Health Committee on Feb. 3rd, 2011

[Barbara von Tigerstrom, Associate Professor, College of Law, University of Saskatchewan]

Thank you.

Thank you for inviting me to attend this meeting on healthy living and nutrition. Over the last few years, I have studied the regulation of food labelling, which I will be speaking about today. I have also done some work on food taxes and subsidies, and I would be happy to try to answer your questions on that subject as well.

The prevention of chronic disease is an urgent public health challenge in Canada, but it can be difficult to predict which preventive measures will be effective. Chronic diseases are often the result of a complex matrix of factors that interact in ways that are sometimes unpredictable. Given the serious public health problems we face, we should move forward with measures that seem promising, based on the best evidence currently available, and then monitor those measures and adapt them as needed. Available evidence suggests that changes to our food labelling regulations could help to better protect public health and consumers' rights.

First is menu labelling. There are now city, county, and state menu labelling laws in the United States, and national regulations are expected within a few months. Most of these laws require calorie amounts to be posted on menus or menu boards, with other nutrition information also available in each outlet.

Surveys have consistently found high levels of public support for menu labelling. Without disclosure, people find it very difficult to estimate the nutritional content of restaurant meals. Many restaurant chains already make some nutrition information available in various forms, but these voluntary efforts are still too limited to fully realize the benefits that could be achieved through mandatory regulations.

The evidence that menu labelling will influence people's eating habits is not conclusive, but most recent studies have found significant, though modest, effects. The impact of calorie information on product choices is greater for some groups and where calorie amounts are higher than people expect. Research also suggests that this information can influence future purchase intentions as well as the consumption of other food that same day.

At a minimum, it should be mandatory for chain restaurants to have nutrition information readily accessible to consumers in each outlet. We should also seriously consider requiring that calorie information be posted on menus and menu boards. Having menu labelling laws in place in the United States makes it more feasible and less costly to have similar laws in Canada.

In the United States, industry representatives supported federal legislation that would create consistent national standards.

Second is front-of-package labelling. Simple nutrition labels on the front of food packages can be useful, but right now there are many different types of front-of-package labels, each with their own format and criteria. This leads to confusion and mistrust among consumers.

Some front-of-package labels are said to be misleading if they suggest that foods that are high in sodium, fat, or sugar are healthy choices. In addition to enforcing laws that prohibit false or misleading labelling, we should move ahead with the nutrient profiling approach used in other countries, where health and nutrition claims, or any labels suggesting that foods are healthy, can only be used if the product meets basic minimum nutritional criteria.

A standardized front-of-package label would provide consumers with consistent and reliable information. The U.K., and more recently the U.S., have been working to develop criteria and formats for front-of-package labels, initially to be promoted on a voluntary basis. If a purely voluntary approach doesn't achieve enough consistency, the official scheme could then be made exclusive--meaning that it would be the only type of front-of-package label that could be used--or mandatory.

A recent report of the U.S. Institute of Medicine made recommendations on what information to include on front-of-package labels. The second phase of their study, expected later this year, will examine the effectiveness of different label formats. We could use this, along with other available research, to choose a national front-of-package labelling scheme for Canada that would be promoted along with education and public awareness initiatives.

[The Chair, Conservative, Joy Smith]

Thank you very much.

We'll now go into our first round of questions and answers. We'll have seven minutes for questions and answers.

We'll begin with Mr. Dosanjh, please.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

I thank all of you for presenting your views here today. I'm going to start with the last presentation and go backwards.

Ms. Tigerstrom, you said you're recommending menu labelling for restaurant meals. Also, you're talking about front-of-package labelling and some regulations to standardize them. Do you know what work is being done within Health Canada on that?

[Barbara von Tigerstrom]

I'm aware that both of those are under consideration. I haven't been privy to any of the details of their discussions, unfortunately.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Turning to the Québec Coalition and the Canadian Sugar Institute, we heard contradictory testimony. The Canadian Sugar Institute said that it's not true that obesity is related to these drinks that are promoted. The Québec Coalition is saying yes, it is. Whom should I believe and why?

You can both have a crack at it briefly.

[Suzie Pellerin]

In fact, it is not Quebec that you must believe, but rather the WHO, the Institute of Medicine, the CDC and the Ruth Centre, who have all concluded that sugar-sweetened beverages are an important contributing factor in obesity. I think that these are references that are solid and well recognized. There is clearly conclusive data.

[Sandra Marsden]

We have a nutrition scientist who has actually looked at the studies. Certainly, if you decrease consumption of sweetened beverages it could help you lose weight, just as decreasing consumption of other caloric sources does, but there is not strong evidence linking sweetened beverages in particular to obesity. It's part of a complex set of behaviours and lifestyle patterns, including screen time, frequent consumption of fast foods, and physical inactivity. It's very difficult to disentangle any individual factors linked to obesity.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Let me ask if you are funded by the industry.

[Sandra Marsden]

As I mentioned, we are not here to defend soft drinks. Ninety per cent of soft drinks in Canada are not sweetened with sugar.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Bill Jeffery, I have two questions for you.

One is with respect to sodium. This is a question regarding our government's most recent announcement with respect to voluntary work on lowering sodium. Can you comment on that?

[Bill Jeffery]

First of all, I can't speak on behalf of the Sodium Working Group, although I was a member of that.

The recommendations in the Sodium Working Group report were consensus recommendations in that we all kind of grinned and bore it. They recommended sodium reduction limits on a voluntary basis. That approach was contradicted by a report that was published last April by the U.S. Institute of Medicine, which is a highly respected scientific organization that Health Canada relies upon quite a lot for designing nutrition policy. They were dismissive of the idea of using voluntary targets. They didn't think they would work very well.

Second, a few weeks after the Sodium Working Group report came out, the provincial and territorial ministers of health issued a communiqué saying that they thought the federal government should develop mandatory targets from the outset and should at least be prepared to go the mandatory route if it becomes clear that there won't be compliance.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

On the trans fats question, I remember there was a group started on trans fats during my brief time, but I lost track of what's happened. Do you know what's happened? You said Denmark has regulated trans fats out essentially.

[Bill Jeffery]

Yes, that's right.

You know, I think the trans fat experience was a useful learning experience for me. I was part of that task force as well, and we recommended, along with the Heart and Stroke Foundation and others, including industry, that there be regulations restricting the amount of trans fat that can be used in foods from the partially hydrogenated sources, the synthetic.

We sort of assumed, with such broad consensus that this was the way to go, that it would just happen within weeks or months that the regulations would be promulgated, the draft regulations. That didn't happen. A year passed. Then the minister said, well, let's wait another two years. Now it's almost four years. I kind of regret that as health advocates we weren't more vigilant about pressing the government's feet to the fire on implementing those recommendations.

I feel the same way about sodium. The Sodium Working Group, as far as I know, doesn't exist anymore. We were thanked for our service in December, and Health Canada started referring to it in the past tense. I don't know what's going to happen now.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Do I have more time?

[The Chair, Conservative, Joy Smith]

You have about a minute and a half.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Going back to soft drinks, I'm an immigrant, and when I came to England, and then, more importantly, to Canada in 1968, Coke was a godsend. It used to be so expensive when I was growing up as a little kid. Now I'm told that Coke is almost poison when you drink it, with the amount of sugar it has.

I have five grandchildren, and I'm worried about them. I'm South Asian, and there's a higher incidence of diabetes among South Asians.

Do you want to say anything with respect to what I just said, Ms. Marsden?

[Sandra Marsden]

I'll give you a couple of facts with respect to Canada.

First of all, diabetes is not caused by sugar or soft drinks. It is related to obesity, and obesity is a complex problem related to a lot of the behaviours I've mentioned.

Just in terms of facts--

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Let me ask you a brief question. Is sugar, among other things, at all related to obesity?

[Sandra Marsden]

Sugar is not. I mentioned that in my remarks. Scientific studies that look at sugar--

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Let me ask you this. You answered the question--

[The Chair, Conservative, Joy Smith]

I'm sorry, your time is up.

I'm sorry, Ms. Marsden.

We now have Mr. Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you very much, Madam Chair.

I thank the witnesses for being here this afternoon.

Ms. Pellerin, you consider both soft drinks and energy drinks to be a factor in childhood obesity. You in fact used the word “children”.

I would like to remind you of two statements made in committee here, at a hearing held on June 8, 2010. Firstly, the senior scientific officer at Red Bull, Mr. Andreas Kadi, said the following: “When you look at the events we are supporting [...] these are clearly events that are targeted at adults. When you look at the marketing activities we perform, when you look at the universities, for example, starting with students who are 18, yes, this is where we are. When you look at high schools, where students are younger, then this is where we are not.”

Mr. Justin Sherwood, president of Refreshments Canada, added the following: “The target market is young adults who are 18 to 34 years old.”

In light of that, how can you say that energy drinks contribute to childhood obesity?

[Suzie Pellerin]

First of all, there has been a change in consumption habits. Soft drinks used to be consumed, but that sector is now losing popularity. Energy drinks are spurting ahead and gaining market share at an exponential rate. As I said earlier, they are available everywhere. I invite all of you to go and see to what extent these brands are prevalent. If you walk into a convenience store, you may trip over them, and you may well see their trademark as you walk in.

Children are also attracted by extreme sports, an activity that is clearly sponsored by the producers of energy drinks. And so I have trouble believing that they are neither exposed nor influenced. In addition, I have myself seen that in places that are popular with children, energy drinks are sold in vending machines.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Where, precisely?

[Suzie Pellerin]

In fact, in sports centres. The distributor's argument was that the can was attractive. It was clear that the composition of the product had not been taken into account at all before that choice was made.