Grocery store shelves are lined with products that claim they’re good for you. Some food labels say they’ll help you dodge health conditions – like oatmeal boxes that say “oat fibre helps reduce cholesterol.” Others let shoppers infer the benefits of vitamins or minerals, like Reese’s Puffs that boasts it’s a good source of fibre .
That information can be misleading, and makes it harder to properly compare products. “Any claim tends to get accepted as a health halo,” says Charlene Elliott, Canada Research Chair for food marketing, policy and children’s health and a professor at the University of Calgary.
“Manufacturers are using this stuff as marketing,” says Valerie Tarasuk, a professor of nutritional sciences at the University of Toronto. Her advice to people trying to pick healthy foods? “Don’t use [the front]: turn that package over,” she says. That might be wishful thinking – a 2012 online survey from Nielsen found that only 49% of Canadians said they “mostly” understood nutritional labels. And the upfront information is hard to ignore: a U.S. FDA survey found 67% of respondents sometimes or often used front-of package symbols when shopping.
The Canadian landscape changed this month, as The Heart and Stroke Foundation announced on June 18 that it would be cancelling its 15-year-old Health Check program, leaving the space occupied by companies and regulators. The question is, what should they do with it?
An incomplete truth: Current regulations
Front-of-package labelling is regulated by Health Canada and enforced by The Canadian Food Inspection Agency. All claims must be true, and phrases have to pass a standard – products that claim they’re “a high source of fibre,” for example, must have at least 4 g of fibre per serving.
Studies have found front of package labels can help consumers identify healthier food, especially those that use colour in addition to numbers or percentages. But companies often highlight the good on food labels and leave out the bad – for example, with products that are marketed as low-fat but are also high in sugar.
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It’s difficult to compare products when some have front-of-package labelling and others don’t. Tarasuk studied front-of-package marketing and fibre in 2013. She found fibre claims were sporadic, and that 17% of food labels that made claims about fibre fell into Canada’s Food Guide’s “foods to limit” category. On the other hand, fibre claims were rare on foods that were naturally high in fibre, many of whom made no reference to fibre on the front of their packages, including 51% of canned or dried beans, 95% of nuts and seeds, and 96% of frozen and canned fruits and vegetables.
“The only place you don’t see front of package claims are on products that you already know are healthful, like fruits and vegetables,” says Yoni Freedhoff, medical director of the Bariatric Medical Institute in Ottawa. Most often, the processed foods making health claims are “less-bad-for-you products,” he says, not ones that are good for you. That could push people towards snacks and processed grain products.
Unregulated terms are also confusing. “’Made with real fruit’ is the most deceptive claim out there,” says Freedhoff. “It usually means fruit concentrates – and basically when you concentrate a fruit, you get sugar.”
Newer concepts like whole grains also aren’t included. Despite recommendations that at least half of Canadians’ grain consumption be from whole grains, the language around it is mostly unregulated – and information about whole grains isn’t found on the nutrition facts label. Manufacturers have created a Whole Grain stamp, but a recent study found products with the stamp on them tended to have more sugar and calories.
“We are now totally dependent on manufacturers [when it comes to whole grains],” says Tarasuk, who would like the regulations to be “a bit more nimble.”
Markers like “organic” and “gluten free,” both of which are also regulated, contribute to the health halo effect that can be created by front-of-box nutrient claims, which make foods seem healthier than they are. “The claim organic is hands down the most widely misunderstood term for kids, and adult consumers too,” says Elliott. “You put organic on the front of the box and it means it’s healthy, full stop.” She recently led a study on “better for you” foods for children, and found that the organic Nature’s Path EnviroKidz Koala Crisp Cereal had a higher percentage of calories from sugar than Kellogg’s Pop Tarts – a finding that shocked even her.
Some, like Freedhoff, argue for less front-of-package information, believing it tends to be misleading. Others, like David Jenkins, Canada research chair in nutrition and metabolism and inventor of the Glycemic Index diet, believe the real need is for different, not fewer, front-of-package facts. Instead of listing nutrients, he’d like to see health claims that list the potential benefits of ingredients, like heart health.
He thinks the more info, the better. “We’re in an information-thirsty age,” he says. “I wouldn’t necessarily buy a product because it tastes creamy. But if they say that this is organic, grown on the mountain hills of Peru, harvested at 10 p.m. because that’s when the isoflavones are at their highest level…. I want people to start thinking about what they’re eating, and I think if you make it interesting they will,” he says.
Crossing off Health Check
When The Heart and Stroke Foundation introduced Health Check in 1999, they were one of the few front-of-package logos on the market, offering their stamp of approval to products that paid a fee and passed the foundation’s nutrient criteria. But in the years since, the check became controversial, coming under fire from Freedhoff and others for approving unhealthy foods like fruit bars and fries .
The foundation announced earlier this month that they would stop the initiative, with the checks phasing out over the year. It was competition, not controversy, that drove the decision, says Terry Dean, the program’s director. “We have a really cluttered landscape now, and we’re hearing from consumers that they’re very confused,” he says. “We weren’t having the impact that we need to have.”
Freedhoff sees it differently. Though the program was good when it began, by the end, “some of the things they were putting the checkmark on were really quite horrifying,” he says.
The fact that the check only went on products that paid to be evaluated was also criticized, along with its pass/fail nature. “The simplicity of it made it vulnerable,” says Tarasuk. “I don’t think the way forward lies in a single summary index.”
Regulations around the world
The U.K. has a well-received voluntary traffic-light labelling system that colour-codes the amount of fat, saturated fat, sugars and salt per serving, as well as displaying calorie counts. It seems to work: A 2013 review of the research on front-of-package labelling found the multiple traffic light label is the most well-established to help consumers identify healthier products.
The health claims system in the E.U. is also stricter than Canada’s. And recently, a group in the U.K. campaigned for the EU to ban labels with any nutritional or health claims if the product goes over a set cap of sugar, salt or fat.
In the U.S., The Institute of Medicine recommended a points-based scheme in 2011 – an “energy star” equivalent, as they put it – that would show calories and a ranking of zero to three points.
Another option is full-supermarket systems that rate every product in the store. The Guiding Stars program, found in Loblaws and other stores, is the most prominent in Canada. Created in 2006 by Hannaford grocery stores and a scientific advisory panel, it considers things like vitamins, fibre, saturated fat and added sodium to rank foods on a scale of 0 to 3 stars. But some have critiqued it, saying that because it has only four categories, it’s too broad.
Some supermarkets in the States have NuVal, which uses a proprietary algorithm to rank foods out of 100. It includes vitamins and minerals, GI load, and artificial sugars and chemicals, among other things. It then weighs them according to their impact on health. The formula, which may help people lower their risks of chronic diseases, adapts to new research, and participating supermarkets have a score on every product on their shelves.
It’s meant to solve the fact that companies naturally “prefer information that accentuates the positive,” says David Katz, director of the Yale-Griffin Prevention Research Center, who developed the ranking along with a team of doctors, including Jenkins. “The big food companies don’t mind telling the truth, but they don’t particularly want to tell the whole truth.”