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Strategy Consultations on: Elimination of Partially Hydrogenated Oils & Front-of-Package Labelling December 6, 2017 Food Directorate, Health Products and Food Branch, Health Canada Welcome Élaine De Grandpré Manager, Bureau of Nutritional Sciences, Food Directorate 2 Format of the webinar • Approximately 2 hours • Presentation (1 hour) • Question and answer session (1 hour) - Submit questions at any time Use the chat panel (right hand side of your screen) to submit questions to FD Webex Host Troubleshooting • Trouble hearing? Try adjusting the volume on your phone • For technical assistance: – Call-in toll-free number: 1-800-226-6338 (Canada) – Call-in number: 1-613-941-9554 (Canada) – Or during the call, press *0 for operator assistance 4 Outline • Presentation − Healthy Eating Strategy − Prohibition of partially hydrogenated oils − Front-of-package (FOP) labelling − Openness and transparency: disclosure of stakeholder communications • Questions and answers 5 Presenters Alfred Aziz, PhD Chief, Bureau of Nutritional Sciences, Food Directorate Janice Daoust Senior Project Coodinator, Bureau of Nutritional Sciences. Food Directorate Susan Sinclair Senior Project Coodinator, Bureau of Nutritional Sciences. Food Directorate Brook Bertrand Policy Analyst Bureau of Policy Intergovernmental and International Affairs Food Directorate Anne-Marie Bédard Senior Policy Analyst, Bureau of Policy Intergovernmental and International Affairs Food Directorate 6 OVERVIEW: HEALTHY EATING STRATEGY Alfred Aziz Chief, Bureau of Nutritional Sciences, Food Directorate 7 Purpose To outline the framework under which Health Canada will fulfill the ministerial priorities on food and nutrition 8 Canada’s healthy eating challenges 1. Many Canadians do not follow a healthy eating pattern as part of a healthy lifestyle 2. Poor diet is the primary risk factor for obesity and many chronic diseases, which places a significant burden on the health of Canadians and our health care system 3. The food environment makes it increasingly difficult for Canadians to make healthy choices: • • • • • Widespread availability of inexpensive foods and beverages high in calories, fat, sodium and sugars Marketing of foods is very powerful and children are particularly vulnerable There is a constant flow of changing (and often conflicting) messages Canadians face challenges in understanding and using nutrition information Some subpopulations in Canada face challenges in accessing nutritious foods 9 Significant progress to date… • One of Canada’s most-requested government publications, Canada’s Food Guide is integrated into nutrition policies, programs, and resources across Canada • The Nutrition Facts table is used by more than 80% of Canadians when they make first time food purchases and is a credible source of nutrition information on food labels • Promising results to date in reducing levels of trans fat and sodium in foods through voluntary targets • Health Canada is supporting knowledge development initiatives to improve access and availability of nutritious foods under the Curbing Childhood Obesity Framework and the Nutrition North Canada program 10 …but important challenges remain. • Cluttered nutrition information environment with competing and often contradictory messages can erode public confidence in dietary guidance • Limited capacity to leverage partnerships and collaborations with stakeholders has limited our opportunities to advance and increase the outreach of healthy eating initiatives • Emphasis on guidance and voluntary approach has diminished our ability to maximize impact through the appropriate combination of policy interventions 11 Healthy Eating Commitments Through the Mandate Letter, the Minister of Health is committed to: • Introducing new regulations to improve the food supply by eliminating industrially produced trans fats and reducing sodium in processed foods • Improving food labels to give more information on added sugars and artificial colours in processed foods • Introducing new restrictions on the commercial marketing of unhealthy food and beverages to children, to protect our children from influential marketing practices • Work with the Minister of Indigenous and Northern Affairs to update and expand the Nutrition North program, in consultation with Northern communities 12 Strategy 13 Vision for a Healthy Canada • • • • • Canada’s Food Guide Nutrition North Marketing to Kids Nutrition Facts table Front-of-Package Nutrition Labelling • Sodium Reduction • Industrial Trans Fat • Tobacco plain packaging • Vaping regulations • Prohibit menthol in tobacco • Physical activity promotion • Concussion prevention • Mental health promotion partnerships • First Nations and Inuit Hope for Wellness Help Line 14 TOWARD THE PROHIBITION OF PARTIALLY HYDROGENATED OILS IN THE CANADIAN FOOD SUPPLY Janice Daoust Senior Project Coordinator, Bureau of Nutritional Sciences Food Directorate Current Context • One key objective under the Healthy Eating Strategy is to improve the nutritional quality of the Canadian food supply. • As one way to achieve this, Health Canada is proposing to amend the Food and Drug Regulations to prohibit the use of partially hydrogenated oils (PHOs), the main source of industrially produced trans fat, in any food sold in Canada • Prohibiting PHOs will reduce trans fats in the food supply to the lowest level possible so that we achieve our public health objective: – To reduce the trans fat intakes of the great majority of Canadians to less than 1% of total energy intake Background What are trans fats? • Trans fat are a type of unsaturated fatty acid • There are two sources: Naturally occurring trans fats • Produced in the gut of some grazing animals • Small quantities of trans fat found in dairy and ruminant meats • Levels of trans fat range from 0.5 to 8% of fat content • • • • Industrially produced trans fats Partially hydrogenated oils (PHOs) are the main source Used to improve the texture and shelf life of products May be found in margarines, shortenings and baked goods Levels of trans fat range from 25 to 45% of the oil Background What are the health risks of consuming trans fat? • The risk of coronary heart disease (CHD) is substantially increased with increasing intakes of trans fat • The main mechanism through which trans fats increase CHD risk is by altering blood lipid levels: LDL “Bad” cholesterol HDL “Good” cholesterol Total/HDL cholesterol Background What are the current scientific recommendations for trans fat intake? • The Institute of Medicine advises that trans fat consumption should be as low as possible while consuming a nutritionally adequate diet • In 2003, the World Health Organization (WHO) recommended that the mean population intake of trans fat should be less than 1% of total energy • In 2008, a WHO Scientific Update concluded that this recommendation should encompass the great majority of the population and not just the population mean in order to protect vulnerable populations from having high trans fat intakes. − This goal could be achieved by the virtual elimination of PHOs from the food supply. Background Replacements for PHOs • A recent meta-regression analysis concluded that replacing the same amount, calorie for calorie, of trans fat from PHOs with either monounsaturated or polyunsaturated fats led to beneficial changes in blood lipid levels • The effects of replacing trans fat from PHOs with saturated fats led to less beneficial changes in blood lipids compared to replacing them with unsaturated fats Canadian Context • In the 1990s, Canadians had one of the highest trans fat intakes in the world, with average intakes estimated to be ~3.7% of energy • Since the early 2000s, Health Canada has pursued a multifaceted approach aimed at reducing the trans fat intakes of Canadians, which included: − Mandatory trans fat labelling − Permitting claims such as “trans fat free” − Setting voluntary targets for trans fat content − Active monitoring and open reporting on industry’s progress Canadian Context • Health Canada’s initiatives to decrease the trans fat consumption of Canadians have been very effective: − By 2007, the average trans fat intake for all Canadians had decreased to 1.42% of total energy − By 2011, the great majority of the food supply was meeting the voluntary targets for trans fat Canadian Context • As of 2011 there were still certain food categories that continued to have large proportions of foods not meeting the trans fat targets For prepackaged foods: Dairy-free cheeses Coffee whiteners Shortbread cookies Frosting Lard and shortening Refrigerated dough For foods sold in food service establishments: Biscuits Scones Cookies Canadian Context • A 2011 risk assessment by Health Canada showed that some subpopulations were at risk for higher trans fat intakes: – Children and teens – Canadians living in remote areas – Price sensitive consumers – Those who regularly consumed foods remaining high in trans fat Canadian Context • In the 2015 Mandate Letter from the Prime Minister a commitment was made to bring in tougher regulations to eliminate industrially produced trans fats • In response to the commitment, Health Canada launched a Call for Data in May 2016 to collect information on the current use of PHOs • Findings*: – Respondents: 7 manufacturers, 2 fats and oil processors, 1 restaurant, 2 industry associations and 1 academic – Many respondents indicated they were phasing out PHOs – None of the data received supported the need to maintain allowance for PHO use * The response rate was low and may not provide a comprehensive picture of the Canadian food supply Proposed Approach In order to achieve the public health objective of reducing the trans fat intake of the great majority of the population to less than 1% of total energy: Health Canada is proposing to amend the Food and Drug Regulations to prohibit the use of partially hydrogenated oils (PHOs) in foods sold in Canada Proposed Approach • Partially hydrogenated oils (PHOs) are defined as those fats and oils that have been hydrogenated, but not to complete or near complete saturation, with an iodine value greater than 4 • Health Canada is proposing that a 12 month transition period be provided following the adoption of the prohibition into regulations • Health Canada urges industry, wherever possible, to consider the use of more healthful alternatives: – e.g. the use of unsaturated rather than saturated fats to replace trans fats Global Context • The proposed approach aligns with global efforts toward the elimination of PHOs in foods: − The WHO has called for the elimination of industrially produced trans fats from the global food supply − The U.S. Food and Drug Administration issued a final determination that PHOs are no longer Generally Recognized as Safe in food − Select European Union countries have regulations restricting the content of trans fats in foods (e.g. Denmark, Austria, Hungary) − The European Commission concluded that setting a legal limit for industrially produced trans fat content would be the most effective measure for reducing intakes Consultation Health Canada is requesting comments and feedback on the proposed approach; particularly on the following key aspects: 1. Do you support Health Canada’s proposal to prohibit the use of PHOs in foods? Please explain your position. 2. Do you have any comments/concerns with the proposed definition for PHOs? 3. Do you have any comments/concerns with the proposed transition period of 12 months following adoption into regulation of the prohibition? PROPOSED FRONT OF PACKAGE (FOP) NUTRITION LABELS FOR CANADIANS Susan Sinclair Senior Project Coordinator Bureau of Nutritional Sciences Food Directorate 30 Outline • Part I - Why do we need a front-of-package system? • Part II - What is the proposed Canadian front-ofpackage approach? • Part III – What are the expected results and outcomes? • Part IV – What is Health Canada proposing with respect to other front-of-package labelling? 31 Nutrition information on food labels is regulated… • Sodium free • Lower in saturated fatty acids • Source of fibre • High in vitamin D • Excellent source of calcium • “A healthy diet low in saturated and trans fats may reduce the risk of heart disease. X food is free of saturated and trans fats.” • “A healthy diet with adequate calcium and vitamin D, and regular physical activity, help achieve strong bones and may reduce the risk of osteoporosis. X food is an excellent source of calcium and vitamin D.” • “A healthy diet low in sodium may reduce the risk of high blood pressure, a risk factor for stroke and heart disease. X food is sodium-free.” Health Claims Nutrient Content Claims Nutrition Facts table 32 …but has limitations… Nutrient Content & Health Claims • Highlights positive attributes of a food • Voluntary • Used as marketing tool Nutrition Facts table • Location on side/back limits visibility when consumers are making choices • Complexity makes it difficult for some consumers to understand • Amount of detail can overwhelm some consumers 33 …that FOP nutrition labelling can help resolve. What is FOP nutrition labelling? • Systems that use nutrient criteria and symbols to indicate that a product has certain nutrition characteristics Benefits include: • Focus on key nutrition information that consumers need to make healthier choices • Help a wider range of consumers interpret factual nutrition information to make informed choices • Improve the prominence of nutrition information when making choices at a glance • Balance claims on front of packages • Encourage industry to improve the nutritional quality of their foods There is growing interest in FOP worldwide 34 The proposed FOP approach… Health Claims Would be: • Mandatory Nutrient Content Claims Front-of-Package Nutrition Labelling key nutrients of public health concern Nutrition Facts table • Symbol-based • Visible when a food is “high in” key nutrients that contribute to negative health outcomes • Built on existing nutrition labelling 35 …focuses on three nutrients of concern. SODIUM SATURATED FAT • Excess intake can lead to high blood pressure, a major risk factor for stroke, heart and kidney disease • More than 75% of Canadians exceed the upper limit • Excess intake raise “bad” low-density lipoprotein (LDL) cholesterol levels, a risk factor for atherosclerosis and coronary heart disease • About 50% of Canadians exceed the recommended limit SUGARS • Excess intake, particularly free sugars, can lead to excess calorie consumption, and contributes to overweight and obesity • More than 50% of Canadians exceed the recommended limit 36 Thresholds for triggering FOP symbols What are the proposed nutrient thresholds? • Individual foods exceeding 15% Daily Value (DV) per serving size for sodium, sugars, and/or saturated fat would be required to display one (or more) “high in” symbol(s) on their principal display panel High in Sodium ≥ 345 milligrams / serving size High in Sugars ≥ 15 grams total sugars / serving size High in Saturated Fat ≥ 3 grams or more per serving size The levels for foods intended solely for young children (1-4 years) are provided in the consultation document 37 Nutrient thresholds for triggering FOP symbols Why 15% of the DV? • Consistent with Canadian dietary guidance which promotes healthy eating and reduces the risk of nutrition-related chronic diseases • Nutrition Facts Education Campaign and the proposed Nutrition Facts table footnote communicates that 15% DV or more is considered “a lot” for all nutrients − Stakeholders have already endorsed and adopted this message • Consistent with the established threshold for food manufacturers to make nutrient content claims (e.g., “high in calcium”) 38 Prepackaged meals • Prepackaged meals and combination dishes (e.g. lasagna) are generally made up of 2 or more individual foods combined together • To account for larger proportion of nutrients to daily intake, Health Canada is proposing to apply higher thresholds (i.e., 30% of the DVs) for these foods − “High in sodium” ≥ 690 mg − “High in sugars” ≥ 30 grams − “High in saturated fat” ≥ 6 grams 39 Foods with small reference amounts • Foods with reference amounts smaller than 50 grams or 50 mL can be significant contributors of nutrients of concern if consumed frequently • To help consumers identify products that could contribute to excess intakes, we are proposing to require these foods to apply the thresholds based on 50 grams (or 50 millilitres) . Sample food cheese cookies coffee cream Based on a Adjusted for labelled serving density 210 mg sodium 350 mg sodium per 30 g per 50 g 13 g sugars 22 g sugars per 29 g per 50 g 1.5 g saturated fat 5 g saturated fat per 15 ml per 50 ml 40 Targeted exceptions Exception Examples Foods consistent with Canadian dietary guidance • Unsweetened, whole or cut, fruits and vegetables exempted from “high in sugars” • 2% Milk exempted from “high in saturated fat” • Eggs exempted from “high in saturated fat” • Healthy vegetable oils exempted from “high in saturated fat” Foods always exempted (B.01.401 (1)(c)) • One bite confections • Pre-packaged individual portion of food (like creamers) • Milk or cream in refillable glass containers Foods conditionally exempted (B.01.401 (1)(b)) • Foods made and sold in a retail establishment • Foods sold at roadside stands, farmers markets, craft fairs, etc. • Raw, single-ingredient meat, poultry, and fish Certain foods for special dietary • Formulated liquid diets uses (Division 24 and 25) • Infant formula • Foods for use in a very low energy diet 41 Example of potential FOP symbols 42 …to improve health outcomes. High in Sodium Reinforce other healthy eating initiatives • Consistent with CFG on foods to limit • Reinforces Nutrition Facts table information High in Sugars High in Sat fat Better inform consumers • When buying foods, consumers can more easily identify products high in nutrients of public health concern related to excess intake • Complements voluntary sodium reduction strategy • Restrict marketing to children of unhealthy foods and beverages Influence composition of the food supply • Industry will be motivated to reformulate or innovate to reduce sugar, sodium, or saturated fat levels below established thresholds • Increase prevalence of healthier options available ion the market Healthier choices are easier for consumers to make Population intake of critical nutrients is reduced Improve public health by reducing important risk factors for key chronic diseases 43 NUTRIENT CONTENT CLAIMS AND OTHER NUTRITION-RELATED STATEMENTS 44 NEW: “Low in sugars” claim • To encourage foods lower in sugars, Health Canada is proposing to introduce a new "low in sugars" claim • Criteria for using the claim would require the food to have no more than 5 grams sugars: a) per reference amount and per serving, b) per 50 grams or 50 millilitres if the reference amount is 30 grams or 30 millilitres or less, or c) per 100 grams if the food is a prepackaged meal 45 NEW: “Lightly sweetened” claim • To encourage foods lower in sugars , Health Canada is also proposing to introduce a new “lightly sweetened” claim, similar to the “lightly salted” claim (item 36 in the table following B.01.513) • Conditions would require the food to have at least 50% less sugars-based ingredients compared to those added to the similar reference food that is not "low in sugars" 46 Changes to the “No added sugars” and “Unsweetened” claims • Foods that would be required to display the "high in sugars" FOP symbol could carry "no added sugars" and "unsweetened" claims under current conditions of use for these claims • To help limit potentially contradictory messages on foods, Health Canada is proposing to change the conditions of use for the "no added sugars" and "unsweetened" claims by: a) aligning the meaning of "added sugars" with the new definition of "sugars-based ingredients" and b) not permitting the claim on fruit juices that meet the threshold for "high in sugars" 47 Changes to the “Free of sugars” claim • Conditions for using the "free of sugars" claim • Less than 0.5 g of sugars per serving and per reference amount AND • Meet “free of energy” condition of less than 5 Calories per serving and reference amount. • Some foods containing high-intensity sweeteners cannot use this claim because the foods end up containing more than 5 Calories per serving. • Health Canada is proposing to change the condition so that the food instead meets the conditions for "low in energy“ rather than “free of energy" • “Low in energy” : the food contains 40 Calories or less per serving and per reference amount. 48 “Free of” claims versus quantitative statements • Certain “free of” claims have conditions beyond the nutrient named in the claim • Free of trans fat: must be less than 0.2 g trans per serving and reference amount AND the food has to meet “low in saturated fats” • Free of sugars: must be less than 0.5 g sugars per serving and reference amount AND the food has to meet “free of energy” • There is a permitted list of synonyms for these claims which include “0 trans fat” and “0 sugars” • The FDR permits quantitative statements on labels. So if the amount of trans fat is declared as 0 g in the NFt this can be reproduced outside the NFt as “0 g trans fat per serving” even if the food doesn’t meet the conditions for free of trans fats • Proposal is to no longer allow this loophole. 49 Changes to the “Lean” Claim • Currently, many portion-controlled foods for weight maintenance are not eligible to use the term "lean" in English • To provide more choices for consumers, Health Canada is proposing to allow foods represented for use in a weight maintenance diet to carry a "lean" claim 50 Representation of the amount of alcohol • Currently there are restrictions on the representation of the amount of alcohol in beverages containing less than 0.5% alcohol • To provide more choices for consumers interested in these products, Health Canada is proposing to permit the representation of the amount of alcohol in beverages containing 0-0.5% alcohol • This will allow products such as non-alcoholic beers and wines and “mocktails” to be represented as “alcohol-free” 51 Foods intended solely for young children (1 to 4 years) • There are several references to "food intended solely for children under two years of age" in the Food and Drug Regulations related to claims (sections B.01.502(g), B.01.503(2), B.01.601(1)(c)) • In the nutrition labelling amendments proposed in 2015, the age range for young children has changed • Health Canada is proposing to amend applicable sections of the regulations to reflect the new age range: i.e., “food intended solely for children under four years of age” 52 Proposed updates to the requirements for FOP labelling of four high-intensity sweeteners Brook Bertrand Policy Analyst Bureau of Policy Intergovernmental and International Affairs, Food Directorate 53 Regulatory context • High intensity sweeteners, which are used as “sugar substitutes”, are regulated as food additives in Canada • As food additives, their use is subject to pre-market approval to ensure that they are safe and that they achieve the claimed technical effect • As with any food additive, the presence of sweeteners must be indicated in the food’s list of ingredients (LOI) 54 Additional labelling requirements Foods containing the high intensity sweeteners aspartame, sucralose, acesulfame-potassium and neotame are subject to additional labelling requirements: 1. Declaration on the principal display panel (PDP) 2. Declaration of the content in mg per serving 3. For aspartame only, a statement to the effect that aspartame contains phenylalanine 55 Additional labelling requirements Statement to the effect that aspartame contains phenylalanine Aspartame content in mg per serving Declaration on the principal display panel 56 Why these additional requirements? • First introduced in 1981 with the approval of aspartame • Additional labelling deemed necessary for enabling consumers to “make use of this new substance in an informed manner” • Phenylalanine labelling added as a mitigating measure for individuals with phenylketonuria (PKU) who must avoid consuming foods with phenylalanine (which aspartame contains) • For consistency, these labelling requirements (except phenylalanine labelling) were applied to sucralose, acesulfamepotassium and neotame 57 Drivers for change Certain stakeholders have requested that the PDP declaration and the content in mg declaration be eliminated Why? • These sweeteners have an established history of safe use in Canada • Health-based rationale exists for additional labelling for aspartame but not for the other 3 sweeteners • The mandatory declaration in the list of ingredients is sufficient to allow consumers to identify the presence of these sweeteners 58 Drivers for change (cont.) • Other high-intensity sweeteners and ingredients of health concern (e.g., priority allergens) are not subject to such additional labelling requirements • Technical challenges to label design, particularly for small or irregularly-shaped packages • Canada is inconsistent with other regulators – USA, UK, EU, and Australia/New Zealand do not require a PDP declaration or content in mg declaration for any sweeteners 59 Health Canada’s proposal For sucralose, acesulfame-k and neotame: • Eliminate the requirement for the PDP declaration • Eliminate the requirement for the declaration of content in mg per serving For aspartame: • Retain the requirement for the statement that aspartame contains phenylalanine • Consider eliminating the requirements for the PDP and content in mg declarations – Targeted consultations with PKU groups underway 60 Consultation information • Online consultations • Prohibition of partially hydrogenated vegetable oils http://healthycanadians.gc.ca/health-system-systemesante/consultations/hydrogenated-oils-huiles-hydrogenees/indexeng.php • Front-of-package labelling http://healthycanadians.gc.ca/health-system-systemesante/consultations/labels-nutrition-etiquetage/index-eng.php • Please submit comments by: January 13, 2017 61 Openness and Transparency: Disclosure of stakeholder communications for healthy eating initiatives Anne-Marie Bédard Senior Policy Analyst, Bureau of Policy Intergovernmental and International Affairs, Food Directorate 62 Openness and Transparency • The Government of Canada is committed to openness and transparency, to provide Canadians with more opportunities to learn about and participate in government and, at the same time, create a more efficient and responsive government • Health Canada is making more information available to Canadians than ever before and Canadians will be offered many opportunities to input on Healthy Eating Strategy related proposals • Health Canada is taking steps towards improving the openness and transparency of its stakeholder communications on the development of Healthy Eating initiatives 63 Disclosure of Communications with Stakeholders during the Policy Development of Healthy Eating Initiatives • Health Canada developed a new policy for the disclosure of Communications with Stakeholders during the Policy Development of Healthy Eating Initiatives The details can be found on Canada.ca: http://healthycanadians.gc.ca/healthycanada-vision-canada-en-sante/transparency-stakeholder-communicationstransparence-intervenants-eng.php • What will be disclosed monthly on Canada.ca: • All meetings between stakeholders and Health Canada • Correspondence between stakeholders and Health Canada in which views, opinions and information intended to inform the development of policies related to healthy eating are relayed • Documents provided during meetings between Health Canada and stakeholders • The healthy eating initiatives covered by this policy include the elimination of industrially produced trans fat , front-of-package labelling, sodium reduction, marketing to kids, and revision of Canada’s Food Guide 64 Information and Privacy • Policy entails a significant change in the way Health Canada approaches its communications with stakeholders. • Stakeholders will be advised of this policy when a meeting is requested and will be reminded that the meeting will be publically disclosed at the onset of a meeting • Information, views and opinions intended to inform the development of policies related to healthy eating, beyond a written submission in response to a consultation, will not be treated confidentially by Health Canada. Health Canada will not accept correspondence or documents marked as confidential in this context • Personal information provided to Health Canada during stakeholder communications will be governed in accordance with the Privacy Act. • The following will be posted on Canada.ca: − Meetings: stakeholder, date, subject and purpose of the discussion and titles of any documents − Correspondence: stakeholder, date, subject and purpose of the correspondence 65 Thank you! [email protected] Nutrition labelling http://www.hc-sc.gc.ca/fn-an/label-etiquet/nutrition/index-eng.php Food and Nutrition RSS feed www.hc-sc.gc.ca/fn-an/_feeds-fils/index-eng.php NUTSCI mailing list [email protected] CSIMS https://csims-sgici.hc-sc.gc.ca/csims/login.html?lang=en 66