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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.08.011 Byline: Joanne Arcand, Vanessa Floras, Mavra Ahmed, Abdul Al-Hesayen, Joan Ivanov, Johane P. Allard, Gary E. Newton Abstract: Sodium restriction is the primary nutritional strategy in heart failure; however, other diet-related concerns may also occur. We characterized dietary intake among stable patients with heart failure and a non-heart-failure cardiac control group to quantify and determine prevalence of inadequate micronutrient intake. Two 3-day food records were completed by 123 patients with heart failure and 58 controls. A subset of each group provided two 24-hour urine collections. Mean intake of sodium (2,540[+ or -]1,122 vs 2,596[+ or -]1,184 mg/day) and potassium (3,190[+ or -]980 vs 3,114[+ or -]828 mg/day) was similar between the heart failure and control groups. Prevalence of inadequate potassium intake was 94% among patients with heart failure and 91% among controls. More than 50% in each group had inadequate intakes of calcium, magnesium, folate, and vitamins D and E. In stable patients with heart failure, sodium intake was not excessive. However, we demonstrated widespread dietary inadequacies of other vitamins and minerals. These findings highlight the importance of diet beyond that of sodium restriction. Article History: Accepted 31 March 2009

Both the US Institute of Medicine and the Canadian Standing Committee on Health have called for simple, standardized front-of-package (FOP) nutrition labelling systems on packaged foods. However, despite scientific evidence and expert consensus on the topic, Canada's Minister of Health has dismissed these recommendations, stating that Canadian consumers already have 'the tools they need to make healthy food choices when they shop for groceries'. This is relevant since existing evidence suggests that the current regulated nutrition labelling tools may not meet their intended objectives. Furthermore, Canada's current FOP labelling environment--characterized by a variety of FOP labels with varying criteria--does not support the objectives of good nutrition labelling defined by Health Canada. Evidence suggests that well-designed FOP systems are capable of positively influencing consumer purchases as well as product reformulations by manufacturers. The US Institute of Medicine suggests a standardized, simple, interpretive, and ordinal FOP symbol as the ideal FOP labelling system. Although additional research is required, such a system should be considered in Canada, as it may be capable of addressing the shortcomings of existing nutrition labelling tools found in the Canadian marketplace. Key words: Nutrition policy; food labeling; public health Tant l'Institute of Medicine des Etats-Unis que le Comite permanent de la sante du Canada ont reclame des systemes d'etiquetage nutritionnel << sur le devant de l'emballage >> (SLDDE) simples et standardises pour les aliments emballes. Toutefois, malgre les preuves scientifiques et le consensus des specialistes sur le sujet, la ministre de la Sante du Canada a rejete ces recommandations en disant que les consommateurs canadiens possedent deja << les outils dont ils ont besoin pour choisir des aliments sains quand ils font l'epicerie >>. C'est un element pertinent, car les donnees existantes portent a croire que les outils actuels de reglementation de l'etiquetage nutritionnel pourraient ne pas respecter leurs objectifs prevus. De plus, l'environnement d'etiquetage SLDDE actuel du Canada--caracterise par diverses etiquettes SLDDE choisies selon divers criteres--n'appuie pas l'objectif d'un bon etiquetage nutritionnel defini par Sante Canada. Les faits montrent que des systemes SLDDE bien concus sont capables d'influencer positivement les achats des consommateurs ainsi que les reformulations de produits par les fabricants. Selon l'Institute of Medicine americain, le systeme d'etiquetage SLDDE ideal est un symbole SLDDE standardise, simple, interpretatif et ordinal. Il faudrait pousser la recherche, mais un tel systeme merite qu'on s'y interesse au Canada, car il pourrait combler les carences des outils d'etiquetage nutritionnel que l'on trouve actuellement sur le marche canadien. Mots cles : politique nutritionnelle; etiquetage aliments; sante publique, In 2011, the US Institute of Medicine (IOM) called for a standardized, universal Front-of-Package (FOP) nutrition labelling system, '... that encourages healthier food choices through simplicity, visual clarity, and the [...]