Mandatory Labeling Research Articles

Evaluation of a voluntary nutritional information program versus calorie labelling on menus in Canadian restaurants: a quasi-experimental study design

BackgroundA significant proportion of the Canadian diet comes from foods purchased in restaurant settings. In an effort to promote healthy eating, the province of British Columbia (BC) implemented the Informed Dining Program (IDP), a voluntary, industry supported information program in 2012, while the province of Ontario implemented mandatory calorie labelling on menus in 2017. The study examined differences in awareness and the self-reported influence of nutrition information on food choices in restaurants with voluntary nutrition information, calorie labelling on menus, and no nutrition information program.MethodsExit surveys were conducted outside of nine chain restaurants in Toronto, Ontario and Vancouver, British Columbia (Canada) in 2012, 2015, and 2017 with varying nutrition information programs implemented. Logistic regression analyses compared self-reported noticing and influence of nutrition information in restaurants with: 1) the IDP which provided nutrition information upon request, 2) calorie labelling on menus, and 3) control restaurants with no specific nutrition information program in place, adjusted for year, city and socio-demographic characteristics. Awareness and knowledge of the IDP were also examined.ResultsThere were no significant differences in noticing and self-reported influence of nutrition information on food choices between restaurants with the IDP and restaurants with no program. Participants were more likely to notice nutrition information in restaurants when calorie information was provided on menus (57%) compared to in restaurants with the IDP (22%, AOR = 6.20, 95%CI 3.51–10.94, p < 0.001) or restaurants with no nutrition information program (20%, AOR = 7.44, 95%CI 4.21–13.13, p < 0.001). Participants in restaurants with menu labelling were also more likely to report that nutrition information influenced their food purchase (38%) compared to restaurants with the IDP (12%, AOR = 4.43, 95%CI 2.36–8.30, p < 0.001) and restaurants with no nutrition information program (12%, AOR = 5.29, 95%CI 2.81–9.95, p < 0.001). Fewer than 1 in 5 participants who visited an IDP restaurant had heard of the IDP across all data collection years in both cities.ConclusionsThere was no evidence that voluntary programs which provide nutrition information upon request were effective. Providing calorie information on menus increased the likelihood that consumers noticed and that their food choices were influenced by nutrition information in restaurant settings.

Use of research evidence in state health policymaking: Menu labeling policy in California.

Addressing the translational gap between research evidence and state health policy requires an understanding of the current use of research evidence in the state policymaking process. In this study, we explore the use of research evidence to inform the legislative debate about restaurant nutrition labeling policy in California. In 2008, California was the first state to enact a mandatory menu calorie labeling policy in the U.S. Using a qualitative approach, we examine data sources and types of evidence used in legislative documents (n = 87) related to six menu labeling bills introduced in California’s state legislature between 2003 and 2008. Federal- and state-level government agency reports were the most frequently cited sources of technical knowledge. Advocacy coalition members who were active participants involved in the policy debate were also cited as experts. Five of the six bills included evidence in related legislative documents. While documents included considerable evidence on the magnitude and severity of the obesity problem to justify policy enactment, there were a limited number of statements referring to policy effectiveness and only one statement identified attesting to implementation context and acceptability. Reference to evidence on related policy suggests policy precedence may also play an important role in policy decision making. There is a need to improve the dissemination of obesity policy effectiveness and implementation studies in a politically time sensitive manner to influence state health policy debates. Strategies are discussed to effectively integrate the use of research evidence in the state health policymaking process.

Differences in energy and nutritional content of menu items served by popular UK chain restaurants with versus without voluntary menu labelling: A cross-sectional study.

BackgroundPoor diet is a leading driver of obesity and morbidity. One possible contributor is increased consumption of foods from out of home establishments, which tend to be high in energy density and portion size. A number of out of home establishments voluntarily provide consumers with nutritional information through menu labelling. The aim of this study was to determine whether there are differences in the energy and nutritional content of menu items served by popular UK restaurants with versus without voluntary menu labelling.Methods and findingsWe identified the 100 most popular UK restaurant chains by sales and searched their websites for energy and nutritional information on items served in March-April 2018. We established whether or not restaurants provided voluntary menu labelling by telephoning head offices, visiting outlets and sourcing up-to-date copies of menus. We used linear regression to compare the energy content of menu items served by restaurants with versus without menu labelling, adjusting for clustering at the restaurant level. Of 100 restaurants, 42 provided some form of energy and nutritional information online. Of these, 13 (31%) voluntarily provided menu labelling. A total of 10,782 menu items were identified, of which total energy and nutritional information was available for 9605 (89%). Items from restaurants with menu labelling had 45% less fat (beta coefficient 0.55; 95% CI 0.32 to 0.96) and 60% less salt (beta coefficient 0.40; 95% CI 0.18 to 0.92). The data were cross-sectional, so the direction of causation could not be determined.ConclusionMenu labelling is associated with serving items with less fat and salt in popular UK chain restaurants. Mandatory menu labelling may encourage reformulation of items served by restaurants. This could lead to public health benefits.

The framing effect of the media in the regulation of GMOs: a case study of Russia

ABSTRACTDespite the rapid adoption of Genetically Modified Organisms (GMOs) in agriculture, countries like Russia, have developed restrictive procedures for their approval (i.e. mandatory labeling). The country, which recently banned GMOs, had a relatively approving regulation up until 2010. In order to provide context to the 2016 GMOs ban, this paper examines whether there was a media-framing effect, before and after the 2010 regulation shift. The findings suggest that before 2010, the tone was more positive, and it became more negative during the years leading to the 2016 ban. Additionally, the frames describing GMOs also changed from emphasizing Science and Business to focusing on Concerns. Since only the changes in Frames were significant, our work suggests that media-related factors, and other economic and political factors may have influenced the major policy shift in 2016 – from being more accessible in 2010 to becoming more restrictive in 2016. Our findings add to the literature of the inter-relationship of the mass media coverage and the regulation around GMOs.

Consumers’ Perceptions of Five Front-of-Package Nutrition Labels: An Experimental Study Across 12 Countries

Consumers’ perceptions of five front-of-pack nutrition label formats (health star rating (HSR), multiple traffic lights (MTL), Nutri-Score, reference intakes (RI) and warning label) were assessed across 12 countries (Argentina, Australia, Bulgaria, Canada, Denmark, France, Germany, Mexico, Singapore, Spain, the UK and the USA). Perceptions assessed included liking, trust, comprehensibility, salience and desire for the label to be mandatory. A sample of 12,015 respondents completed an online survey in which they rated one of the five (randomly allocated) front-of-pack labels (FoPLs) along the perception dimensions described above. Respondents viewing the MTL provided the most favourable ratings. Perceptions of the other FoPLs were mixed or neutral. No meaningful or consistent patterns were observed in the interactions between country and FoPL type, indicating that culture was not a strong predictor of general perceptions. The overall ranking of the FoPLs differed somewhat from previous research assessing their objective performance in terms of enhancing understanding of product healthiness, in which the Nutri-Score was the clear front-runner. Respondents showed a strong preference for mandatory labelling, regardless of label condition, which is consistent with past research showing that the application of labels across all products leads to healthier choices.

Are side effects of cannabidiol (CBD) products caused by tetrahydrocannabinol (THC) contamination?

Cannabidiol (CBD)-containing products are widely marketed as over the counter products, mostly as food supplements, to avoid the strict rules of medicinal products. Side-effects reported in anecdotal consumer reports or during clinical studies were first assumed to be due to hydrolytic conversion of CBD to psychoactive Δ9-tetrahydrocannainol (THC). However, research of pure CBD solutions stored in simulated gastric juice or subjected to various storage conditions such as heat and light with specific liquid chromatographic/tandem mass spectrometric (LC/MS/MS) and ultra-high pressure liquid chromatographic/quadrupole time-of-flight mass spectrometric (UPLC-QTOF) analyses was unable to confirm THC formation. Another hypothesis for the side-effects of CBD products may be residual THC concentrations in the products as contamination, because most of them are based on crude hemp extracts containing the full spectrum of cannabinoids besides CBD. Analyses of 28 food products of the German market containing hemp extract as an ingredient (mostly CBD oils) confirmed this hypothesis: 10 products (36%) contained THC above the lowest observed adverse effects level (2.5 mg/day). Inversely, CBD was present in the products below the no observed adverse effect level. Hence, it may be assumed that the adverse effects of some commercial CBD products are based on a low-dose effect of THC and not due to effects of CBD itself. The safety, efficacy and purity of commercial CBD products is highly questionable, and all of the products in our sample collection showed various non-conformities to European food law such as unsafe THC levels, full-spectrum hemp extracts as non-approved novel food ingredients, non-approved health claims, and deficits in mandatory food labelling requirements. In view of the growing market for such lifestyle products, the effectiveness of the instrument of food business operators' own responsibility for product safety must obviously be challenged.

New concerns on caffeine consumption and the impact of potential regulations: The case of energy drinks

The increasing consumption of energy drinks and caffeine added products, coupled with somewhat inconsistent labeling practices, has generated health concerns from possible excessive caffeine intake. In this paper, we simulate the impacts of potential caffeine content regulatory policies on demand for energy drinks as well as caffeine and sugar consumption. We model demand for energy drinks as a function of price and product characteristics that includes both caffeine levels and the presence of labeled caffeine content. Using our demand estimation results, we simulate the impact of potential policies including mandatory caffeine content labeling, advertising restriction and caffeine content regulations. Results indicate that mandatory labeling and advertising restrictions would reduce the overall sales in the energy drinks sector, but with a limited impact. The effect of caffeine content regulation would vary depending on whether the policy is implemented on a per-ounce basis or a per-can basis. Furthermore, these policies have different impacts on sugar and caffeine consumption, and therefore policymakers should be cautious when implementing caffeine regulations.

Knowledge, attitudes and perceptions towards genetically modified foods in Zimbabwe

Controversy regarding use of genetically modified (GM) foods still persists in both developing and developed worlds. Proponents of genetically engineered foods argue this is a sustainable solution to resource-limited settings where food insecurity continues to increase. However, in this pertinent debate, there is deficiency of knowledge on the opinion of the general public from resource-limited African communities. The aim of this paper is to describe the general public’s level of knowledge and perceptions towards use of GM foods in Zimbabwe. A descriptive cross sectional survey was conducted among 301 participants attending a country-wide Traditional and Organic Foods Festival in Harare. A self-administered questionnaire was used to collect data. Poor level of knowledge on GM foods was demonstrated among most respondents (60%) and associated with level of education (p<0.05). More than a third of respondents (36%) believed that GM chicken was being sold on Zimbabwean local markets. Lack of understanding on the genetic engineering process in food production was common among respondents. Attitude towards GM foods was negative and intention to consume GM foods was low (38%). Genetic engineering on food production was viewed as driven by a few companies for profit maximization (72%) with consequences for GM foods complex and too risky for humans (70%). Consumers believed a total of 44 GM foods were available on the Zimbabwean market with chicken, maize and fruits being common foods reported as GM foods. More than half (54%) of respondents reported to have consumed GM foods in the past even though GM foods are not permitted in the country. People with increased knowledge on genetic engineering and GM foods were more receptive of GM foods in their diets. Although intention to consume GM foods was high among individuals with increased knowledge and positive perceptions towards GMOs, knowledge and understanding on GM foods among study participants was limited. Positive perceptions, increased knowledge on genetic engineering and GM foods makes people more receptive of GM foods in their diets. There is need to improve consumer awareness on genetic engineering in food production to empower consumers to make informed choices regarding GM food. Consumers in resource-limited settings are sceptical of genetic modification in food and should be consulted during policy formulations on GM foods. Mandatory labelling of GM foods could also improve confidence among consumers on the foods they consume. Keywords: Genetically-modified Foods, Knowledge, Attitudes, Beliefs, Publicperceptions, Acceptance, Resource-limited Communities, Zimbabwe Afr. J. Food Agric. Nutr. Dev . 2019; 19(3): 14752-14768

Quality of life of consumers following a gluten-free diet. Results of a questionnaire survey in Hungary and Romania

Introduction and aim: With the rising consumer's health awareness, especially towards patients with celiac disease, gluten has become a food ingredient to be avoided by many people expecting various positive health effects. The strict adherence of diet requires serious abandonments and lifestyle changes that affect directly their quality of life. The aim of the present study was to recognise the quality of life of Hungarian and Romanian consumers following a gluten-free diet as well as to explore the negative effects on them. Method: An online questionnaire survey was conducted upon 1155 Hungarian and Romanian respondents. Results: For gluten-free consumers, self-control was relatively easy to overcome, but their lifestyle was negatively affected by social events and dining out. In addition, diet adherence was a burden from both lifestyle and financial point of view. For Hungarian consumers, external factors such as price, choice, taste and availability of products had become a major obstacle, while Romanian ones were more likely to be affected by internal factors (product information, diet knowledge, lifestyle, self-control). Mandatory labelling of substances and products causing allergies and intolerances has achieved its purpose, as it has made it easier for consumers on diet to choose food and increased their confidence. Conclusions: The study points out that dieters' quality of life can be enhanced not only by general actions (improving the preparedness of out-of-home meal services and rationalising the price of products), but also through country-specific community intervention. Orv Hetil. 2019; 160(25): 980-986.

How will mandatory nutrition and ingredient labelling affect the wine industry? A quantitative study of producers’ perspectives

PurposeThe purpose of this study is to examine producers' perspectives on the mandatory labelling of nutrition and ingredient information for wine, as suggested by the European Commission. Producers’ expectations about consumer reactions to new label information, the consequences of mandatory labelling on production processes and relative competitive advantages for different producer sizes are assessed. MethodologyData for this survey was collected from producers using the quantitative research method of an online survey. In total, 483 German wine producers, covering a substantial share of the country's wine acreage, took part in the survey, comprising 434 estate wineries, 29 cooperatives and 20 large bottling wineries. FindingsThe study concludes that mandatory nutrition labelling will have several effects on the wine industry. Producers' expectations of consumer reactions largely agree with the findings of recent qualitative studies focusing on wine consumers. While nutritional information is unlikely to have an effect on consumer demand, the listing of ingredients is likely to create consumer confusion and uncertainty, weakening wine's image as a natural product. This creates the opportunity for some wineries to focus on clean labelling strategies by completely avoiding additives that require labelling. From a production point of view, mandatory nutrition labelling is likely to increase costs due to changes in oenological practices, the increased need for laboratory analyses and more challenging labelling processes. Large wineries are better informed, and likely to be better equipped, to react to labelling changes. Practical implicationsThe degree to which negative effects will be realised will not only depend on legal decisions about the classification of additives versus processing aids, but also on producers' willingness and ability to adapt to the changes mandatory nutrition labelling will impose on the industry. Producers should react proactively and anticipate consumers’ requests for fair and transparent ingredient labelling.

Can a mass media campaign raise awareness of alcohol as a risk factor for cancer and public support for alcohol related policies?

Alcohol consumption increases the risk of several cancers, but public awareness of alcohol as a risk factor for cancer is low. Research indicates that public opinion about alcohol related policies can be influenced by mass media campaigns and awareness of alcohol as a carcinogen. The objective of this study was to test whether a mass media campaign intended to raise awareness of the relation between alcohol and cancer is associated with higher public awareness of alcohol as a risk factor for cancer, and higher levels of support for alcohol related policies. Cross-sectional surveys of a nationally representative sample of N = 6000 Danish adults were conducted pre- (n = 3000) and post campaign (n = 3000) in 2017–2018.Awareness of alcohol as a cancer risk factor significantly increased between the pre and post campaign survey (approximately 5 percentage points). The proportion of respondents who supported minimum unit pricing, a ban on alcohol advertising, and mandatory nutrition labelling was significantly higher post campaign than pre campaign, while support for limited number of retail outlets and limited sale hours were unchanged. For males, but not females, higher support for an 18 year age limit for purchasing alcohol, age limits for buying alcohol at secondary education school parties, and increased enforcement of age limits was found after the campaign than prior to it. Conclusively, the results show that a mass media campaign was associated with an increase in awareness of alcohol as a risk factor for cancer as well as alcohol policy support at a population level.

Nano-enabled products in South Africa and the assessment of environmental exposure potential for engineered nanomaterials

In order to address risks associated with nanotechnology, there needs to be improved understanding of potential sources of engineered nanomaterials (ENMs) into the environment. Nano-enabled products (NEPs) are amongst such sources, and the current study identified NEPs sold in South Africa as a means of examining their potential to emit ENMs into the environment. Two hundred and sixty-four products were identified, mainly from the health and fitness category (66.7%), followed by electronics and computers (15.2%), home and garden (10.6%), appliances (3.8%), automotive (2.7%) and food and beverage category (1.1%). The chemical identity of ENMs was reported in 62.8% of those products with the top five most common being ENMs (in the descending order) Ti, C, Ag, Si and bisoctrizole. Determining the NEPs environmental exposure potential indicated that 63.6% exhibited high exposure potential comprising predominantly health and fitness, personal care, cosmetics and clothing products. The priority NEPs in terms of environmental exposure were sunscreens, hair relaxers, moisturising lotions, eye creams, cosmetic sera and socks. Assessed through analytical examination, NEPs were found to contain ENMs with length and width ranges of 15–350 and 8–185 nm, respectively. Our study suggests that most NEPs sold in South Africa pose a high potential for nanopollution, with water resources as the highest risk. Mandatory labelling of NEPs is recommended in order to better estimate the extent of nanopollution arising from usage of the NEPs.

Nutritional Regulation and International Trade in APEC Economies: The New Chilean Food Labeling Law

In many countries, economic growth has induced a general change in eating patterns, from high rates of malnutrition, to recurrent obesity problems and other health related issues in the population. Changes to nutritional labeling regulations that are aimed at providing more information to the consumer have been part of the strategy to fight obesity. Mandatory labeling schemes constitute a technical barrier to trade (hereinafter “TBT”), which must respect the principles of the WTO TBT Agreement. This article examines the new Chilean Food Labeling Law and the accompanying regulation in effect since 2016 which together form one of the earliest methods to mandate front-of-pack food labeling, while focusing on its compatibility with WTO law and its implications for other APEC economies. We present a review of the origin and content of the Chilean regulation and the discussion of the WTO TBT Committee, complemented with the analysis of related WTO jurisprudence and the response from the food industry.

Legal Feasibility of US Government Policies to Reduce Cancer Risk by Reducing Intake of Processed Meat.

The World Health Organization, the World Cancer Research Fund, and the American Cancer Society have each in recent years concluded that processed meats are probable carcinogens. The 2015-2020 Dietary Guidelines for Americans did not separately evaluate health effects of processed meat, although it mentioned lower processed meat intakes among characteristics of healthy diets. We summarized the international scientific literature on meat intake and cancer risk; described the scientific and political processes behind the periodic Dietary Guidelines for Americans; described the US red meat and processed meat industries and the economic structure of government-supported industry initiatives for advertising and promotion; and reviewed and analyzed specific factors and precedents that influence the feasibility of four potential policy approaches to reduce processed meat intake. Based on a review of 800 epidemiological studies, the World Health Organization found sufficient evidence in humans that processed meat is carcinogenic, estimating that each 50-gram increase in daily intake increases the risk of colorectal cancer by 18%. Among the four policy responses we studied, legal feasibility is highest in the US for three policy options: reducing processed meat in school meals and other specific government-sponsored nutrition programs; a local, state, or federal tax on processed meat; and public service announcements on health harms of processed meats by either the government or private sector entities. Legal feasibility is moderate for a fourth policy option, mandatory warning labels, due to outstanding legal questions about the minimum evidence required to support this policy. Political feasibility is influenced by the economic and political power of the meat industries and also depends on decisions in the next round of the Dietary Guidelines for Americans about how to assess and describe the link between processed meat consumption and cancer risk. Public policy initiatives to reduce processed meat intake have a strong scientific and public health justification and are legally feasible, but political feasibility is influenced by the economic and political power of meat industries and also by uncertainty about the likely treatment of processed meat in the 2020-2025 Dietary Guidelines for Americans.

Health warnings on wine labels: a discrete choice analysis of Italian and French Generation Y consumers

This paper aims to analyse Generation Y consumers' preferences for, interest in and attitudes towards different formats of health warnings on wine labels in two countries with different legal approaches: France and Italy. A Discrete Choice Experiment was realized on a sample of 500 wine consumers. Three warning options were applied: the long-term effect of drinking (brain damage); a short-term effect (car crash) and no warning option. Four attributes composed the choice set: alcohol content; framing of warning statement; warning size and position. Findings reveal that both the general degree of attention to the label and the level of visibility of the warnings are low, as are their effectiveness in changing consumption. Generation Y tend to prefer the "no logo option", short-term effects warnings and a small logo posted on the back label with neutrally framed messages. Results also show some significant differences among preferences in France and Italy, providing inputs to the ongoing debate in the EU on mandatory labelling. Although findings are subject to limitations related to the use of self-reported questionnaire and prone to social-desirability bias, practical implications are clear for private companies interested in implementing marketing strategies focused on enhancing the efficacy and readability of labels.

Nutrition Labelling on Alcoholic Beverages: A Behavioural Law and Economics Study on Mandatory Alcohol Labelling

The exemption for alcoholic beverages from the nutrition declaration is currently discussed by policy makers. In this contribution, we use findings from consumer studies in order to analyse alcohol nutrition labelling. We first explain how alcohol nutrition labelling is currently regulated and survey the on-going policy process, including an analysis of the self-regulatory proposals that have been tabled by the alcohol beverages industry. On the basis of consumer studies, we argue that there are no reasons for excluding alcohol beverages from nutrition labelling. We further suggest that alcohol content labelling itself, currently absent from the policy agenda, should be included. Our recommendations are to study directive, semi-directive, and non-directive alcohol nutrition information labelling options. In light of highly varying attitudes across EU Member States to alcohol consumption, non-directive nutrition information (e.g. alcohol gram content in the nutrition declaration) may be most politically feasible and suitable to accommodate this diversity in the EU context.

Are current EU policies on GMOs justified?

The European Court of Justice's recent ruling that the new techniques for crop development are to be considered as genetically modified organisms under the European Union's regulations exacerbates the need for a critical evaluation of those regulations. The paper analyzes the regulation from the perspective of moral and political philosophy. It considers whether influential arguments for restrictions of genetically modified organisms provide cogent justifications for the policies that are in place, in particular a pre-release authorization requirement, mandatory labelling, and de facto bans (in the form of withholding or opting out of authorizations). It is argued that arguments pertaining to risk can justify some form of pre-release authorization scheme, although not necessarily the current one, but that neither de facto bans nor mandatory labelling can be justified by reference to common arguments concerning naturalness, agricultural policy (in particular the promotion of organic farming), socio-economic effects, or consumers' right to choose.

Quantifying Children’s Non-Supermarket Exposure to Alcohol Marketing via Product Packaging Using Wearable Cameras

The aim of this research was to quantify children's exposure to alcohol marketing via product packaging using wearable cameras, observing sociodemographic differences and contextual features of exposure. In Wellington, New Zealand, 167 children (ages 11-13; 53% girls) wore wearable cameras for 4 consecutive days. The cameras automatically captured images approximately every 7 seconds. Image data (n = 700,000 images) were coded through content analysis to determine the extent of children's exposure to alcohol marketing via product packaging. Negative binomial regression models were used to calculate rates of exposure per day and to examine differences between groups. Children were exposed to alcohol marketing via product packaging 7.7 times per day, on average. Product packaging contained limited health information and lacked defining features that could provide visual cues to children to differentiate alcohol from other commodities. No statistically significant differences by sociodemographic characteristics were detected. Children are frequently exposed to alcohol marketing via product packaging. Such exposure normalizes alcohol in children's environments and fails to send accurate information to children about the health risks associated with alcohol consumption. Mandatory labeling on alcohol product packaging, including prominent health warnings (text, pictorial, and graphic), or plain packaging, provides governments an opportunity to substantially reduce children's overall exposure to alcohol marketing and potentially increase children's awareness of the risks associated with alcohol consumption.

Optimal patch test concentration for three widely used sensitizing fragrance substances without mandatory labelling in cosmetics.

Optimal patch test concentration for three widely used sensitizing fragrance substances without mandatory labelling in cosmetics.

Calorie Intake from Alcohol in Canada: Why New Labelling Requirements are Necessary.

We estimated calorie intake from alcohol in Canada, overall and by gender, age, and province, and provide evidence to advocate for mandatory alcohol labelling requirements. Annual per capita (aged 15+) alcohol sales data in litres of pure ethanol by beverage type were taken from Statistics Canada's CANSIM database and converted into calories. The apportionment of consumption by gender, age, and province was based on data from the Canadian Tobacco, Alcohol and Drug Survey. Estimated energy requirements (EER) were from Canada's Food Guide. The average drinker consumed 250 calories, or 11.2% of their daily EER in the form of alcohol, with men (13.3%) consuming a higher proportion of their EER from alcohol than women (8.2%). Drinkers consumed more than one-tenth of their EER from alcohol in all but one province. By beverage type, beer contributes 52.7% of all calories derived from alcohol, while wine (20.8%); spirits (19.8%); and ciders, coolers, and other alcohol (6.7%) also contribute substantially. The substantial caloric impact of alcoholic drinks in the Canadian diet suggests that the addition of caloric labelling on these drinks is a necessary step.