This document outlines recommendations from the Heart & Stroke Foundation to address issues related to marketing of unhealthy foods and sugary drinks to children in Canada. It recommends that all levels of government implement restrictions on marketing of these products to kids. It also recommends that schools, communities and health organizations support healthy choices for children by limiting unhealthy options and increasing availability of healthy alternatives in places where kids spend time.

1. Saskatchewan Oral Health Coalition
May 29th, 2017

2. Outline
2
• Overview: Heart & Stroke
• Issue:
• Health care costs are climbing
• The kids are not alright
• The problem with sugary drinks
• The problem with marketing to kids
• Heart & Stroke’s commitment to action
• Recommendations

3. Overview
One of Canada’s most effective health charities
A national, unified organization with:
• 1.4 million donors and 125,000 volunteers
• Grassroots presence in every community across the country
Effective health promotion programs:
• Facilitated CPR Training for 100,000 Canadians
• Leaders in public awareness campaigns (CPR, signs of stroke, tobacco)
• Community design initiatives (active transportation)
Almost $1.5 billion in research funding since our inception
• Led to ground-breaking discoveries resulting in significant number of lives saved

4. Heart and Stroke’s Transformation
• A new website provides highly customized information and support
• A new research strategy - combines partnerships, innovative
thinking and emerging opportunities that lead to medical
breakthroughs
• New areas of focus - children’s health policies, women’s health
and Indigenous health
• Our bold and modern logo that revitalizes our cause
• Our unifying belief - Life. We don’t want you to miss it. - is the
reason why we lead the fight against heart disease and stroke

5. Health care costs are climbing
• Heart disease and stroke cost the Canadian economy $21 billion
each year.
• Burden of obesity in Canada approx. $4.6 - $7.1 billion annually
(direct and indirect).
• Treatment of chronic diseases and other illnesses takes up 67%
of health care spending and costs our economy $190 billion
annually in direct and indirect costs.

6. 6
The problem
with sugary
drinks
Heart & Stroke
recommends that an
individuals total intake of
free sugars not exceed
10% of total daily calorie
intake, which aligns with
the WHO. For the average
2000 calorie diet that would
equate to a max of 48
grams or 12 tsp of sugar
per day

7. 7
Sugary
drinks are
killing us
and our kids

8. 8
• Food and water insecurity remain a significant
threat to healthy living
• Voluntary efforts to reduce sugar content have
failed
• Milk and water are more expensive and often
inaccessible in remote communities, while
sugary drinks, such as pop and juice are
cheaper and sold almost everywhere
• A large number of First Nation communities
are under drinking water advisories in
Canada. For many of these communities safe
drinking water remains out of reach and
sugary drinks become the only affordable
options offered in local stores

9. 9

10. 10
Losing our
appetite for
advertising
• Children’s exposure to food and beverage
advertising is increasing
• 83% of food and beverage companies’
websites target children under 12
• Marketing to kids used to only mean
commercials during Saturday morning
cartoons
• Today’s kids are bombarded with food and
beverage marketing morning, noon and
night, every day of the week
• The most frequently advertised products to
teens online are cakes, cookies, ice cream,
cereal, restaurants and sugary drinks

11. The kids are not alright
The food and beverage industry is marketing our kids to death
Unhealthy diets are responsible for about 50,000 deaths in Canada
11
Marketing
• Approximately 90% of food &
beverages marketed to kids on
TV and online are high in salt,
fat or sugar
• The average child watches
about two hours of TV per day,
seeing four – five food &
beverage ads per hour
• Canadian children (ages 2-11)
see 25 million food and
beverage ads a year on their
top 10 favourite websites
Diet
• Less than half of youth eat the
minimum recommended fruit
and vegetables daily
• Food security remains a
significant issue in Indigenous
communities. Some
communities report four times
the rate of insecurity, as
compared to non-Indigenous
populations
• One-quarter of children ages 5
– 19 say they consume sugary
drinks every day.

12. What is Heart & Stroke doing?
We’re working with dozens of other like-minded individuals and organizations to
improve research, inform Canadians, advocate for policy changes
Marketing &
Communications
M2K Coalition
Sugary Drink
Coalition
Research
Position
Statements
Public Awareness
Campaign

13. Children’s nutrition campaign
• An integrated advocacy campaign designed to secure government action
to improve the well-being of Canadian children and youth
• The campaign relies upon strong evidence, broad support and our ability
to effectively communicate with our target audiences
• Two unique objectives that require distinct strategies and tactics:
• Restrictions on M2K (co-Chair of M2K Coalition)
• Levy on sugary drinks (funding partner of Sugary Drink Coalition)

15. Recommendations

16. 16
Policy intervention ladder
Source: Bioethics. Public health ethical issues. London: Nuffield Council on Bioethics. 2007

17. 17
Raise public awareness on the issue

18. Educate consumers with warning labels
• Health warning label on sugary drinks
• Twice through CA legislature
• Shut down in the state assembly due to
heavy industry lobbying
• Changes parental perceptions
• Being considered in NY, VT, HW, WA

19. Make water the default
• Stockton and Davis, CA “healthy-by-
default” in kids meals.
• By-law mandates restaurants offer
water or un-sweetened milk as the
default beverage choice for kids
meals instead of sugary drinks.

20. Guide choice by limiting the availability
• Mandate/encourage manufacturers
to reduce added sugar content
through a variety of approaches
such as:
1. Reformulating products to contain
less added sugars.
2. Reducing portion sizes of energy
dense, nutrient poor products.
3. Diversifying to develop products
that are healthy alternatives and low
in added sugars.

21. Ban free refills
• France National Assembly voted (almost unanimously) to ban free-refills
of sugary drinks at shops and fast food chains
• Legislation will apply to any public place and ban access to fountains
dispensing sugary drinks
• The ban would include those containing sweeteners which "contribute to
the development and maintenance of an appetite for sweet taste"

22. Restrict choice
• Standardize the portion size of sugary drink containers in foodservice
sector outlets.
• Limit the consumption of sugar-loaded beverages through restricting
portion size to 16 ounces (500 mL) in food service outlets.
7 ounces 12 ounces 16 ounces 32 ounces 64 ounces
140 calories 82 calories 180 calories 374 calories 780 calories
22g sugar 38 g sugar 49 g sugar 102 g sugar 217 g sugar

23. Innovative marketing restrictions
• San Francisco has put forth legislation that will restrict advertising of
sugary drinks
1) requiring health warnings on posted ads in San Francisco
2) banning ads for sugary drinks on publically owned property, such as
transit centers
3) prohibiting the use of city funds for the purchase of sugary beverages.

24. Tackle price – Levy on sugary drinks

25. Marketing to kids: Action items for SOHC
future planning session discussion
How can we protect children and support parents?

26. What can provincial governments do?
• Implement and enforce restrictions of the commercial marketing of foods and
beverages to children and youth (See Quebec example which used it
Consumer Protection Act)
• Restrict exposure to food and beverage marketing in public places, including
setting where children gather, such as nurseries, schools and school
grounds, preschool and daycare centres, recreation centres, playgrounds,
pediatric services, sporting or cultural activities, as well as hospitals
• Educate Canadians about the risks associated with unhealthy food and
beverage consumption through public awareness campaigns. Consider
media literacy as part of school curriculum to address marketing to children
• Conduct a review of food and beverage marketing in child-focused settings
• Review and limit sole-sourced contracts with food and beverage companies
to ensure the healthfulness of food and beverage options. This would include
the numbers, content and placement of vending machines

27. What can municipal governments do?
• Conduct a review of food and beverage marketing in child-focused settings
• Review zoning restrictions close to child-focused settings including schools
and playgrounds
• Restrict food and beverage marketing to children on municipal property, such
as childcare settings, schools, libraries, public transit, recreation centres and
parks
• Educate people about the risks associated with unhealthy food and beverage
consumption through public awareness campaigns
• Review and limit sole-sourced contracts with food beverage companies to
ensure the healthfulness of food and beverage options. This would include
the numbers, content and placement of vending machines

28. What can schools and school boards do?
• Review and limit sole-sourced contracts with food beverage companies to
ensure the healthfulness of food and beverage options. This would include
the numbers, content and placement of vending machines
• Review, broaden and strengthen nutrition policies. These policies should
include guidelines around the types of foods available to children; restrictions
around food and beverage marketing including in educational materials,
prizes and giveaways; and guidelines around foods and beverages used in
fundraising and served at special events
• Do not enter into incentive programs with food and beverage companies
• Prioritize the implementation of healthy eating policies, resources and
curriculum, including food preparation and media literacy

29. What can communities do?
• Advocate for healthy choices to be available in their neighbourhoods,
including stores to enable purchase of vegetables and fruit and fresh,
whole foods
• Advocate for restrictions on unhealthy food establishments near schools,
rec centres and other areas where children congregate
• Push for policies in community centres to ensure healthy food and
beverage choices are available and unhealthy choices are restricted

30. What can health organizations do?
• Endorse the Ottawa Principles and the Stop Marketing to Kids Coalition at
stopmarketingtokids.ca
• Educate Canadians about the risks associated with unhealthy food and
beverage consumption through public awareness and educations
campaigns
• Advocate for healthier food and beverage environments so that healthy
choices are the easy choices for Canadians

31. What can the Saskatchewan Oral Health Coalition
do?

32. Thank you for your time.