Monday, January 25, 2010

2010 Weighty Matters Report on the Heart and Stroke Foundation

Coincident with the publication of this blog post there's a press conference going on at the Courtyard Marriott in Toronto where the Heart and Stroke Foundation is presenting their 2010 Annual Report on Canadians' Health. This year the report's called,

"A Perfect Storm of Heart Disease Looming on Our Horizon"
The report cites some genuinely grave statistics,
"Between 1994 and 2005, rates of high blood pressure among Canadians skyrocketed by 77%, diabetes by 45% and obesity by 18% — affecting both younger and older Canadians. Moreover, even younger age groups are experiencing increases in risk: among those 35 to 49 years of age, for example, the prevalence of high blood pressure increased 127%, diabetes by 64% and obesity by 20% — all major risk factors for heart disease."
And Dr. Beth Abramson, a Heart and Stroke Foundation spokesdoctor, sums it up brilliantly,
"Canada is truly at a crossroads. As a society we need to decide if we are going to invest in making our society more heart healthy so we can reduce our future risk, or would we rather continue to pay for a healthcare system overwhelmed by cardiac patients."
Like all of the Heart and Stroke Foundation Annual Reports this report ends with multiple calls to action with Heart and Stroke Foundation issued directives for the Federal Government, Provincial Governments and for all Canadians.

Conspicuously absent? A call to action with directives for the Heart and Stroke Foundation.

I guess that's where I'll come in. Think of this as the missing last page of the report (and certainly if heads remain firmly implanted in the sand, a new annual feature at Weighty Matters):

To the Heart and Stroke Foundation:

1. Rebuild the Health Check Program.

- Actually have the Heart and Stroke Foundation's Health Check program adopt the Heart and Stroke Foundation's own recommendation for a daily maximal intake of 1,500mg of sodium and adjust the program's criteria to bring them in line with the Canadian Stroke Network and Blood Pressure Canada's recommendation that maximal per serving sodium be 200mg.

- Create more than just a yes or no seal of approval so that foods with check marks can actually be compared to one another as there are often far healthier choices to be made even within comparable Health Check'ed products themselves.

- Evaluate all of the foods in the marketplace so that foods healthier but not a party to health check can be identified by consumers.

- Eliminate Health Check products made with refined grains (whether they're "enriched" or not).

- Eliminate beverages from the program. People should not be encouraged to drink their calories.

- Eliminate Health Check products where sugar is added as fruit juice concentrate or puree and in so doing recognize that sugar is sugar.

- Eliminate Health Check products containing processed and red meats and in so doing fall in line with organizations like the Canadian Cancer Society who unlike the Heart and Stroke Foundation, takes evidence-based nutrition seriously.

- Expand Health Check's nutrient criteria to include the literally dozens of nutritional determinants of health its current iteration ignores (right now the majority of Health Check categories only evaluate 3-4 nutritional criteria in awarding the seal).

- Eliminate restaurants from Health Check. The Heart and Stroke Foundation should be encouraging Canadians to eat out less and cook with whole foods more rather than enabling Canadians to eat out and feel a false security about their choices. "Less bad" is in fact still "bad".

2. Acknowledge the existence and importance of calories.

- Immediately add a robust energy expenditure online calculator and caloric education and guidance section to the Heart and Stroke Healthy Weight Action Plan which currently has only the most rudimentary caloric guidance.

- Issue a complementary report to go along with the "FAT - Saving a generation before it's too late" report on childhood obesity in Ontario that actually discusses the impact of calories consumed on the etiology of childhood obesity given that in the report as published, despite it being about childhood obesity, calories - the currency of weight - aren't mentioned even once.

- Add calories as a criteria to be considered for every product category in Health Check.

- Never again release any type of tool or report having to do with obesity without explicitly including and discussing calories.

3. Call for a revision to Canada's Food Guide

- The Heart and Stroke Foundation should call upon the federal government to immediately revise the Food Guide (reinforcing the Canadian Medical Association's call to have the Guide revised every 3-5 years to incorporate advances in our understanding of the impact of dietary choices on health) to provide useful guidance to Canadians on sodium consumption and thereby be consistent with our best evidence on sodium.

4. Buy a mirror

- Before criticizing federal and provincial governments, before chastising the public about their need to be more concerned about their determinants of health, the Heart and Stroke Foundation should take a good long look at themselves in the mirror. What might they see?

Health Check'ed Slush Puppies?

Health Check'ed vegetable juice with nearly a 3rd of their own daily recommended sodium maximum?

A front-of-package labeling program that thinks 3-4 nutritional determinants of food are all that matter?

Partnerships with Boston Pizza that lead to the sale of heart shaped pizzas on Valentines day (a practice akin to a lung association having a day where they promote cigarette sales in 7-11s where part of the proceeds of smoke sales would go to them)?

Reports on childhood obesity that don't mention the word calorie even once?

For such a proud and supposedly stalwart organization these glaring shortcomings besmirch their good name.

Perhaps Stephen Samis said it best in their own 2010 report,

"This is an embarrassment for all Canadians",
and while he wasn't referring to the mess I've highlighted above, he may as well have been.