Health Committee on June 15th, 2006

[Dr. Diane T. Finegood]

We know most people walk as their form of physical activity. We also know there are good relationships between lower body mass index and the use of public transit and walking, having destinations to walk to.

If you live in the suburbs, having nice trails to walk to will lead to an increase in physical activity, and if you live in a city, having access to all kinds of stores and things like that is what makes people walk. So when we construct suburbs with no destinations to walk to, people don't walk.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Just before I let Mr. Fletcher on for five minutes, I'll say this to Mr. Ménard. You know, I've never met him in the gym. I've also never met him in the stairwell of our building.

[Réal Ménard, Bloc, Hochelaga, QC]

I go there three or four times a week. I have no fat.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Actually, come to think of it, I use the elevator a lot, and I see both of you guys in the elevators. I have an excuse. What's your excuse?

[An hon. member]

There goes two minutes.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

My, time flies when you're having fun.

First of all, I found the presentations very excellent, from each of the presenters. I think the distinction between obesity and trans fats is helpful. I also found the feedback on the trans fat task force helpful, because in fact this is something the NDP has worked on, and when I was health critic, I was able to assist the NDP in coming up with the wording of that to include an all-stakeholder panel. So I'm glad to hear that it worked out well.

The issue of active living is talked about a lot, and I just want to assure the panel that the government is committed to an active living program. You have seen that in the budget with specific tax credits, and I think you'll see a lot more progress in that area, particularly with input from stakeholders like yourselves. So we look forward to working with you on that.

One thing I would like to see this committee do, if the committee is open to it, is an extensive study on obesity, and come back with an all-party report, because I think this is a non-partisan issue and we can deal with prevention and education and include stakeholders. I would be interested in hearing the opposition's point of view on that.

But if we do decide to do that, I wonder if the committee could comment on whether there would be value in having an economist type of person deal with not only the costs and so on of what chronic disease does...but to follow up on Ms. Keeper's point, in northern communities, it's ironic perhaps that the cost of an apple or a carton of milk is many, many more times that in the city. I know in Manitoba, for example, even for alcohol, if you're in Churchill, it costs the same amount to get a bottle of beer as it does in the city, due to the way the liquor commission works.

So I wonder if there's any thought on the economics of making healthy food affordable in the north--and that would obviously affect the aboriginal community as well as the non-aboriginal community.

Also you mentioned that lower-income families tend to eat out more, which is maybe counter-intuitive, because that's often more expensive overall. I wonder if there are ways to make it economically attractive for lower-income people and other demographics to eat healthy?

[Dr. Diane T. Finegood]

As Stephen alluded to, the evidence that we do have so far about economic incentives and disincentives suggests that economic incentive is a much better driver for making healthy choices. So lowering the price of healthy food or subsidizing nutritious, healthy food--low energy-dense food--tends to have a greater impact on people's purchases and food-related behaviours.

That may be in part because we haven't made the disincentive great enough to really affect people's behaviour. That's difficult to do, because the more energy-dense foods are much cheaper, so the amount you would have to increase the taxes by, as with gasoline or tobacco, would have to be quite severe.

So yes, economics are clearly an important component of this, and understanding that and collecting the information about how to drive healthy eating and active living is extremely important.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Do you think it would be helpful if the health committee were to study obesity?

[Sally Brown]

Yes.

May I just add two short comments?

I think this just shows what we mean by a comprehensive approach. With smoking, nobody would have guessed it was municipal bylaws that would have the most effect.

For obesity in the north, it's transportation policy. It's not just health policy. I think it's very important, if this committee looks at it, that you get the other departments that are relevant around the table.

The other point I would make is that I had the pleasure of being in Australia a short while ago. Jeff Reading from the Institute of Aboriginal Peoples’ Health was a guest speaker. This is an identical problem in Australia. They have the distances; they have the aboriginal issues. They're going to start focusing on it. I know our Prime Minister met with the Australian Prime Minister. This is something we can look at together.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

The Australian Prime Minister, by the way, is a great guy.

[The Chair, Conservative, Rob Merrifield]

Ms. Priddy, you have five minutes.

[Penny Priddy, NDP, Surrey North, BC]

Thank you.

By the way, here is my pedometer, just so you know I'm....

[A voice]

How many steps?

[Penny Priddy, NDP, Surrey North, BC]

So far today it's about 3,000.

[A voice]

It should be 12,000.

[Penny Priddy, NDP, Surrey North, BC]

Yes, I know, but it is only 12:30 p.m. It's usually 12,000 by the end of the day--truly.

There are several points I'd like to make. I'm sure you've thought of what action you might be taking. I know that Canada's Food Guide has been translated. I missed the last part, though. Has it been translated in ways that also recognize the food used culturally by people from different countries?

It's one thing to translate it into Punjabi--okay, fine--but you have to talk about what that means if you're cooking dahl or if you're cooking whatever. Has it taken that into account?

[Francy Pillo-Blocka]

There are two things. First of all, yes, absolutely, the translated versions of the current guide take into account the culture, the different foods, and that sort of thing. But keep in mind that Canada's Food Guide to Healthy Eating, the new one, is coming out and we'll need to do the same sort of thing for the new version.

[Penny Priddy, NDP, Surrey North, BC]

Yes, because we're getting so much more.... Thank you.

I'm wondering, on any of the committees that people are involved in, whether there are representatives from anti-poverty groups. Maybe there are lots, but for many people, aside from what we know about other predisposing causes, it is about cost. If my children are really hungry and I give them a piece of melon but I can buy Kraft Dinner for about the same cost, the melon won't keep them full and the Kraft Dinner will.

People have worked very hard in the anti-poverty movement to find ways to offer those suggestions, so I'm just trying to ensure that they indeed are involved in the work that people are doing in terms of how that information gets out to people. Yes?

[A voice]

Yes.

[Penny Priddy, NDP, Surrey North, BC]

Okay, thank you.

Thirdly, I'm wondering if you're involved with city managers at all. I come from a city that issues more building permits than any other city in Canada. God forbid that we should leave a piece of free land rather than put six more houses on it. In many ways it is the municipal area that ensures there is enough space, that the leisure activities are close enough together.

If you looked in my community you'd find skateboarding and rock climbing, because they're free and because people can get to them. Even if you get a tax credit for enrolling your child in hockey, I haven't got $500 or $600 to put up front. So municipal governments have a really important role to play in this one as well, and I've never heard them talk about being involved in this. They also deal with transportation as well.

I'll just say one more thing and then I'll leave it.

Can I say one more thing?

[The Chair, Conservative, Rob Merrifield]

You can. They want to respond, but go ahead.

[Penny Priddy, NDP, Surrey North, BC]

Yes, I know.

The other is seniors. If you go into McDonald's at mealtime, often half the people you see will be seniors, because it's a really inexpensive meal. We didn't talk about that sort of further-on age group, but they have those same kinds of risks.

Thank you. Okay, go ahead and talk now.

[Stephen Samis]

I can speak to a couple of things you mentioned. The alliances that are at the provincial level--the chronic disease and other healthy living alliances--definitely have groups concerned with poverty involved in them. The recommendations that they tend to bring forward tend to be very conscious of those kinds of issues and concerns. And the Heart and Stroke Foundations across the country participate in those alliances. Through a variety of other fora, I think we tend to find ourselves in meetings with people looking at the issue from a number of perspectives, including that one.

Specifically with respect to the municipal level and a built environment, we're doing a number of things at the Heart and Stroke Foundation to try to increase awareness of this linkage. We have an annual healthy public policy award that we award to a policy-maker in the country who is really seen to make a difference in heart health. This year's award winner was Mr. Larry Beasley, who is the head of planning for the City of Vancouver. We gave him that award in terms of highlighting the ways in which Vancouver has worked very hard to develop a city that encourages physical activity and a more active population.

We're also in discussions right now with the Canadian Institute of Planners to develop a joint award between the Heart and Stroke Foundation and the Canadian Institute of Planners that would go every year to a municipality of whatever size in the country that has done something to get at this issue and to help Canadians live more active lives.

We are also coming out--and we're going to be working with Diane's institute to do it, as well as with a number of other institutes, including the Institute of Aging--with a request for proposals this fall that will really try to build the evidence base on the link between how we design our communities and the food and activity choices available to Canadians in communities and obesity.

[The Chair, Conservative, Rob Merrifield]

Mr. Batters, you have five minutes.

[Dave Batters, Conservative, Palliser, SK]

Thank you very much, Mr. Chair.

I appreciate all of you coming before this committee on this very important subject. Certainly we all recognize in this room, and Canadians recognize, that healthy, active kids equal healthier, happier adults. I think you've explained to us very well today the tremendous human cost associated with childhood obesity. We've talked about the fact that it's associated with diseases such as diabetes and heart disease.

Clearly, the human cost is most devastating, but there's also the tremendous financial cost, as Dr. Katzmarzyk has pointed out, and the costs for drugs and hospital procedures we will incur as a result of childhood obesity are staggering and must be addressed by parliamentarians.

The government certainly feels this is a very important subject. I think the parliamentary secretary said it best: this would be a good issue to study. I hope that members opposite feel the same way and that we'd perhaps issue a report on this very important subject. I'm very proud to be part of a government that provides tax credits, a $500-a-year credit per child, for registration fees in activities that involve physical fitness. Clearly, the government feels this is a priority.

I'm going to give you a heads-up. I'm going to talk for another minute and a half, Mr. Chair, and then I'd like the panellists to answer a quick question. I'll give them a few minutes to prepare their answers, and then perhaps in the rest of this meeting the rest of you would have a chance to respond.

At some point you can get to paralysis by analysis--we have all these reports--but I'd like to ask each of you as experts in this field, what are the two biggest changes that can be made to address this important issue of the increasing trend of childhood obesity? I leave you with that to think on. What are we doing in Canada for prevention, and how do we break this cycle? We can either spend some money now or we can spend a heck of a lot of money later on this problem.

Clearly, we need to do more in terms of physical activity and healthy eating. I believe we need more public education, things like ParticipACTION. We have all seen the ParticipACTION ads. I personally don't see as much of that on television as I used to, or I don't notice it as much, and I think there could be room for a lot more of that. We need the education of parents, as well as children; more programs in our primary schools; changes in school curriculum, perhaps changes in physical education curriculum; education from doctors.... Perhaps we can produce kits that physicians can give to patients, although from talking to many physicians, I know they are less than optimistic about a patient's ability to make dietary and lifestyle changes. The figures are that about 10% to 15% actually work. I know in adults that's certainly the case, and then they come looking for their dyslipidemia medication.

My God, 20 hours of screen time a week, and I'm guilty of perhaps almost as much. What can we do to turn off that television or video game and get the kids outside to play?

I leave you the remaining time. What are the two biggest things that we can do to reverse this very worrisome trend?