Health committee  Sorry, I'm not an educator and I can't give you the details, but that's the purpose of setting up the Joint Consortium for School Health, with education and health at the same table.

Health committee  Stress and mental health I guess is what you're alluding to, and how it relates to that clearly is an indicator that's related. Did you want to speak from a scientific perspective, Diane?

Health committee  You can't have one take precedence; it has to be both. The approach can be independent, and some of the approaches to get physical activity are different from some of the approaches for nutrition, but it's pretty tough to pick and choose which one. They're so interrelated, and I think that's what the evidence has shown us.

Health committee  I think you're talking about educating the outcomes and the risks of being obese to families, so that they can make sure they're feeding their children appropriately. There is evidence that education is important, but as with tobacco it's not sufficient. There's lots of good survey evidence in tobacco, and Canadians know obesity is bad and probably for the most part know that it's related to diabetes.

Health committee  Let me add, on surveillance with respect to weights, that we try to make it more comprehensive for all our disease collection things and risk factors. The other thing to think of is that surveillance is a mechanism to actually evaluate what you've done. Surveillance isn't sophisticated enough yet.

Health committee  So on your third question....

Health committee  I'll begin to try to address that. I'm not sure we can say this is where we're going wrong. I come back to the tobacco analogy--multiple interventions over a sustained period of time. Forty years ago tobacco began the work that led us to where we are now. In the last few years what's been very exciting for us is looking at things totally outside health.

Health committee  There is evidence. The CCHS, the Canadian community health survey, had very good evidence because they looked at socio-economic status at the same time. Interestingly enough, men in higher income levels actually have higher rates of obesity, which is quite surprising. Women in the middle-income area tend to have the highest rates of obesity.

Health committee  I could begin. In the material we provided there's a recent study showing an annual cost of about $4 billion, but I think that's an underestimate. Part of what we're worried about--and where I work our lens is a chronic disease lens--is the kind of disease that obesity is going to lead to, such as diabetes, heart disease, high blood pressure, arthritis, etc.

Health committee  I think it's a combination of all those factors. The aboriginal groups are the ones we talked about specifically, but there is a combination of genetic predisposition, ethnocultural types of food they eat, and socio-economic status. There are multiple factors. Is that concise enough?

Health committee  I want to pick up on your comment about labelling not being enough. I think it is very clear that this is one of the many things that must be done. It's not sufficient on its own. The best comparison that we like to use is tobacco. Canada is a global leader in tobacco reduction, but that's been over many years of sustained investment and multiple interventions.

Health committee  Just very quickly, if you're talking about the taxation of junk food, there's been some controversy--that may be a bad word to use--or some evidence that in some situations it does work very well, but it's not as easy as some of the taxation that has existed, such as with tobacco.

Health committee  If I may, I believe Mary Bush wanted to comment in answer to your question.

Health committee  I can start that response. It's been on the horizon and on the radar for quite some time, but we haven't had really good, accurate data until recently. Part of the data that tells us what's going on has been self-reported data, until just 2004, when the Canadian community health survey, which was done by Stats Canada, actually measured people's height and weight.

Health committee  Well, we have proof of that now. So when you actually measured people and measured children, the rates were much higher. That doesn't mean it wasn't on the radar scope, but it really does mean that the problems were worse than we anticipated. As well, it's been particularly difficult in the aboriginal communities to get good, solid data.