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Can graphic warning labels on food help to solve the country's obesity problem?

The Ontario Medical Association believes it can and floated the novel, if controversial, idea at a press conference this week as part of its call for action on obesity. Under the proposal, foods that are high in calories but offer little nutritional value, such as pop, would be accompanied by a graphic picture, say, of a diseased liver, and a warning of the potential health risks.

Public-health and obesity experts are divided over the effectiveness of graphic warnings on food, particularly considering the plethora of nutrition claims and labels that are already screaming at consumers from the front of food packages.

How would new graphic warnings fit into an already-crowded food-labelling landscape? And how would it fit in with numerous other labelling strategies that are already in place in grocery stores across the country?

Here is a breakdown of some of the most common food-labelling initiatives and whether they are actually making an impact on our waistlines.

The nutrition facts panel

The ground zero of nutrition labelling, nutrition facts panels are mandatory on virtually all prepackaged foods sold in Canada.

The panel provides a snapshot of the amount of calories and 13 nutrients, such as calcium, sugar, sodium and fibre, in a serving of a particular food. It also includes a feature called "% Daily Value," which is designed to tell consumers whether the calories, sugar, sodium or other nutrients in a serving of food accounts for a lot or a little of their recommended daily intake.

It's a potentially valuable tool that may help consumers make better decisions about the food they purchase. But the nutrition facts panel has been criticized by numerous health experts for being too difficult to understand or for being misleading.

For instance, companies are allowed to determine what serving size their nutritional information should be based on. As a result, the nutrition panels found on packaged juice, bread, soup, pizza, sauces or other items may be based on unrealistically small serving sizes. Without looking closely at the panel, many people may be unwittingly consuming far more calories, sodium and sugar than they thought.

Different serving sizes also make it difficult, if not impossible, for consumers to comparison-shop based on nutritional information.

In addition, the values found on the "% Daily Value" portion of the panel may be based on numbers that are too high. For instance, the "% Daily Value" for sodium is based on a diet of 2,400 milligrams a day, which exceeds the upper tolerable limit set by Health Canada.

Private labelling initiatives

You can't turn around in a grocery store without seeing a product label emblazoned with nutritional information.

Many grocery chains and private food companies have created their own labelling plans to promote foods that may be low in fat and calories or high in certain vitamins and nutrients. Similarly, organizations such as the Heart and Stroke Foundation have developed food labelling designed to give foods a rating based on its nutritional profile.

Under these programs, foods may carry a variety of nutritional claims or may simply feature the logo of the program to indicate it qualifies as a "healthy" food.

However, some health experts point out that many of these initiatives may be misleading. For example, product labels that boast about a low number of calories do not mention that the product may also carry significantly high amounts of sodium.

Under some organized programs, such as the Heart and Stroke Foundation's Health Check, food companies have to pay in order to be rated, which some public-health advocates argue creates a potential conflict of interest.

Another limitation is that these programs do not follow rigorous nutritional criteria, meaning that qualifying foods may still contain too many calories or be too high in saturated fat or sodium, for instance.

Loblaw Cos. Ltd. is rolling out a U.S.-based program called Guiding Stars in some of its stores. The program gives foods a nutritional rating between zero and three stars. The advantages to the program include the fact that it uses a comprehensive assortment of nutritional information to make a judgment and the fact the work is done by an independent third party.

Government-sanctioned labels

Governments around the world are considering new ways to reduce the consumption of unhealthy processed foods through initiatives that go beyond basic ingredient lists that are currently required on labels.

Perhaps the most notable example comes from Britain, where the government announced on Wednesday that is expanding a program to help consumers quickly and easily evaluate the health of foods. Under the program, which will soon encompass virtually all packaged foods, products are given a traffic-light rating of red, green or yellow based on a variety of nutritional factors, such as the amount of fat, salt and sugar they contain.

Many health experts say the traffic-light system is a good model because it removes the guesswork and need for consumers to do in-store calculations. It's easy to see, with one glance at the front of a package, how much fat, saturated fat, sugar, sodium and calories that products contain.

Graphic warning labels

If the OMA gets its way, nutritionally devoid foods will come with large graphic warnings. Association president Doug Weir said the idea was inspired by anti-tobacco efforts, which have helped to reduce the overall rates of smoking across Canada in recent decades.

Weir noted that graphic labels cannot put a stop to rising rates of obesity on their own, but that they could play a role as part of a larger, complex set of solutions.

However, the idea is already being met with criticism from experts, who argue that it is simply not feasible.

Dr. Arya Sharma, a professor of medicine and chair of obesity research and management at the University of Alberta, said it would be difficult, if not impossible, to figure out what qualifies as "junk food" and which items should have graphic warning labels.

Does olive oil, which is high in fat but good for heart health, qualify as junk food? What about pizza or crackers or orange juice, items that all can contain a high number of calories?

Sharma argues that nearly all foods could potentially qualify as "unhealthy." What matters is the context in which the foods are served and how much of it is consumed.

Instead of getting bogged down with potentially questionable labelling initiatives, Sharma suggested that it would be more effective to focus on the encouragement of healthy eating, the availability of nutritious foods and other measures that could make a difference in the lives of Canadians.