Trans Fat and Sodium in Canada Moving from Knowledge to Action to Results
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1 Trans Fat and Sodium in Canada Moving from Knowledge to Action to Results 1 WHO Nutrition Guidance Advisory Group (NUGAG) Meetings Geneva, February 23, 2010 Mary R. L Abbé, PhD Earle W. McHenry Professor and Chair, Dept of Nutritional Sciences, University of Toronto
2 Outline: Two case studies Trans Fat and Salt Reduction 2 In order to develop and implement national strategies: Understand the issues; sound scientific basis for action Moving from Knowledge to Action Phase Levers for Action and Implementation Instrument(s) of choice Importance of the media/consumer awareness Developing and supporting the research agenda Follow up, monitoring, reporting, sustaining progress
3 1. Understand the issues: sound scientific basis for action 3 Establish the science/health case
4 2. Moving from Knowledge to Action Phase a) Engage key players 4 Integrating food, agriculture, and business with the health agenda Who are the key players CEO s, VPs, Directors Need for champions ideally 1 or 2 in each sector Trans Fat Task Force (23) Co chairs (Govt & Health NGO) 2 Industry 7 Government 4 Health/consumer NGOs 4 Academics 4 Health Professionals 2 Sodium Working Group (25) Chair/Vice Chair (Govt/Acad) 2 Industry 7 Government 6 Health/consumer NGOs 5 Health Professionals 5
5 5 2. Moving from Knowledge to Action Phase b) Nature of the Problem Major Food Sources Sodium Trans
6 6 Percentage of total sodium consumed from major grouped-food sources by all respondents (sandwiches split into components) Other 17% Breads 14% Potato Chips and salty snacks Rice dishes 2% 2% Eggs 2% Fish and Shellfish 2% Potatoes 3% Breakfast Cereals 3% Pizza 3% Gravies and sauces 4% Poultry dishes 4% Red Meats dishes 4% Milk Products 4% Cheese 5% Processed Meats 9% Pasta dishes 6% Vegetables, Tomatoes and Vegetable Juice 8% Soups 7% Data are based on the Canadian Community Health Survey - Cycle 2.2 on Nutrition, Statistics Canada, 2004.
7 2. Moving from Knowledge to Action Phase c) Finding Solutions 7 Common or similar solutions Complex and specific solutions needed Functional Uses of Sodium Taste saltiness Flavour enhancing Microbial safety prepared meats Dough conditioning, leavening breads Texture and bacterial growth cheeses Many firms purchased similar solutions Many firms need to develop custom solutions
8 3. Levers for Action and Implementation 8 Ideally, action should be multi level to mobilize and sustain progress International WHO Global Strategy and implementation documents Codex Alimentarius Committees: Nutrition and Foods for Special Dietary Uses (CCNFSDU), Food Labelling (CCFL) Regional Actions e.g. PAHO Trans Free Americas; EU Platform on Diet, Physical Activity and Health; PAHO regional expert group on Cardiovascular Disease Prevention through Dietary Salt Reduction National Canadian Trans Fat Task Force; Sodium Working Group; IOM Salt Panel Local: states/provinces or city action
9 4. Instrument(s) of choice Overview 9 Often employing a variety of governmental instruments at multi level is the most successful approach WHA resolutions, Codex standards Regional Frameworks, policy statements, guidelines.. National policies, guidelines, regulations Local regulations, guidelines Combined with Industry/NGO led Logos/symbols Brand identities Association or company pledges Effective Monitoring and publishing results
10 Instrument of Choice Governmental 10 Regulatory actions Labelling with claim criteria in regulations Regulations setting product or product category limits Non regulatory actions Dietary Guidelines Voluntary codes Monitoring and market forces public shaming
11 Instrument of Choice Governmental 11 Health Claims: conditions and criteria for authorizing disease risk reduction health claims based on systematic review of the evidence Nutrient Content Claims (47): criteria and requirements: quantitative (good, excellent source; trans free) and comparative (reduced) claims Mandatory Nutrition Facts table declaration of energy and 13 nutrients Health Claims Nutrient Content Claims Nutrition Labelling
12 12 Industry/NGO led instruments Symbols / Logos Broad healthy choice claims that promote overall health, healthy eating or provide dietary guidance using a broad range of logos/symbols Often no specific regulatory requirements mandating their use Some guidance may be provided e.g. healthy eating guidelines; but often are no specific standards in Regulations
13 13 5. Importance of the media/consumer awareness all have contributed to reductions Government or health led social marketing/consumer awareness campaigns A Awareness of food component / health link B Action what consumers can do themselves C Information what to look out for e.g. high trans or high sodium (i) types/classes of foods or (ii) brand comparisons within categories Media led campaigns / in depth TV or news articles / series of articles, Political agendas Health / consumer / NGO led (partnered) campaigns, public service announcements Industry led health campaigns (not brand or product specific) Marketing campaigns company or product specific
14 5. Importance of the media/consumer awareness (cont d) 14 Canadian Sodium Working Group meeting Sept 28 29, news articles on sodium appeared in Canadian newspapers during the following month (mid Oct mid Nov/09) (Google News, Canada) Major Newspaper series on Salt June July 2009 Give Your Head a Shake TV spots on actions to reduce sodium (CCPN) CSPI releases Canadian report Salty to a Fault Sept 23, 2009 Champlain Cardiovascular Disease Prevention Network (CCPN)
15 Action Campaign What consumers can do themselves 15 Champlain Cardiovascular Disease Prevention Network (CCPN)
16 16 A) International News Sodium in the same food varies internationally* Kelloggs Breakfast Cereals (Sodium mg/100 g) Country All Bran Corn Flakes Special K Canada USA Netherlands France Australia United Kingdom Source: WASH International Products Survey, July 2009
17 17 B) Creating databases for consumers using restaurant public website data Rate Your Plate series Search database Chains not included Update information Nutrition live-chats Select a meal type or restaurant (or both) to see the most recently available online nutritional information. Vancouver Sun Series Fatabase database available at:
18 18 C) Local Articles Restaurant Foods: (i) Fish and Chips Why such high sodium? probably portion size Probably 2 x portion size (422 g vs 210 g) Expected sodium levels for portion size (from the 2x weight, 2x calories; 2x fat levels) Source: Toronto Midtown Post (Jan 2010) analyzed data
19 Restaurant Foods: (ii) Pad Thai 19 Why such high sodium? probably portion size + additional Na source?? Probably is 3 to 4 x portion size (754g vs 171 g in the CNF) But (3x protein; 9x fat level; 9x sodium level) Source: Toronto Midtown Post (Jan 2010) analyzed data
20 5. Importance of the media/consumer awareness (cont d) 20 Social marketing/consumer awareness campaigns are expensive UK FSA Media Campaign approx $36 million over 3 5 years Effective awareness requires sustained activity by all sectors government, industry, health and consumer NGOs, media
21 6. Developing and supporting the research agenda 21 Solutions finding the right balance Publicly funded research for the public good vs proprietary, IP protected research Value added solutions with price premium over less healthy alternatives National niches, economic opportunities e.g. high oleic canola oils for frying applications Consumer awareness /consumer behaviour research how to affect change? Trans fat awareness 45% of Canadians claimed that they have heard or that they understand the term "trans fat (1999) vs. 79% (2005), > 90% (2008) Understand and make food selections based on trans content: 41% (2001) to 69% (2008) 89% of Canadians think that others were consuming too much sodium; but only 41% thought that they themselves were ingesting too much (2009).
22 7. Follow up, monitoring, reporting, sustaining progress 22 Pledges to work towards FSA voluntary salt reduction targets. UK retailers, including Asda, Boots, Budgens, Co op, Iceland, Marks and Spencer, Sainsbury's, Somerfield, Spar, Tesco and Waitrose Major manufacturers, such as Arla Foods, Bernard Matthews, Birds Eye, Cadbury Schweppes, Heinz, Kellogs, Kerry Foods, Kraft, McCain, Nestle, Northern Foods, Pepsico, Premier Foods, Procter & Gamble, Unilever, United Biscuits and Vion Foods
23 23 7. Follow up, monitoring, reporting, sustaining progress (cont d) A Food supply changes publishing the results are effective motivators for change (example french fries partial data only) Company Product Name/ Description Sampling Date Fat (% by weight of food) TFA 1 (% of total fat) SFA 2 (% of total fat) TFA +SFA (% of total fat) A&W French Fries Oct A&W French Fries March Arby s French Fries March Kelsey s French Fries March KFC French Fries Oct KFC French Fries March
24 Percent of restaurants and fast food chains with french fries meeting the 5% TFA of total fat limit 24 * indicates the number of establishments sampled
25 25 7B Overall Health Benefits Trans going down and Saturated Fats not increasing! Ratnayake, L Abbe, Mozaffarian. Eur J Clin Nutr Ratnayake, L Abbe, et al, J AOAC Int 2009
26 Estimated trans fat intakes in Canada in 1995, 2005 and g g g 2009 WHO Recommended Level 2-2.7g 200? Overall 76 78% of foods met the TFTF recommended limits: Has not resulted in SFA; nationally SFA remained constant (10.2 vs 10.3%) But TFA intakes still at 1.4% of E
27 Trans 4 years later Are we there yet? 27 Unequal success across different pre packaged food products categories in achieving TFA targets Examples cookies (68%), coffee whiteners (53%), tub margarines (62%), print margarines (0%), and vegetable shortenings (50%) met the TFA limits Bakery breads (100%); but poor progress for some products brownies (45%), cakes (43%), croissants (25%), Danishes (45%), garlic breads (55%), pies (36%), and tarts (67%) Fast food restaurant establishments Good progress in pizzas (100%), chicken products (79%), fish products (83%), French fries (79%), muffins (89%) and onion rings (75%) Donuts poor only 29% and have high SFA content (48% SFA) Ethnic Foods 89% meeting the TFA limits Ratnayake, L Abbe, et al, J AOAC Int 2009
28 28
29 Conclusion: Collective Action requires effort from all sectors 29 Media Health and Consumer Advocates Government Political climate Consumers Science Industry Global Initiatives Economics
30 30 Thank You! Websites: sc.gc.ca/fn an/nutrition/gras trans fats/indexeng.php sc.gc.ca/fn an/nutrition/sodium/index eng.php
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