Nutrient intakes and top food categories contributing to intakes of energy and nutrients-of-concern consumed by Canadian adults that would require a ‘high-in’ front-of-pack symbol according to Canadian labelling regulations

Abstract

Canada recently mandated front-of-pack (FOP) labelling regulations, where foods meeting and/or exceeding recommended thresholds for nutrients-of-concern (i.e., saturated fat, sodium, and sugars) must display a ‘high-in’ FOP nutrition symbol. However, there is limited research on the amounts and sources of foods consumed by Canadians that would require a FOP symbol. The objective was to examine the intakes of nutrients-of-concern from foods that would display a FOP symbol and to identify the top food categories contributing to intakes for each nutrient-of-concern. Using the first day 24-hour dietary recall from the nationally representative 2015 Canadian Community Health Survey-Nutrition (CCHS), Canadian adults’ intakes of nutrients-of-concern from foods that would display a FOP symbol was examined. Foods were assigned to 1 of 62 categories to identify the top food categories contributing to intakes of energy and nutrient-of-concern that would display a FOP symbol for each nutrient-of-concern. Canadian adults (n = 13,495) consumed approximately 24% of total calories from foods that would display a FOP symbol. Foods that would display a FOP symbol for exceeding thresholds for nutrients-of-concern accounted for 16% of saturated fat, 30% of sodium, 25% of total sugar, and 39% of free sugar intakes among Canadian adults. The top food category contributing intakes of each nutrient-of-concern that would display a FOP symbol were nutrient-specific: Processed meat and meat substitutes for saturated fat; Breads for sodium; and Fruit juices & drinks for total and free sugars. Our findings show that Canadian FOP labelling regulations have the potential to influence the intakes of nutrients-of-concern for Canadian adults. Using the findings as baseline data, future studies are warranted to evaluate the impact of FOP labelling regulations.

Examining the diet quality of Canadian adults and the alignment of Canadian front-of-pack labelling regulations with other front-of-pack labelling systems and dietary guidelines

“…The findings are likely related to the very low consumption of foods that are rated as "least healthy" (i.e., display a front-of-pack symbol for meeting and/or exceeding all 3 nutrients-of-concern), and the high rating of foods in the exemption criteria (i.e., 100 out of 100) according to CAN-FOPL regulations. In fact, Canadian adults consumed <1% of total energy from foods that would display a front-of-pack symbol for all 3 nutrients-ofconcern, while 35% of energy intakes came from foods that would be exempted from CAN-FOPL regulations (8), thus limiting its ability to discriminate among a wide range of foods of varying nutritional quality. The nature of the CAN-FOPL nutrient profiling model, which only focuses on nutrients-of-concern, may contribute to lower discriminatory ability to further differentiate the healthfulness of foods and diet quality, compared to the other examined nutrient profiling models (i.e., DCCP and Nutri-score), which take both nutrient-and food-based approach to rank the healthfulness of foods.…”

“…Figure 1 shows the flow chart of the nutrient profiling model developed according to Canadian FOPL regulations. FOPL regulations published in Canada Gazette II (7) were used to develop a Canadian Front-of-Pack Labelling (CAN-FOPL) nutrient profiling model (8). The model uses exemption criteria (i.e., not assessed for nutrient levels) and thresholds for 3 nutrients-of-public health concern (i.e., saturated fat, sodium, and total sugars) based on age groups (1-4year-old children; and children over 4 years of age and adults) and reference amounts (foods with a small reference amount ≤30 g or 30 mL; foods with a reference amount >30 g or 30 mL; foods with a reference amount ≥170 g for 1-4-year-old children; and foods with a reference amount ≥200 g for children over 4 years of age and adults) to classify foods into 5 categories (Exempted from FOPL regulations; Not display a symbol due to <thresholds; Display a symbol for 1 nutrient; Display a symbol for 2 nutrients; Display a symbol for 3 nutrients).…”

“…Based on the reported energy intake to total energy expenditure ratio, 50% of the respondents were identified as plausible, 44% as under-reporters and 6% as over-reporters. Detailed participant characteristics can be found elsewhere (8).…”

“…In 2022, Canada published FOPL regulations to mandate pre-packaged foods and beverages meeting and/or exceeding thresholds for nutrients-ofconcern (i.e., saturated fat, sodium, and sugars) to display a "high-in" nutrition symbol at the front of the package (7). A recent study showed that foods that would display a "high in" front-of-pack symbol, according to Canadian FOPL regulations, contribute to 15-40% of intakes of nutrients-of-public health concern among Canadian adults (8). Although one of the key guiding principles of effective FOPL is the consistency with other dietary guidelines (3), it remains unclear how Canadian FOPL regulations compare to other FOPL systems and dietary guidelines for Canadians, particularly for those with risk factors for NCDs that are more vulnerable to unhealthy diets.…”

The estimated dietary and health impact of implementing the recently approved ‘high in’ front-of-package nutrition symbol in Canada: a food substitution scenario modeling study

“…It is worth noting, however, that most of the foods that are not included in FLIP would be exempted from the ‘high in’ FOPL regulations in Canada and would not have been involved in the modeled food substitution scenarios. Then, all foods in both datasets (FID file and FLIP 2017) were assessed under final FOPL regulations published in Canada Gazette II ( 11 ), methods that have been previously published ( 45 ).…”