■加拿大于2022年颁布了强制性的包装前标签(FOPL)法规,要求预包装食品达到和/或超过推荐的关注营养素阈值(即,饱和脂肪,钠,糖)显示“高含量”营养符号。然而,关于加拿大FOPL(CAN-FOPL)法规与其他FOPL系统和饮食指南相比的证据有限.因此,本研究的目的是使用CAN-FOPL膳食指数系统及其与其他FOPL系统和膳食指南的一致性来检验加拿大人的膳食质量.
■来自2015年加拿大社区健康调查-营养调查的具有全国代表性的饮食数据(n=13,495)被分配了支持CAN-FOPL的饮食指数得分,加拿大糖尿病临床实践(DCCP)指南,Nutri-score,停止高血压的饮食方法(DASH)和加拿大的食物指南(健康饮食指数-2019[HEFI-2019])。通过评估CAN-FOPL饮食指数得分的五分之一组的营养素摄入量的线性趋势来检查饮食质量。CAN-FOPL膳食指标体系与其他膳食指标体系的一致性,以HEFI为参考标准,使用皮尔逊相关性和κ统计数据进行了检查。
■CAN-FOPL的平均[95%CI]饮食指数得分(范围:0-100),DCCP,Nutri-score,DASH,HEFI-2019年为73.0[72.8,73.2],64.2[64.0,64.3],54.9[54.7,55.1],51.7[51.4,51.9],和54.3[54.1,54.6],分别。从CAN-FOPL膳食指标体系中的“最不健康”到“最健康”的五分之一,蛋白质的摄入量,纤维,维生素A,维生素C,钾增加了,当摄入能量时,饱和脂肪,总糖和游离糖,钠减少。CAN-FOPL与DCCP呈中度关联(r=0.545,p<0.001),Nutri评分(r=0.444,p<0.001),和HEFI-2019(r=0.401,p<0.001),但与DASH的相关性较差(r=0.242,p<0.001)。CAN-FOPL的五分之一组合与所有饮食指数评分之间略有一致性(κ=0.05-0.38)。
■我们的研究结果表明,CAN-FOPL将加拿大成年人的饮食质量评价为比其他系统更健康。CAN-FOPL与其他系统之间的分歧表明,需要提供额外的指导,以帮助加拿大人在不显示包装前营养符号的食物中选择和食用“更健康”的选择。
Canada promulgated mandatory front-of-pack labelling (FOPL) regulations in 2022, requiring pre-packaged foods meeting and/or exceeding recommended thresholds for nutrients-of-concern (i.e., saturated fat, sodium, sugars) to display a \"high-in\" nutrition symbol. However, there is limited evidence on how Canadian FOPL (CAN-FOPL) regulations compare to other FOPL systems and dietary
guidelines. Therefore, the objectives of the study were to examine the diet quality of Canadians using the CAN-FOPL dietary index system and its alignment with other FOPL systems and dietary
guidelines.
Nationally representative dietary data from the 2015 Canadian Community Health Survey-Nutrition survey (n = 13,495) was assigned dietary index scores that underpin CAN-FOPL, Diabetes Canada Clinical Practice (DCCP)
Guidelines, Nutri-score, Dietary Approaches to Stop Hypertension (DASH) and Canada\'s Food Guide (Healthy Eating Food Index-2019 [HEFI-2019]). Diet quality was examined by assessing linear trends of nutrient intakes across quintile groups of CAN-FOPL dietary index scores. The alignment of CAN-FOPL dietary index system compared with other dietary index systems, with HEFI as the reference standard, was examined using Pearson\'s correlations and к statistics.
The mean [95% CI] dietary index scores (range: 0-100) for CAN-FOPL, DCCP, Nutri-score, DASH, and HEFI-2019 were 73.0 [72.8, 73.2], 64.2 [64.0, 64.3], 54.9 [54.7, 55.1], 51.7 [51.4, 51.9], and 54.3 [54.1, 54.6], respectively. Moving from the \"least healthy\" to the \"most healthy\" quintile in the CAN-FOPL dietary index system, intakes of protein, fiber, vitamin A, vitamin C, and potassium increased, while intakes of energy, saturated fat, total and free sugars, and sodium decreased. CAN-FOPL showed moderate association with DCCP (r = 0.545, p < 0.001), Nutri-score (r = 0.444, p < 0.001), and HEFI-2019 (r = 0.401, p < 0.001), but poor association with DASH (r = 0.242, p < 0.001). Slight to fair agreement was seen between quintile combinations of CAN-FOPL and all dietary index scores (к = 0.05-0.38).
Our findings show that CAN-FOPL rates the dietary quality of Canadian adults to be healthier than other systems. The disagreement between CAN-FOPL with other systems suggest a need to provide additional guidance to help Canadians select and consume \'healthier\' options among foods that would not display a front-of-pack nutrition symbol.