The Heart and Stroke Foundation Still Backpedaling on Trans-Fats

For long time readers, the Heart and Stroke Foundation hypocrisy highlighted here is not exactly going to be news. Newer readers on the other hand may find it surprsing.

You see the Heart and Stroke Foundation and most specifically their CEO Sally Brown are heavily entrenched in the war against trans-fats.

Only thing is, appeasement appears to be their battle cry.

Yesterday the trans-fat monitoring program coadministered by Health Canada and the Heart and Stroke Foundation released their year two findings.

The results?

Not surprisingly the non-regulated approach to removing trans-fat, referred to by Sally Brown in the past as a toxin unsafe in any amount, from our food supply is piecemeal at best. Still plenty of major transgressors and with no teeth to bite them and no incentives or disincentives other than market pressure (which does in fact amount to something - trans-fat free labels help sell foods), not much hope that anything real is going to happen anytime soon.

Of course none of this is a surprise to the Heart and Stroke Foundation's CEO Sally Brown as you'll see below, yet over the past few years, she has been very vocal about her support of this ridiculous voluntary approach afforded to industry.

One ray of light though - perhaps not everyone at the Heart and Stroke Foundation is as comfortable as Ms. Brown at dismissing the absolute need for regulation as Mr. Stephen Samis, the Scientific Director of the Heart and Stroke Foundation, last night on CBC televsion stated,

"We still do believe that the best way to regulate this across the country on a national scale is through regulation."

Below are a collection of posts from Ms Brown issued before the government decided to give Big Food the unconscionable gift of self-"regulation".

Frankly I feel badly for Ms. Brown, as I can't imagine that the woman who made the quotes below is truly ok with the charade of effort that has come to pass over the course of these past two years.

Here's some of what she had to say before she decided or was forced to kowtow to either Big Food or governmental pressure:

(By the way, the formal press release? Conducted at a Swiss Chalet. Nice to know the government and the Heart and Stroke Foundation think eating out is a good plan)

"Taking all the evidence into consideration, the task force agreed to a regulatory approach to effectively eliminate trans-fat in all processed foods"

Sally Brown, CBC News Jun. 28, 2006

The task force took many factors into consideration and was careful in choosing the limits and timeline that it did"

"When you're changing public policy, you have to come up with a solution that is doable, practical but meets your outcomes and that's what we very much tried to do"

"We believe if these regulations were promulgated, Canada would become a world leader in this area"

Sally Brown, Vancouver Sun Jun. 28th, 2006

"The problem is, without regulations, we won't get everyone on board and it's harder to get product changes. Unlike french fries, with something like doughnuts and chocolate bars, you have to take it out of the formulation which is more difficult. We needed regulations uniform across both sectors"

Sally Brown, Vancouver Sun Nov. 1st, 2006

"Trans fats are a "toxic" killer that need to be removed from the food chain as soon as possible"

"We know that the government is taking our recommendations very seriously, but we also know that they're getting some push back from industry who traditionally don't like regulatory approaches"

"Our argument is, if you don't regulate it, it'll be piecemeal"

"We also say that by regulating it, you're sending a signal to the marketplace to ... create healthier oils."

"We think we've given the government a great opportunity to implement what was a consensus report," she said. "[The food industry] supported all the recommendations, they're ready to act. Now we need the government to act."

Sally Brown, National Post Jan. 11th, 2007

"We don't understand why the federal government has not moved on this important health issue,"

"We want this toxin - which is what it is - removed from our food supply"

"Canadians are consuming on average 2.5 times the daily limit, and in some age groups, much higher than that"

Sally Brown, CNews, Apr. 5th, 2007

"could account for between 3,000 and 5,000 Canadian deaths annually from heart disease"

"The longer we wait, the more illness and in fact death will happen, so we know we have to get it out of our food supply"

"There is no safe amount of trans consumption, but many of these foods are well past recommended limits."

Sally Brown, The Windsor Star, Jun. 5, 2007

BRING BACK THE OLD SALLY BROWN!

Chatelaine Sticks it to Health Check

Canada's answer to Cosmopolitan has something not nice to say about Health Check, the Heart and Stroke Foundation's mis-information program?

Yup!

On page 71 of the August issue of Chatelaine is an article entitled, "How to Decode Food Labels". It's a 4 step process, and unfortunately the article's not available in full online.

Here's step four (emphasis mine):

"DON'T BELIEVE THE HYPE

Marketing symbols like Health Check and PC Blue Menu can be distracting, but stay vigilant. These designations don't have to follow standardized criteria the way nutrition labels do. "Just because it has the stamp doesn't mean it's the best option out there," says Yong (a Vancouver dietitian), who recommends going the extra mile by comparing and contrasting the food labels of similar products to find your healthiest bet."

I love the fact that Chatelaine magazine, not exactly a magazine known for its health reporting, is able to see through the smoke and mirrors of Health Check's deceptive advertising and hits the nail right on the head rightly labeling Health Check a, "Marketing symbol".

The most ironic part?

Remember how a few months ago I blogged about the fact that rather than fix their awful program the Heart and Stroke Foundation has apparently elected to simply spend money on huge advertisements?

Well, not 6 pages after the Chatelaine swipe are not one, but two Health Check ads. One is a full page (page 78) and the other a half page right beside.

I'm guessing they'll be getting some discounted ads in the next issue.

[Congratulations to blog reader and friend Brad, his wife Tracy and their son Jack on the birth of future Weighty Matters reader Wilson]

Health Check - The Food Guide Made Us Do It!

That's basically their new advertising campaign (paid for of course by the money raised by selling the Health Check logo).

Yesterday's full colour ad in the Ottawa Citizen actually took up 3/4 of a page and given that I've advertised in the Citizen, I'd venture that the one time cost was in the neighbourhood of $7,000-$10,000.

For those of you who aren't familiar with Health Check it's the now nationally maligned Heart and Stroke Foundation mis-information program that sells companies the right to promote their products as healthy and formally endorsed by the Heart and Stroke Foundation even if those products contain flabbergasting amounts of salt and sugar and pays no heed whatsoever to decades of medical evidence suggesting refined carbohydrates and beef are not only unhealthy choices but in fact choices that increase the risk of developing heart disease.

The program was soundly slammed by both the CBC in the Marketplace expose Hyping Health that demonstrated foods with Health Check failed to classify themselves as healthy in the far more robust Yale's ONQI and Hannaford Brothers Guiding Stars food labeling programs, as well as in the Canadian Medical Association Journal.

So what has Health Check decided to do about it?

Change their criteria to base them off of sound science?

Heaven forbid.

Instead they've decided to throw money at advertising in the hopes that Canadians have short memories.

They've also decided to formally get married to the Food Guide as evidenced in the ad above that starts with the line,

"With nutrient standards based on Canada's Food Guide"

So in effect they're saying, "don't blame us if our recommendations stink, they're simply based off the Food Guide."

"Simple" is indeed an excellent adjective to describe the brain trust behind Health Check's design.

Oh, and I love their new slogan too,

"Put Your Heart Into It - Check for Health Check"

Yeah, that sounds about right. They want you to trust in your heart's belief that the Heart and Stroke Foundation is looking out for your best interests and then shop with Health Check. What they don't want you to do is actually put your brain into it because if you do decide to use your brain you'll likely come to the conclusion that Health Check's not such a healthy choice.

The Heart and Stroke Foundation Needs Remedial Math!

You know, the fact that I think the Health Check program is nutritionally bereft and a national disgrace is debatable for some and indeed there are folks out there who disagree with me and think Health Check's great.

I think they're wrong of course (and so too does nutritional evidence) and certainly I've posted plenty on why Health Check stinks in the past.

Of course even the folks who disagree with me the most aren't going to be able to squirm their way out of acknowledging that math is certainly not Health Check's strong point.

Today I'd like to look at a page I've scanned in from Health Check's recent publication, "A Woman's Guide to Healthy Eating and Active Living" that my wonderful wife picked up for me at Sobey's.

Click the page for a larger view (the red highlighted areas are my added emphases)


So here the fantabulous dietitians of the Heart and Stroke Foundation are once again endorsing the consumption of beef. According to them,

"Choosing leaner beef is part of healthy eating"

"Beef, Goodness in Every Bite"

and,

"Eating well is easy by adding lean beef to your busy mealtimes"

Now let's put aside the fact that eating beef is certainly NOT a part of healthy eating (for more information click on the Beef tag at the end of this post to see my various concerns regarding beef). Instead I want to focus on lean ground beef.

I've gone through this math before on my blog, but for the sake of the Heart and Stroke Foundation (clearly they need some help), let's go through it again:

Following the Food Guide and eating Health Check'ed-dietitian-approved lean ground beef women are allowed 150 grams a day and men, 225 grams a day.

Lean ground beef in Canada by definition is 17% fat (extra lean is 10%).

17% of a woman's 150 gram allotment = 25.5 grams of fat.

17% of a man's 225 grams = 38.25 grams of fat.

There are 9 calories per gram of fat.

25.5 grams of fat = 229.5 calories.

38.25 grams of fat = 344.25 calories.

Health Canada, as evidenced by our food labels, believes the average adult needs 2,000 calories daily (though that's likely too much for the average woman and too little for the average man).

If only 30% of our daily calories are supposed to come from fat, 30% of 2,000 calories would mean that Health Canada recommends that we get no more than 600 calories from fat daily.

However, 229.5 calories divided by the recommended 600 total daily fat calories = 38% of the recommended daily intake of fat, while 344.25 calories divided by the recommended 600 total daily fat calories = 57% of recommended daily intake of fat!

So in case you didn't follow all of that the end result is that if you choose the Health Check'ed lean ground beef that Heart and Stroke Dietitians say, "is part of healthy eating" and you even actually restrict your portion to those recommended by the Food Guide (and let me tell you, that's not a ton of meat), then in that single serving if you're a woman you'll be consuming 38% of your total daily recommended intake of fat and if you're a man 57%.

That sure sounds like a lot.

Apparently that's even a lot for the Heart and Stroke Foundation given that highlighted on the left hand side of the page is there admonishment not to consume foods containing more than 10% of your total daily recommended value of fat.

So here we have the left hand telling us no more than 10% and the right hand telling us 38%-57% is just dandy.

Brilliant work Health Check!

(Oh, and of course I'd be remiss if I didn't point out the admonishment not to consume more than 10% also applies to sodium, yet doing the math on sodium, Health Check allows single items to contain between 21% and 57% of current daily recommended maximums and between 32% and 87% of those the Heart and Stroke Foundation themselves endorsed in signing the National Sodium Policy Statement)

Any of my readers grade school math teachers that want to do a good deed? Maybe you can give the HSF a call and offer your help.

Health Check's Latest Atrocious Product Endorsement

Yup, Health Check, the nationally disgraced Heart and Stroke Foundation front of package labeling program, is at it again.

Today's inappropriately labeled-as-healthy product is Chapman's Dark Chocolate Rapture YogurtPlus.

Per half cup you'll be getting 3 teaspoons of sugar, 3 grams of fat, 85mg of sodium and 150 calories.

I'm sure a great many consumers will be thrilled to have a "healthy", Heart and Stroke Foundation endorsed alternative to ice cream.

Well, they shouldn't get too excited.

Comparing the Chapman's frozen yogurt to another Chapman's product, Chapman's Original Dutch Chocolate ice cream you'll find that the Chapman's Health Check'ed frozen yogurt contains an identical amount of sugar, 2 grams less fat, an identical amount of sodium and 25% MORE calories than an equivalent portion of ice-cream.

Comparing it to Chapman's Premium Vanilla Fudge Chunk ice cream described on Chapman's website as,

"the essence of indulgence"

you'll still find that the Health Check'ed yogurt has an identical amount of sugar, more sodium and more calories.

Gee thanks Heart and Stroke Foundation.

Health Check Technical Advisor Doesn't Recommend Health Check

Maybe I'm reading into this, but I don't think so.

Fran Berkoff is a nutrition columnist for the Toronto Sun and Canadian Living. She's the author of Foods that Harm, Foods that Heal and she's a member of the 7 person Technical Advisory Committee for the Heart and Stroke Foundation's Health Check program.

Today in her nutrition column for the Toronto Sun she wrote a piece for Heart Month entitled, "All the Right Foods your Heart Desires". Heart Month, in case you forgot, is the Heart and Stroke Foundation's largest grassroots fundraising initiative.

Sounds like a perfect fit for a Health Check plug, and clearly Fran's not afraid to plug things as in the article she plugs Kellogg's All Bran Guardian cereal (Fran's worked for Kellogg's on multiple initiatives in the past) and Canada's Food Guide.

So in this nutrition column about foods that are Heart Healthy, written in the midst of Heart Month - the Heart and Stroke Foundation's major fundraising initiative, written by one of the Heart and Stroke Foundation's Health Check technical advisors, an advisor who is clearly comfortable promoting corporate programs and products, I think it's rather telling that she does not recommend that folks seek out the Health Check in making their product choices!

Can't say that I blame her.

[FYI: Kellogg's All Bran Guardian cereal's second ingredient is sugar. It contains over 83% the sugar of fruit loops (10 times the sugar of Cheerios), almost 50% more sodium than fruit loops, and like fruit loops it's also made with BHT, the food additive the CSPI recommended we ought to avoid if at all possible. Why am I not surprised that this particular product has a Health Check?]

Updates on Health Check

Well, there have been some changes with Health Check, but unfortunately only with their website's FAQ section which seems to be growing on an almost daily basis. It's now a whopping 27 questions long whereas six months ago, it was only 9!

Here are some of the newer frequently asked questions:

What are the Health Check's criteria for sodium/salt?

What limits have you set for sugar?

Could products without the symbol be healthier than Health Check products?

Some good questions there. Unfortunately the answers on their website (at least as of today's version of their website) are not particularly informative.

Let's look at them. Let's start with that last question,

"Could products without the symbol be healthier than Health Check products?".

Here's their complete answer,

"Health Check is a voluntary program, and we can only evaluate the products that are submitted to us. Companies that choose not to participate in Health Check may meet our criteria, but participation is their choice. We encourage consumers to read the nutrition facts panel and compare products, and know that they can always use Health Check as a quick reference to say "this product fits within a balanced diet following Canada's Food Guide."

Did you notice that they didn't in fact answer the question? The question was actually a yes or no question; it certainly didn't call for a long winded circular non-answer.

(The answer of course is "Yes, products without the symbol could be healthier than Health Check products".)

Regarding sugar and salt, here are a few choice quotes from their answers,

"The Health Check criteria for sodium for packaged products already in the program are mainly based on the values from Health Canada's Heart Health Claim (480 mg for single foods such as crackers and 960 mg for entrées such as a frozen dinner/entree) which is meant to help reduce the risk of developing heart disease.) These claims are widely accepted by the majority of health professionals and dietitians in Canada."

and,

"Until recently, Health Check did not have sugar criteria, because there are no accepted scientific national or international limits we could use to establish criteria."

Oh really?

The Canadian Stroke Network on page 8 of their winter 2008 newsletter recommended that foods containing more than 400mg of sodium be labeled as high in sodium. Frankly so too do the Heart and Stroke Foundation, Blood Pressure Canada, the Canadian Hypertension Education Program, the Canadian Hypertension Society and the Societe Quebecoise D'Hypertension Arterielle, all of who on page 2 of a 2007 joint public recommendations document advised us not to consume foods that contain greater than 10% of our total daily recommended sodium intake. If we take the current 2300mg recommendation that would mean that they, including the Heart and Stroke Foundation, would want us to avoid foods containing more than 230mg of sodium per serving.

Regarding sugar, as noted before the World Health Organization's expert consensus was to limit consumption to reflect less than 10% of total daily Calorie consumption.

So what would a person consume if they ONLY chose Health Check'ed items?

Well in the test diet I created using only Health Check'ed items, it led to the consumption of an astronomical 4,065mg of sodium and a mind-numbing 190.5g of sugar - that's 47 teaspoons of sugar - almost a full cup in one day, with sugar accounting for 30% of the day's total Calories.

Now before you conclude that I chose only those items highest in sugar and sodium, I'll tell you that I did nothing of the sort. To view my test diets, click here.

Oh, and by the way, doing the same type of test diet for children yielded 2,285mg of sodium and 40 teaspoons of sugar (also reflective of 30% of their total daily Caloric intake).

Another new development came from one of the world's most indefatigable advocates of healthy eating and evidence-based nutrition, Dr. Marion Nestle from NYU, (I link to her blog on my sidebar) who weighed in on the debate on the Canadian Medical Association Journal's website. Her response, along with a letter from me and a couple from folks "defending" Health Check are available in their entirety on the CMAJ's online response section however here's her first paragraph,

"I view front-of-package labeling programs as a slippery slope. They make it all too easy for food companies to reformulate products to make them conform to criterion cut-points. The fewer the criteria, the greater the potential for such manipulation. As I understand it, the Heart and Stroke Foundation's Health Check program currently relies on few criteria, a method that permits the Foundation to endorse foods containing amounts of sodium and sugar than would be excluded by more comprehensive criteria, and lesser amounts of health-promoting ingredients."

So keep on asking your questions to the Heart and Stroke folks and perhaps eventually they may come to recognize that Health Check is broken and that they can either roll it up or fix it.

Whether you've done so already or not, if you find all this the least bit concerning, I would urge you to voice your concerns with the folks responsible for Health Check and in positions of authority at the Heart and Stroke Foundation.

Click here to send Health Check an email, and included on the email will be Sally Brown (CEO of the Heart and Stroke Foundation), Stephen Samis (Scientific Director of the Heart and Stroke Foundation), and Terry Dean (General Manager of Health Check) as well as the members of the Technical Advisory Committee responsible for overseeing Health Check's inclusion criteria.

What can YOU do about Health Check?

Horrifyingly, the picture above was taken in the cafeteria of the Ottawa General Hospital where Health Check'ed Slush Puppies are pushed on an unsuspecting public.

Will Canadians really benefit from a front-of-package labeling program that endorses Slush Puppies as a healthy choice?

If you're like me and think the answer is a definite "NO", what can you do?

Well, if it's your first time here, you can educate yourself.

I have a great many posts on Health Check so rather than force you to wade through them, I've selected a few that should provide you with sufficient background:

The Hypocrisy of the Heart and Stroke Foundation

Heart and Stroke Foundation Pours on the Salt

Heart and Stroke Foundation Sells Junk Food to Kids

My Letter to the Heart and Stroke Foundation

Sally Brown's (their CEO's) Response

Why Health Check Matters

Why it May Soon Matter More

Health Check's Insignificant Revisions

Follow Health Check and Eat a Full Cup of Sugar a Day!

CBC Marketplace's Expose on Health Check

If you're already outraged, then I believe it's time for you to write.

First you can write to the Heart and Stroke Foundation - to the bosses and also to the people directly responsible for the Health Check criteria.

Who's responsible?

Well, I had mentioned in a prior post that on the Health Check's website there's reference to an expert technical advisory committee that established and oversee the Health Check criteria. I had also mentioned that the names of those experts were nowhere to be found on the site and that it seemed odd to me that they weren't there. Well, thanks to a kind reader, I've got the names of Health Check's Technical Advisory Committee as of January 2006.

[UPDATE: January 30th, 2008 the Health Check website posted the names of the current advisory committee]

They are:

Bretta Maloff, RD: She was the person interviewed by the CBC on the Marketplace expose, and is the chair of Health Check's technical advisory committee. She's been at Health Check from the very beginning having helped set the original Health Check nutritional criteria.

Fran Berkoff, RD: She wrote the book, "Foods that Harm, Foods that Heal".

Chantal Blais, RD: She's the head of Clinical Nutrition Service at the Clinical Research Institute of Montreal.

Sharyn Joliat, RD, MSc: She runs her own nutritional analysis company Info Access Inc.

Allison M. Stephen, PhD: She's the head of nutritional epidemiology at the Medical Research Council's Human Nutrition Research in England.

Laurie Wadsworth PhD: She's an assistant professor in the Department of Human Nutrition at St. Francis Xavier University in Antigonish.

Bernard LeBlanc, BSc: According to the Health Check website (at least as of January 30th, 2008) he's "self- employed as a consultant to the food industry."

So those seven folks presumably are in fact the dietitians (and the food industry consultant) that go shopping with you every time you buy Health Check'ed products.

Do you think they've done a great job? Have they helped you and your families make "healthier" choices?

Feel free to drop them a line. Click here to send them an email, and included on the email will be Sally Brown (CEO of the Heart and Stroke Foundation), Stephen Samis (Scientific Director of the Heart and Stroke Foundation), and Terry Dean (General Manager of Health Check)

You can also write your MP and let them know that you'd be quite unhappy were the government to adopt the Health Check as our official, national, front of package labeling program. If you don't know who your MP is, click here and using your postal code, you'll find out not only who it is, but also their email address.

You can also spread the word. Link to this post, email it to friends, Stumble it, Digg it, Facebook it, whatever - if you're concerned, please help spread awareness.

Lastly, if you're the Heart and Stroke Foundation (and I know that they do indeed read my blog) you can actually make real changes. Martin Luther King Jr. once said,

"It's always the right time to do the right thing"

Here's a wonderful opportunity for you to in fact do the right thing and in so doing, regain some of the trust you've lost through Health Check. I promise, were there real and evidence-based changes made, I would certainly be among the first to stand up and applaud.

(Unfortunately, I'm missing email addresses for: Sharyn Joliat and Bernard LeBlanc - if anyone out there has them, please email me with them and don't worry, I protect my sources).

[Hat trip to Adrian, a medical student at the University of Ottawa who during a rotation through my clinic dropped the bombshell that Health Check'ed Slush Puppies were in fact being sold at the Ottawa General Hospital and then was kind enough to snap me a picture]

Health Check's "Comprehensive" Approach

In the Canadian Press article that detailed some of my concerns with Health Check, Terry Dean chose to attack me and reported that my focus and my clinic's focus is, "very much on diet".

Of course, that's not even remotely true given that my office's staff includes physicians, registered dietitians, personal fitness trainers (with on-site facilities) and a clinical psychologist and that we actually don't have any particular diet that we espouse, nor any food that we forbid.

We do however, teach our patients a great deal about nutrition.

I think it's quite telling that rather than respond to my concerns the Heart and Stroke Foundation chose to question the messenger.

Telling, but not particularly surprising, given that their recommendations are quite indefensible as evidenced by their efforts to defend them last night on CBC's investigative journalism program Marketplace.

According to Terry Dean, Health Check's approach,

"is more of a comprehensive view that it's a public health model. It's not a sodium reduction problem, it's not a diet program, it's not a fat reduction program. Our program is based on the overall diet and general healthy eating recommendations."

and in the Ottawa Citizen article that came out the following day Mr. Dean, while admitting sugar and sodium levels were sub-optimal went on record to state that while perhaps suboptimal in one nutrient,

"In every case, there are two or three nutrients it has to have"

Two or three whole nutrients. You don't say.

So the question I've got for you today - do you think that a "comprehensive" approach to nutrition would only involve looking at 2-3 nutrients?

Looking at the Health Check criteria, here is a list of every thing Health Check considers in evaluating a product (and bear in mind, according to Terry only 2-3 things are considered per product):

1. Fat
2. Fibre
3. Sodium
4. Sugar
5. Vitamin A
6. Vitamin C
7. Calcium
8. Iron
9. Folate

That's it, that's all.

So does Terry Dean really think that there are only 9 things worth considering when evaluating the nutritional value of a food? Nope, not if he agrees with his Health Check program he doesn't, because if he agrees with his Health Check criteria, he believes that there in fact are not 9 things worth evaluating per food item, he believe that there are only 3 or 4 things worth considering. If he believes in the "comprehensive" approach of Health Check he would therefore also believe that foods should be considered in if, then rule form whereby for example if a slice of bread has less than 480mg of sodium, is a source of fibre, and is low in fat and trans fat it's good with the Health Check folks irregardless of whether or not the grain is refined or how much sugar might have been added.

Contrast Health Check's 9 nutrient if then rules with the list of nutrients and nutritional concepts recently woven together by 14 of the world's experts in nutrition into a complex food rating algorithm known as ONQI and also featured on last night's program:

1. Fiber
2. Folate
3. Vitamin A
4. Vitamin C
5. Vitamin D
6. Vitamin E
7. Vitamin B12
8. Vitamin B6
9. Potassium
10. Calcium
11. Zinc
12. Omega 3 fatty acids
13. Bioflavanoids
14. Carotenoids
15. Magnesium
16. Iron
17. Saturated fat
18. Trans fat
19. Sodium
20. Sugar
21. Cholesterol
22. Fat quality
23. Protein quality
24. Energy density
25. Glycemic load

Oh, and they apply all 25 criteria to every single food they rate.

Yup Terry, ensuring every food has "2 or 3 nutrients" is super comprehensive. Great job.

You know the Hindenburg looked great from afar as well.

[If you missed last night's show, CBC has it up on their website here.]

CBC Marketplace Takes on Health Check Tonight at 7:30pm

Sorry for the very short notice.

Watch CBC Marketplace tonight at 7:30EST on CBC television for their take on Health Check.

You might even see a familiar face!

Heart and Stroke agrees Health Check sub-optimal

Gee that's reassuring.

Terry Dean, General Manager of Health Check from an article published last Saturday in the Ottawa Citizen, apparently agreed that some Health Check products may have a sugar or sodium content that is higher than optimal.

He also reported both to the Canadian Press and the Ottawa Citizen that Health Check was:

A. Not a diet program
B. Not a sodium reduction program
C. Not a fat reduction program

Ok, so let me get this straight.

According to the General Manager of Health Check, if you choose foods using the Health Check, that won't help you reduce your weight, won't help you reduce your sodium, won't help you reduce your fat and will possibly provide you with products that have admittedly higher than recommended amounts of sugar and sodium.

Fantastic?

So what is Health Check good for again?

Oh yeah, it generates close to $3,000,000 in annual revenue for the Heart and Stroke Foundation.

I wonder if changing their criteria making them more stringent and actually evidence-based would limit the number of companies and products to which they could sell their logo?

Do you think that would affect their revenue?

Stay tuned tomorrow for an exploration of ALL of the criteria used by Health Check (don't worry, there are only 9 so it won't be that long of a post).

Health Check and the attack of Bizarro Beef

Let's go back to that press release from the Beef Information Centre where Heart and Stroke Foundation Registered Dietitian Carol Dombrow tells us that lean ground beef is a healthy choice,

"With ground beef burgers being one of the most popular meats in the summer months, having the Health Check symbol in place now helps consumers understand that lean and extra lean ground beef can be part of a healthy diet."

Now for the sake of today, let's pretend that we don't know that beef consumption increases our risk of cancer and therefore let's ignore the argument that regardless of "lean-ness", beef is a food we should limit.

Today I'd like to talk about fat.

Now I'm not personally, terrifically scared of saturated fat. Trans I avoid and unsaturated I maximize but saturated, the stuff of beef, I simply try to minimize.

Health Canada on the other hand, really doesn't like fat and it puts a blanket limitation on its consumption at 30% of your total daily calories and since the Heart and Stroke Foundation reports that it models its Health Check program off of Health Canada's recommendations, therefore they too recommend that you limit fat to 30% of your total daily calories.

The Heart and Stroke Foundation adds additional caveats to fat consumption in the directives we saw yesterday, "

"Look for a lower (10% or less) % Daily Value for fat, saturated and trans fat, cholesterol and sodium."

and

"Get less of these nutrients: Look for a lower % Daily Value (10% or less) for nutrients such as fat, saturated and trans fat and sodium"

So that seems pretty clear. Health Canada says that we should get less than 30% of total daily calories from fat and the Heart and Stroke adds that we should avoid foods containing more than 10% of our total daily fat value.

Now back to lean beef (and sorry, some math too).

Following the Food Guide and eating Health Check'ed lean beef women can have 150 grams a day and men, 225 grams a day.

Lean beef by definition is 17% fat (extra lean is 10%).

17% of women's 150 grams = 25.5 grams of fat.

17% of men's 225 grams = 38.25 grams of fat.

There are 9 calories per gram of fat.

25.5 grams of fat = 229.5 calories.

38.25 grams of fat = 344.25 calories.

Health Canada, as evidenced by our food labels, believes the average adult needs 2,000 calories daily (though that's likely too much for the average woman and too little for the average man).

If only 30% of our daily calories are supposed to come from fat, 30% of 2,000 calories would mean that Health Canada recommends that we get no more than 600 calories from fat daily.

Therefore, 229.5 calories divided by the recommended 600 total daily fat calories = 38% of the recommended daily intake of fat,

and,

344.25 calories divided by the recommended 600 total daily fat calories = 57% of recommended daily intake of fat.

So in case you didn't follow all of that the end result is that if you choose the Health Check'ed lean ground beef that Heart and Stroke Dietitian Carol Dombrow says can be part of your healthy diet and you actually restrict your portion to those recommended by the Food Guide (and let me tell you, that's not a ton of meat), then in that single serving if you're a woman you'll be consuming 38% of your total daily recommended intake of fat and if you're a man 57%, this despite the fact that the Heart and Stroke Foundation also recommends that you avoid choosing any item containing more than 10% of your total dietary fat daily value.

So I've got a few questions here.

Firstly the obvious one, can I have some of what the folks over at the Heart and Stroke Foundation's Health Check are smoking because their world certainly seems much kinder and gentler than mine.

Secondly though, and this one's glaring. Even putting aside all of these astronomical numbers, can you explain to me why the Heart and Stroke Foundation has agreed to lend its good name to lean ground beef when extra-lean ground beef, with 41% less fat than lean ground beef, is readily available?

It make me wonder if that Marvel Comics bizarro code, "Us do opposite of all earthly things" is posted outside the Health Check offices.

[Though you should know, run those same equations with even extra-lean ground beef and the Heart and Stroke Foundation would still be giving its blessing for women to consume 22% of their total daily fat intake and men 33% from a single, approved, Health Check'ed portion, despite at the same time recommending not consuming more than 10% from any one choice]

Heart and Stroke Bashes Health Check on their own.

But because they apparently live in bizarro-world, they probably don't even realize they have.

On the Heart and Stroke Foundation's Health Check website there's a sidebar linked to a PDF entitled, "A food label can tell you alot!".

If you click it you'll get a PDF explaining how to read a food label. I've got nothing to criticize from their directions and would like to pull one of their directives out for my readers,

"Look for a lower (10% or less) % Daily Value for fat, saturated and trans fat, cholesterol and sodium."

Pretty good advice.

So good in fact, they've repeated it and published it in their October 2007 Healthwise newsletter where one of the Heart and Stroke Foundation's Registered Dietitians Alyssa Rolnick wrote a piece entitled, "Judge a food by its label". She provides a four step program to employ when reading food labels. Here's step 3,

"Step 3 Get less of these nutrients: Look for a lower % Daily Value (10% or less) for nutrients such as fat, saturated and trans fat and sodium."

So that sounds pretty clear. If an item contains more than 10% the daily value of sodium, the Heart and Stroke Foundation thinks you should avoid it, right?

Apparently not.

I created some tables to illustrate what I mean.

The tables were created by taking the Health Check criteria and plotting the allowable limits per item on sodium vs. what that would mean in percent daily value looking at both the current 2300mg recommendation and the 1500mg recommendation (coming from the National Sodium Policy Statement that the Heart and Stroke Foundation signed).

Let's have a peek:

Grocery Store Food Item	Health Check	%DV	%DV
	Allowable	Sodium	Sodium
	Sodium	2300mg	1500mg
ALL GRAIN PRODUCTS	480 mg	21%	32%
Canned Vegetables	480 mg	21%	32%
Frozen Vegetables	480 mg	21%	32%
ALL MILK PRODUCTS	480 mg	21%	32%
ALL MEAT PRODUCTS	480 mg	21%	32%
Store Pizza	480 mg	21%	32%
Veggie or Meat Pies	480 mg	21%	32%
Main Entrée Sauce	480 mg	21%	32%
Potato Salad	480 mg	21%	32%
Other Salad	480 mg	21%	32%
Tomato Juice	650 mg	28%	43%
Vegetable Juice	650 mg	28%	43%
Soups	650 mg	28%	43%
Store Dinner Entrees	720 mg	31%	48%
Store Mixed Dishes	720 mg	31%	48%

Yes, you're reading the table correctly. Not one item, not a single one, has criteria that would limit sodium to less than 10% of your total daily value - thereby allowing the food industry to happily market foods that can contain between 21% and 48% of your total daily recommended sodium intake as healthy, nutritious and approved by the Heart and Stroke Foundation.

But wait, it gets worse.

What about restaurants?

Restaurant Food Item	Health Check	%DV	%DV
	Allowable	Sodium	Sodium
	Sodium	2300mg	1500mg
Side Salad	480 mg	21%	32%
Appetizer	480 mg	21%	32%
Soups	650 mg	28%	43%
"Small" Entrée	960 mg	42%	64%
Pizza	960 mg	42%	64%
Large Entrée	1,300 mg	57%	87%

Again here, not one single item is limited by the Health Check criteria so as to provide no more than 10% of the daily value of sodium and now restaurants can market foods that can contain between 21% and 87% of your total daily recommended sodium intake as healthy, nutritious and approved by the Heart and Stroke Foundation - that's 87% of the National Sodium Policy Statement's daily sodium recommendation in a single Health Check'ed food item.

If any of the readers out there have Alyssa Rolnick's email, I'd love to send her a copy of these tables and ask her for her thoughts. Clearly either her recommendation to avoid foods containing greater than 10% of total daily sodium values was wrong, or she must agree that the Health Check sodium criteria are woefully deficient. Either way, I'd love to hear her explanation.

Stay tuned tomorrow for a similar post, this time looking at fat.

Heart and Stroke Thinks Cookies are Grains!

Yup, cookies.

If you click on the image above you'll see a screen capture of Health Check's nutrient criteria page for groceries. The column where I've highlighted cookies is their grain column and yes indeed, if you look carefully at the screen capture up there they also for reasons beyond me, consider potatoes a grain (last I checked they were a starchy tuber).

But let's get back to the cookies.

In what alternate universe would cookies qualify as a grain choice?

Interesting thing about cookies, Health Check and Canada's Food Guide. You see the Heart and Stroke Foundation are now on record stating that my concerns with Health Check are because I don't like Canada's Food Guide (published yesterday in the Canadian Medical Association Journal). And it's true, I don't like Canada's Food Guide, yet here's a statement that may shock you coming from me,

Canada's Food Guide does a far better job than Health Check's criteria at steering people to healthier choices.

Here's what the Food Guide has to say about cookies and a few other tidbits,

"Limiting foods and beverages high in calories, fat, sugar or salt (sodium) such as cakes and pastries, chocolate and candies, cookies and granola bars, doughnuts and muffins, ice cream and frozen desserts, french fries, potato chips, nachos and other salty snacks, alcohol, fruit flavoured drinks, soft drinks, sports and energy drinks, and sweetened hot or cold drinks."

So not only does the Food Guide not think that cookies are grains, it recommends that they be limited. It also recommends that muffins, granola bars, ice cream, french fries, fruit flavoured drinks and sweetened hot or cold drinks be limited.

The Heart and Stroke Foundation?

They use their Health Check logo to deceive Canadians into thinking that muffins, cookies, ice cream, french fries, granola bars, slush puppies and sugar sweetened milk are not only choices that shouldn't be limited but rather choices that are

"'nutritious', 'healthy', 'good for you' or 'approved by the Heart and Stroke Foundation.'"

- Carol Dombrow Registered Dietitian and nutrition consultant for the Heart and Stroke Foundation, Press release explaining how consumers interpret the Health Check

So again I've got to point out, if shopping with the Health Check is like shopping with the Heart and Stroke Foundation's dietitians, and if the Heart and Stroke Foundation's dietitians think cookies and potatoes are grains, that french fries, sugar sweetened milk and slush puppies are healthy, don't you think it's time for them to hire some new dietitians?

Oh and Heart and Stroke Foundation, please stop hiding behind the Food Guide because the fact is you don't even manage to follow the Food Guide's albeit meager nutritional recommendations.

Regular readers, this is indeed Funny Friday. It's one of those schadenfreude ones where cookies have magically become grains.

What a train wreck.

Have a great weekend.

Health Check's Insignificant Revisions

So almost a full year after the release of the new Canada's Food Guide the Heart and Stroke Foundation's Health Check has finally figured out what revisions it wants made to their incredibly poor, 16 year old, criteria.

Perhaps tellingly the revisions were released without fanfare or press release on their website this past Friday and despite noting,

"Health Check's Technical Advisory Committee, made up of dietitians and nutritional experts from across the country, have developed and recommended these changes."

a list of said dietitians and experts is nowhere to be found (Though I can't say I blame them, I wouldn't want my name attached to this mess either)

So what exactly did they change?

Not much.

Restaurant criteria stayed exactly the same.

Supermarket criteria had 6 minor adjustments:

1. Trans-fats can now only make up 5% of an item's total fat content.

[Contrast that weak limitation to these statements that the Heart and Stroke Foundation's own CEO Sally Brown made last year,

"Trans fats are a "toxic" killer that need to be removed from the food chain as soon as possible"

Sally Brown, National Post Jan. 11th, 2007

"We want this toxin - which is what it is - removed from our food supply"

Sally Brown, CNews, Apr. 5th, 2007

"The longer we wait, the more illness and in fact death will happen, so we know we have to get it out of our food supply"

"There is no safe amount of trans consumption"

Sally Brown, The Windsor Star, Jun. 5, 2007]

2. Breakfast cereals, waffles, and pancakes can now only contain 11grams or less of sugar (6 grams or less in cold breakfast cereals) per serving.

3. Breakfast cereals, waffles, and pancakes now must be "a source of fibre" (how much of course they don't specify)

4. Grain based bars (breakfast bars), muffins, snack breads and cookies may now only have 50% of their carbohydrates be sugar based.

5. A blanket fat reduction (including healthy fats) in the fats found in grain based bars, muffins, snack breads, cookies and dips.

and lastly,

6. A reduction in total sodium for dinner entrees purchased in groceries down to 720mg or less.

So to sum up:

They've recommended limiting but not eliminating trans-fats, a food additive that their own CEO called a toxin unsafe in any amount.

They've recommended some blind fat reductions thereby ignoring the concept of some fats in fact being beneficial to heart health (something even our lowly Food Guide noticed).

They've still pretty much ignored sodium so for example pieces of bread, beverages or soups with 1/3 of your total recommended sodium intake are still just dandy with them.

They've recommended a small reduction in added sugar to a very small percentage of their categories and still ignore the fact that juice is simply a glass of sugar with a few nutrients, and with no limitations on its consumption thereby also ignore the recommendations of the world's experts in childhood obesity.

They haven't touched their restaurant criteria thereby they still allow for restaurants to push salt at you in total day's worth quantities in single, Health Checked meals.

They haven't put any limits on red meat consumption despite its clear cut link with cancer and the limitations recommended by the World Cancer Research Fund and the world's experts in nutrition including Harvard's Walt Willett.

They haven't made any distinction between whole grain consumption and refined and are therefore happy selling you products that are entirely refined (this despite the new Food Guide's weak but perhaps better than nothing recommendation we make at least half of our grains whole) thereby allowing you to, with their explicit blessing, increase your risk of developing type II diabetes.

They haven't stopped endorsing junk food as healthy choices thereby continuing to lull consumers into thinking that perhaps serving their children Health Check'ed cookies, muffins or french fries are just as good and healthy as fruit and vegetables (interestingly again here even our Food Guide recommends we limit the sweet stuff and certainly unlike the Heart and Stroke Foundation doesn't suggest in any way shape or form that cookies are healthy).

They haven't banned the use of cartoon characters to peddle their foods to children - a practice universally maligned among responsible children's and nutritional advocates.

Lastly of course, they still ignore obesity inducing Calories.

Forgive me if I don't applaud.

Trans Fat Hypocrisy Continues at the Heart and Stroke Foundation

Some of my longer term readers may remember a post from a while back that contrasted the messages of the Heart and Stroke Foundation's CEO and Chairperson of Canada's trans-fat task force Sally Brown taken from before and after Tony Clement announced that our government was not going to adopt the task force's consensus recommendation to regulate trans-fats in our food supply in place of a please, pretty please wait and see gift to the food industry.

Well that hypocrisy continued a few weeks ago when the first "report card" came in. Sally Brown had this to say in the Heart and Stroke Foundation's press release on the report,

"Many companies have made significant progress in reducing trans fats, which we applaud, but other companies do not seem to be getting the message."

"At the end of the day, this first report on trans fat is mixed".

Clearly this shouldn't have been a surprise to her as prior to the official government stance she had been quoted as saying,

"if you don't regulate it, it'll be piecemeal"

A point not lost on MP Judy Wasylycia-Leis who a few weeks ago in a meeting of the Standing Committee on Health stated,

"That's my point. The task force said to put in place your regulations so that by June 2008 industry must be in compliance. You are now letting them off the hook until the spring of 2009; then you're going to assess, and then you're going to see if mandatory.... Look at how much time is wasted, when you have the facts, you have the correlation, and you know what works.

Who got to you? Why the delay? It's not industry. Who got to you, or the minister? What happened?"

I'd love to pose those same questions to Sally Brown and also to Stephen Samis, the Director of Health Policy for the Heart and Stroke Foundation who in this CBC video from April 2007 clearly made the case for a regulated approach:


If anyone knows where the Sally Brown from before has gone perhaps you could discuss her own quotes with her, more specifically the quotes she gave before she decided that along with the government the Heart and Stroke Foundation would apparently prefer to sit idly by while the industry enjoys their 2 year get out of jail free card.

"Taking all the evidence into consideration, the task force agreed to a regulatory approach to effectively eliminate transfer in all processed foods"

Sally Brown, CBC News Jun. 28, 2006

The task force took many factors into consideration and was careful in choosing the limits and timeline that it did"

"When you're changing public policy, you have to come up with a solution that is doable, practical but meets your outcomes and that's what we very much tried to do"

"We believe if these regulations were promulgated, Canada would become a world leader in this area"

Sally Brown, Vancouver Sun Jun. 28th, 2006

"The problem is, without regulations, we won't get everyone on board and it's harder to get product changes. Unlike french fries, with something like doughnuts and chocolate bars, you have to take it out of the formulation which is more difficult. We needed regulations uniform across both sectors"

Sally Brown, Vancouver Sun Nov. 1st, 2006

"Trans fats are a "toxic" killer that need to be removed from the food chain as soon as possible"

"We know that the government is taking our recommendations very seriously, but we also know that they're getting some push back from industry who traditionally don't like regulatory approaches"

"Our argument is, if you don't regulate it, it'll be piecemeal"

"We also say that by regulating it, you're sending a signal to the marketplace to ... create healthier oils."

"We think we've given the government a great opportunity to implement what was a consensus report," she said. "[The food industry] supported all the recommendations, they're ready to act. Now we need the government to act."

Sally Brown, National Post Jan. 11th, 2007

"We don't understand why the federal government has not moved on this important health issue,"

"We want this toxin - which is what it is - removed from our food supply"

"Canadians are consuming on average 2.5 times the daily limit, and in some age groups, much higher than that"

Sally Brown, CNews, Apr. 5th, 2007

"could account for between 3,000 and 5,000 Canadian deaths annually from heart disease"

"The longer we wait, the more illness and in fact death will happen, so we know we have to get it out of our food supply"

"There is no safe amount of trans consumption, but many of these foods are well past recommended limits."

Sally Brown, The Windsor Star, Jun. 5, 2007

I miss you old Sally Brown.

Heart and Stroke Dietitians - Asleep at the Switch?

Remember that Calendar from the Heart and Stroke Foundation? The one that had recipes with butter, non-skimmed milk and regular soy sauce? Well, here's another example from that calendar of why you might think that the Heart and Stroke's dietitians aren't paying too much attention to their recommendations - December's Chewy Cinnamon Oat Cookies.

My wife made those cookies yesterday. Putting aside the fact that the Heart and Stroke Foundation seemingly prefers you eat almost a half cup of sugar rather than zero-calorie sweeteners (artificially sweetened juices can't apply for Health Checks) and recommended 3 tablespoons of canola oil rather than go half and half with something like apple sauce, and adds a tremendous amount of raisins and cranberries, those aren't the weird parts. The weird part is the fact that the recipe says it makes 48 cookies. It says that because it instructs you to use a teaspoon to dole out the dough.

Really? A teaspoon?

Recognizing that a teaspoon of dough wouldn't even yield a cookie the size of a Ritz cracker my wife decided to use a tablespoon. Doing that didn't make giant cookies, it made pretty normal sized cookies. Here's a picture: