by Marion Nestle
Feb 2 2010

Oh those Canadians: heart-checking McDonald’s!

Thanks to Dr. Yoni Freedhoff for keeping me current on Canadian food politics. His latest post is about the Canadian Heart and Stroke Foundation’s new program to heart-check fast food meals.  The Foundation hasn’t officially announced the program yet, although you can  find it buried in an obscure questionnaire on its website.  Pizza Hut also mentions its participation in the program on its website.   [Update February 3: Pizza Hut has now announced its participation in the program]

The program is coming soon and here’s Dr. Freedhoff’s political cartoon of what it is likely to look like .  No, this isn’t real.  Dr. Freedhoff’s point is that it could be.

What, you might ask, are the criteria for the heart check?  Let’s just try sodium: 720 mg per serving.   Even the late and not lamented Smart Choices program did better than that (480 mg per serving).

You think Dr. Freedhoff is exaggerating and this is improbable?  Alas, not so.  In Australia a couple of years ago, I took this snapshot at a McDonald’s on the Adelaide beach.

The check marks come from the Heart-Tick program of the National Heart Foundation of Australia.  So Canada is just now catching up.  Canadian readers: can’t you do something about this?  And American Heart Association: clean up your act too!

Addendum: Thanks to Lisa Sutherland for pointing out that what gets heart-checked in Canada is comparatively low in U.S. terms.  She sends McDonald’s nutrition information as proof.   Practically everything is higher in sodium than 720 mg.  When it comes to sodium, everything is relative, I guess, but all of it is way high.

  • Carly Z

    Dear Marion, first of all thank you for all that you do in food politics’ I am currently reading What to Eat.

    As a Canadian with Heart Disease in my family and a past supporter of the Heart and Stroke Foundation, I am seriously disappointed in this incredibly irresponsible choice. I plan to write a letter directly to the foundation, but do you know who in Canadian government would be most influential in governing the Heart and Stroke foundation?

  • Do that many fast food restaurants really offer heart healthy options? Clearly not, which is why these restrictions would be somewhat futile.

  • Marion

    @Carly Z: do follow up with your idea of writing the Foundation. They need to hear from the public about such things. Thanks!

  • Anthro

    Is nothing sacred? What’s next? The Cancer Society gives gives little pink tick marks to “pretend” health foods?

    I’ve always admired Canada’s approach to health care and public health. This is very disappointing.

  • Bobby

    I have treated this label like the scam that it is for a while, but I do notice that a baby step has been taken in providing a new, lower sodium level to met the health check criteria of the near future, but like all industry funded activities, it’s too little too late, and industry finds anything that slows change to their profits to be a good thing, so they must love health check.

    Eat real food, not too much, mostly plants… works for me.

  • and the governmental lip service continues ! let them proclaim whatever magical # 4 sodium that they like. if ur eatin the right foods it dosnt matter worth a damn what they say-just ignore it.if u want 2 b as healthy as u can ur not eatin that type of food anyway. we sure dont need the government 2 tel us what is healthy or not,most of them dont kno themselves. and if they do,most dont apply their knowledge-look @ them,they r a mess ! just more talk talk talk.

  • Cathy Richards

    If true, this will be interesting to see unfold. Hopefully it will be a positive that helps get some revamping of products. However check out the criteria.

    Here’s some stuff on the children’s entrees:

    othe fat/salt limits on children’s entrees are the same as for regular entrees except that it must include 2 food groups or more including 55 g of veggies (1/2 cup frozen peas/carrots = 70 g).

    oBut still 720 mg of sodium [their AI=1000-1500 mg] and 10-15 g of fat! NOTE: this is a new revised ‘lower’ sodium requirement. Really….

    oNo fibre requirement!!!!

    oOne more time for a bit more emphasis: No fibre requirement, no need for any buns to be whole grain or whitey-but-fibrery.

    oNo requirement about beverages and add-ons – will restaurants be able to advertise a health check meal but then combo it with a pop? There’s no criteria for drinks or add-ons to the children’s entrée. “Enjoy your Happy Meal with a Health Check burger and carrot sticks (and fries and pop)”.

    oCheck out the sodium for pizza – how do they define a menu serving for pizza? 1 slice? The whole pizza as served or only if listed on the menu as “made for one”?

    oI know that H&S has in the past deferred to a company’s definition of a serving, as opposed to a realistic serving. A soup I bought got the Health Check symbol – it met the sodium criteria of 480 mg per 250 mL (1 cup) however the H&S is supposed to consider it as “per 250 mL serving and per on-pack serving”. The can held 540 mL so one serving would be 46% of the can – clearly people are not getting 2.16 servings out of the can, they are realistically going to serve 1-2 people with one can of soup. My regular cereal bowl at home held the whole can with no problem. I wrote the H&S about this and they responded that they typically serve ½ cup servings of soup to their family at home. Try that yourselves someday.

    Also, check out my Jan 25th comment on one of Marion’s salt posts — I commented on the soup issue with Canada’s H&S Health Check program in that comment.

    The Health Check symbol is expensive and requires an extensive application process. This is beyond the financial and time scope of individually-owned and small chain restaurants, so it gives multinationals the edge.

  • Cathy Richards


    The Health Check program has been slammed in the past, but the still carry on. I won’t go into any more details of my own opinion, as I don’t want to burn partnerships I need for work. But check out others’ thoughts: (video excerpt from our public news service CBC)

    Until this expose, entrees could have 1300 mg of sodium!!! After, they lowered the sodium criteria to 960 mg. 960!! More than half the acceptable intake for a day.

    Another blogger:

    The Health Check program needs to have its health checked.

  • Thank you for bringing this little bit of Canadian food politicing some attention. Unfortunately we are not able to hold our heads higher than our southern neighbours on a lot of issues these days, including that of corporate food and misleading ‘nutritional’ information.

    I personally have not eaten at McDonald’s in well over a decade and it will take a lot more than a red check mark to convince me to darken the door/drive-thru. However, the reality is that many Canadians eat there or similar establishments daily. The CBC posted this calorie tracker a few months ago (, which will give the nutritional breakdown for menu items at a number of popular fast food chains (based on the information given provided by the individual chains). There really aren’t too many items in any of these establishments that pass the 720mg check, much less any reasonable assessment of ‘low sodium’.

    I am well aware that the solution is to eat real food that is unprepared, fresh and if at all possible local and organic. However, the reality is that people are reluctant to change and tend to reach for food that is easy and cheap. Not to mention the media influence, which is a whole other issue. I am going to be joining Carly Z in writing to the Heart and Stroke Foundation. It’s bad enough that the corporations themselves mislead consumers, independent health groups have no business going down that same path.

  • Carly Z

    Here is the response I got back from the Canadian Heart and Stroke Foundation (confused the Health Check program with the Smart choices oops):

    Thank you for your email outlining some of the concerns you have with the Heart and Stroke Foundation’s Health Check program. We value all of the letters we receive and appreciate the opportunity to respond. The health of Canadians is a priority for the Heart and Stroke Foundation, and this includes healthy eating with the Health Check program being one part of how we do this. The Foundation also advocates for better access to healthy and nutritious foods and improved food labelling, and continues to be a leader in having trans fat removed and sodium reduced in the foods we eat. In partnership with the Canadian Cancer Society we support a program that encourages Canadians to eat more vegetables and fruit. The Foundation encourages Canadians to eat fresh and cook from scratch, and offers a variety of healthy eating information and recipes to support them in their efforts. But we also recognize that people are busy and this is not always possible. Health Check helps Canadians identify food products and restaurant menu items that meet our strict nutrient criteria and allows them to make informed choices. And we know that Canadians eat out a lot – in fact one out of every 10 meals comes from a restaurant. This is the reality and confirms why it is so important for Health Check to work with restaurants to ensure Canadians have healthy choices when dining out. Health Check is the only third-party population health-based program doing this work in Canada. I should point out that McDonald’s is not part of the Health Check program. The program is indeed carrying out a survey with dietitians in Alberta and the mention of quick service restaurants “such as McDonald’s, Tim Horton’s and Subway” were given as examples only, to explain the term. None of these restaurants are part of the Health Check program. We regret if this was not clear. I should also note that the US program I believe you are referring to is Smart Choices. Health Check has no affiliation with this program and is structured very differently. As a program of the Heart and Stroke Foundation of Canada it is voluntary and non-profit. Food products and restaurant menu items must first meet the nutrient criteria developed by the Foundation’s registered dietitians based on recommendations in Canada’s Food Guide to earn the right to display the logo. Once the criteria are met, companies pay a modest fee. All fees are used to administer the program and develop healthy eating resources; the program is not a fund-raiser for the Foundation. Industry has no involvement in setting the criteria. Health Check has been around for 10 years and it continues to evolve. We will continue to strengthen the program and work directly with food companies and restaurants to improve the food supply by challenging them to meet stronger nutrient criteria and offer Canadians more healthy choices. This approach is working. Thanks again for taking the time to contact us. Sincerely, Terry DeanDirector, Health Check programHeart and Stroke Foundation of Canada