Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study
BackgroundFront-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy diets. Health Canada has recently published FOPL regulations that will require food and beverages that meet or exceed set thresholds for sodium, sugars, or saturated fat to display a ‘high in’ s...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2023.1098231/full |
| _version_ | 1797868158438080512 |
|---|---|
| author | Nadia Flexner Alena P. Ng Mavra Ahmed Mavra Ahmed Neha Khandpur Neha Khandpur Neha Khandpur Rachel B. Acton Jennifer J. Lee Mary R. L’Abbe |
| author_facet | Nadia Flexner Alena P. Ng Mavra Ahmed Mavra Ahmed Neha Khandpur Neha Khandpur Neha Khandpur Rachel B. Acton Jennifer J. Lee Mary R. L’Abbe |
| author_sort | Nadia Flexner |
| collection | DOAJ |
| description | BackgroundFront-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy diets. Health Canada has recently published FOPL regulations that will require food and beverages that meet or exceed set thresholds for sodium, sugars, or saturated fat to display a ‘high in’ symbol on the front of the package. Although a promising measure, its potential impact on dietary intakes and health have not yet been estimated in Canada.ObjectiveThis study aims to estimate (1) the potential dietary impact of implementing a mandatory FOPL among Canadian adults; and (2) the number of diet-related non-communicable disease (NCD) deaths that could be averted or delayed due to these estimated dietary changes.MethodsBaseline and counterfactual usual intakes of sodium, total sugars, saturated fats, and calories were estimated among Canadian adults (n = 11,992) using both available days of 24 h recalls from the 2015 Canadian Community Health Survey-Nutrition. The National Cancer Institute method was used to estimate usual intakes, and adjusted for age, sex, misreporting status, weekend/weekday, and sequence of recall. Estimated counterfactual dietary intakes were modeled from reductions observed in experimental and observational studies that examined changes in sodium, sugars, saturated fat, and calorie content of food purchases in the presence of a ‘high in’ FOPL (four counterfactual scenarios). The Preventable Risk Integrated ModEl was used to estimate potential health impacts.ResultsEstimated mean dietary reductions were between 31 and 212 mg/day of sodium, 2.3 and 8.7 g/day of total sugars, 0.8 and 3.7 g/day of saturated fats, and 16 and 59 kcal/day of calories. Between 2,183 (95% UI 2,008–2,361) and 8,907 (95% UI 8,095–9,667) deaths due to diet-related NCDs, mostly from cardiovascular diseases (~70%), could potentially be averted or delayed by implementing a ‘high in’ FOPL in Canada. This estimation represents between 2.4 and 9.6% of the total number of diet-related NCD deaths in Canada.ConclusionResults suggest that implementing a FOPL could significantly reduce sodium, total sugar, and saturated fat intakes among Canadian adults and subsequently prevent or postpone a substantial number of diet-related NCD deaths in Canada. These results provide critical evidence to inform policy decisions related to implementing FOPL in Canada. |
| first_indexed | 2024-04-09T23:52:44Z |
| format | Article |
| id | doaj.art-a0387cfb32c34f059fcd4293b64f274b |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-09T23:52:44Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-a0387cfb32c34f059fcd4293b64f274b2023-03-17T05:38:27ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2023-03-011010.3389/fnut.2023.10982311098231Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling studyNadia Flexner0Alena P. Ng1Mavra Ahmed2Mavra Ahmed3Neha Khandpur4Neha Khandpur5Neha Khandpur6Rachel B. Acton7Jennifer J. Lee8Mary R. L’Abbe9Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaJoannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Human Nutrition and Health, Wageningen University, Wageningen, NetherlandsCenter for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, BrazilDepartment of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, United StatesSchool of Public Health and Health Systems, University of Waterloo, Waterloo, ON, CanadaDepartment of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaBackgroundFront-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy diets. Health Canada has recently published FOPL regulations that will require food and beverages that meet or exceed set thresholds for sodium, sugars, or saturated fat to display a ‘high in’ symbol on the front of the package. Although a promising measure, its potential impact on dietary intakes and health have not yet been estimated in Canada.ObjectiveThis study aims to estimate (1) the potential dietary impact of implementing a mandatory FOPL among Canadian adults; and (2) the number of diet-related non-communicable disease (NCD) deaths that could be averted or delayed due to these estimated dietary changes.MethodsBaseline and counterfactual usual intakes of sodium, total sugars, saturated fats, and calories were estimated among Canadian adults (n = 11,992) using both available days of 24 h recalls from the 2015 Canadian Community Health Survey-Nutrition. The National Cancer Institute method was used to estimate usual intakes, and adjusted for age, sex, misreporting status, weekend/weekday, and sequence of recall. Estimated counterfactual dietary intakes were modeled from reductions observed in experimental and observational studies that examined changes in sodium, sugars, saturated fat, and calorie content of food purchases in the presence of a ‘high in’ FOPL (four counterfactual scenarios). The Preventable Risk Integrated ModEl was used to estimate potential health impacts.ResultsEstimated mean dietary reductions were between 31 and 212 mg/day of sodium, 2.3 and 8.7 g/day of total sugars, 0.8 and 3.7 g/day of saturated fats, and 16 and 59 kcal/day of calories. Between 2,183 (95% UI 2,008–2,361) and 8,907 (95% UI 8,095–9,667) deaths due to diet-related NCDs, mostly from cardiovascular diseases (~70%), could potentially be averted or delayed by implementing a ‘high in’ FOPL in Canada. This estimation represents between 2.4 and 9.6% of the total number of diet-related NCD deaths in Canada.ConclusionResults suggest that implementing a FOPL could significantly reduce sodium, total sugar, and saturated fat intakes among Canadian adults and subsequently prevent or postpone a substantial number of diet-related NCD deaths in Canada. These results provide critical evidence to inform policy decisions related to implementing FOPL in Canada.https://www.frontiersin.org/articles/10.3389/fnut.2023.1098231/fullfront-of-pack nutrition labeldietary intakesdiet-related NCDNCD and risk factorsmacrosimulation modelfood policy |
| spellingShingle | Nadia Flexner Alena P. Ng Mavra Ahmed Mavra Ahmed Neha Khandpur Neha Khandpur Neha Khandpur Rachel B. Acton Jennifer J. Lee Mary R. L’Abbe Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study Frontiers in Nutrition front-of-pack nutrition label dietary intakes diet-related NCD NCD and risk factors macrosimulation model food policy |
| title | Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study |
| title_full | Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study |
| title_fullStr | Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study |
| title_full_unstemmed | Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study |
| title_short | Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study |
| title_sort | estimating the dietary and health impact of implementing front of pack nutrition labeling in canada a macrosimulation modeling study |
| topic | front-of-pack nutrition label dietary intakes diet-related NCD NCD and risk factors macrosimulation model food policy |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2023.1098231/full |
| work_keys_str_mv | AT nadiaflexner estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT alenapng estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT mavraahmed estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT mavraahmed estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT nehakhandpur estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT nehakhandpur estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT nehakhandpur estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT rachelbacton estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT jenniferjlee estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy AT maryrlabbe estimatingthedietaryandhealthimpactofimplementingfrontofpacknutritionlabelingincanadaamacrosimulationmodelingstudy |