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other·public health, nutrition, epidemiology, cardiology, food science·PMC10065472

Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study

Frontiers in Nutrition · 7 authors, 6 centres

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TL;DR

This modeling study estimated that implementing a mandatory 'high in' front-of-pack label in Canada could reduce intakes of sodium, sugars, and saturated fat, and potentially avert between 2,183 and 8,907 diet-related non-communicable disease deaths annually.

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This macrosimulation modeling study used 2015 Canadian Community Health Survey-Nutrition data to estimate the dietary and health impacts of implementing a mandatory 'high in' front-of-pack nutrition labeling (FOPL) policy in Canada. The study modeled four counterfactual scenarios based on reductions in nutrient and calorie content observed in existing experimental and observational studies. These changes were estimated to avert or delay between 2,183 and 8,907 deaths annually from diet-related NCDs, primarily cardiovascular diseases (~70%). The study notes that while FOPL could be effective, it should be accompanied by monitoring for unintended consequences and complemented by other policies like sodium reduction targets and sugar-sweetened beverage taxes. Limitations include reliance on modeled counterfactuals based on external studies and assumptions about consumer and industry responses.

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other

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public health

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ORIGINAL PAPER

PMC10065472

Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study

Frontiers in Nutrition

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ABSTRACT

Abstract Background Front-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. Objective This 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. Methods Baseline 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. Results Estimated 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. Conclusion Results 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. Keywords: front-of-pack nutrition label, dietary intakes, diet-related NCD, NCD and risk factors, macrosimulation model, food policy

CITATION EXPORT

Nadia Flexner, Alena P Ng, Mavra Ahmed et al.. Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study. Frontiers in Nutrition. (2023). https://doi.org/10.3389/fnut.2023.1098231

AUTHORS

7 · 6 CENTRES

Nadia Flexner, Alena P Ng, Mavra Ahmed, Neha Khandpur, Rachel B Acton, Jennifer J Lee, Mary R L’Abbe

1Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
2Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
3Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
4Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
5Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, United States
6School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada