Health committee  I'm not aware of any benefit other than the fact that it's a quick source of energy, and that can be debated, I'm sure. Adam van Koeverden can talk about what's best to fuel your body through sports. If we did talk about it from an evolutionary point of view, for most of human evolution, it has really important to get calories in as quickly as possible.

Health committee  I also have an evolutionary bias, so I believe in evolutionary medicine. I would say that the food industry doesn't set out to harm anyone. What it does is engineer food products that are attractive. They're savoury and they're sweet. We have an evolutionary bias to want to maximize caloric intake.

Health committee  Thanks for the question. It is conjecture; however, the University of Waterloo did a study looking at the financial benefits of implementing a tax on sugar-sweetened beverages. I don't have the study in front of me, but it seems to me it was close to roughly $1 billion per year over 25 years in health care cost savings because of the role of excess sugar in the diet.

Health committee  That's correct. There are a number of jurisdictions that looked at improving food literacy and the impact of those didactic sessions on behaviour. I would say that they're not non-existent, but they're dwarfed by the power of marketing that kids are subjected to. The budget for marketing unhealthy foods and beverages to kids is over $1 billion per year.

Health committee  It should be taught; however, I don't think we should rely upon that to have a substantive change in eating patterns for children. Part of it is the neurobiology of kids, their neurocognitive perceptions. The organ of thought of the brain area—the prefrontal cortex—doesn't fully develop until age 20 to 25.

Health committee  When you look at the key action statement around the AAP recommendations, you see that they don't differ significantly from what's been recommended in Canada. They talk about monitoring and detecting early departure from healthy weight trajectories, and when that's detected, they have a conversation about fundamental behavioural changes.

Health committee  I think in part it's industry lobbying, but also there's a natural hesitation for government to increase taxes. That's worldwide. Over the last decade, we've met with various levels of government, both provincially and federally, to advocate this step. In British Columbia, we were successful in persuading the government to remove an exemption on provincial sales tax that sugary beverages enjoyed.

Health committee  We would love to see that happen. In fact, that was our initial proposal back in 2015 when we met with the government. You're right about the unique vulnerabilities of adolescents. They have discretionary income, they have less supervision, and they have unique drivers in terms of their social relationships.

Health committee  That's correct.

Health committee  Media literacy for children has not proven to be effective at all. The media literacy messages are kind of staid, boring, brief, and they pale in comparison to the pizzazz and sizzle of advertising.

Health committee  I like the use of the term “kernel” because I think it gets back to keeping it simple. Like you, as a physician, I don't know much about nutrition. I think that there's more and more awareness of talking about calories, about carbohydrates and about particular components. People gloss over this, and really we're talking about whole foods—purchasing and cooking whole foods at home.

Health committee  I would characterize it as bidirectional. Sometimes, due to genetics and the obesogenic environment, unhealthy weights develop, and then, as a result of stigma, mental health deteriorates. In other times, children who have been subject to child maltreatment—sexual abuse, physical abuse and that sort of thing—and children with biological tendencies to depression or anxiety can also use food for solace.

Health committee  I'm going to try to unpack that. Eating disorders have increased in prevalence, but they're still dwarfed by the incidence of unhealthy overweights and obesity. Mental health is hugely important. I would say that 80% of my practice deals with anxiety, depression, autism, and ADHD, so it's out there.

Health committee  It affects them quite severely, actually. In a study that's now 10 years old or older, children living with obesity rate the quality of their lives lower than children who are undergoing chemotherapy for cancer. Stigma against obesity—bias against obesity—is one of the last publicly acceptable prejudices.

Health committee  Absolutely.