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Checking up on Health Check “As Much As Muffins and Cookies Are a Delicious Part of Our Lives, to Try and Tell Published at on Jan

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Checking up on Health Check “As Much As Muffins and Cookies Are a Delicious Part of Our Lives, to Try and Tell Published at on Jan News Checking up on Health Check “As much as muffins and cookies are a delicious part of our lives, to try and tell Published at www.cmaj.ca on Jan. 17, 2008. people that they’re a healthy choice in our diet is just madness,” Freedhoff says. hey seem at first a saving grace for He particularly objects to Health parents of picky eaters: a source Check items in the Compliments Junior T of calcium, made with whole Disney-line of foods, which includes wheat, low in saturated and trans fats; items like Mickey Mouse-shaped beef iGor muffins look and taste like choco- burgers, letter-shaped tater tots, and late Twinkies. On the front of the pack- sweetened, flavoured “Milk Buddies.” age, a cartoon gorilla grins at children “There is more sugar and more calo- wandering the grocery aisles with their ries than Coca-Cola in these beverages parents. The box’s upper right-hand cor- that they’re marketing with Disney ner displays the Heart and Stroke Foun- characters to children as healthy dation of Canada’s “Health Check” logo. choices,” Freedhoff says. “Parents will The nutrition information on the think, ‘This is great, I’m going to give back of the package reveals — in much these to my kids.’ Basically, they’re just smaller print — that the muffins are al- shoveling sugar into their mouths.” most one-third sugar. The Heart and Stroke Foundation of Rob Matthews iGor muffins are one of several Canada charges licensing fees for inclu- Health-Checked products a Canadian sion in Health Check, which requires Dr. Yoni Freedhoff, Ottawa-based spe- obesity expert is up in arms about. The that products meet nutrient criteria cialist in obesity medicine, seen here Heart and Stroke Foundation of Canada based on Canada’s Food Guide to jogging on the office treadmill, believes that parents are often “shovelling sugar” wants Health Check to become part of a Healthy Eating. Terry Dean, the general into the mouths of their children when mandatory national food labeling policy, manager of Health Check, says the fees they indulge them with some foods bear- but Dr. Yoni Freedhoff, the medical di- allow the program to be self-supporting ing The Heart and Stroke Foundation of rector of the Ottawa-based Bariatric (Box 1). As of last fall, there were 1225 Canada’s “Health Check” imprimatur. Medical Institute, says putting the seal of products bearing the Health Check logo. approval on foods that are high in sugar Dean says the program is lowering or sodium, or that contain red meat or the amounts of acceptable added sugar kind of red meat that we recommend you refined flours, is a betrayal of the trust to match 2007 revisions to the food eat — red meat that is lean or extra lean.” Canadians place in the Foundation. guide. iGor muffins are one of many Last fall, the Foundation endorsed a products that will have to change in or- national Sodium Policy Statement re- der to meet the new criteria. “We’re giv- leased by Blood Pressure Canada, which ing people time to reformulate, because says that about 1 million Canadians have we don’t want them defaulting to higher hypertension as a result of salt con- levels and going out of the program, so sumption levels. The statement recom- our hope is that they can do it.” mended consuming between 1200 and But it’s not just sugar and calories 2300 mg of sodium per day; the average that make the program questionable, Canadian consumes about 3500 mg. Freedhoff says. The World Cancer Re- It would be easy to eat a whole days’ search Fund released a report in early worth of sodium in 1 meal at Boston November linking the consumption of Pizza, eating only Health Checked red and processed meats with cancer, menu items. The lime and parmesan but Health Checks still appear on lunch shrimp skewers appetizer, for example, meats and lean beef. has 1110 mg of sodium. The Thai Stephen Samis, the Heart and chicken wrap has 1180 mg. Stroke Foundation of Canada’s director But Samis says the sodium content of health policy, takes issue with Freed- in Health Checked products is generally hoff’s interpretation of the cancer re- lower than in comparable items, and port, which “did not say, ‘don’t eat red the Foundation is gradually reducing Wayne Kondro meat. It said, ‘limit your consumption the allowable amount of sodium. “The of red meat,’ and it said ‘limit your con- sodium policy statement talked about iGor muffins and other products now sumption to something like 4–5 serv- getting Canadians down to 1500 mg per bearing the Health Check seal of ap- ings per week.’” day by 2020, not by tomorrow, and proval will have to lower their sugar Millions of Canadians eat red meat, he that’s very important. … It takes time to content to match 2007 revisions to Canada’s Food Guide. says. “So what we’ve done is said, look, if adjust the consumer palate downward. you’re going to eat red meat, this is the Canadians eat a lot of sodium. They’re 386 CMAJ • February 12, 2008 • 178(4) News used to eating a lot of sodium. They ex- say we should be drinking less milk.” dard or a number, and we’re always go- pect their food to have a certain taste The Heart and Stroke Foundation’s ing to argue whether that number is and texture, and sodium is part of that.” adherence to the food guide could be high or low. … I think Heart and Stroke That’s not good enough, Freedhoff politically motivated, linked to its at- is doing the best they can, in terms of counters. “You just can’t have it both tempts to get Health Check included in probably being the strictest out there.” ways. You can’t say that we should re- a national front-of-package labelling Cronier also acknowledges that duce sodium and then recommend program, Freedhoff surmises. “I don’t healthy choices are invariably easier for products high in sodium.” think that we could have a national pro- a dietitian than for the average con- Freedhoff says part of the problem is gram sponsored by our government sumer. “Some consumers are really that Health Check is based on the food that was at odds with our food guide.” looking for that little logo or check or guide, which he believes is heavily influ- But not all nutrition experts agree whatever to reinforce their choice so enced by the beef, dairy and restaurant with Freedhoff’s condemnation of food they don’t have to think about it.” industries (CMAJ 2006;174[5]:605-6 guide’s recommendations as “nutri- Samira Barakat, a mother of 2 who and CMAJ 2007;176[6]:752-3). “I’m not tionally indefensible.” works at Winners, notices the Health sure it would look good for the number Registered Dietitian Claire Cronier Check on certain foods, but also pays 3 beef-producing country in the world has mixed feelings about Health Check. attention to nutrition information on to say, ‘beef’s not good for you.’ “I believe that one has to look at a total the back of packages. “I always check. I Canada’s got a $20 billion dairy indus- diet rather than singling out individual don’t go by the picture,” she says. try. It’s going to be a difficult thing to foods. Everybody’s going to have a stan- Retired teacher Norma Dowdles is similarly skeptical. “Having seen this label [points at Health Check logo] and Box 1: Primary features of the Health Check program this label together [points at “V” for Vachon brand name on iGor muffins),” Created in 1999 by the Heart and Stroke Foundation of Canada as a quick means of Dowdles says “I would probably make identifying foods and restaurant menu items that meet nutrient criteria based on Canada’s Food Guide, the program aims to help Canadians make healthy food my own judgment, to be honest.” choices. “It’s like shopping with the Heart and Stroke Foundation’s dietitians,” For them, the issue is not clear-cut. organizers say. For Freedhoff, it is. “This is so — for Procedures me anyhow — black and white wrong.” Food manufacturers or restaurants submit applications for Health Check approval But he emphasizes that his problem is for a specific product or menu item. Applications must include a nutrient analysis. with Health Check, not the foundation. Applications are reviewed by Foundation dietitians and evaluated against specific “I think it’s a great organization. So, I Health Check serving sizes. Those who meet the test are issued a licence to use the want to be very clear: I’m not bashing Health Check symbol on their labels or menus. them, but I am bashing Health Check Criteria because it’s just not what we under- Criteria are established by a Health Check Technical Advisory Committee “made up stand to be true about diet and nutri- of dietitians and nutritional experts from across the country.” tion, and it promotes the very diseases Nutrient criteria (available at healthcheck.org) are fairly extensive. They were that the Heart and Stroke Foundation is revised in mid-January, with the changes to take effect in December 2009 for supposed to be rallying against.” existing products, and immediately for new ones. Generally, a product must Samis respects Freedhoff’s passion meet “entry-level” maximums for total fat, saturated fat, protein and sodium content. and concern for Canadians’ health, but adds that “he’s not the sole arbiter of For example, a 55-g serving of a breakfast cereal must have low or no added fat (3 g or less), have at least 2 g of fibre and a sodium level under 480 mg.
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