Evidence of meeting #22 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was consultation.
A recording is available from Parliament.
3:35 p.m.
Conservative
The Chair Conservative Rob Merrifield
We want to thank the witnesses for coming forward and for their testimony before the committee. It's been a very interesting session on childhood obesity. This is the eighth meeting, I believe.
We welcome you back again.
We have Mary Bush from the Department of Health talking about Canada's Food Guide. I'll ask you to introduce the people from your department as well.
We will start with your presentation. The floor is yours.
3:35 p.m.
Mary Bush Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
Thank you very much, and let me thank you for the kind invitation to be here.
We've been following the deliberations of this committee with great interest. It's truly a privilege to be invited back and to be able to share with you some of the issues around process and evidence in developing a food guide.
I'd like to start by introducing my colleagues. There's a coterie of us from Health Canada. I'll start with Janet Pronk, the acting director, policy and standard setting. It is within the policy and standard setting group that Canada's Food Guide is evolving, and Janet has a lot of involvement in this particular initiative.
Chantal Martineau, who is actually the lead on the food guide development itself, sends her regrets. She's at the Montreal meetings, les journées annuelles de santé publique, that are going on currently.
Also with me is Danielle Brulé, who is the director of research, monitoring and evaluation, and who has played a very significant leadership role in the science that's underpinning Canada's Food Guide. Also here is Elaine De Grandpré, who is a nutritionist in our dissemination and outreach area. She has taken on the significant challenge of ensuring that the messaging and packaging of the food guide itself in terms of delivering appropriate messages to Canadians is done well and that it is understood.
As well, we have Lori Doran, who is the acting director of the chronic disease and injury prevention group within the first nations and Inuit health branch of Health Canada is here. She will share some insights on that particular initiative, in which I know the committee has an interest.
My hope today is to engage in a discussion and to allow you an opportunity to ask questions. I'm going to run through a bit of a presentation, because I think it's important that we all start with the same understanding of what has been done to date.
You've heard a lot about the food guide. You've had a lot of people share their perspective on the food guide with you. I'd like to start by making sure everyone understands that the only food guide that people have seen is the food guide that was put out last November for consultation. It was in fact put out precisely for the reason that we wanted to get people's input to enable us to put out the best tool we could.
My plan here is to provide an overview of process, of the evidence used to guide this development, to discuss obesity in relationship to the food guide, and look at the next steps. But we are mainly here to provide an opportunity for your questions and discussions.
Canada's Food Guide actually is designed to promote a pattern of eating that will meet nutrient needs, promote health, and minimize the risk of nutrition-related chronic diseases. We consider it to be a very important and significant evidence-based policy vehicle. It is taken with great seriousness by those of us in the department and others across Canada. Canada's Food Guide is not only used to try to explain to Canadians what healthy eating means, it also underpins policies and programs that are used by provincial, regional, and local governments.
The evidence base that underpins this work has been significant. We have updated nutrient standards, the dietary reference intakes, which are a set of nutrient standards that have been executed by the National Academy of Sciences' Institute of Medicine in the U.S.
I think it's important that you understand that up until the mid-1990s it was in fact Health Canada, along with expert advisory committees, that actually reviewed science, looked at where the evidence had moved, and put out the Canadian dietary standard. The name was changed to nutrition recommendations over time. But it was in fact Health Canada.
In the mid-1990s, with the recognition that the complexity of the science that underpins nutrition was now sufficiently complex, and because there was a need to call on the best science and the best scientists that we could access, it moved to a more North American platform. We've been working with the Institute of Medicine ever since.
Through a review of literature and synthesis of what's known, eight reports have come from eight nutrient panels. It's all with the goal of taking the best that nutrient science has and putting forward a statement of nutrient standards about how much of each nutrient is needed. For those nutrients that we know play a role in chronic disease, such as fat, trans fats, saturated fat, the goal is to establish acceptable macronutrient ranges.
Beyond that, because much of the evidence that underpins diet and health is not simply on a nutrient basis but on a food basis, we've undertaken a review of foods and chronic disease and looked at that evidence. That's a very significant undertaking, and not one for which we're resourced to execute in terms of manpower or time. We called on work that has already been done. We looked at the WHO-FAO joint report on diet and nutrition in the prevention of chronic diseases, as well as the work done by the dietary guidelines advisory committee in 2004.
The goal there was to look at what we knew from the literature about foods and food patterns and health outcomes, and make sure we captured and reflected that in Canada's Food Guide as best we could. For example, we know that fruits and vegetables provide protection against forms of cancer and cardiovascular disease. You don't want to generate a food guide based on a nutrient platform and miss the very important relationship with food and food patterns. So that work was also part of our evidence base.
On the environmental context, we know that Canada is a different place from it was 30 years ago. There are socio-demographic and cultural changes to the profile of who we are. There has been significant evolution in the foods in the marketplace, and we needed to make sure we captured and understood what was going on in the environments in which Canadians are eating.
We also undertook a significant review of the 1992 food guide. Canadians and the stakeholders who were involved in the review identified strengths of the 1992 food guide, including flexibility, simplicity, visual appeal, and high recognition, but they also identified significant challenges in understanding and using it.
The challenges that were identified included confusion about serving sizes, serving ranges, and the use of terms such as moderation. We were told they didn't understand what that meant. There was the perception that the graphics themselves were out of date. We had clumped together in 1992 something we called “other foods”. They included what I'll call non-nutritious, high-sugar/salt snack foods, water, and essential oils, with the one overriding direction: moderation. We were quite appropriately challenged on why we would be encouraging Canadians to moderate their intake of water, and at the same time use one message for this entire group of foods. So several problems were identified, and all of those challenges have informed the food guide revision.
We initiated the revision in 2004 and put together a range of advisory committees to help us with the task. We already had a dietary reference intake expert advisory committee that had been put in place to take the science of the Institute of Medicine's nutrient standards and help us interpret and implement that into a range of guidance for Canadians. They were called upon to really help us with what that work suggested to us in terms of a dietary pattern. I'll touch on the process shortly.
There was an interdepartmental working group established. We called on the various branches in the health portfolio, as well as CIHR and our colleagues in the Public Health Agency of Canada. We also involved INAC, the Agriculture and Agri-Food group, and Canadian Heritage to help us with the multicultural challenges. Its mandate was to give a broader Government of Canada view to this issue.
We then established a food guide advisory committee. We put it together to bring into the loop a range of different stakeholder perspectives on dietary guidance. We tried not to line ourselves up with people who looked at the world the way we did as a department of health. Rather, we considered a range of perspectives. We wanted to hear first-hand from stakeholders outside the process. The membership included knowledgeable individuals who provided advice from a range of perspectives, including public health, industry, education, health policy, nutrition, disease prevention, and communication. At the same time, we tried to ensure that we captured both national, provincial, and local perspectives.
I'll now turn to the food guide content.
Through our process, which involved several advisory groups and consultation, we came up with a pattern of eating that would provide age- and sex-specific guidance on amounts and types of food. This was in response to the criticism we encountered when we reviewed the 1992 food guide. People said we had such large ranges that they had no idea how much they needed to eat. We wanted to ensure that people didn't think they needed to eat more than they did. The recommendations were age- and sex-specific based on specific nutrient requirements. The pattern reflects the food supply available to Canadians and their eating habits. If you were to go to, say, Thailand, or to other countries, you would see a different pattern. All food guides, regardless of where they're issued, look at the food supply, the kinds of things that people eat, and include it in their dietary pattern. So if you were putting a food guide together in Singapore, for instance, bread wouldn't be part of it, because bread is not a staple there.
In developing the food guide pattern for each of 16 age and sex groups, 15 diets were generated, following what the pattern laid out in amounts and type of food. Distributions were assessed in terms of nutrient adequacy. This led us to develop more specific messages to make sure we were getting adequate advice, and that we didn't favour Canadians consuming too much energy, too little folic acid, or not enough fibre. We examined all these parameters in the 500 diets for each age and sex group. And we took one extra step: we made sure that if we were assessing a dietary pattern for children we actually used popular children's food choices. We derived the data from our provincial surveys, which have been going on for the last decade.
Once we got the pattern, once we packaged the pattern so as to ensure that we had adequate direction in communication, we went out to consultation. Our consultations started back in January 2004 with a meeting in which we brought together stakeholders from all aspects of food guidance to discuss what we had found in the review. We all agreed it was time to go into a revision. In May 2005, we crossed the country, holding 13 regional meetings in the provinces and up in Yellowknife. In these meetings, we shared the direction we were taking and allowed stakeholders to tell us if they thought we were headed in the right direction. We didn't just show them what the food guide was going to look like. We told them that our plan was to have something in hard copy but to put a lot of emphasis on the Internet, to have educator-communicator material, and to include something special for Inuit first nations.
What we heard back from this process was that it's good to really enhance the web, for instance; we think that's going to have lots of use for schools and for many people, but you must ensure that you have hard copy, because that's very much the piece that is used in teaching situations across the country.
In November 2005, we actually launched our national consultation activities. That was done with online as well as regional meetings. The online consultation was in fact designed to enable people right across Canada to provide input to us in a relatively easy manor.
However, with that online consultation came constraints. One of the criticisms I think you've heard is that there was little focus on the actual pattern and more focus on the packaging of the pattern. That was, indeed, a constraint that emerged out of the online approach to this consultation. And part of that was due to our wanting and needing to take the consultation down a pathway that asked specific questions but at the same time provided Canadians an opportunity to say to us, “We think you've missed it. We think there's a problem with what you've done.” So there was a question, and it was how we ended the entire consultation: “Do you have anything else you wish to say to Health Canada about the Food Guide?”
In fact, over 6,000 Canadians participated in the online consultation, and from that we learned a great deal. At the same time, we went into focus testing because we wanted to ensure that the piece that we had put together was able to be used by Canadians, and we garnered input from that. Overall, the feedback was positive, but it was also very positive from our perspective in indicating where people thought we hadn't been direct enough, we hadn't gone far enough, we had put in too much information. It brought a wealth of information to us that we're using right now as we take this food guide through to the end product.
The outcome of the pattern and the processes we're using is to ensure we have a pattern that, when followed, will provide the nutrients that are required for health. We know that it meets the nutrient requirements of Canadians, except for Canadians over 50, where there's a need for extra vitamin D, but we also want to make sure we're consistent with evidence that exists that associates the food pattern with reduced risk of a range of diseases, such as diabetes type 2, diabetes, obesity, cancer, and cardiovascular disease.
There is a tailored aboriginal food guide being developed. It's being tailored for aboriginal people and is inclusive of first nations, Inuit, and Métis. It recognizes the importance of traditional foods as well as non-traditional or store food. There has been broad support from national aboriginal organizations, from nutrition educators and health services providers, for the need and the importance of having something that's tailored to this target group.
My colleague Lori Doran, of the first nations and Inuit health branch, with her team, is leading this work. They have the expertise within the department in terms of first nations people. They have a nine-member advisory group. A needs assessment was undertaken with people who work with first nations, Inuit, and Métis. It was conducted in October 2005. There's a consultation under way now, or just completing, and there are focus group tests that are planned for November and December of this year. Their product is following slightly behind the main food guide, and Lori is here with information should you have more specific questions on that particular initiative.
In terms of overweight and obesity, we're very concerned. Part of what has driven us throughout the entire process is making sure we come up with guidance to Canadians, recognizing that they live in an environment where overweight is a significant health issue and, generally, overweight and obesity are of great concern to Canadians themselves. We and you, more than anyone, potentially recognize that obesity is a very complex issue.
We recognize there's a need for a comprehensive strategy. We looked internationally to the global strategy on diet, physical activity, and health that WHO developed. We were in fact very involved with the development of that particular strategy. Nationally, there has been the development of a pan-Canadian healthy living strategy.
It's only to anchor the fact that we recognize obesity is not something that a food guide is going to fix. It's not something that a food guide in and of itself will solve. But at the very least, we need to expect that the food guide will be a policy piece that provides Canadians with the kind of guidance they need in order to meet their food supply and enjoy their food in a knowledgeable manner.
This means we have to help Canadians understand that the food guide pattern that will emerge will in fact contain very basic foods. It means we're talking about breads and cereals, not croissants and muffins. There's very little room for extras in this pattern, such as cakes, pastries, french fries, ice cream, and alcohol. It requires different choices to be made.
On our next step in this process, we're looking to release a planned suite of products early in 2007. There will be a hard-copy consumer piece. There will be extensive web-based material for consumers. It will be an extension of what's in the actual policy piece, the consumer hard copy. But we'll also go further to try to enable Canadians to do some tailoring for themselves.
My example of this is that if you look at the age and sex specifics with which Canada's Food Guide will come out, we know we're giving a range of ages that starts at the age of four and goes up to over the age of 70. We know there's a certain amount of confusion in looking for your sex and age and coming down to the number of food guide servings that you would choose.
We're making a web-based platform where you can actually go to the Internet to put in your age, your sex, and the physical activities you enjoy, and you'll then have a printed copy of something you can put on your refrigerator as an adjunct to the hard-copy piece. There will be communicator-educator material as well.
We look at this whole suite of products as being step one on a pathway that we'll be able to add to as we start to be able to identify with increasingly specific evidence where we see the need to support Canadians with more information.
Mr. Chairman, that's my presentation. We welcome your questions.
3:55 p.m.
Conservative
The Chair Conservative Rob Merrifield
Thank you very much.
I think there's quite a bit of interest in this, with regard to the upcoming food guide. It is rather disturbing that you're going to take away our cakes, pastry, french fries, ice cream, and alcohol. You're going to be seen as worse than the tax man. Good luck with that.
We'll now open up the floor to questions.
We'll start with Ms. Dhalla, and then Ms. Bennett.
3:55 p.m.
Liberal
Ruby Dhalla Liberal Brampton—Springdale, ON
Thank you very much for coming to the committee.
A number of the stakeholders we've had a chance to meet and witnesses over the past few weeks have expressed serious concern in regard to the consultation process that took place for the development of the food guide. I was quite interested in listening to your presentation. You mentioned that a number of groups and organizations were consulted. Could you perhaps provide this particular committee with a list of some of the nutritional science experts who were consulted?
In regard to some of the working groups that you had, I believe you had a food guide advisory committee. Could you also forward this committee those names, along with the committee on dietary reference intakes? I believe it has a total of 11 individuals with experience in a variety of different areas.
You also mentioned that some online consultation took place and some of the restrictions surrounding that. I know you mentioned that you were trying to do as much outreach as possible.
Unfortunately, I think this committee has now heard from all of those stakeholders studying the topic of obesity, and no one seems to have been consulted. I think having those names come forward will allow us some insight into that.
Secondly, from your perspective, you mentioned online consultations. What type of advice were they able to provide? How many people partook in that type of consultation? How did the nature of those consultations change your final draft food guide that is now being put forward?
3:55 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
I'll start, and I'll ask Janet Pronk to continue.
We actually have those lists. Those lists were requested. We actually generated those lists. They're part of what's gone to the department to come to this committee, and they are en route.
Specifically, you asked how the nature of the consultations influenced where it is that this food guide is going. I would say profoundly.
What we did in November was come out with a platform. It was the best we could do at the time. What we heard back was, “Sorry, it's not good enough.” So what we've done is take the nature of, “Sorry, it's not good enough,” and we have taken the next steps.
As an example, we had significant input around the issue of salt and sodium. A lot of people said that they thought we had missed it. We hadn't spent nearly enough time or enough energy ensuring that Canadians understand when they're choosing these foods that sodium or salt is an important issue.
Absolutely, that comment was correct. We've gone back, and we've engaged in making sure that when we come out we address that kind of issue.
4 p.m.
Liberal
Ruby Dhalla Liberal Brampton—Springdale, ON
Many of the individuals who came to this committee said that when they were asked for their particular advice and their input, they were asked to determine what colours the diagrams should be and where they should be placed on a page and what the pictures should look like, and they felt a tremendous amount of frustration that they weren't consulted in terms of content and substance.
I think their ultimate goal, like ours, is to ensure that the food guide is reflective of the multicultural dynamic we have in Canada, that it is reflective of the unique quality of each Canadian. You're obviously not going to have a food guide that caters to every single Canadian across the country, but they were just saying that their consultation was limited to determining where the pictures were going to be placed on the food guide.
4 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
I saw that comment.
4 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
I hear the comment, and I would say to you two things. First, the online consultation did look at packaging as well as content. Was there a specific question that asked whether you think the age- and sex-specific guidance we're giving is the way to go? We didn't ask that. Did we ask whether you think the number of fruits and vegetables that are part of the pattern for the age and sex groups from six to nine are appropriate? We didn't ask that.
This piece is absolutely rife with needs for decisions, and we're very anxious to hear from anybody who thinks this is not an appropriate pattern and to hear why. We are probably more interested than anyone on the planet when we hear from people that there is a problem, in their opinion. What we want to know is what the problem is and what the solution is.
So we've spent an enormous amount of time trying to take the input that's been given to us, understand it, reflect on it, and make sure that when we finish this process we have something that's stronger.
4 p.m.
Liberal
Carolyn Bennett Liberal St. Paul's, ON
One of the concerns I think we have with the food guide is that it be all things to all people. Two weeks ago in Nunavut, in the grocery store, four litres of milk was $16. What capacity does the food guide have to have people make alternate choices when certain groups are not available or are too expensive for people to actually access?
4 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
I think your question is very good, in that the cost associated with the basket for healthy eating is a very significant issue. We're very concerned. This isn't specific to the food guide; this is specific to Canadians' food security and where the population is with respect to adequate resources to buy a nutritious basket of food.
So I think the question is an important one, and it's bigger than the food guide. But to answer your question specifically, we often hear that we have a lot of fruits and vegetables in that food guide and are asked if it will be something that people can afford to buy. We hear that. We have the question asked, and what I can say to you is that we look at the food pattern and we look at the costing of that basket. I think it's important for you to know that there is a nutritious food basket that is actually based on the food guide of the day. It is that basket that is costed right across Canada and used by provincial and local municipal governments in terms of social assistance programs, in terms of calculating the amount it's going to cost. So costing food baskets is part and parcel of what emerges from a food guide.
But in order to assure ourselves that this wasn't going to be a pattern that was too costly for fruits and vegetables, for instance--
4:05 p.m.
Liberal
Carolyn Bennett Liberal St. Paul's, ON
You address the nutrient standards, but again, on the evidence around foods that prevent cancer or heart disease, or things such as omega-3, how are we advising Canadians now? That is my number one concern. This isn't only about nutrients anymore; it's about how you make healthy choices, from farmed salmon to non-farmed salmon; how you make choices on whether it is really calcium you need, or is it vitamin D.
Maybe in the next round we'll deal with the aboriginal piece in terms of so much of this being based on a 70-kilogram white male. That's what I learned in medical school, and that seems to be how this thing is sorted out. How do we help people make other choices if they're from genetic backgrounds where they're clearly lactose intolerant? This just seems to be one size fits all.
I know you've worked hard on the web-based strategy, but I am concerned. As you know, my number one question has always been, is there evidence? I know you will always tell me that it's the most requested piece of government literature, but do we have any evidence that this piece of literature has ever changed anybody's behaviour?
4:05 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
I think it's a good question. I would answer no, we don't have rigorous evidence that the food guide is the vehicle to change behaviour broadly. I don't think there is good evidence that a piece of paper really does that. We know behaviour change is more to ask of one piece of paper than is possible.
What we do know, though--
4:05 p.m.
Liberal
Carolyn Bennett Liberal St. Paul's, ON
Is there a double-blind study, or a study where you have the food guide in certain households and don't have the food guide in other households, and these households end up less obese?
4:05 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
No, there is not.
4:05 p.m.
Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
Why do we do the food guide? I think the food guide is absolutely an essential undertaking, because more than anything else, people want to know what healthy eating means. We all talk about healthy eating. Oh, it's important for chronic disease prevention, it's important for healthy growth and development, it's important for health, but what does that mean? You need to be able to help a population understand what healthy eating means and what it looks like. If I want to follow a healthy pattern of eating, what does that mean? If you look over time,you'll see that the food guide changes, and it changes very much.
4:05 p.m.
Liberal
Carolyn Bennett Liberal St. Paul's, ON
I think the question is, did it change anybody's behaviour? Are they making better choices?
4:05 p.m.
Conservative
The Chair Conservative Rob Merrifield
Our time is gone, but if someone wants to answer that very quickly, we'll allow that, and then we go to Ms. Gagnon.
4:05 p.m.
Élaine De Grandpré Nutritionist, Planning, Dissemination and Outreach, Office of Nutrition Policy and Promotion, Department of Health
I've been a dietician for 16 years. A lot of my colleagues do develop educational resources to use either in the schools or with clients or with patients. Some resources will use the food guide as a basis of comparison.
For example, if a person is looking at the food guide for guidance, they say, okay, I need about x amount of fruit and vegetables. If that person is not eating this amount of fruit and vegetables, there is research out there, which I don't have on hand here, that shows that if you switch your pattern of eating, if you make changes to try to reach your goal in terms of vegetables and fruit, the rest of your diet would naturally change, because at some point there is a certain volume that we eat in a day, and you might end up eating less pastry because you're having fruit as a snack.
It can be used like that by many health professionals in the field who do develop resources and use it as a basis for their work.
4:05 p.m.
Bloc
Christiane Gagnon Bloc Québec, QC
Thank you, Mr. Chairman.
You haven’t convinced me of the need to produce a new food guide because you’re unable to provide us with data on the impact of Canada’s current guide. It might be important to study its effects on society. There’s been an increase in obesity. The only information I have to assess Canada’s Food Guide is that a food guide does exist and that obesity has increased.
You tell us that if people want to improve Canada’s Food Guide, they’re welcome to do so. The Guide is just about to be published, so I find it difficult to see how you’re going to accept recommendations. As you know, we’ve heard witnesses with a certain amount of experience in the area of food. One of those witnesses, Dr. Yoni Freedhoff, Medical Director of Ottawa’s Bariatric Medical Institute, told us that the first thing his authorized dietician teaches patients is especially to not follow Canada’s Food Guide recommendations. That’s quite a stunning statement! He even told us that the diet recommendations differ radically from the traditional scientific and medical interpretation of the role played by diet in the prevention of chronic diseases, so he couldn’t help but wonder whether the information provided was biased or incomplete.
Mr. Bill Jeffery, from the Centre for Science in the Public Interest, spoke about the process that was set up and the list of people who participated in it. He said that some of the advisory committee members might be in a conflict of interest. There were many people from industry, as well as nutritionists from small communities, two of which had fewer than 15,000 inhabitants. The problem was not that they came from small communities but that they were employed full-time elsewhere and that they couldn’t make recommendations based on results obtained by organizations with the necessary institutional resources.
I read all of the comments made. Some people say that Canada’s Food Guide is not tailored to people with low levels of literacy and that it will be difficult for very-low-income families to understand it. Other witnesses have told us that Aboriginals and First Nations were not consulted. They don’t see the relevance of Canada’s Food Guide or how it could be adapted to their communities. So many people have told us that Canada’s Food Guide should be reviewed and corrected.
You claim to be open to receiving recommendations. Would you be willing to do this before the Guide is released? We’re in no hurry. Obesity is not an issue that can be solved in two or three months. Twenty years may be required to set things straight. Are you willing to accept a set of recommendations, before Canada’s Food Guide is published, from people whose only interest is in helping Canadians eat better?
4:10 p.m.
Danielle Brulé Director, Research, Monitoring and Evaluation, Office of Nutrition Policy and Promotion, Department of Health
I’ll begin. The first question referred to the impact of the current Guide, which was published in 1992. During the 1990s, I worked on provincial surveys. We worked with all 10 provinces to gather information on what Canadians were consuming. We’re talking about adults 18 and over. Using questionnaires, we asked them whether they were familiar with Canada’s Food Guide. It’s very likely that we can refer to that data and see whether people who were aware of the Guide followed its recommendations and what their weight was. With that data, I’ll make the link to what Ms. Bennett was saying.
I have here an article from the
Journal of the American Dietetic Association, “The obesity crisis: don’t blame it on the pyramid”,
which clearly states that—and I quote:
Because obesity is such a complex issue, it is overly simplistic to argue that a single educational device such as the Pyramid offers a root cause for the problem.
I’d like to clarify that the article deals with the evaluation of data from a survey that established a link between people with a low body mass index and those who followed American food guide recommendations. The same type of analysis could probably be performed using the data from the provincial surveys that we conducted in the 1990s. We could likely demonstrate that people who follow Canada’s Food Guide recommendations have a lower body mass index.
4:15 p.m.
Bloc
Christiane Gagnon Bloc Québec, QC
Would you be willing to work with a team of consultants from various fields who could analyze Canada’s Food Guide before its scheduled release in 2007? You claim to be willing to accept advice from certain people.