Health Committee on Dec. 5th, 2011

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you very much, Madam Chair.

I would like to thank all of our witnesses for being here today. I certainly appreciated your opening remarks.

Ms. MacLeod, I appreciated what you had to say and I'm pleased that we actually are embarking on this study on the heels of the endorsement by the ministers of health of a declaration on prevention and promotion, as well as the endorsement of the first report, Actions Taken and Future Directions 2011, on curbing childhood obesity.

You started and ended your remarks with the same statement, that healthy eating plays an important role in promoting health and reducing the risks of nutrition-related chronic diseases.

Ms. Elmslie, you stated that experience tells us that health promotion should begin early and continue throughout someone's life course, and that promoting healthy living in children sets the stage for good health and reduced risk of chronic disease in later years.

Of course, Mr. Sherman, you highlighted obesity and said that you were adding that to the list, as it has become a global issue.

I understand that our government has made some investments in research to help promote physical activity and obesity, and I know you touched on some of those research projects in your opening remarks. I'm wondering if you could give us some examples of these research projects or pick a couple that you would like to showcase here today.

[The Chair, Conservative, Joy Smith]

Mr. Sherman.

[Dr. Philip Sherman]

Thank you, Madam Chair.

CIHR has helped foster obesity research, turning an expert but very small research community into a large pan-Canadian and internationally recognized research funding group. Indeed, a bibliometric study of CIHR-funded obesity researchers has found that Canadian obesity researchers ranked number five in the world in productivity. The number of grants coming to the competition over the last eight years has increased sixfold. Two Canadian universities--Laval University and the University of Toronto--are ranked in the top 20 institutions in the world publishing obesity-related research.

So targeting research on obesity has been a public health issue that CIHR has addressed in a timely manner.

The point made about early intervention is an important one. There is research being done at the Hospital for Sick Children, where I work part of the time, showing that if you intervene on screening time for children, it has a big impact. That intervention has to take place early in life to really have a meaningful impact on body weight, and it has a long-term impact. So one needs to intervene early in life.

I hope that answers some of your questions.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you.

Ms. Elmslie, would you like to take a shot at answering my question?

[Kim Elmslie]

Sure. We are doing a number of intervention research studies in communities across the country. Under our innovation strategy at the Public Health Agency, one of our priorities is to test out in communities the types of things that will work to reduce obesity.

The Public Health Agency has made a major investment in figuring out best practices. That will build on work that CIHR and the public health community are doing.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you very much.

We know that obesity rates among children and youth have nearly tripled in the past 25 years. We also know that the Minister of Health met with provincial health ministers very recently and discussed issues around obesity.

I wonder if you can explain to the committee what the government has done to prevent obesity in Canada.

[Kim Elmslie]

On the work the government is doing, curbing childhood obesity was named a priority of federal, provincial, and territorial health ministers. Last week when health ministers met they endorsed a progress report and future action.

So the kinds of things we're working on collectively include developing guidelines for schools and public areas where children gather so that we can start to influence the kinds of foods available there. We're working to promote breastfeeding so that moms are breastfeeding to the optimal timeframe. We're working on access to healthy foods, as my colleagues from Health Canada have indicated. It's not an easy topic, but one that's very important. Of course, Nutrition North Canada is a good example of an initiative where we're learning about how to bring more healthy foods into remote populations.

We're working on surveillance. We're measuring childhood obesity and understanding where changes are occurring so we can target populations where the need is greatest. Through our programs, such as Canada prenatal nutrition program, we're working on providing healthy foods and the skills moms need to provide healthy foods to their families.

There's quite an array of initiatives currently under way that has provided us with a really strong foundation.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Ms. MacLeod, in response to my colleague's question about sodium, you mentioned the percentage facts table.

I know that when I buy something in the store, I look at the nutrition facts table. What is the government doing to ensure that all Canadians understand these tables?

Can you explain to the committee how the “percent daily value” works?

[Catherine MacLeod]

We're very proud of this project. It involves many different partners. We recently had a campaign focused on increasing awareness among Canadians of the facts table, how to use it, and what it means.

I'm going to ask my colleague Dr. Hutchinson to give us a little more detail on how that's working.

[Dr. Hasan Hutchinson, Director General, Office of Nutrition Policy and Promotion, Department of Health]

Thank you.

This was an exciting initiative that we launched just over a year ago, last October. It took a while because we put together an innovative collaboration with industry. It was with Food and Consumer Products of Canada that we partnered, and through them we partnered with an additional 34 companies and a number of different NGOs.

We tried to concentrate on bringing Canadians up to speed on how to interpret the nutrition facts table. We know from research that people will look at it, but they don't necessarily use the per cent DV. So we've used a multimedia approach to get the information out there about how to interpret the per cent daily value on the package signs contributed by the different food industries. We have TV ads and print media driving toward our new website, where there are interactive tools to help people walk through that.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Hutchinson.

We'll now go to Ms. Sgro.

[Judy Sgro, Liberal, York West, ON]

Thank you, Madam Chair, and my thanks to all of you for your presentation and the work that you do to keep us all safe.

Certainly, the nutritional facts labelling issue has been one that has been debated for quite a long time. I don't pick up anything now without looking at this label, and I put down probably 60% of the things I might otherwise have bought. I look at the label and decide that all those numbers are way too high, so I put a lot of these items down.

Where are we with the campaign to get more restaurants to produce the information? How is that going when it comes to public health?

[The Chair, Conservative, Joy Smith]

Dr. Hutchinson?

[Dr. Hasan Hutchinson]

This is an area that has a lot of interest. Last year Health Canada, working with some other partners, held a workshop. Food and Consumer Products of Canada was involved. EatRight Ontario and CIHR were also involved. A think tank came together to try to figure out how to make nutrition information available at the point of purchase in restaurants and food services.

A lot came out of that. A report will be available in the next little while. The FPT group on nutrition, of which I am the federal co-chair, formed a working group that is looking at this. We're working closely with the provinces and territories to develop a framework for making nutrition information available at restaurants and food services. That working group was co-chaired by Health Canada as well as B.C.

It's important to note this is not just a federal responsibility. This is a responsibility shared by the provinces and the territories, and we are collaborating in putting together a framework.

CIHR has also funded some research. Do you want to talk about that, Phil?

[Dr. Philip Sherman]

There is interest in the impact of food labelling in restaurants, and there is the issue of unintended consequences. Some groups, like teenage boys, respond totally differently from others to nutrient labelling, so thought needs to be given to special segments of the population.

[The Chair, Conservative, Joy Smith]

Is there scientific data for that, Dr. Sherman?

[Dr. Philip Sherman]

There is.

[The Chair, Conservative, Joy Smith]

I was just wondering.

[Judy Sgro, Liberal, York West, ON]

Maybe it was just--

[Dr. Philip Sherman]

Research is under way to understand why teenagers look at things differently. For food labelling, it was teenage boys we looked at.

[Judy Sgro, Liberal, York West, ON]

What percentage of restaurants have voluntarily agreed to participate? I think it is higher in the U.S. than in Canada. Have you any idea of what the percentage is now? That's a difficult issue.

[The Chair, Conservative, Joy Smith]

Dr. Hutchinson.

[Dr. Hasan Hutchinson]

Through the Canadian Restaurant and Foodservices Association, they have a voluntary approach to making this information available. The 16 largest companies, which represent about 60% of restaurant sales in Canada, have committed to this and have acted on it in different ways. You have certain companies like McDonald's where you can walk in and see the signs on the side. They have them in the tray liners. You can go on the website. They have pamphlets.

Other members of the association have taken different approaches, but we have a strong commitment by a number of the large restaurant chains to make this information available.

[Judy Sgro, Liberal, York West, ON]

Ms. Elmslie, you had mentioned an issue that I'm quite interested in, the issue of mental health and the need for Canada to really move forward on that issue, especially when we're talking a lot about the suicide of so many young people, which has been in the news a lot.

What do you see the plan being for the next year or two, as to the kind of action that you might be able to take?

[Kim Elmslie]

Thank you very much for that really important question.

I'll reiterate once again that the work of the Mental Health Commission of Canada is so vitally important to actions that we will take in the years to come to promote positive mental health and to prevent mental illness. The work they have done on homelessness is really essential to understanding how we can prevent mental illness and promote mental health in street-involved children and youth, and in adults.

We are all looking forward to the mental health strategy that we expect will come forward from the commission early in 2012. That will represent many, many months of consultation across the country with Canadians, with health care providers, with researchers, and other experts, taking all of that into account and looking at what the important things are that we should be doing as a country.

Of course, providing mental health services to Canadians is the jurisdiction of the provinces and territories. Therefore, the work that we do with provinces and territories in surveillance of mental illness is providing reliable data on which to build solutions, but also to monitor the magnitude of change that we can achieve.

Our research efforts in mental health—and I'll turn to my colleagues from CIHR to talk about those—are certainly second to none internationally. We have a great deal of important research under way that is translating what researchers are finding into real-world solutions. That's so important to us as we're trying to deal with mental health problems, which, as you know, do not conform to one-size-fits-all solutions.

So I would say that the work that we're doing is building to a strong crescendo in terms of a very solution-oriented approach, armed with the tools that will enable us to measure progress and really see where we're having an impact.