Health Committee on Dec. 5th, 2011

[The Chair, Conservative, Joy Smith]

Thank you very much, Ms. Elmslie.

We'll now go to Mr. Gill.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you, Madam Chair.

And I want to thank the witnesses for being here with us today.

Health Canada emphasizes that the revised food guide is evidence-based. Can you please tell us how the food guide has incorporated the most recent scientific evidence?

[Catherine MacLeod]

I'll start this off by giving you a broad overview of how it's changed over the decades.

Of course, the Canadian population has changed and we've had to adjust accordingly. Different consumption patterns, a variety of foods from various cultural backgrounds, and availability all come into play as we look at how Canadians eat and as we provide the best possible advice.

In terms of the scientific evidence and how that has evolved, I'll ask Dr. Hutchinson to add to that.

[Dr. Hasan Hutchinson]

Sure.

Certainly, when the Office of Nutrition Policy and Promotion—and this actually predates me—was reviewing the old food guide, the 1992 food guide, they really looked at the scientific basis of that and compared it with the new dietary reference intakes that were referred to earlier. This is the work that we do in partnership with the U.S. government through the Institute of Medicine, where we get the requirements for a wide range of different nutrients.

We looked at the best science available there. There had been 14 years of concerted effort by both of our countries to bring those up to date, so we had those, which were new. We looked at the latest evidence that connects the food supply with different chronic diseases and the effects on your health in general. Using that information, there was a very extensive modelling process, where for every age-sex category that's in the food guide, they would produce 500 different model diets, and then look at the distribution of nutrients in there. So it was an iterative process until you really got the best type of pattern of eating, where you ensured that you had the right amount of nutrients, but not too many nutrients as well. So you're really controlling there for things like sodium as well.

That was the process that was entered into, and then it went out for consultation. It went across Canada. I think there were 7,000 people who provided input to that. We had a lot of academics. I was at CIHR at the time and we had quite a lot of input from CIHR, with a lot of different academics at CIHR looking at what had been put forward, and assessing the science behind it. NGOs were assessing it, and the provinces and the territories. So it was really open to very wide consultation, which was incorporated; and in the end, we got the pattern that we recognize now as the Canadian food guide.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you.

My next question is to Ms. Elmslie.

In the overview of the report, Actions Taken and Future Directions 2011, one of the statistics in the sidebar of your website mentions that 70% of children are sedentary after school. Could you explore the factors for why that is and how the statistics have arrived at that conclusion?

[Kim Elmslie]

Those statistics come from survey data. The Canadian school health behaviour survey is one really important source of data, along with work that Statistics Canada does to look at the patterns of behaviour among our children in the after-school time period.

Of course, there are many factors that contribute to that. For instance, there's kids' interest in video games and the fact that, in some cases, we are more concerned about the safety of our children and therefore tend not to promote, as much as we may have in the past, their running around and playing outside in parks, etc. So there are a number of sociological and behavioural studies that are being done, given those realities of modern life, at how we can shift that paradigm. How can we start to encourage our kids, particularly during that critical after-school time period, to become more active, to be engaged in safe and active play, either through school programs or in their communities? That, in particular, is an important part of the work that we are doing at the Public Health Agency, with our counterparts in provincial-territorial governments, working with the education sector and the sports and recreational sector to provide guidance to communities and parents around allowing their kids to play safely. It's an important priority for us and will continue to be over the next number of years.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you.

You mentioned video games. What impact, if any, on physical activities do you notice from interactive games such as Wii Fit and now Kinect?

[Kim Elmslie]

That's a really good question. I don't have data on the impact of those more physically active video games, but I'm wondering if anyone--

Philip does. Go right ahead.

[Dr. Philip Sherman]

I'm a pediatrician who is interested in obesity, so I do follow this. There is a literature on this that the kinds of video games that children choose, or are encouraged to choose, do have an impact on energy expenditure. So it turns out that some of these interactive games really do have a big impact—and, again, it's not one-size-fits-all.

The interesting thing about the Wii exercise is that visible minority teenage girls take to that very positively, whereas boys might go for competitive sports or go to a community centre. So it is a real opportunity to intervene to prevent and treat adolescent obesity, anyway.

There are researchers around the world, including in Canada, looking at the potential of using what kids are playing with, but to reduce and prevent obesity.

[Parm Gill, Conservative, Brampton—Springdale, ON]

You mentioned visible minority girls. Why?

[Dr. Philip Sherman]

The observation is that's the group that had the biggest impact. Why? That's what we need to know next. It was the observation that was made. I can't tell you why.

[Parm Gill, Conservative, Brampton—Springdale, ON]

That's interesting.

Also, are there preliminary conclusions from the four research teams studying the effects of exercise on the body and its role in the prevention and treatment of chronic disease? Can you discuss any recommendations these findings will underline?

[Dr. Philip Sherman]

The work is in progress so we don't have the final evidence. Usually the research is funded for a period of time, typically between three and five years, and then the results sometimes take even a little longer than that. The work has been funded and we're awaiting the results. I'm sorry, but I don't have the....

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Sherman.

We'll go into our second round of questions and answers now. Remember, we're down to five minutes so the time is a little tighter.

Madam Quach.

[Anne Minh-Thu Quach, NDP, Beauharnois—Salaberry, QC]

Thank you, Madam Chair.

Thank you to all of you for being here.

I have several questions.

Several experts have come to talk to us about health and told us that in order to do prevention and encourage the adoption of healthy life habits, we have to start early, and this also has to happen within communities.

Has the government considered a political commitment, that is to say more funding for facilities in urban areas so as to make improvements and promote the creation of local services?

For instance, in the city of Saint-Rémi, a family-aware policy led to investments in the creation of a BMX bike path and a pool. Some rural communities are looking for funding to create and build community sports centres. All of this not only contributes to the social and cultural life of the community, but it helps to promote active living.

One hears that youngsters spend too much time playing video games. However, if they had easier access to community centres, that would be a positive factor in their lives.

Will the government create incentives or invest in more programs to allow for the construction of this type of infrastructure?

[Kim Elmslie]

Thank you very much. That's another very important question--

[The Chair, Conservative, Joy Smith]

Dr. Hutchinson, I'll give you a minute to say something if you'd like as well.

We will have Ms. Elmslie and then Dr. Hutchinson.

[Kim Elmslie]

Okay, thank you.

That is a really important question. In terms of the role of the federal government in this area, we've put our emphasis on the investment in identifying the best practices in communities and in helping communities test ways and innovations for disease prevention and health promotion. Once we are able to identify those important outcomes and those interventions that work, we share those very broadly with municipalities and with provincial and territorial governments, which have the jurisdiction to determine what kinds of infrastructure they are going to invest in within their communities. Our approach has been to take a research and best-practices approach and to share the learnings of that broadly.

[The Chair, Conservative, Joy Smith]

Dr. Hutchinson, would you like to add to that?

[Dr. Hasan Hutchinson]

It was actually for the CIHR to respond.

[The Chair, Conservative, Joy Smith]

Okay.

Dr. Edwards.

[Dr. Nancy Edwards]

I just have a couple of examples. One is an initiative that we're involved in with the Heart and Stroke Foundation of Canada, which is actually looking at research that targets the built environment. The built environment is something that's so important to promote physical activity in youth, and in older people as well.

There's an interesting project under way in Montreal, which is actually a natural experiment. It's something that was put in place by the municipal government. It involves the bicycles you can rent, pick up, and take. It looks at patterns of commuting and at how people are using these. It also looks at negative impacts, whether there are injuries and so on. It looks at how this is promoting physical activity in our cities. These kinds of studies are very important to us so we can know what it is that needs to be scaled up.

[Anne Minh-Thu Quach, NDP, Beauharnois—Salaberry, QC]

Thank you very much.

Among the best practices—several are already known—it has been proven that the presence of infrastructure encourages people to go outside and engage in physical activity.

I would now like to discuss the matter of incentives to encourage people to eat healthy foods. We know that Quebec is the larder of the country. There are many farmers in that province and yet family farms are having a great deal of trouble surviving because of multinationals and large agri-food companies.

Is the government doing anything about that? Is the government encouraging public markets in some proactive way? In my community there is a distribution coop that is having trouble getting the word out. In fact, farms are too small to hire people to work in the distribution cooperatives in public markets. In addition it is difficult for them to get into the large food store chains since they must provide a supply of food products throughout the year. And we know that with our winters it is difficult to supply product the whole year round.

Could the government invest so as to ensure that local food can be offered at good prices, or have some traction in our grocery stores—

[The Chair, Conservative, Joy Smith]

Mrs. Quach, you've almost run out of time.

Can you answer her question as well as you can within a very short framework, Ms. MacLeod?

[Catherine MacLeod]

Generally, that wouldn't necessarily be within the federal jurisdiction, other than perhaps in the north. We can provide some additional information to the committee on what we're doing on that with first nations and Inuit communities in the north.