Heart health expert: Consumers deserve ‘useful’ food information

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This article is part of our special report Food & Responsible Marketing.

Ahead of a European Parliament vote tomorrow (16 June) on a European Commission proposal for a Regulation on the Provision of Food Information to Consumers, the director of the European Heart Network (EHN) called on MEPs to back "fair presentation" of the nutritional content of food products.

Susanne Løgstrup is director of the European Heart Network (EHN), a Brussels-based alliance of heart foundations in Europe.

She was speaking to Outi Alapekkala.

To read a shortened version of this interview, please click here

What does the European Commission's proposal for a regulation on the provision of food information to consumers mean from a health perspective?

There are a significant number of health aspects in this proposal particularly with regard to the nutrition labelling part of it. If people don't know or understand how much of any specific nutrient is in a product, they can't make the right choice and may make the wrong choice. And we know that over-consumption of salt and saturated fats, for example, is detrimental to a population's cardiovascular (CDV) health, leading to hypertension and blocking up arteries, which may lead to strokes or heart attacks.

It is very important that people have clear nutrition labelling they can read and understand.

We are happy that the Commission has proposed to make nutrition labelling mandatory. We are also very happy that it includes front-of-pack labelling.

We have a common position with the European Consumers Organisation (BEUC) and the European Public Health Alliance (EPHA). Recently, a large number of health organisations have supported our position.

We want full nutrition labelling back-of-pack, while a limited set of nutrients that are relevant to public health should be mandatory front-of-pack. These are saturated fats, salt, sugar and energy, and total fats as well.

But there shouldn't be more than five nutrients front-of-pack. The importance of front-of-pack labelling is to give quick, at-a-glance, clear information on nutrients that are of importance to health.

What is your position regarding the Guideline Daily Amounts (GDAs) and traffic lights?

Our position is very clear. It must be traffic lights. All independent surveys and studies in Europe and Australia show that people understand them best, most easily and most quickly. We think that it is fine to have GDAs in combination with traffic lights. While GDAs give an indication, many people don't understand them, which is why, on their own, they are not useful.  

It is not because you get a percentage of a nutrient that you will understand what it means, because a percentage of a nutrient is not a clear indication of whether it is a little or a lot. Same for grams: people have a hard time understanding whether there is a little or a lot in the product. But when you put a traffic light colour on it, people understand immediately whether the nutrient is present at a low, medium or high level.

What is your response to industry concerns about traffic lights dividing products into 'good' and 'bad' ones?

CDV diseases are the biggest health burden in Europe. They account for more than two million deaths annually and are estimated to cost the EU-27 €192 billion a year. And this is probably an underestimate. Moreover, there is a loss of well-being, which is hard to measure. Also if you add diabetes and obesity as well as certain cancers, you will appreciate that we have a huge health burden of these chronic non-communicable diseases. Politicians have to make a choice.

Of course, the industry is concerned that if they put a red light on their product, it won't sell. But there are ways out of it – you can reformulate products and change the colour, i.e. from red to yellow light. We have to give people the information in a way that they understand. It is no good giving them information if they can't use it. In that case we might just as well not give any.

The concept of GDAs is not bad – it is just that it is not as well understood as traffic lights. It is also important that front-of-pack labelling is expressed per 100 grams, because otherwise you cannot compare products easily.

Aren't nutrition labels enough?

Nutrition labels are not enough on their own. It is important that there is education behind them on two levels. First, it is important that young people are taught in school about nutrition and the link to health: why for example too much salt or saturated fats is not good for you. Secondly, once the new mandatory labelling scheme is launched, you should explain to the population what it is, how it works and how to use it.

Nobody would claim that once we have have achieved nutrition labelling with traffic lights we have solved all our health problems – of course we have not. Other measures are needed; but nutrition labelling is one of the instruments we need badly.

The amendments for traffic lights in the European Parliament's committee on environment and food safety (ENVI) were defeated very narrowly – one with 30-28 and another one with 30-30. We hope that this can be turned around in plenary. The committee kept the national schemes, which are proposed by the Commission. The national schemes are a tool to allow member states to experiment with different supporting schemes like traffic lights [and] nutrient labels.

This is of course very good from a health point of view, but not from a European single market one, the industry would argue.  If we cannot get traffic lights across on mandatory basis at EU level, we would hope that member state pursue it.  

What do you think about the ENVI committee's deletion of a provision from existing EU regulation requiring foods to display appropriate nutrient profiles in order to prove nutrient or health claims? It seems very weird to me.

It seems very weird to me too. But seemingly it is legally possible because the chair of the ENVI committee said that such an amendment was admissible. The committee voted on it and adopted it.

But I agree with you that it is a bit unusual to do something like this. From the public health and cardiovascular health point of view, it is a very bad idea to delete nutrient profiles.

Nutrient and health claims should only be in products that should be promoted as a healthier option.

Nutrient profiles are a sort of 'stop gap' ensuring that claims don't end up on products where, really, there is no real benefit for the consumer of eating the product in terms of health.

Nutrition labelling and claims are not about saying that you should not eat chocolate: of course you should if you want to, but not because it is good for your heart, for example. You eat it because you like a piece of chocolate.

It is not clear for consumers if a product has a label 'low in fat' while it still may be high in salt. It is, therefore, not a fair presentation of the product. And this is what we want – a fair presentation of products. Don't say that it is low in fat if it is high in salt. Because the meaning of a low-fat product to people is that this is a healthy product.

For example, many breakfast cereals say 0% fat – but when you look at the sugar content, it is enormous. Having 30g of sugar per 100g of a product is obviously not good. It is not that the claim is false, but it is misleading and people misunderstand the nature of the product. With the profiles and traffic lights, people will be given good guidance.

Even if there is a red light on a product it does not mean that people won't buy it – they will. But they might buy less and that's the point: people need to eat fewer products that are high in salt, sugar and fat.  So traffic lights can achieve changes in behaviour.

Manufacturers can try to reformulate a product to make it better. If products cannot be reformulated then manufacturers will not be able to put a claim on those products. The products, of course, remain on the market.

Denmark recently banned trans fatty acids. Do you think this kind of approach should be adopted in the EU?

Industrially manufactured trans fatty acids are about as bad it can get and should be banned across the EU. Trans fats are often used in fast food restaurants (not all fast food restaurants, though). But it possible to choose alternative cooking fats.  

Danish authorities acted on the health risk posed by industrially produced trans fatty acids and banned them. Trans fattu acids can be replaced with unsaturated fats.

Denmark was almost taken to court by the European Commission. But the Commission decided to stop its infringement procedure because Denmark could prove how detrimental trans fatty acids are and that the ban was the only way to achieve what they wanted, which was to limit its population's exposure to them and reduce the risk of cardiovascular disease.  

Austria has also banned trans fatty acids.

There is currently an initiative for a written declaration by five MEPs calling on the Commission to introduce legislation in line with the Danish one and ban trans fatty acids. If 50% of all MEPs sign the declaration it is adopted. We are very much in favour of an EU-wide ban on these.

Many companies and retailers have taken out trans fatty acids, so we know that it is possible.

Banning trans fats across the EU would have an important impact on reduction of cardiovascular diseases in Europe.

Do you have any special message regarding this proposal for a regulation?

My message is always to our MEPs: This is important for the health of people. If we don't have a healthy population, we will not have a healthy economy. Getting this regulation right is important for health and the economy.

Protection of industry interests comes at a cost to society. In terms of healthcare costs, people living with suboptimal health and indirect cost in terms of lost productivity.

The food industry needs to be more modest with marketing and claims and give people information they can understand. We are not taking any products off the market.

We want to make sure that people know what they are buying. And if industry does not want people to know what they are buying, then it is not being very honest.

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