Nutrition labels have the answers

But the answer to "how much vitamin D" is changing.

With new recommendations, Canadian doctors have increased the time many parents will spend reading nutrition labels on foods. In September, the Canadian Pediatric Society suggested women who are pregnant or breast-feeding should consider increasing their vitamin D intake to 2,000 international units (IU) a day. As recently as last June, the Canadian Cancer Society said adults should take 1,000 IU daily.

Until the Institute of Medicine issues an update to the Dietary Reference Intakes for vitamin D, Health Canada continues to recommend 200 IU of vitamin D per day for adults 19 to 50 years of age, including pregnant and lactating women. A factor of ten lower than the recent CPS suggested intake, it is this lowest recommended level that you'll find reflected in the nutrition labels on food. The current standards were set in 1997.

Vitamin D is essential to maintain normal calcium in the bloodstream, and keep healthy calcium levels in bones. That much is clear, but new evidence is also suggesting that more vitamin D in our blood might lead to less bowel and breast cancer, multiple sclerosis, and diabetes. If these connections are real, they will affect many of us. A study in 2003 found that 34% of two- to 12-year-old children in Edmonton had insufficient vitamin D levels.

In the summer, most vitamin D in the human body is made in the skin, in a chemical reaction powered by sunlight’s ultraviolet rays. But with the late fall comes less sunshine and less outdoor time for many Canadians, especially in the North. That makes it even more important to find foods that can give us the nutrients we need, including vitamin D. A key source of information to help guide our food choices is the nutrition label.

Health Canada and other institutions have worked together to provide Canadians with a reliable nutrition tool. Since the beginning of 2006, all large food companies have displayed a new nutrition label on their food products which provides accurate information in a consistent format. Smaller food companies will meet the requirements by the end of 2007.

Not every nutrient is shown on every label. If you're searching for vitamin D, check eggs and fatty fish, in which the nutrient occurs naturally. You'll also find some foods are fortified with vitamin D, such as cow's milk and margarine. Some, but not all, orange juice, soy milk, and goat's milk will also be fortified — check the label.

Why new nutrition facts labels?

To help address increasing rates of diet-related health conditions such as obesity, heart disease, high blood pressure, high cholesterol, and diabetes, the new nutrition label is designed to:

• help Canadians make informed choices for healthy living
• help better manage special diets where nutrition plays an important role
• help Canadians judge the nutritional value of more foods
• allow Canadians to compare foods more easily

What’s on the label?

Serving size

All information on the nutrition label is based on a specific amount of food. It is very important to make sure the serving sizes are the same when comparing two similar foods. Here’s an example:

Canned Soup A	Canned Soup B
Serving size - 125 mL	Serving size - 250 mL
Fibre 2 g	Fibre 2 g

 

Which canned soup has more fibre?

a) They have the same amount of fibre.

b) Canned soup A has more fibre.

c) Canned soup B has more fibre.

Answer: Canned Soup A. To compare the two soups correctly, the serving sizes must be the same. If you doubled the serving size of Canned Soup A to 250 mL (to match Canned Soup B), the amount of fibre would also double to 4 grams.

Remember, always compare the serving size to the amount of food you actually eat.

Calories

Nutrition experts agree it is important to focus on overall calorie intake by paying attention to serving sizes rather than trying to cut out fat or carbohydrates. Carbohydrate, protein, and fat are all made up of calories. Consuming too many calories, no matter where they come from, could cause weight gain even if you are eating a low fat or low carbohydrate diet.

Total fat, saturated fat, and trans fat

There are many types of fat and not all are rated equally. Some are considered “healthy” while others are not. The new nutrition label lists only saturated and trans fat because these fats are considered harmful to heart health and have been linked to increasing “bad cholesterol” and the risk of heart disease.

When comparing foods using the nutrition label:

• Choose foods that are lower in total fat.
• Look for foods that contain less than 2 grams of saturated and trans fat combined per serving.
• Choose foods that are “trans fat free” as they are even healthier choices.

Cholesterol and sodium

All foods made from animal products contain cholesterol. Some examples of foods with high levels of cholesterol include shellfish like shrimp, egg yolk, and liver. Consuming foods low in cholesterol is positive for your health, however, reducing the total amount of fat, saturated fat, and trans fat in your diet is actually more beneficial to heart health than reducing just cholesterol.

Most Canadians consume more sodium than required in the form of sodium chloride (table salt). Foods like french fries, ready-to-eat dinners, soup, and many snack foods contain large amounts of sodium.  Canada ’s Guidelines to Healthy Eating state that Canadians should limit the amount of sodium in their diet and consume no more than 2400 mg per day (equivalent to 1 teaspoon of table salt). In some people, sodium can increase blood pressure, which may lead to other heart conditions.

When comparing foods using the nutrition label:

• Choose foods with lower amounts of cholesterol and sodium.
• Remember to choose foods low in saturated and trans fat since these fats are more strongly linked to heart disease than cholesterol.

Carbohydrates, fibre, and sugars

Carbohydrates are important to health because they provide energy to the muscles and brain. However, whole grain sources of carbohydrate are more nutritious than refined sources. Whole grains contain more fibre and other vitamins and minerals.

Fibre is important to our health. It relieves constipation, helps manage blood sugars, helps to decrease “bad” cholesterol, may reduce the risk of colon cancer, and helps in weight management. On the other hand, when it comes to sugar, moderation is important. Sugary foods play a role in tooth decay, are often low in nutrients, and do not provide any benefit to our health.

When comparing foods using the nutrition label:

• Choose foods high in fibre (more than 2 grams per serving).
• Choose foods that are lower in sugar.
• Products that contain sweeteners like Aspartame, Sucralose, Saccharin, and sugar alcohols should be used in moderation.

Protein

Protein helps our muscles, organs, and immune system function properly. Most people get enough protein in their diet and do not necessarily have to compare foods using the nutrition label. Instead, choose a variety of protein-rich foods like legumes, milk products, nuts, eggs, soy products, fish, and lean meat or poultry.

Vitamin A and C, iron, and calcium

These four nutrients were chosen for the nutrition label because they all play different roles in maintaining our health.

• Vitamin A assists in the development of healthy eyesight, bones, and skin.
• Vitamin C helps to develop healthy teeth and skin and assists in tissue repair.
• Iron is responsible for helping to carry oxygen to all parts of the body.
• Calcium is very important in keeping our bones and teeth healthy and strong.

When comparing foods using the nutrition label:

• Choose foods higher in vitamin A, C, iron, and calcium.
• Read on to find out how to use percent Daily Value (%DV) to choose foods higher in these nutrients.

New features on nutrition facts labels

Percent daily value (% DV)

% DV is a simple way of finding out if a food has a little or a lot of a nutrient. They are based on recommendations for a healthy diet and represent the contribution (from 0 to 100%) the food makes towards the particular nutrient’s recommended intake for Canadians. Depending on your age and gender, you may need less or more than 100% of each of the nutrients listed, however, the %DV is a good benchmark to give you an idea of how much or how little of a nutrient a particular food contains. It is wise to strive for a lower % DV for some nutrients and a higher one for other nutrients.

Strive for a lower % DV	Strive for a higher % DV
Fat	Fibre
Saturated and trans fat	Vitamin A
Sodium	Vitamin C
	Iron
	Calcium

 

Here’s an example:

 

Which fruit cocktail has more vitamin C?

Answer: Fruit Cocktail B has more vitamin C because its % DV is higher. If you consume fruit cocktail B, you will be getting 20% of your recommended intake of vitamin C for the day.

Some nutrients on the food label do not have a % DV:

• Sugars: Since there are no general recommendations for how much or how little sugar is acceptable to consume, there is no % DV for sugar. But remember, moderation is key.
• Protein: The amount of protein Canadians consume is generally enough, so there is no % DV.
• Cholesterol: Providing a % DV for cholesterol is optional on nutrition labels. Lowering the saturated and trans fat in your diet will automatically lower the amount of cholesterol as well.

Health claims

For the first time, Health Canada has allowed diet-related health claims based on scientific evidence to be placed on food products that meet certain requirements. Choosing foods with these diet-related health claims can help influence your food choices and in turn potentially lower the risk of nutrition-related chronic diseases like cancer, diabetes, heart disease and stroke. This is where you'll find some nutrients not mentioned above, such as vitamin D. But remember, your overall eating habits are important in helping to maintain health and reduce the risk of chronic disease.

Allowed diet-related health claims:

• A healthy diet low in sodium and high in potassium — may reduce the risk of high blood pressure.
• A healthy diet adequate in calcium and vitamin D — may reduce the risk of osteoporosis. This connection is very well established, compared to more recent claims related to lower risk of cancer, diabetes, or multiple sclerosis.

• A healthy diet low in saturated and trans fat — may reduce the risk of heart disease.
• A healthy diet rich in vegetables and fruit — may reduce the risk of some types of cancer.

Take-home message

• Food labels are reliable sources of nutrition information that will help Canadians make informed choices for healthy living.
• All information on the nutrition label is based on a specific amount of food called the serving size. When you compare products, ensure that the serving sizes are the same.
• When comparing foods, choose foods with lower amounts of total fat, saturated fat, trans fat, cholesterol, and sodium. Consume sugar in moderation.
• Percent daily values (% DV) are a simple way of finding out if a food has a little or a lot of a nutrient. Strive for lower % DVs for total fat, saturated fat, trans fat, and sodium. Strive for higher % DVs for fibre, vitamins A and C, iron, and calcium.
• Health claims can help influence your food choices and in turn potentially lower the risk of nutrition-related chronic diseases.

It's probably impossible to attach a label to sunshine, so Health Canada's nutrition labels will remain our best source of information in the search for vitamin D and the many other nutrients in a healthy diet.

Cristina Cicco is a Registered Dietitian at the Specialty Food Shop in The Hospital for Sick Children.

Resources

Canadian Pediatrics Society position statement on Vitamin D:
http://www.cps.ca/english/statements/II/FNIM07-01.htm

CPS key message on Vitamin D in breastmilk and formula:
http://www.caringforkids.cps.ca/babies/VitaminD.htm

Health Canada update on Vitamin D recommendations:
http://news.gc.ca/web/view/en/index.jsp?articleid=319529