Centre for Science in the Public Interest

For the Record

CSPI Centre for Science in the Public Interest
Centre pour la science dans l’intérêt public

October 10, 2000

Mr. Allan Rock, M.P., P.C.
Minister of Health
House of Commons
Parliament Buildings
Ottawa, ON K1A 0A6

Re: Status Report on Nutrient Content Claims

Dear Minister Rock:

     We have attached our submission concerning the proposals contained in the Health Canada document entitled Status Report on Nutrient Content Claims.(1) While some public health benefits may result from the recommendations in the report, these pale in comparison to the benefits that could be expected from comprehensive, mandatory nutrition labelling on all foods. We strongly urge Health Canada to require that all foods, especially foods that are permitted to make nutrient content claims, bear a complete nutrition label, including calories, total fat, saturated fat, trans fat, cholesterol, total carbohydrates, added sugars, dietary fibre, protein, sodium, vitamin A, vitamin C, folic acid, calcium, potassium, and iron. Without this information, consumers cannot fully understand the nutritional advantages and disadvantages of the foods making the claims.

     Under Health Canada's proposed nutrient content claim rules, a food bearing a claim for most nutrients could be very high in sodium, saturated fat, trans fat, total fat, added sugars, or cholesterol, provided it meets the qualifying levels of the specific nutrient about which the claim is made. This allows manufacturers to promote the sale of a food on the basis of one nutritional feature, even when that food contains unhealthful amounts of other nutrients. For instance, a nutrient content claim for a low sodium food (which may, as part of a low sodium diet, help reduce high blood pressure and, by extension, the risk of cardiovascular disease) could be made for a food that is very high in saturated/trans fat (which may promote high LDL cholesterol levels and, by extension, increase the risk of cardiovascular disease). Thus, without any special qualification, a manufacturer may remain silent about the amount of a nutrient in its food that works at cross purposes to the beneficial effect of the highlighted nutrient.

     This problem is exacerbated by the forthcoming approval of several generic health claims for foods. While health claims may educate some consumers about the relationships between certain nutrients and health, many consumers may apply that knowledge to the selection of foods bearing nutrient content claims that are not subject to disqualifying levels of other unhealthful nutrients. For instance, a health claim concerning the relationship between heart disease and diets low in saturated/trans fat on one product may misleadingly cause a consumer to infer that another food bearing a low saturated/trans fat nutrient content claim can offer the same health benefits. However, under the proposed nutrient content claim rules, a food bearing this nutrient content claim could be very high in sodium, added sugars, cholesterol, or total fat without the consumer being alerted to this fact. Nutrient content claims could, in effect, ride on the coattails of health claims that are subject to stricter qualifying conditions for nutrient composition.

     Accordingly, we propose a requirement that all nutrient content claims be accompanied by a statement directing consumers to check the amounts of the specified nutrients in the nutrition information panel when they are present in the food at moderate or high levels.(2)

     If we can be of any further assistance to your office in addressing these concerns, please do not hesitate to contact us at 613-565-2140. We look forward to your reply.

Respectfully submitted,

[original signed by BJ]

Bill Jeffery, L.LB.
National Coordinator

 

att.Submission by the Centre for Science in the Public Interest (CSPI) on Health Canada’s Status Report on Nutrient Content Claims (October 10, 2000)
 
cc.The Right Honourable Prime Minister Jean Chrétien, M.P., P.C.
The Honourable Paul Martin, M.P., P.C., Minister of Finance
The Honourable Lyle Vanclief, M.P., P.C., Minister of Agriculture and Agri-food
 The Honourable Lucienne Robillard, M.P., P.C., President of the Treasury Board
 Ms. Val Merideth, M.P., Canadian Alliance Party Health Critic
 Mr. Reed Elley, M.P., Canadian Alliance Party Deputy Health Critic and joint seconder to Bill C-319
 Ms. Judy Wasylycia-Leis, M.P., New Democratic Party Health Critic and joint seconder to Bill C-319
 Mr. Svend Robinson, M.P., joint seconder to Bill C-319
 Mr. Nelson Riis, M.P., New Democratic Party Industry Critic and joint seconder to Bill C-319
 Mr. Greg Thompson, M.P., Progressive Conservative Party Health Critic
 M. Réal Ménard, député, porte-parole de Bloc Québécois en matière de Santé
 Madame Aline Alarie, M.P., Bloc Québécois Agriculture and Agri-food Critic
 Mr. Tom Wappel, M.P., sponsor of Bill C-319
 Mr. Mel Cappe, Clerk of the Privy Counsel and Secretary to the Cabinet
 Mr. Ronald L. Doering, President, Canadian Food Inspection Agency
 Ms. Eunice Chao, Project Coordinator, Nutrition Evaluation Division, Health Canada
 Ms. Melodie Wynne, Generic Claims Project, Health Canada
 Ms. Christina Zehaluk, Nutrition Evaluation Division, Health Canada

 

Submission by the Centre for Science in the Public Interest
on Health Canada’s
Status Report on Nutrient Content Claims

I. Introduction

     The Centre for Science in the Public Interest (CSPI) is pleased to submit comments regarding Health Canada’s Status Report on Nutrient Content Claims (hereinafter, the Status Report).(3)

     We are concerned that Health Canada has devoted considerable activity to shepherding along rules for nutrition claims and other programs favoured by industry(4) while showing no commitment to requiring mandatory nutrition labelling. We strongly urge the department to require that all foods, especially foods that are permitted to make nutrient content claims, bear a complete nutrition label, including calories, total fat, saturated fat, trans fat,(5) cholesterol, total carbohydrate, added sugars, dietary fibre, protein, sodium, vitamin A, vitamin C, folic acid, calcium, potassium, and iron. This information should be based on standardized servings, and should be presented in a manner that reveals how much a serving contributes to the maximum or minimum amount of each nutrient that should be consumed per day. Without this information, consumers cannot fully understand the nutritional properties of foods making claims and compare them to foods that do not bear such claims.

II. Promoting healthy eating with nutrient content claims

     We support any efforts to clear the marketplace of misleading claims concerning nutrient content and to do so by regulation rather than by guidelines. As the Status Report notes (at p. 1), a chief consideration in developing rules for nutrient content claims is to:

     "...assist the Canadian consumer in choosing a healthy diet consistent with Guidelines to Healthy Eating..."

For this reason, it is essential that nutrient content claims not be used in ways that promote over-consumption of unhealthful nutrients and worsen the diets of consumers who select products on the basis of such claims.

     In the Status Report, Health Canada recognized the problem of using nutrient claims to selectively promote the presence or absence of a nutrient while remaining silent about unhealthful levels of other nutrients. For instance, foods bearing "trans fat free," "cholesterol free," or "low cholesterol" claims are completely disqualified from making these claims unless the foods are also "low" in saturated and trans fats. Similarly, foods bearing the "sugar free" claim must also meet the requirements for the "energy free" claim.

     Under existing rule, consumers may select foods labelled "low sodium" with a belief that the food is a good choice for reducing high blood pressure (a risk factor for cardiovascular disease) without recognizing that it is also high in saturated fat, which promotes high levels of LDL serum cholesterol (also a risk factor for cardiovascular disease). However, the proposal does nothing to prevent this problem.

     Indeed, the Status Report concluded, at pages 10-11, that there is no need for a disclaimer indicating that a product is not low in sodium if it carries the claim "no salt added" or "lightly salted" and it contains significant amounts of sodium.(6) We believe that this conclusion is counter-intuitive, at best. Manufacturers should not be able to highlight misleading characterizations of their food products, especially when those statements bear directly on consumers’ health.

     We propose that, whenever a nutrient content claim(7) is made for a food, and a customary serving size or reference amount of that food contains more than 13 g of total fat, 4 g of saturated/trans fat, 480 mg of sodium, 8 g of added sugars, and 60 mg of cholesterol,(8) then the label should bear the following statement, in both official languages, directly below the claim:

     "See nutrition information panel for amount(s) of [total fat, saturated/trans fat, sodium, sugar, and cholesterol, as applicable]."(9)

This statement should appear in the same type face and style as the claim, be printed on a contrasting background, and in type size no less than the size of the claim. This would prevent, for instance, a food high in calcium and saturated fat (such as some types of cheese) from making a promotional claim about its calcium content without also alerting consumers to information concerning the amounts of saturated fat in a serving.

III. Authorized serving sizes are imprecise and promote incorrect product comparisons

     CSPI agrees with the approach of using both reference amounts and serving sizes for establishing eligibility for "low" and "free" claims. We also agree with the proposal to use additional density requirements for "low" claims. However, the permissible ranges for serving sizes set out in section 5.6.3 of the Guide to Food Labelling and Advertising are extremely broad. In some cases, the upper limit of the range is more than four times as high as the lower limit. Discrepancies between serving sizes used on several similar products may lead to considerable confusion, especially when consumers try to evaluate the nutrition information (reported per serving) that accompanies nutrient content, health or health-related claims. Indeed, serving size ranges create problems whenever nutrition information is reported on panels, regardless of whether a claim is made. Accordingly, Health Canada should take steps to standardize serving sizes by discontinuing its reliance on serving size ranges.

IV. Comments regarding individual claims

     In addition to the general comments stated above, we make the following recommendations with respect to specific proposals:

1. Energy (Calorie) Claims

     a. "Energy Free" and high energy claims

     CSPI supports Health Canada’s proposal to allow foods with fewer than 5 calories per reference amount and per labelled serving to promote that feature. However, we urge Health Canada to require that all claims related to high or low caloric content of foods only refer to calories, not energy. The term "calories" is well understood by most consumers. The term "energy" is not. Also, some claims, particularly claims for so-called "sports drinks" and "energy drinks," communicate the impression that the consumer will derive special dietary benefits resulting in increased vitality or endurance when, in fact, these foods do nothing more than supply calories — usually in the form of simple table sugar. Accordingly, energy claims should be stated on product labels and in advertizing only as "(naming the food) is high in calories."

     Furthermore, we urge Health Canada to require that, if foods meet the conditions for "energy free" without the benefit of special processing, alteration, formulation or reformulation to lower the caloric content, they be labelled to disclose that calories are not usually present in the food. For example, the front label of a container of bottled water could state "a calorie-free food."

     b. "Low in Energy"

     Likewise, CSPI supports Health Canada’s proposal to allow the descriptor "low in energy" or "low calorie" on foods that contain no more than 40 calories per reference amount and per labelled serving and not more than 40 calories per 50 grams or ml of food if its reference amount is 30 grams or less.

     Furthermore, we urge Health Canada to require that, if foods meet this condition without the benefit of special processing, alteration, formulation or reformulation to vary the caloric content, they be labelled to clearly refer to all foods of its type and not merely to the particular brand that bears the label. For example, the front panel of a package of celery might state that "all celery is low in calories" or "a low calorie food."

2. Fat Claims

     a. "Fat Free"

     CSPI supports Health Canada’s proposed definition of "fat free." We urge Health Canada, however, to require that fat in amounts of 0.5 grams or less be listed on the label in 0.1 gram increments. Allowing manufacturers to label products containing less than 0.5 grams of fat as containing "0 grams of fat" implies that even large quantities of these foods contain no fat. However, some foods such as salad dressings, cakes, cookies, and nondairy creamers, are sometimes eaten in quantities far greater than the labelled serving. Consumers who eat large quantities of these foods would have no way of knowing that they are still consuming small amounts of fat, even though they are eating a "fat-free" product.

     b. "Low Fat"

     CSPI supports Health Canada’s definition for "low fat." However, we urge Health Canada to require that, if foods meet this condition without the benefit of special processing, alteration, formulation, or reformulation to lower fat content, they be labelled to clearly refer to all foods of its type and not merely to the particular brand that bears the label.

     c. "Percent Fat Free"

     CSPI agrees with Health Canada’s proposal to limit the use of "percent fat free" claims to foods that contain no more than 3 grams of fat per reference amount and per labelled serving, and per 50 grams if the reference amount is 30 grams or less. These claims should be restricted to low fat foods because their use implies that a food is low in fat. However, we urge Health Canada to require that the percent declared and the words "fat free" are in uniform type size. Without this requirement, labels might use far larger type for the words "fat free" than for the percentage.

3. Omega-3 & Omega-6 Polyunsaturated Fatty Acid Claims

CSPI urges Health Canada not to allow claims for linoleic acid or omega-3 or omega-6 polyunsaturated fatty acids, except perhaps on foods for infants. While the 1990 Nutrition Recommendations stated that diets should include specific levels of these fatty acids, the basis for these recommendations consists largely of evidence that infants need them in sufficient quantities. Although humans need essential fatty acids throughout life, the requirement is quite small (e.g., linoleic acid should supply 1% of calories) and the incidence of fatty acid deficiency is extremely low.

     Furthermore, claims for linoleic acid or omega-3 or omega-6 fatty acids have a great potential to mislead and confuse the public. A claim that a food is a source of a fatty acid implies that the public is in need of those nutrients. In fact, there is no shortage of omega-6 fatty acids in the diets of most Canadians. While a number of studies suggest that fatty fish or omega-3 fatty acids may reduce the risk of heart attacks, the evidence is not yet sufficient to warrant recommendations from Health Canada.

     Misleading claims for some omega-3 fatty acids — especially docosahexaenoic acid or DHA — have already started to appear on foods or supplements in the U.S. For example, some brands of fresh eggs claim to "have the same amount of Omega 3 DHA as 3 oz. of fish." In fact, a serving of two eggs supplies only 0.1 gram of DHA, an amount smaller than that found in a 3-oz. serving of virtually all species of fish.(10) More importantly, such claims are used as a ploy to distract consumers from the fact that egg yolks raise blood cholesterol levels.

     Claims on supplements of DHA also make misleading claims in the U.S. For example, an advertisement for Neuromins claims that "low DHA levels may be impairing your brain and eye function." The ad also implies that DHA supplements promote mental function with slogans like "feed your head" and "think fast." In fact, the evidence that DHA promotes brain and eye development only applies to newborns, especially premature newborns. Other than a few observational studies that have detected lower DHA levels in people with depression or Alzheimer’s, to date, there is no good evidence that DHA supplements would improve brain or eye function in anyone but newborns.

4. Cholesterol claims

     To prevent misperceptions, we urge Health Canada to require that, if foods that meet this condition without the benefit of special processing, alteration, formulation, or reformulation to lower cholesterol content, they be labelled to disclose that cholesterol is not usually present in the food.

5. Dietary Fibre Claims

     CSPI supports Health Canada’s proposed definitions for fibre claims. However, we urge Health Canada to consider raising the minimum fibre levels slightly, to 2.5 grams per serving (for "source of" claims) and to 5 grams per serving (for "high in" claims). A number of foods made of refined grains — such as a cup of cooked spaghetti or macaroni or a McDonald’s hamburger (largely due to the bun) — have 2 grams of fibre. These are not foods that most experts have in mind when they recommend eating more fibre-rich foods. Requiring a minimum of 5 grams of fibre for foods that make "high in" claims is reasonable because many breakfast cereals, beans, and a few whole grain breads or crackers contain 6 to 15 grams of fibre per serving. "High in fibre" claims should be reserved only for those foods with the highest levels per serving.

     CSPI supports Health Canada’s proposal for fibre claims on meals and main dishes (with the minimum levels described above). However, we urge Health Canada to require the label to disclose which food is the source of the fibre. This disclosure would help educate the public about good sources of fibre.

6. "Healthy" claims

     CSPI urges Health Canada to propose and implement a definition of "healthy" to steer consumers toward foods that can help them make several improvements in their diets. For example, many consumers might welcome a claim that points them to foods that meet the definitions of "low fat," "low saturated fat," "low cholesterol," and "low sodium" (and that naturally contain some vitamins and minerals). Health-conscious consumers should be provided with an easy to use mechanism to identify foods that contain low amounts of fat, cholesterol, and sodium, and that contain at least moderate amounts of some healthful nutrients.

     In the U.S., the government’s definition of health has had an important impact on the marketplace. For example, by limiting sodium levels in "healthy" foods, the regulation has created lower-sodium segments of the markets for canned soup, frozen dinner, processed meats, and other foods that are typically high in sodium. A similar regulation could have the same impact on those markets in Canada.


References

1. The Centre for Science in the Public Interest (CSPI) is a non-profit health advocacy organization specializing in food safety and nutrition issues with offices in Ottawa and Washington, D.C. CSPI’s Ottawa public health advocacy office is funded by 135,000 subscribers to the Canadian edition of Nutrition Action Healthletter. CSPI does not accept funding from industry or government. For three years, CSPI has urged Health Canada and Members of Parliament to establish mandatory, comprehensive, easy-to-read nutrition information on all food labels.

2. Foods that make nutrient claims, but contain more than 8 g of sugar, 13 g of total fat, 4 g of trans fat plus saturated fat, 60 mg of cholesterol, and 480 mg of sodium (per stated serving size and per reference amount) should carry the following statement directly below the claim on the label:

"See nutrition information panel for amount(s) of [total fat, saturated/trans fat, cholesterol, added sugars, and cholesterol, as applicable]."

These thresholds should be set 25% higher for main dish entrées and 50% higher for pre-packaged meals.

3. The Centre for Science in the Public Interest (CSPI) is a non-profit health advocacy organization specializing in food safety and nutrition issues with offices in Ottawa and Washington, D.C. CSPI’s Ottawa public health advocacy office is funded by 135,000 subscribers to the Canadian edition of Nutrition Action Healthletter. CSPI does not accept funding from industry or government. For three years, CSPI has urged Health Canada and Members of Parliament to establish mandatory, comprehensive, easy-to-read nutrition information on all food labels.

4. Other efforts include allowing health claims to market foods, permitting voluntary fortification of foods, and developing programs to promote natural health products.

5. CSPI urges Health Canada to either include trans fat and saturated fat on the same line (i.e., "saturated + trans fat") or to disclose the sum of trans and saturated fats next to the term "saturated fat*" with an asterisk at the bottom of the label that states "contains trans fat."

6. It is insufficient to require only that the amount of the specified nutrient (such as sugar or sodium) be disclosed on the label (especially if the amount is reported only as an absolute number, not as a percentage of a recommended daily intake) because many consumers are not able to interpret those amounts as high or low. Health Canada should establish maximum daily intakes for total fat, saturated/trans fat, sodium, added sugars, and cholesterol, and should require that nutrition information panels express the amounts of these nutrients present in a serving of the food as a percent of the maximum recommended daily intake.

7. "Nutrient content claim" means "any statement or expression which describes, directly or indirectly, the level of a nutrient(s) in a food or group of foods." (See, Guide to Food Labelling and Advertising (Ottawa: Food Division, Canadian Food Inspection Agency, 1998) at 6.1.1. These claims include, but are not limited to: "low," "reduced," "free," "source," "good source," "excellent source," "high," "very high," "contains (naming the nutrient)," "fortified," "enriched," "vitaminized," "lean," "extra lean," "light/lite," as well as any non-addition claims, and comparative claims regarding nutrients.

8. Only the names of the 6 nutrients that are present in the food in excess of these levels must be reported. Thresholds should be 25% higher for main dish entrées and 50% higher for pre-packaged meals.

9. No other nutrients should be listed in this label statement.

10. Three ounces of cooked cod has 0.1 gram of DHA. However, the same serving of flounder, sole, or light canned tuna has 0.2 grams of DHA, white canned tuna has 0.5 grams, and a fatty fish like salmon has 0.9 grams.


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