Correct.
Evidence of meeting #14 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was children.
A recording is available from Parliament.
Evidence of meeting #14 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was children.
A recording is available from Parliament.
4:10 p.m.
Director General, Community Programs Directorate, First Nations and Inuit Health Branch, Department of Health
Correct.
4:10 p.m.
Liberal
Tina Keeper Liberal Churchill, MB
I want to ask you one more question. You said you received this data in 2004 and that there had been the thought that in Canada we weren't at the levels of our counterparts in North America with a similar lifestyle.
A couple of you mentioned the World Health Organization, that it had a strategy on diet. Is there extensive research in other countries, western nations or developed countries, that we're looking to in terms of what will have a significant impact on obesity rates in children?
4:10 p.m.
Acting Director General, Centre For Chronic Disease Prevention and Control, Public Health Agency of Canada
Yes.
I think if you're looking to compare us to other countries, we're quite comparable to other developed countries, which is actually quite worrisome, as developing countries are actually acquiring the same problem. So it's now being thought of as a double burden, meaning that developing countries not only have infectious disease problems, they also have obesity and chronic disease problems at the same time.
We're clearly looking at research in other countries.
Perhaps Dr. Finegood could comment.
4:10 p.m.
Dr. Diane T. Finegood Scientific Director, Institute of Nutrition, Metabolism and Diabetes
Sure, I'd be happy to comment.
I think your question was more directed toward how to solve the problem--did I understand correctly?--or how big the problem is.
4:10 p.m.
Liberal
Tina Keeper Liberal Churchill, MB
Well, yes. Is there research that can point to really effective strategies?
4:10 p.m.
Scientific Director, Institute of Nutrition, Metabolism and Diabetes
Yes, there are a number of efforts around the world. One I can point to specifically is called the community guide, which is organized by the Centers for Disease Control in the U.S., whose sole purpose is to take the whole bulk of literature that's out there and ask what we can actually learn from that literature about how to intervene.
Particularly on the physical activity side, there's enough data now to know that a number of different kinds of interventions around physical activity actually have an impact on people's behaviour--and this is generically, beyond childhood obesity--for example, things like comprehensive programs; quality daily physical education; point-of-decision prompt, so that when you're at an elevator it says if you take the stairs, you'll actually burn this many more calories.
On the nutrition side, unfortunately, the database is really much weaker, and although there are some good studies that show there are ways to intervene in nutrition in schools and things like that, there isn't enough data yet for that body to actually make strong recommendations about how to intervene. It really speaks to a gap in our understanding about intervention.
So while we know something and we know enough to know that we need to act, one of the really important things is that when we do act we make sure we also learn from those actions in order to be able to feed our understanding in an ongoing way.
4:15 p.m.
Liberal
Tina Keeper Liberal Churchill, MB
Do we have enough data to project where we'll be in five years or ten years if we don't have any effective strategies in place or if we don't take action quickly?
4:15 p.m.
Scientific Director, Institute of Nutrition, Metabolism and Diabetes
Absolutely, and the projections, of course, are always a bit challenging because the world changes over that time. But I think the most striking statistic I've heard is that one in three children born in the year 2000 will develop diabetes in their lifetime, and that's as a consequence of, obviously, growing obesity rates. So that's a very frightening statistic. It doesn't mean that they'll necessarily develop the diabetes as children, but if they develop obesity as children, then it leads to the consequences of that.
4:15 p.m.
Liberal
4:15 p.m.
Scientific Director, Institute of Nutrition, Metabolism and Diabetes
Yes, because that's what it's linked to.
4:15 p.m.
Liberal
Tina Keeper Liberal Churchill, MB
Can I also ask about type 2 diabetes amongst children? I know that within the first nations community this is occurring. Do we see that across the board in Canada with children?
4:15 p.m.
Scientific Director, Institute of Nutrition, Metabolism and Diabetes
Yes, but when you look at it from a statistical point of view it doesn't sound very frightening because the numbers are down at 1% or 2%, or something like that. I think it's about 1% across Canada in children. The problem, of course, is that is really the tip of an iceberg, and it's a disease that you shouldn't get, if you're going to get it, until you are 50 or 60 or 70. That is very frightening, because most people with type 2 diabetes, even if they work hard to control their disease, within 15 years or so usually develop the complications of diabetes. So if you have children developing diabetes at age 10 and developing the complications of diabetes at age 25, it's a very frightening prospect for the health system.
There's an excellent researcher in Manitoba who has had a pediatric obesity and diabetes clinic for a number of years. When she went to follow up those children to find out what happened to them after they left her clinic--because she's a pediatrician--many of them were on dialysis and some of them had already died of their disease. It's a very frightening prospect.
4:15 p.m.
Acting Director General, Centre For Chronic Disease Prevention and Control, Public Health Agency of Canada
If I may, I believe Mary Bush wanted to comment in answer to your question.
4:15 p.m.
Director General, Health Products and Food Branch, Office of Nutrition Policy and Promotion, Department of Health
I think your question about whether we had some indication of this is a very important one. And I think it's important to flip back not many years, to 2001, when the Institute of Nutrition, Metabolism and Diabetes, Obesity Care Canada, and ourselves held a meeting for two days called “National Dialogue on Healthy Body Weights”. Part of that was to try to peel back and say: What is it that we know? What data do we have? Is it an issue of energy and food being consumed? Is it physical activity? Where are we?
We were truly at an exploration stage.
Data you will hear over and over again has been an issue, but equally an issue is not just having the data, but having a system that someone is analyzing, looking at, reflecting on, and using in an ongoing way. I know Dr. Taylor mentioned that in his opening remarks. That kind of system is part and parcel of what's absolutely essential.
4:15 p.m.
Conservative
The Chair Conservative Rob Merrifield
You actually are, yes.
Perhaps you can pick it up in the second round.
Christiane Gagnon.
4:15 p.m.
Bloc
Christiane Gagnon Bloc Québec, QC
Thank you.
Over the past few days, we have been trying to better understand why there has been an increase in obesity in both the aboriginal and non-aboriginal populations.
I referred to a longitudinal inquiry into the health of the First Nations in the Quebec region. I was struck by certain factors and lifestyles pertaining to the population as a whole, in this case the aboriginal people. Geographical remoteness is a big factor in determining whether one can obtain good information and certain services. The problem of obesity is greater since they are located in regions that are very far away from centres where services and information are available and there is a greater awareness about healthy eating habits.
We have a Food Guide which we are encouraged to consult and we have food labelling, but these things will not result in young people being more physically fit or eating better.
What solutions could we suggest to people who live in remote areas, and here I refer more specifically to the aboriginal people?
4:20 p.m.
Director General, Community Programs Directorate, First Nations and Inuit Health Branch, Department of Health
I will refer specifically to aboriginal people in remote regions. I will ask my colleagues to discuss isolated communities in general.
Let me give you an example. We have information about the Nunavik region, which is an Inuit region in northern Quebec. We've set up projects where the indicators are more positive. This relates to the notion of food security/insecurity.
Nunavik has set up programs that apparently help with nutrition. For example, the Fédération des coopératives du Nouveau-Québec operates stores in northern Quebec. Their price policy favours healthy nutrition. Moreover, these communities have a support program for Inuit hunters. That program is part of the land claims. The communities also have community freezers to store the food brought back by the hunters.
The community has access to food in these freezers, and we believe that is a good practice.
In this region, pregnant women can obtain Arctic char through our prenatal nutrition program.
4:20 p.m.
Acting Director General, Centre For Chronic Disease Prevention and Control, Public Health Agency of Canada
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. As you've pointed out, no one thing is going to fix it or attack it, but there are multiple interventions. We've tried to give you a flavour here of what we're actually engaging in to try to deal with the problem.
But your point is so right on; no one intervention is actually going to do it.
4:20 p.m.
Bloc
Christiane Gagnon Bloc Québec, QC
There is another aspect that seems to be troublesome. In low income families, it is more difficult to pay for groceries, and these people often pay less for their food. You just have to look at the food in shopping baskets when you go to the grocery store. People who seem less privileged will buy products that cost less and are often on sale.
What steps could we be taking? I know there are incentives, we referred to accounting-related measures. It was mentioned that, for example, we could give a tax credit for healthier food. I don't really like the punitive approach, such as imposing a tax or increasing the price of food that is less healthy.
Could this type of initiative help the less fortunate populations to have access to better nutrition?
4:20 p.m.
Conservative
4:20 p.m.
Acting Director General, Centre For Chronic Disease Prevention and Control, Public Health Agency of Canada
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.
I think Mary's area has done a fair bit of work in that area, and I'd like her to comment, if possible.
4:20 p.m.
Director General, Health Products and Food Branch, Office of Nutrition Policy and Promotion, Department of Health
I took your question as being focused very much on those who have limited income and who have difficulty purchasing food that's adequate. You are absolutely right. Our statistics suggest that 6.8% of our population, some 2 million Canadians, live in households with insecure food access due to limited financial resources.
We actually have a tool, called the Nutritious Food Basket, that is used right across Canada by other jurisdictions to cost a basket for healthy eating. It's used as one of the inputs into social service decision points right across the country.
So the issue you touch on is important, and it's important also in terms of what it leads to. You touched on the fact that calories can be cheap when they're high in fat and not always the most nutritious choices, and you're very right.