Monday, March 21, 2011

Heart and Stroke dietitian labels Health Check useless.

So what do you think is the point of a front-of-package health claims program?

I would imagine that most people would answer that a front-of-package health claims program ought to allow for easy comparisons between different foods. Certainly that'd be my definition.

Comparison between foods would be a rather important feature as presumably the front-of-package claim system is meant to be utilized as a shopping shortcut.

With that in mind, I found a recent post by Katie Jessop, a Heart and Stroke Foundation Health Check dietitian, to be very telling. The post was entitled,

"How can you possibly compare one food to another?"
In the post Katie rightly points out that with Health Check, it's in fact impossible to compare foods.


Because according to Katie (and wholeheartedly agreed upon by me), in regard to the nutritional criteria the Health Check program evaluates,
"The dimensions we have chosen are limited"
And that's a nutritional understatement.

Health Check generally only evaluates 3-4 different nutritional criteria, and it does so on a black and white basis. There's no attempt whatsoever made by Health Check to weight certain nutritional determinants as being more important than others, meaning their outdated take on low-fat carries just as much weight as their take on low-sodium, and far more than their non-existent take on refined carbohydrates.

Contrast that with Nuval, my favourite front-of-package program which in fact scores more than 30 nutritional determinants using a weighted algorithm designed by some of the most important names in the history of nutritional epidemiology. Using Nuval shoppers can easily and confidently compare the health benefits of any two foods as every food in the Supermarket will receive a Nuval score between 0-100.

Health Check on the other hand is so useless that you can't even use it to compare virtually identical Health Check'ed items to one another.

Case in point?

Those cans of diced tomatoes up above. Two have Health Checks, one doesn't.

Health Check'ed can #1, Aylmer Diced Tomatoes: 290mg sodium/half cup
Health Check'ed can #2, Aylmer Diced Tomatoes, no salt added: 20mg sodium/half cup

Can #1 has more than 14x as much sodium as can #2, yet both carry the same Check mark?

Moreover, my wife and I have noticed that not all stores carry the no salt added Aylmer tomatoes.

Therefore enter the no Health Check'ed can, Selection Diced Tomatoes: 160mg sodium/half cup.

But it's in fact basically identical to Health Check'ed can #1, with roughly half the sodium?

Guess they didn't want to pay the Heart and Stroke Foundation to belong to their misinformation program.

Health Check is a useless program. It fails to score all items in a supermarket making it easy to miss healthier, non-Check'ed items; it has no gradations to its Check making it impossible to compare even Health Check'ed items; and as so rightly noted by Health Check dietitian Katie Jessop, it only scores a very limited range of nutritional criteria and in so doing makes Health Check a program which you can't possibly use to compare one food to another.

How anyone who cares about nutrition and public health can work for Health Check is beyond me.

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  1. Totally agree with you Yoni! Yes.
    If Health Check is not helpfull, then it is confusing.
    My point is technical. What the 4.49$ label has to do with it. It is extremely overpriced. I thought that your article had to do with the end of subsides for food in the far north. If not, your photo is very confusing if not annoying. I suggest you to use a great feature of any picture software. It is call crop. Bonne journée.

  2. Mark McGill, RD (Ottawa)9:09 am


    Having read-up on Nuval, I am very intrigued and would love to see this at my local grocery store.

    I have completed the "suggest a store/chain" form, but wanted to know if you/any one else has done this for Canadian grocery chains?



  3. Mark - I spoke with David Katz about Nuval coming to Canada. He mentioned he was in talks with someone or other but was cryptic. Here's hoping.

    Paul - I can only hope that readers who take the time to read the posting won't be as confused or annoyed as you were by inclusion of a price tag extraneous to the story.

  4. Anonymous9:54 am

    Great post! I wasn't confused by the pic, btw... and what is this call crop feature?

  5. There's quite an amazing little thing called common sense that I try to use as much as possible. OK, it's not foolproof, but it makes my own little mind work and seems to often lead me in the right direction.

    I'm a label reader and here's what interests me most:
    -sodium: if there's none bravo, if there's some, you have to compare different brands using the same quantities (i.e. y sodium per x grams and not y sodium per x + 100 grams);
    -unpronounceable ingredients: inasmuch as possible, I try to avoid food additives, especially ones with names so long you need a wheelbarrow to pronounce them;
    -other unnecessary, extraneous ingredients, like sugar.

    As you point out, Health Check is a useless pseudo-shortcut.

    Vive le gros bon sens ! (Long live common sense!)

  6. Anonymous6:48 pm

    On the weekend my brother, who normally doesn't read labels said to me "how the f*** does mayo get a Health Check?"

    That made me laugh because my fat free mayo didn't have the Health Check.

    I don't put stock in those labels but I think they need to do away with that program until some guidlines can be set that actually make sense.

    PS. How the heck does Pizza Hut pizza get the Health Check??? WOW!

  7. Health Check is not objective, since the companies pay the Heart and Stroke Foundation for the privlege of Health Check. So really there is a conflict of interest there.

    The best advice: limit carbs, especially refined carbs, shop around the outside of the grocery store (instead of in the aisles), and if you are buying a lot of products with nutrition labels, you are buying the wrong food.

    In sum, the Health Check is really a way to enrich the Heart and Stroke Foundation, it is not a public service

  8. This post has been bothering me all day because of the last line you wrote. I think, rather than implying that Ms Jessop does not care about nutrition and public health, you should be applauding her moment of mini-rebellion.

    Change comes in all different forms, and can often be most effective when it comes from within. Ms Jessop pretty much states that the program is limited in its use. In public. On the internet. That's a permanent record. Do you know how hard that is? She's not biting the hand that feeds her, but she's certainly sniffing the air and wondering if it tastes good.

    I have no issues with the rest of this post, but that line was personal. I think you should thank this dietitian for telling the truth, not excoriate her for her association with a program that she admits is flawed.

    Just my two cents!

  9. That's a fair comment Gymnauseous.

    Admittedly my confirmation bias has me assuming the worst, and not the best, of folks comfortable working for Health Check.

    My assumption was that it did not even occur to her that her post effectively slammed Health Check, not that she was bravely standing up against it.

    Here's hoping your interpretation's right and mine's wrong.

  10. Michael Klaassen9:58 pm

    I think a simple and understandable rating method is much better than one that is not. Malcolm Gladwell, in a recent article in the New Yorker (14-02-11), outlines how results from collecting data can be very different by merely applying different algorithms in assessing that data. His arguments apply to colleges and cars, but would work for any kind of rating. As a consumer, I would rather know the rating system than not.

  11. Anonymous1:59 pm

    It's amazing how much salt is in pureed and chopped tinned/carton tomatoes. Even without adding salt whatever you're cooking ends up too salty. So much for the healthy option...

  12. Hi Yoni, I am a dietitian and I am bothered by your position. There are many dietitians who work in the industry, including major fast food chains like McDonald's. Dietitians who work in food industry do not care any less about the health of the public than dietitians working in hospitals. These dietitians advocate within these companies for healthier products, very often competing with the opposite -to-health agenda of the marketing department and product development teams. It is not fair for you to assume that these dietitians do not care. And I'm glad that someone else also raised this concern in the comments before me.

    As for the health check, it is not the only tool we have that we can use to decide if a product is healthy or not. There are clear criteria for which products get the health check, and Health Check Program does not receive compensation for putting a health check logo on specific products. Companies pay annual fees if they want to participate in the program, but that does not guarantee that their products will get the logo, unless they meet the criteria. In reality, many companies change their recipes so that their products can meet the criteria and in result the consumers end up with a healthier option. I think that's a good thing.

    I get your point, though. Dietitians should be recommending whole foods, unprocessed and with no added sodium, sugar or fat. The reality is, however, that packaged and canned products are here to stay and we need to be able to incorporate these foods into a healthy diet. Teaching people to eat only fresh fruits and vegetables, and unprocessed foods, is frankly too extreme, and can actually contribute to someone developing an eating disorder.

    I actually do not recommend my clients to use Health Check. I doubt any dietitian is. I teach people to read the nutrition facts table. I recommend looking at DV%, 5% or less of a nutrient is little, 15% or more is a lot. So those canned tomatoes in your post have 12% of sodium in 1/2 cup. Compared to other products out there, it is not terrible and can be used as part of a healthy diet.

    Health check can be used by people who have no access to a dietitian, as a reference, as something to look at, not follow. And there is always the nutrition facts table that can be used to compare the product.