September 15, 2000

Mr. Allan Rock, M.P., P.C.
Minister of Health
House of Commons
Ottawa, ON K1A 0A6

Re: Standards of Evidence for the Evaluation of Foods with Health Claims (June 2000); and Generic Health Claims for Foods (August 2000)

Dear Minister Rock:

     We are writing to express our serious concerns about the proposals advanced in two recently released Health Canada consultation documents concerning health claims for food. We are especially concerned that the latter document initially requested comments to be filed by stakeholders only three weeks following its release.⁽¹⁾ We are also concerned that approval of these proposals is being forced through without an adequately visible public consultation process.

     The Alliance for Food Label Reform is a 17 member coalition of non-profit organizations representing nearly two million consumers, health professionals and scientists from all across Canada. For more than three years, the Alliance has urged Health Canada and Members of Parliament to establish mandatory, comprehensive, easy-to-read nutrition information on all food labels. Comprehensive nutrition information on all foods is almost certain to produce more healthful dietary practices than the voluntary use of health claims that manufacturers use on selected products based on marketing considerations.

1. Mandatory nutrition labelling

     Given the vastly superior public health potential of mandatory nutrition labelling, Health Canada will be doing consumers a great disservice if it establishes a health claims regime without first establishing a comprehensive, mandatory nutrition labelling requirement. We are disappointed that broad support for mandatory nutrition labelling from public health experts and from the public at large has not yet produced a commitment from Health Canada, while the industry-driven proposal to authorize the use of health claims by food manufacturers has been given higher priority.

2. International experience with health claims

     On September 15, 1999, the Alliance wrote to you to express its concerns about the use of generic health claims on food labels. We regret that Health Canada has failed to address many of our concerns.

     There is a clear need for Canadian consumers to have a better understanding of the relationships between diet and disease. However, there is little evidence that health claims on a few manufacturer-selected foods — even with strict eligibility criteria — will accomplish this objective. On the contrary, health claims on a few foods (currently, less than 1% of products in the U.S.) may promote over-reliance on foods bearing claims and may discourage the consumption of more healthful foods that do not bear claims.

     While there is a theoretical potential for a market-driven health claims program to educate consumers about the health benefits of certain foods, this potential has not been demonstrated in either Japan or the U.S., where regulatory programs permitting such claims have been in place for several years. Indeed, a comprehensive report issued by the International Association of Consumer Food Organizations (IACFO) indicated that the Japanese and American programs have been beset with problems, many of which Health Canada appears willing to replicate here.

3. Criteria for validation of health claims

     a. Standards of evidence

     If health claims are to be used on food labels, standards for scientific substantiation of these claims must be set high — at the level of "significant scientific agreement among qualified experts" — in order to ensure that reliable messages are communicated and maximum health benefits accrue to consumers. Claims based on preliminary or inconclusive evidence — even with disclaimers — and claims about insignificant public health problems should be explicitly prohibited. Trivial or uncertain claims should not lure consumers away from foods that are known to be healthful, but not labelled as such. The consultation documents do not demonstrate a clear commitment to these principles.

     b. Nutritional value of foods with health claims

     Claims should not be permitted for foods that contain significant quantities of unhealthful nutrients or are of low nutritional value. Health Canada’s proposal to restrict health claims to certain food groups in the Canada Food Guide is imprecise, lacks certainty, and may not be legally enforceable. Instead, Health Canada should prohibit the use of health claims on foods that contain significant levels of fat, saturated fat, trans fatty acids, cholesterol, sodium, or added sugars. Excessive consumption of these nutrients is linked to heart disease, some forms of cancer, and obesity (which is a risk factor for diabetes and coronary heart disease). In addition, foods bearing health claims should have at least 10% of the recommended daily intake of protein, fibre, vitamin A, vitamin C, calcium, or iron so that less-than-nutritious foods, like coffee, are prohibited from making claims.

     c. Pre-market approval and transparency of application process

     We urge Health Canada to require that all claims must be approved by Health Canada prior to marketing. In addition, all industry materials tendered in support of any health claim approval must be fully accessible to the public and subject to a transparent public review process before authorization to make the claim is granted. Furthermore, the potential for bias in commercially-motivated research needs to be explicitly acknowledged by Health Canada, and the weight assigned to such research should follow an explicit appraisal of this potential.

     d. Loopholes

     All health-related claims — including biological role claims, structure/function claims, and endorsements by third party health charities — must satisfy the same standards for claim substantiation, safety, pre-market approval, and labelling as those set out for disease risk-reduction claims. Health-related claims can be easily mistaken by consumers to be authorized health claims and should, therefore, be required to meet the same high standards.

     e. Product- and food-specific claims

     Food- or product-specific claims (as opposed to generic claims) should never be permitted. By promoting the "magic bullet" approach to nutrition, such messages would run counter to accepted nutritional advice to eat a balanced diet.

4. Mandatory health claims

     If Health Canada decides to proceed with permitting health claims, despite the risks we have identified, it should set standards for claims high and require all eligible foods to make applicable claims on their labels. Alternatively, Health Canada could prohibit label claims, but require authorized generic claims to be printed on posters and placed in relevant sections of grocery stores. Voluntary health claims on a few products may simply mimic the problems of voluntary nutrition labelling. By contrast, mandatory health claims for all eligible foods would ensure that consumers have complete health information about all foods that qualify to make claims. Foods that are eligible to make more than one claim on labels (e.g., most fruits and vegetables) could either make all claims on each label or rotate the use of eligible claims. This approach is analogous to warning labels that appear on cigarette packages except that, in this case, all of the messages would be positive and would promote the sale of the foods bearing the label statements rather than discourage it.

5. Phase-in period

     If health claims are permitted, we recommend that authorization to use claims validated by Health Canada be phased-in gradually. Time is needed to monitor the impact of these claims on purchasing patterns, dietary practices and health outcomes. If a claim is having the intended effect, additional claims could be authorized on labels at a later date. Also, if health claims are shown to have deleterious effects on dietary practices, remedial measures would be much quicker and less costly (to manufacturers, government and consumers’ health) with fewer claims in the marketplace. In this regard, we note that Norway, Denmark, Australia, and New Zealand have indicated that they will examine the impact of claims before permitting health claims on foods.

6. Resources for administration

     Health Canada should require that adequate public resources are available for conducting nutritional/dietary surveillance, product inspections and evaluations, and public education to ensure that the effects of these measures effectively enhance, not impair, public health.

     In closing, we urge you to carefully consider the concerns raised here before proceeding further with the health claims labelling program for foods. We further urge you to show leadership by taking bold measures to improve the health of Canadians by promoting more effective programs, such as mandatory nutrition labelling, rather than measures that suit the marketing objectives of food manufacturers.

     If we can be of any assistance to your office in addressing these concerns, please do not hesitate to contact Alliance Coordinator, Bill Jeffery, by phone at 613-565-2140. We look forward to your reply.

Respectfully submitted,

1. The deadline was extended only two days before comments were due.