Explore the vast range of titles available.

Background Food labelling is a common intervention to improve diets, where the back-of-pack Nutrition Information Panel (or Nutrition Facts table (NFt)) provides comprehensive nutrition information on food packages. However, many consumers find it difficult and time-consuming to identify healthier foods using the NFt. As a result, different interpretative nutrition rating systems (INRS) may enable healthier food choices and it is essential that consumers have the tools to allow for easily accessible nutrition information. The objective of this study was to examine consumers’ perceptions of different (INRS) for delivery of nutrition information using different versions of a smartphone app, FoodFlip©. Methods This study was part of a larger randomized controlled trial examining consumer perceptions of different INRS on food products. A nationally representative commercial sample of 2008 Canadians were randomized to one of four INRS intervention groups: 1) traffic light, 2) health star rating, 3) ‘high-in’ warning labels or 4) no INRS (NFt only; control) and asked to scan or enter 20 products into FoodFlip© from a list of food products provided to them with varying levels of healthfulness. After completing the app task, participants were asked a series of 7-point Likert-scale and open-ended questions to provide opinions on the usability and functionality of the app. Results Of the survey sample of 1997 participants, 95% ( n  = 1907) completed the app task, with similar number of participants in each treatment group. The mean age was 40 ± 12 years with no differences in sociodemographic characteristics between treatment groups. The health star rating ranked significantly lower in comparison to the other treatment groups in terms of usefulness (OR, 95% CI -0.67, 0.52–0.85), believability (0.59, 0.46–0.75), and understanding (0.55, 0.44–0.71) ( p  < 0.001). The health star rating (1.20, 0.94–1.53) and control (NFt) (1,1,1) ranked significantly lower than the traffic light or the ‘high-in’ warning labels for their ability to compare the healthfulness of products ( p  < 0.001). Conclusion This study demonstrated Canadian consumers’ preference for a nutrient-specific system (i.e. traffic light or ‘high-in’ warning labels). The app, which was liked by majority of the participants for its functionality and usability, has the potential to support healthy dietary decision making and may also encourage reformulation. Trial registration NCT03290118 (Clinicaltrials.gov).

Poor nutrition is harmful to one's health as it can lead to overweight and obesity and a number of chronic diseases. Understanding consumer perceptions toward diet and nutrition is critical to advancing nutrition-related population health interventions to address such issues. The purpose of this paper was to examine Canadians' perceived health and diet status, compared to their actual health status, and general concern about their own diet and beliefs about health. Also analyzed were some of the perceived barriers to eating \"healthy\" foods, with a focus on the availability of \"healthy\" processed foods. Two surveys were administered online to a group of Canadian panelists from all ten provinces during May 2010 to January 2011. Thirty thousand were invited; 6,665 completed the baseline survey and 5,494 completed the second survey. Panelists were selected to be nationally representative of the Canadian adult population by age, sex, province and education level, according to 2006 census data. Approximately one third of Canadians perceived their health or diet to be very good while very few Canadians perceived their health or diet to be very poor. While the majority of Canadians believed food and nutrition to be very important for improving one's health, fewer Canadians were concerned about their own diets. The majority of Canadians reported difficulty finding \"healthy\" processed foods (low in salt and sugar and with sufficient vitamins and minerals). Many also reported difficulty finding healthy foods that are affordable. Although consumers believe that nutrition is one of the most important factors for maintaining health, there are still a number of attitudinal and perceived environmental barriers to healthy eating.

Background In 2010, nutrition claims were investigated in Canadian foods; however, many nutrition and other claims have been introduced since then. This study aimed to determine: i) the proportion of foods carrying claims in 2013, ii) the types and prevalence of nutrition claims (nutrient content claims, health claims, general health claims) and other claims displayed on labels in 2013, iii) and trends in use of nutrition claims between 2010 and 2013. Methods Repeated cross-sectional analysis of the University of Toronto Food Label Information Program (FLIP) of Canadian foods (2010/11 n  = 10,487; 2013 n  = 15,342). Regulated nutrition claims (nutrient content, health claims) were classified according to Canadian regulations. A decision tree was used to classify non-regulated general health claims (e.g., front-of-pack claims). Other claims (e.g., gluten-free) were also collected. Proportions of claims in 2013 were determined and χ 2 was used to test significant differences for different types of claims between 2010 and 2013. Results Overall, 49% of products in 2013 displayed any type of claim and 46% of foods in FLIP 2013 carried a nutrition claim (nutrient content claim, health claim, general health claim). Meal replacements and fruits/fruits juices were the categories with the largest proportion of foods with claims. At least one approved nutrient content claim was carried on 42.9% of products compared to 45.5% in 2010 ( p  < 0.001). Health claims, specifically disease risk reduction claims, were slightly lower in 2013 (1.5%) compared to 1.7% in 2010 ( p  = 0.225). General health claims, specifically front-of-pack claims, were carried on 20% of foods compared to 18.9% in 2010 ( p  = 0.020). Other claims, specifically gluten-free, were present on 7.3% of foods. Conclusions Nutrition and other claims were used on half of Canadian prepackaged foods in 2013. Many claims guidelines and regulations have been released since 2010; however, little impact has been seen in the prevalence of such claims in the food supply. Claims related to nutrients of public health priority, such as sugars and sodium, were not commonly used on food labels. Monitoring trends in the use of nutrition and other claims is essential to determine if their use on food labels reflects public health objectives, or instead are being used as marketing tools.

To assess the prevalence of partially hydrogenated oils (PHO), hydrogenated oils (HO) and/or both in Canadian packaged foods in 2013 and 2017 and to determine the mean trans-fatty acid (TFA) content of products declaring such oils. Repeated cross-sectional study of the Food Label Information Program. Food labels (n 32 875) were collected from top Canadian grocery retailers in 2013 and 2017. Proportions of products declaring PHO, HO and/or both in the Ingredients List were calculated by year and food category. The percentage contribution of TFA (g) to total fat (g) was calculated and compared against the voluntary TFA limits, defined as <2 % of total fat content for fats and oils, and <5 % for all other foods. Foods exceeding limits were identified. The mean TFA content (in g/serving and per 100 g) was calculated for products with these oils. The use of PHO, HO and/or both significantly decreased in Canadian foods from 2013 to 2017 (0·8 to 0·2 %, 5 to 2·4 % and 5·7 to 2·6 %, respectively, for PHO, HO and/or both). The mean TFA content of products containing PHO increased (0·34 to 0·57 g TFA/serving); although it was not statistically significant, it is still concerning that TFA content increased. The TFA content significantly decreased in foods with HO (0·24 to 0·16 g TFA/serving, P < 0·05) during 2013-2017. Products with PHO continue to be present in the Canadian marketplace, despite voluntary efforts to eliminate them. Products with HO should also be monitored, as they can also contribute to TFA content in foods.

A number of recommendations for policy and program interventions to limit excess free sugar consumption have emerged, however there are a lack of data describing the amounts and types of sugar in foods. This study presents an assessment of sugar in Canadian prepackaged foods including: (a) the first systematic calculation of free sugar contents; (b) a comprehensive assessment of total sugar and free sugar levels; and (c) sweetener and free sugar ingredient use, using the University of Toronto’s Food Label Information Program (FLIP) database 2013 (n = 15,342). Food groups with the highest proportion of foods containing free sugar ingredients also had the highest median total sugar and free sugar contents (per 100 g/mL): desserts (94%, 15 g, and 12 g), sugars and sweets (91%, 50 g, and 50 g), and bakery products (83%, 16 g, and 14 g, proportion with free sugar ingredients, median total sugar and free sugar content in Canadian foods, respectively). Free sugar accounted for 64% of total sugar content. Eight of 17 food groups had ≥75% of the total sugar derived from free sugar. Free sugar contributed 20% of calories overall in prepackaged foods and beverages, with the highest at 70% in beverages. These data can be used to inform interventions aimed at limiting free sugar consumption.

Reducing dietary salt is recommended by the 2011 United Nations Summit Declaration on Prevention of Non communicable Diseases and the World Health Organization Global Action plan for Prevention and Control of Noncommunicable Diseases, where one of the 9 global targets is a relative reduction of sodium intake by 30% by 2025. High blood pressure is a contributory factor in at least 40% of all heart disease and strokes which represent approximately 45% of NCDs. In the Americas, hypertension is a major health risk, as between 15-35% of the adult population has elevated blood pressure. This evidence led many governments in the Americas, including Argentina, Brazil, Canada, Chile, and the National Salt Reduction Initiative in the US to set salt reduction targets. These national level targets formed the basis of the Pan American Health Organization (PAHO) regional targets for the Americas for 12 major food categories and several sub-categories. In Canada, the targets for salt reduction (for 2010-2016) were used to assess interim progress in monitoring changes in sodium levels in foods between 2010 and 2013. Overall, 58% of foods met at least 1 of the 3 phases of the sodium reduction benchmark targets and the proportion exceeding maximum benchmark levels decreased from 25.2% to 20.8%. The greatest reductions in sodium were seen in imitation seafood (26%), condiments (20%), Downloaded by: breakfast cereals (20%), canned vegetables/legumes (19%), plain chips (19%), hot cereals (15%), canned condensed soup (14%), and sausages and wieners (11%), (all p<0.01), although significant reductions were not yet seen in many food categories. In 2015, PAHO in collaboration with representatives of the LatinFoods network in Argentina, Brazil, Barbados, Chile, Costa Rica, Cuba, Ecuador, Guatemala, Jamaica, Mexico, Paraguay, Panama, Peru and Trinidad and Tobago, conducted a baseline survey of packaged foods in 14 countries in the region in order to be able to assess progress in meeting the PAHO regional targets during the upcoming years for: 1) breads; 2) soups, wet and dry, noodles in broth; 3) mayonnaise; 4) cookies and biscuits; 5) cakes; 6) meat; 7) breakfast cereals; 8) dairy (cheese and processed cheese products); 9) butter/dairy spreads; 10) snacks; 11) pasta; 12) seasonings and condiments. These baseline results will be presented per food category and by country. Together these results can help with monitoring progress to reduce sodium levels in packaged foods in the Americas and will also provide information for development of enhanced sodium reduction targets and in a broader range of foods in the upcoming years. Monitoring progress in sodium reduction is an important component of national and regional efforts to reach the sodium reduction goals set by the WHO.

Background: Although packaged foods sold in retail stores must follow food labelling regulations, there are no e-grocery food labelling regulations to mandate and standardize the availability and presentation of product information. Therefore, the objective of the study was to evaluate the availability and quality of food labelling components in the Canadian e-grocery retail environment. Methods: A sample of fresh and pre-packaged products was identified on eight leading grocery retail websites in Canada, to assess the availability and quality of food labelling components. Results: Out of 555 product searches, all products were accompanied by product images with front-of-pack images more readily available (96.0%) than back-of-pack (12.4%) and other side panel images (3.1%). The following mandatory nutrition information was available for 61.1% of the products: nutrition facts table (68.8%), ingredient (73.9%), and allergen (53.8%) information. The majority of the nutrition information was available after scrolling down, clicking additionally on the description page, or viewing only as an image. Date markings were not available; packaging material information was available for 2.0% of the products. Conclusions: There was wide variability and inconsistencies in the presentation of food labelling components in the e-grocery retail environment, which can be barriers in enabling Canadians to make informed purchasing decisions.

The prevalence of overweight and obesity in Canada has increased 2.5 fold over the past 25 years [1]. Unhealthy diets are a major contributor to overweight and obesity, key risk factors for non-communicable diseases (NCDs) [2]. WHO has indicated the widespread production and marketing of energy-dense, nutrient poor foods and beverages high in fat, sugar and sodium as important contributors to obesity and NCDs [2]. As a result, public health initiatives at the nutrient level (e.g. labelling, advertising restrictions and reformulation) have been proposed as complementary strategies to improve diets. Nutrient profiling is the science of classifying or ranking foods according to their nutritional composition for reasons related to preventing disease and promoting health [3]. Thus programs such as front of pack labelling and setting reformulation targets require nutrient profiling systems that can be used in a transparent manner to define 'healthier' or 'less healthy' products for such programs. In Canada, reformulation approaches included publishing sodium reduction benchmark targets for packaged foods in 2012 (as part of the national sodium reduction strategy) and earlier voluntary trans fatty acids (TFAs) limits which also encouraged substitution with unsaturated fats. Recently, Health Canada released their Healthy Eating Strategy which included a number of efforts including front-of-pack labelling, restrictions on marketing to children, and regulations eliminating partially hydrogenated oils. However, the potential for these approaches to be successful relies in part, on reformulation efforts by industry and public monitoring of the food supply. The University of Toronto Food Label Information Program (FLIP) is a branded nutrition composition database of ~26,000 unique food and beverage products that began in 2010. Data includes national and private-label brand foods from the 4 largest Canadian grocery chains, accounting for approximately 75% of food retail sales. FLIP allows for an effective monitoring of the impact of reformulation efforts on the Canadian food supply overtime. We have utilized FLIP to comprehensively assess changes in sodium and trans fat levels in packaged foods sold in Canada from 2010 to 2013. Analyses using the FLIP database to assess changes in sodium levels indicated that 16.2% of the food categories had significant reductions in sodium levels, with significant improvements seen in imitation seafood, condiments, breakfast cereals, canned vegetables/legumes, plain chips, hot cereals, meat analogues, canned condensed soup, and sausages and wieners. However, these analyses were done at year 3, mid-way through the 6-year target goals, and over 80% of the food supply had not yet made significant progress [4]. In contrast, impressive improvements were seen in elimination of trans fat, where 97% of products were meeting the TFAs limits within 7 years [5]. With the recent announcement of a front-of-pack labelling system in Canada (i.e. Warning Signs) and other programs, examination of the Canadian food supply in relation to these policy changes will be important to monitor industry reformulation progress in meeting healthy eating goals.