Food products qualifying for and carrying front-of-pack symbols: a cross-sectional study examining a manufacturer led and a non-profit organization led program

Abstract Background Concern has been raised that the coexistence of multiple front-of-pack (FOP) nutrition rating systems in a marketplace may mislead consumers into believing that a specific food with a FOP is ‘healthier’ than foods without the symbol. Eleven summary indicator FOP systems are in use in Canada, including one non-profit developed system, the Heart and Stroke Foundation’s Health Check™, and ten manufacturer-developed systems, like Kraft’s Sensible Solutions™. This study evaluated FOP’s potential to mislead consumers by comparing the number of products qualifying to carry a given FOP symbol to the number of products that actually carry the symbol. Methods The nutritional criteria for the Health Check™ and the Sensible Solutions™ systems were applied to a 2010–2011 Canadian national database of packaged food products. The proportion of foods qualifying for a given FOP system was compared to the proportion carrying the symbol using McNemar’s test. Results Criteria were available to categorize 7503 and 3009 of the 10,487 foods in the database under Health Check™ and Sensible Solutions™, respectively. Overall 45% of the foods belonging to a Health Check™ category qualified for Health Check’s™ symbol, while only 7.5% of the foods carried the symbol. Up to 79.1% of the foods belonging to a Sensible Solutions™, category qualified for Sensible Solutions’s™ symbol while only 4.1% of the foods carried the symbol. The level of agreement between products qualifying for and carrying FOP systems was poor to moderate in the majority of food categories for both systems. More than 75% of the products in 24 of the 85 Health Check™ subcategories and 9 of 11 Sensible Solution™ categories/subcategories qualified for their respective symbols based on their nutritional composition. Conclusions FOP systems as they are currently applied are not, in most instances, a useful guide to identifying healthier food products in the supermarket as many more products qualify for these systems than the number of products actually displaying these symbols on FOP, and the level of agreement between qualifying and carrying products is poor to moderate. The adoption of a single, standardized FOP system would assure consumers that all products meeting certain nutritional standards are designated by the symbol

Traffic-light labels could reduce population intakes of calories, total fat, saturated fat, and sodium.

Traffic-light labelling has been proposed as a public health intervention to improve the dietary intakes of consumers. OBJECTIVES:to model the potential impact of avoiding foods with red traffic lights on the label on the energy, total fat, saturated fat, sodium, and sugars intakes of Canadian adults. METHODS:Canadian adults aged 19 and older (n = 19,915) who responded to the Canadian Community Health Survey (CCHS), Cycle 2.2. The nutrient levels in foods consumed by Canadians in CCHS were profiled using the United Kingdom's criteria for traffic light labelling. Whenever possible, foods assigned a red traffic light for one or more of the profiled nutrients were replaced with a similar food currently sold in Canada, with nutrient levels not assigned any red traffic lights. Average intakes of calories, total fat, saturated fat, sodium, and sugars under the traffic light scenario were compared with actual intakes of calories and these nutrients (baseline) reported in CCHS. RESULTS:Under the traffic light scenario, Canadian's intake of energy, total fat, saturated fat, and sodium were significantly reduced compared to baseline; sugars intakes were not significantly reduced. Calorie intake was reduced by 5%, total fat 13%, saturated fat 14%, and sodium 6%. CONCLUSION:Governments and policy makers should consider the adoption of traffic light labelling as a population level intervention to improve dietary intakes and chronic disease risk

Traffic light labelling could prevent mortality from noncommunicable diseases in Canada: A scenario modelling study.

BACKGROUND:Traffic-light labelling (TLL) is a promising front-of-pack system to help consumers make informed dietary choices. It has been shown that adopting TLL in Canada, through an optimistic scenario of avoiding, if possible, foods with red traffic lights, could effectively reduce Canadians' intakes of energy, total fat, saturated fat, and sodium by 5%, 13%, 14% and 6%, respectively. However, the potential health impact of adopting TLL has not been determined in the North American context. OBJECTIVE:This study modelled the potential impact of adopting TLL on mortality from noncommunicable diseases (NCDs) in Canada, due to the previously predicted improved nutrient intakes. METHODS:Investigators used data from adults (n = 19,915) in the 2004 nationally representative Canadian Community Health Survey (CCHS)-Cycle 2.2. Nutrient amounts in foods consumed by CCHS respondents were profiled using the 2013 United Kingdom's TLL criteria. Whenever possible, foods assigned at least one red light (non-compliant foods) were replaced with similar, but compliant, foods identified from a Canadian brand-specific food database. Respondents' nutrient intakes were calculated under the original CCHS scenario and the counterfactual TLL scenario, and entered in the Preventable Risk Integrated ModEl (PRIME) to estimate the health impact of adopting TLL. The primary outcome was the number of deaths attributable to diet-related NCDs that could be averted or delayed based on the TLL scenario compared with the baseline scenario. RESULTS:PRIME estimated that 11,715 deaths (95% CI 10,500-12,865) per year due to diet-related NCDs, among which 72% are specifically related to cardiovascular diseases, could be prevented if Canadians avoided foods labelled with red traffic lights. The reduction in energy intakes would by itself save 10,490 deaths (9,312-11,592; 90%). CONCLUSIONS:This study, although depicting an idealistic scenario, suggests that TLL (if used to avoid red lights when possible) could be an effective population-wide intervention to improve NCD outcomes in Canada

Examples of foods of foods with one or more red traffic lights consumed by CCHS 2.2 participants and their no red traffic light replacements.

<p>Examples of foods of foods with one or more red traffic lights consumed by CCHS 2.2 participants and their no red traffic light replacements.</p

Proportion of foods and beverages with red colour codes at baseline and under traffic light labelling scenario, by nutrient.

<p>Proportion of foods and beverages with red colour codes at baseline and under traffic light labelling scenario, by nutrient.</p

Mean energy and nutrient intake under the traffic light scenario compared with baseline.

<p>Mean energy and nutrient intake under the traffic light scenario compared with baseline.</p

Traffic light labelling colour coding pattern of foods and beverages consumed by Canadian adults at baseline and under traffic light labelling scenario.

<p>Under the traffic light labelling scenario, whenever possible, foods that were reported as consumed by Canadians which met the criteria for at least one red colour code for one or more of the nutrients evaluated (total fat, saturated fat, sodium, and sugars) were replaced by similar foods that did not have red colour codes attributed to any of the nutrients evaluated.</p

Example of a front-of-pack traffic light label.

<p>Example of a front-of-pack traffic light label.</p