting TFA limits improved from 75% in 2005-2009 to 97% in 2010-2011, particularly in the following packaged foods: croissants (25% to 100%), pies (36% to 98%), cakes (43% to 90%), and garlic spreads (33% to 100%). Most restaurant categories assessed by the TFMP had 100% of foods meeting TFA limits. Some categories had a large proportion that exceeded TFA limits: dairy-free cheeses (100%), frosting (72.0%), lard and shortening (66.7%), coffee whiteners (66.7%), and restaurant-prepared biscuits and scones (47.4%). Saturated fat amounts were significantly higher (P < 0.05) among some foods with the lowest TFAs, such as cookies, brownies and squares, cakes with pudding/mousse, dessert toppings, and lard and shortening. There has been an impressive improvement in TFA amounts in the Canadian food supply since the termination of the TFMP. However, action by the food industry is required to reduce TFAs in foods that exceed the recommended TFA limits and to minimize the use of saturated fats in replacing TFAs during reformulation.

Front-of-pack symbols are not a reliable indicator of products with healthier nutrient profiles

Background: Front-of-pack (FOP) nutrition rating systems and symbols are a form of nutrition marketing used on food labels worldwide. In the absence of standardized criteria for their use, it is unclear if FOP symbols are being used to promote products more nutritious than products without symbols. Objectives: To compare the amount of calories, saturated fat, sodium, and sugar in products with FOP symbols, and different FOP symbol types, to products without symbols. Methods: The median calorie, saturated fat, sodium, and sugar content per reference amount of products with FOP symbols were compared to products without FOP symbols using data from the Food Label Information Program, a database of 10,487 Canadian packaged food labels. Ten food categories and 60 subcategories were analyzed. Nutrient content differences were compared using Wilcoxon rank-sum test; differences greater than 25% were deemed nutritionally relevant. Results: Products with FOP symbols were not uniformly lower in calories, saturated fat, sodium, and sugar per reference amount than products without these symbols in any food category and the majority of subcategories (59/60). None of the different FOP types examined were used to market products with overall better nutritional profiles than products without this type of marketing. Conclusion: FOP symbols are being used to market foods that are no more nutritious than foods without this type of marketing. Because FOP symbols may influence consumer perceptions of products and their purchases, it may be a useful public health strategy to set minimum nutritional standards for products using FOP symbol marketing.

Nutrition marketing on processed food packages in Canada: 2010 Food Label Information Program

The current study describes the frequency of use of different forms of nutrition marketing in Canada and the nutrients and conditions that are the focus of nutrition marketing messages. Prepackaged foods with a Nutrition Facts table (N = 10,487) were collected between March 2010 and April 2011 from outlets of the 3 largest grocery chains in Canada and 1 major western Canadian grocery retailer. The nutrition marketing information collected included nutrient content claims, disease risk reduction claims, and front-of-pack nutrition rating systems (FOPS). We found that nutrition marketing was present on 48.1% of Canadian food packages, with nutrient content claims being the most common information (45.5%), followed by FOPS on 18.9% of packages. Disease risk reduction claims were made least frequently (1.7%). The marketing messages used most often related to total fat and trans fat (15.6% and 15.5% of nutrient content claims, respectively). Limiting total and trans fats is a current public health priority, as recommended by Health Canada and the World Health Organization. However, other nutrients that are also recommended to be limited, including saturated fats, sodium, and added sugars, were not nearly as prominent on food labels. Thus, greater emphasis should be placed by the food industry on these other important nutrients. Repeated data collection in the coming years will allow us to track longitudinal changes in nutrition marketing messages over time as food marketing, public health, and consumer priorities evolve.