Lana Vanderlee

Front-of-package nutrition labelling policy: global progress and future directions

Nutrition labelling on food packages has been voluntarily implemented by food companies since the beginning of the 20th century. By the end of the 20th century, both governments and non-governmental organizations began to implement different front-of-package (FOP) nutrition labelling systems. FOP nutrition labels encompass a specific element of nutrition labelling postulated to allow for quick decision making about the nutritional content or relative healthfulness of a product provided through its simple, easily viewable and interpretable format. The policy objectives of FOP nutrition labelling are typically twofold: (i) to provide additional information to consumers to inform healthier food choices; and (ii) to encourage the industry to reformulate products towards healthier options. Recent reviews have summarized the implementation of nutrition labelling policies in general. However, there has been an exponential rise in both government and private-sector FOP nutrition labelling policy that deserves specific attention. While it has been argued that FOP nutrition labelling is a marketing, rather than a public health strategy, the purpose of this editorial is to provide an update on the global policy environment regarding governmentendorsed FOP nutrition labelling and to examine realworld evidence of policy implementation.

Self-Report Dietary Assessment Tools Used in Canadian Research: A Scoping Review

Choosing the most appropriate dietary assessment tool for a study can be a challenge. Through a scoping review, we characterized self-report tools used to assess diet in Canada to identify patterns in tool use and to inform strategies to strengthen nutrition research. The research databases Medline, PubMed, PsycINFO, and CINAHL were used to identify Canadian studies published from 2009 to 2014 that included a self-report assessment of dietary intake. The search elicited 2358 records that were screened to identify those that reported on self-report dietary intake among nonclinical, non-Aboriginal adult populations. A pool of 189 articles (reflecting 92 studies) was examined in-depth to assess the dietary assessment tools used. Food-frequency questionnaires (FFQs) and screeners were used in 64% of studies, whereas food records and 24-h recalls were used in 18% and 14% of studies, respectively. Three studies (3%) used a single question to assess diet, and for 3 studies the tool used was not clear. A variety of distinct FFQs and screeners, including those developed and/or adapted for use in Canada and those developed elsewhere, were used. Some tools were reported to have been evaluated previously in terms of validity or reliability, but details of psychometric testing were often lacking. Energy and fat were the most commonly studied, reported by 42% and 39% of studies, respectively. For ∼20% of studies, dietary data were used to assess dietary quality or patterns, whereas close to half assessed ≤5 dietary components. A variety of dietary assessment tools are used in Canadian research. Strategies to improve the application of current evidence on best practices in dietary assessment have the potential to support a stronger and more cohesive literature on diet and health. Such strategies could benefit from national and global collaboration.

Food sources among young people in five major Canadian cities

ObjectiveTo examine food sources among young people in five major Canadian cities.MethodsAs part of the 2016 Canada Food Study, respondents aged 16–30 were recruited from five Canadian cities (Toronto, Montreal, Halifax, Edmonton, and Vancouver) using in-person intercept sampling and completed an online survey (n = 2840 retained for analysis). Descriptive statistics were used to summarize food preparation and purchase locations. A linear regression model was fitted to examine correlates of the proportion of meals that were ready-to-eat or prepared outside the home.ResultsIn total, 80% of meals were prepared at home and 20% were prepared outside the home. More than 25% of meals prepared at home were ready-to-eat/box food. Of all meals consumed, 42% were either ready-to-eat/box food prepared at home or prepared outside the home. Food for meals prepared at home was purchased predominantly at grocery stores/supercentres while meals prepared outside the home were purchased predominantly at fast food/quick service/coffee shop outlets. Respondents who were younger, identified as Aboriginal, had obesity, had no children, lived in residence at school, university, or college, and reported poorer cooking skills reported more meals that were ready-to-eat or prepared outside the home.ConclusionsThe current findings indicate that a substantial proportion of meals consumed by young people consist of meals either prepared outside the home or ready-to-eat/box food prepared at home. Dietary recommendations should highlight basic patterns of food preparation and eating, such as limiting ultra-processed food and food prepared outside the home.RésuméObjectifExaminer les sources de nourriture des jeunes de cinq grandes villes canadiennes.MéthodeDans le cadre de l’Étude sur les aliments au Canada de 2016, des répondants de 16 à 30 ans ont été recrutés par échantillonnage sur place dans cinq villes canadiennes (Toronto, Montréal, Halifax, Edmonton et Vancouver) et ont répondu à un sondage en ligne (n = 2840 ont été retenus pour l’analyse). Les données recueillies sur la préparation et le lieu d’achat des aliments ont été résumées au moyen de statistiques descriptives. Un modèle de régression linéaire a été adapté pour permettre l’examen des corrélats de la proportion de repas prêts-à-servir ou préparés à l’extérieur du foyer.RésultatsEn tout, 80 % des repas étaient préparés au foyer et 20 % étaient préparés à l’extérieur du foyer. Plus de 25 % des repas préparés au foyer étaient des aliments prêts-à-servir/en boîte. De tous les repas consommés, 42 % étaient soit des aliments prêts-à-servir/en boîte préparés au foyer, soit des aliments préparés à l’extérieur du foyer. Les aliments pour les repas préparés au foyer étaient principalement achetés dans des épiceries ou des centres commerciaux, tandis que les repas préparés à l’extérieur du foyer étaient principalement achetés dans des débits de restauration rapide ou des cafés. Parmi les répondants, les plus jeunes, les Autochtones (auto-identifiés), les personnes obèses, les personnes sans enfants, les personnes vivant en résidence à l’école, à l’université ou au collège et celles qui déclaraient avoir peu de compétences en cuisine ont dit consommer plus de repas prêts-à-servir ou préparés à l’extérieur du foyer.ConclusionsLes constatations à ce jour indiquent que les aliments préparés à l’extérieur du foyer ou prêts-à-servir/en boîte préparés au foyer représentent une proportion importante des repas consommés par les jeunes. Les recommandations alimentaires devraient donner des consignes de bases sur la préparation et la consommation des aliments, comme de limiter les aliments ultra-transformés et les aliments préparés à l’extérieur du foyer.

The effectiveness of voluntary policies and commitments in restricting unhealthy food marketing to Canadian children on food company websites

Marketing unhealthy foods and beverages to children (M2K) fosters poor dietary patterns, increasing obesity and noncommunicable disease risk. Federal restrictions on M2K have been under development in Canada since 2016; however, at present, M2K is mostly self-regulated by food companies. This study aimed to compare M2K on Canadian websites of food companies with and without voluntary policies or commitments in this area. A systematic content analysis of company websites was conducted in spring/summer 2017 for major packaged food (n = 16), beverage (n = 12), and restaurant chain (n = 13) companies in Canada. M2K policies were sourced from company websites and published corporate documents. Sixteen companies (43%) reported national and/or global M2K policies, while 21 companies (57%) had no published policies. The websites of Canadian companies (n = 154) were scanned for child-directed products and marketing; type and frequency of marketing techniques were recorded. Child-directed marketing appeared on 19 websites of 12 companies (32%), including 9 companies with M2K policies. Websites featured products with unconventional flavours, colours, shapes, or child-oriented packaging, and used promotional characters, contests, games, activities, or lettering and graphics appealing to children. The nutritional quality of products marketed to children was evaluated using a nutrient profile model developed by Health Canada for proposed M2K regulations. Of the 217 products marketed to children, 97% exceeded Health Canadas proposed ∼5% Daily Value threshold for saturated fat, sodium, and/or sugars, 73% of which were products from 9 companies with policies. These findings highlight the limitations of self-regulation in restricting M2K on food company websites, reinforcing the need for government regulations.