Ontario MPPs Pass Menu Labelling Bill (Calories Without Sodium

Ontario MPPs Pass Menu Labelling Bill
(Calories Without Sodium) in Hastily Called Vote
TORONTO (May 27, 2015)—Bill Jeffery, LLB, National Coordinator of the Centre for Science in the Public
Interest made the following comment on the enactment of Bill 45, Making Healthier Choices Act (concerning
tobacco-related marketing and restaurant menu labelling) in the Ontario Legislature:
In a hastily called vote that caught even health ministry officials by surprise, yesterday MPPs passed Bill 45,
the Making Healthier Choices Act which will require calories to be posted on chain restaurant menus with
20 or more locations in Ontario in a format to be specified by regulations expected to be published for public
comment this summer and fall. (A vote on the bill was expected late tonight or tomorrow morning.)
Three hours after the bill was passed, Ministry of Health officials invited health and industry stakeholders to
an on-line technical briefing on the stated belief that a vote was still pending, then last night the event was
cancelled and discretely converted to an industry-only briefing which was held on-schedule this morning.
Providing calories without sodium levels on menus is like washing one hand or tying one shoelace. Sure,
it does help, but why not take care of both at the same time to efficiently reduce the risk and false sense of
security. The government may say that seeing sodium and calories is too confusing for Ontario consumers,
but saying so probably has less to do with the truth than—unlike with anti-hand-washing crusaders—the
amount of pressure from the chief opponents of sodium labelling: multi-billion-dollar purveyors of salty food
like McDonald’s and Tim Hortons with a huge amount of clout at Queen’s Park and a track record of using
calorie-free salt as a flavour enhancer when sugar or fat are reduced to trim calorie numbers.
Dozens of Canadian community leaders and experts, including internationally recognized experts in
nutrition and health policy, two dozen of MPPs from all three political parties, and the federal Minister of
Health’s Sodium Working Group recommended sodium labelling (along with calories) at restaurants to save
thousands of heart attack and stroke deaths, but the Ontario government relied upon food industry experts
with a vested interest in weak labelling rule. The Ontario government also relied on the U.S. Food and Drug
Administration menu labelling precedent (calories-only) which is based on legislative authorities that were
granted to the FDA five years ago, several months before the before the US Institute of Medicine stressed to
Congress the importance of regulating levels of sodium in salty foods.
Bill 45 could really help Ontarians become healthier—and less reliant on public healthcare—if the Ontario
Ministry of Health and Long-term Care enacts effective regulations that force restaurant chains to make
age-appropriate calorie disclosures prominent and understandable on menus so customers are most likely to
notice them and use them. Nutrition information that blends into the background will be far less effective.
We remain convinced that the evidence and community support for disclosing sodium levels on menus is here
now. The political will for disclosure should be too soon.
One thing now seems clear from the government’s implementation timeline and the industry’s public
response to it: restaurants will need less than a year to add sodium to their menus once the provincial
government gives credence to the advice from sodium experts that is both independent and up-to-date.
An on-line petition started this week invites Canadians to urge the Honourable Dipika Damerla, Associate
Minister of Health (Long-term Care and Wellness) to propose sodium labelling regulations using new
authority given to the government by Bill 45: http://tinyurl.com/require-sodium-on-menus
-30For more information, call: Bill Jeffery at 613-244-7337 (ext. 1) or bjeffery@cspinet.org The jointstatement endorsed by 40 groups and experts—including the Canadian Diabetes Association, Canadian
Nurses Association, Canadian Public Health Association, Canadian Women’s Health Network, College of
Family Physicians of Canada, Dietitians of Canada, and the Fitness Industry Council of Canada—is
available at: http://cspinet.org/canada/pdf/expert_ngo.joint-statement.menu-labelling.pdf
Background: Canadians consume double the recommended amount of sodium, causing upwards of 10,000
premature deaths annually in Canada and heavy use of often government-insured anti-hypertensive drugs.1
Experts estimate that 90% of Ontarians will develop hypertension as they age.2 Health Canada, the World
Health Organization, the Ministry of Health and Long-term Care, and Public Health Ontario urge people to
reduce sodium to reduce blood pressure and the risk of heart disease and stroke. In 2010, premiers and
provincial health ministers urged the federal Minister of Health to implement her Sodium Working Group’s
“Sodium Reduction Strategy for Canada,” though provincial governments have responsibilities concerning
restaurants and pay the lion’s share of sodium-related health care costs. More than 82% of Canadians support
requiring chains to disclose amount of sodium on menus.3 University of Toronto researchers found that
sodium levels in main entrees at 65 fast food and sit-down chains are “alarmingly high” (1,011 mg and 1,455
mg, respectively)4 and that posting sodium numbers on menus could reduce intake by a whopping 681-1,360
mg per meal.5
Large amounts of salt can be added to food by restaurants without consumers’ knowledge. It is much harder to
estimate sodium levels than calories from menu names, pictures, and often even by taste, and sodium levels
are predicted to rise if chains trim sugar and fat to ratchet down calorie levels. Without seeing so on menus,
Ontarians won’t know that, for example:
 McDonald’s Third Pounder Angus Bacon & Cheese Sandwich has nearly triple the amount of
sodium (1,920 mg) as the Quarter Pounder Without Cheese (670 mg); and
 Tim Hortons’ Biscuit, Sausage, Egg, Cheese Breakfast Sandwich has nearly double the sodium
(1,130 mg) of the English Muffin with Egg and Cheese (610 mg).
The Centre for Science in the Public Interest (CSPI) is a non-profit health advocacy organization specializing in nutrition and
food safety with offices in Ottawa, Washington, and staff in Toronto. CSPI's Ottawa advocacy efforts are supported by
100,000 subscribers to the Canadian edition of its Nutrition Action Healthletter,
on average, one subscribing household within a one block radius of every Canadian street corner.
CSPI does not accept industry or government funding and Nutrition Action does not carry advertisements.
References
1
See, e.g., Kirsten Bibbins-Domingo. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. New
England Journal of Medicine. 2010;362:590-9; and Havas S, Roccella EJ, et al. Reducing the public health burden from elevated
blood pressure levels in the United States by lowering intake of dietary sodium. American Journal of Public Health. 2004;
94(1):19-22. Washington-based Institute for Health Metrics and Evaluation’s disease risk factor calculator which uses country
data compiled by the World Health Organization’s Global Burden of Disease project with to estimate, e.g., that approx 5,000 to
24,000 deaths are attributable to sodium in Canada, with higher rates of death among older Canadians and higher levels of sodium
intake. Detailed figures were published in 2013 by the New England Journal of Medicine:
http://www.nejm.org/doi/full/10.1056/NEJMoa1304127
2
Vasan RS, Beiser A, et al. Residual lifetime risk for developing hypertension in middle aged women and men: The
Framingham Heart Study. Jl of the American Medical Assn. 2002; 287:1003-1010 cited in Appel L (Panel Chair). Dietary
Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. U.S. Inst. of Med. Washington, D.C. 2005 at 354.
3
Canadians’ Perceptions of, and Support for, Potential Measures to Prevent and Reduce Childhood Obesity Final Report.
Prepared for: Public Health Agency of Canada. Prepared by: Ipsos Reid. November 2011 at page which found that 92% of
Canadians supported “Requiring fast food restaurants to list nutrition information, such as caloric, fat, and sugar content, on
their menus.” Available at: http://www.sportmatters.ca/files/Reports/Ipsos%20Obesity%202011.pdf
Final Report: Canadians’ and Health Care Professionals’ Views on Sodium. Health Canada POR-08-21. Dec. 16,
2009. Prepared for: Public Health Agency of Canada which found that 90% of Canadians support “Require foods that are
high in sodium to display symbols or words on the front of the label that highlight that fact.” at 46, Available at:
http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/public_health_agency_canada/2009/117-08/report.pdf
Arcand, J, Mendoza, J, et al. Results of a National Survey Examining Canadians’ Concern, Actions, Barriers, and
Support for Dietary Sodium Reduction Interventions. 2013. Canadian Journal of Cardiology at S2.
4
Scourboutakos M, Corey PN, Mendoza J, Henson S, and L’Abbe M. Restaurant Menu Labelling: Is it worth adding
sodium to the label? 104(1) Canadian Journal of Public Health e1-e7. Accessible via:
http://journal.cpha.ca/index.php/cjph/article/view/4492
5
Scourboutakos M and L’Abbe M. Sodium Levels in Canadian Fast Food and Sit-Down Restaurants. 104(1) Canadian
Journal of Public Health e2-e8. Accessible via: http://journal.cpha.ca/index.php/cjph/article/view/3683