Monday, November 05, 2007

The Heart and Stroke Foundation Responds

Just received an email from Sally Brown, the CEO of the Heart and Stroke Foundaiton of Canada in response to my letter of last week.

I will post it below along with my response, and let you draw your own conclusions.

I'm quite curious what you folks think.

Dear Dr. Freedhoff,

Thank you for sharing your comments with us.

We also appreciate your acknowledgement of the important role that the Foundation is playing in funding important heart disease and stroke research, and championing a healthy lifestyle.

For over 50 years, the Heart and Stroke Foundation has been a leader in promoting better health to Canadians, including providing information on nutrition and healthy eating. We introduced the Health Check™ program because we heard from Canadians that they were frustrated in their efforts to identify healthy food options in the grocery store, and all the nutrition advice in the world won’t help if people can’t apply it when they’re staring at the shelves.

To display the Health Check symbol, products must comply with nutrient criteria based on Canada’s Food Guide, which is accepted by most dietitians and health professionals as the best evidence-based source of Canadian nutrition information. We understand that you do not agree.

Health Check™ products are not judged on one sole nutrient, like fat, sugar or salt, but rather on the nutrient composition of the product, including beneficial nutrients like fibre and calcium. Overall, the product must be acceptable as a healthy choice based on specific criteria in each food category.

Health Check™ is designed to contribute to a general healthy diet – it is not a sodium restricted program for people already living with heart disease, or for people on a therapeutic diet. The program criteria are based on current Canadian recommendations. The Foundation is working hard to help Canadians reduce their intake of sodium to healthier levels, in part by working with manufacturers to bring sodium levels down in foods. The changes are ongoing but will take time. In fact, the National Sodium Policy Statement that you referenced, signed by the Heart and Stroke Foundation and other top health organizations in the country, calls for Canadians to reach the daily levels that you quoted by 2020.

In the case of sugar, there are no accepted, evidence-based “safe amounts” against which we can set our criteria, but we realized that leadership was needed on this issue, so our dietitians are in the process of establishing sugar criteria for the program, and we will work with food companies to bring sugar levels down even further in Health Check™ products.

Through Health Check™, we know that we are having a positive influence on the food supply, and contributing to the reduction of salt, saturated and trans fat, and sugar in food products. Companies are reformulating their products, and introducing new ones that meet the nutrient criteria required to qualify for the Health Check™ symbol. Consumers have responded very favourably to the program, and tell us we’re meeting our objective of helping them quickly and easily identify foods that can be part of a healthy diet.

Sally Brown, CEO
Heart and Stroke Foundation of Canada
Here's my response in return,

Dear Ms. Brown,

Thank you very much for your response.

You are quite correct in noting that I am not fond of Canada’s Food Guide. I believe it is a nutritionally indefensible document that provides medically irresponsible dietary recommendations to the detriment of the health of Canadians.

I do realize that the HSF, like the AHA, has based its Health Check program off of national dietary recommendations and recognize too the political safety in such an approach.

I think it is truly a shame that political safety supplants best evidence in formulating and administering the Health Check program. Clearly refined flours, red meats, high levels of sodium and sugar are certainly not foods that our best evidence would suggest we strive to include as parts of our diets, nor would I have thought foods that along with a Disney character and a Health Check are promoted to our children.

Dr. Yoni Freedhoff, MD CCFP Dip ABBM
Obesity Medicine
Medical Director, Bariatric Medical Institute