- © 2008 Canadian Medical Association or its licensors
The Heart and Stroke Foundation's Health Check program was recently discussed in CMAJ.1 Healthy-for-you symbols on the front of food packaging have the potential to help grocery shoppers choose healthy foods and interpret products' nutrition facts. However, programs that use weak nutrition criteria and permit stamps of approval to appear on products sold beside more nutritious products that do not carry the program's symbol may have negative net effects on public health.
The Heart and Stroke Foundation of Canada's Health Check nutrition criteria are certainly stricter than some major companies' healthy-logo standards. However, approaches developed by researchers at Yale and Oxford universities2,3 and the 150-outlet US-based Hannaford Brothers grocery store chain suggest that there is room for improvement.
It is clear that many Canadian shoppers believe the Health Check logo flags foods that, in an absolute way, promote health. However, the Heart and Stroke Foundation concedes that some products that carry the logo are only relatively nutritious compared with non-nutritious products in the same product category.4 However, even that may not be so. For example, of the 257 fruit and vegetable products enrolled in the program, 194 are juices, fruit leather and french fries — hardly nutritional superstars — and only 14 are fresh fruits and vegetables.
In 9 years, the Health Check program has enrolled 1500 products, which is an impressive feat for a nongovernmental organization. However, the Health Check program covers less than 3% of available groceries, which is too small a percentage to ensure a significant or even a net positive effect on public health. Using stricter criteria, the Hannaford Brothers chain credits 28% of its entire inventory of 25 500 products with at least 1 of 3 “guiding stars.” (The other 72% of products do not get any stars.)
The time has come for Health Canada to mandate (and for health advocates to promote) a standard healthy-for-you symbol, colour-coding or rating scheme for all eligible prepackaged and restaurant foods that is based on sound nutrition standards. As a first step, Health Canada should commission, perhaps with the US federal government, the US National Academy of Sciences' Institute of Medicine to conduct a study to help identify the best nutrition standards and most effective approaches to front-of-pack labelling.
Footnotes
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Competing interests: None declared.