Health Committee on Nov. 2nd, 2006

[The Chair, Conservative, Rob Merrifield]

We also have Barbara Isman, from the Canola Council of Canada. Thank you for coming. We look forward to your presentation as well.

Stephen, the floor is yours.

[Stephen Samis]

Thanks very much for the invitation to appear here today, Mr. Chair. I am the chair of the Chronic Disease Prevention Alliance of Canada. With me is Jean Harvey, the executive director.

For those of you who don't know, very briefly, CDPAC, the Chronic Disease Prevention Alliance of Canada, is a network of voluntary public and private organizations at the national, provincial, territorial, and local levels. We have over sixty members at the national and provincial levels, and CDPAC is led by a steering committee that consists of ten national organizations and two provincial and territorial alliances.

Childhood obesity represents a significant public health crisis, as the committee knows. In the past 25 years, obesity rates for children have tripled in Canada, and combined overweight and obesity rates have increased by over 70%. This rate for first nations children is two and a half times the national average. Children of parents with low levels of education and income have increased rates of being overweight and obese, as do children in Atlantic Canada. As you know, the health-related costs attributable to obesity are now over $4 billion a year.

It's estimated that today's 9- to 12-year-olds may experience cardiovascular disease by age 30 if current rates of obesity and being overweight continue. In Canada, like the U.S., it is projected that one-third of babies born today will go on to develop type II diabetes and, by extension, cardiovascular disease.

That gives a bit of a context to the problem. What we would like to talk to you about today is what we should really do about it.

We believe childhood is a critical window of opportunity for promoting health and laying a sound foundation for health throughout life. The solutions to childhood obesity must occur on many fronts over a long period of time, by taking a population health approach that involves addressing both the individual as well as the environmental factors that affect health. To that end, CDPAC has six key recommendations for the committee in order to address this issue.

The first one is that the federal government must address childhood obesity through a multi-pronged strategy that coordinates many initiatives across federal departments and facilitates action at the provincial and local levels. We believe the federal government should develop indicators and targets for dealing with this issue; should partner with national non-governmental organizations that are already highly active on this front; and perhaps most importantly, should coordinate the numerous efforts that are now under way in many federal government departments but are not coordinated.

Secondly, we believe it's important to recognize and address the real link between child poverty and obesity. Evidence suggests that child overweight decreases by 3% for each $10,000 increase in family income; that there's an association between neighbourhood income and rates of childhood obesity and overweight in those neighbourhoods; and that despite an all-party resolution to eliminate child poverty in Canada in 1989, one in six Canadian children continues to live in poverty. There is a relationship here, and we have to address it.

The third thing is to expand the role of the federal government in health promotion through an engaging social marketing campaign, as well as by supporting existing campaigns, such as the five- to ten-a-day program, which is a partnership on the part of the Canadian Produce Marketing Association, the Heart and Stroke Foundation of Canada, and the Canadian Cancer Society. We also think the federal government, through these kinds of health promotion campaigns and social marketing campaigns, should emphasize the important link—and it's an increasingly demonstrated link—between breastfeeding in the first six months and overweight and obesity in childhood.

Fourthly, we believe the federal government really should take seriously addressing the determinants of obesity. We'd like to identify three things in this regard.

Examine the link between the advertising of foods and beverages to children and overweight and obesity by creating an independent panel of experts to review the issue and make policy recommendations. The evidence shows that children under eight are extremely vulnerable to persuasive messages of advertising, and that children up to four cannot distinguish between the commercials and the programming on TV.

Also, content analyses have shown that over 50% of food advertising aimed at children is for energy-dense, nutrient-poor foods. This has to change, and we would like to see a panel of experts be convened to address the issue and examine the policy options.

We'd like the federal government to conduct a review of food policy at the federal level, to ensure that Canada has a sustainable food system that ensures that healthy foods are affordable and accessible. A process is currently under way through the Canadian Agri-Food Policy Institute, and we believe this effort by CAPI requires action and support from the committee.

We think the federal government should continue to implement tax incentives and disincentives to promote physical activity and healthy eating. CDPAC supports the recommendations of the expert panel for the children's fitness tax credit to broaden the credit beyond organized sports and encourages the government to continue efforts in this area, particularly with respect to healthy eating.

We believe the GST on foods offers some opportunities for change. We wonder why, in fact, there is GST on one doughnut but there is no GST on six doughnuts or more. The federal finance department says we can't use the GST to influence eating. Our response would be that we already do.

Fifth, we believe that the federal government should increase its investments to increase physical activity in Canada. We just want to pick up on and support a little bit of what was said by the previous members of the panel. Less than half of Canadian children and youth get sufficient exercise to meet current guidelines for healthy growth and development. Therefore, increased physical activity for children and families is important.

We believe that the federal government should implement those elements of the pan-Canadian physical activity strategy that come under federal jurisdiction.

We believe that the federal government should allocate at least 7% of infrastructure funding at the federal level that goes to municipalities for that kind of infrastructure that would increase physical activity. We should note that the U.S. federal government currently allocates 10% of such infrastructure for this purpose.

Likewise, we would like to pick up on the last panel and urge the federal government to broaden the definition of infrastructure under the gas tax transfer to include social infrastructure such as parks, recreation centres, and community centres, and enable municipalities to address those issues that link the built environment with nutrition and physical activity, as we heard from Dr. Veugelers, Dr. Frank, and the FCM.

Sixth and finally, we believe that Canada's public health infrastructure and chronic disease surveillance capacity needs to be improved. Public health has a crucial and critical role in addressing childhood obesity, and Canada's public health infrastructure capacity requires both attention and resources. The federal government should work with the provinces and territories to strengthen our public health capacity, including in the schools.

We also believe the federal government really needs to address and bring dramatic improvement to Canada's health research and surveillance infrastructure. This is an undisputed role for the federal government and one that the federal government has failed to adequately fund. The result is huge gaps in our health surveillance capacity and a relatively poor research data infrastructure compared to other developed countries. For example, Canada does not have a birth cohort or an aging cohort; therefore, we can't examine health behaviours and determinants of health over the life course. We're one of the very few developed countries that doesn't have a birth cohort. The province of Quebec has a birth cohort, but we don't have one at the pan-Canadian level and we wonder why this is the case. This really needs to be addressed, particularly if Canada is going to retain and attract some of the brightest and best minds in health research in the country and in the world.

We'd also like to touch on one of the issues that has been raised at this committee previously that we've read about--that is, issues related to the development of Canada's new food guide. We're very concerned about recent allegations against the new food guide and the processes of its development. We want to go on the record as saying that CDPAC believes the process to revise the food guide to date has been extensive and inclusive and has involved over 7,000 submissions. Our CDPAC members have provided extensive input into the food guide and believe they've been heard as part of this process. CDPAC believes we do need a new food guide in Canada and we need one sooner rather than later, and what we don't need is another long, protracted consultation process to get there.

In conclusion, we think Canada can take pride in our success in reducing tobacco use, which has been the result of committed, collaborative, multi-pronged, and sustainable action. While this effort to reduce tobacco consumption is by no means finished, we really do believe that it offers excellent lessons learned from a policy and programmatic standpoint and that there are many lessons learned here for childhood obesity.

Again, we're really pleased that the committee has taken on this important health issue. We hope that through its leadership Canada can move from having one of the highest rates of childhood obesity in the world to being a true leader in improving the health of our children.

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much. I really enjoyed your presentation, and I'm sure the committee has some good questions for you.

We also now have Barbara Isman, from the Canola Council of Canada. We hear quite a bit about canola. It is a good news story. So we're looking forward to your presentation. The floor is yours.

[Barbara Isman, President, Canola Council of Canada]

Thank you very much, Mr. Chairman and members of the committee. We appreciate the invitation to appear before you today.

I'm very glad to hear you discuss the role that physical activity and the overall diet play in the health of our children. I'm going to talk about one piece of the diet only, and that's the consumption of fats.

I'm going to spend just a minute explaining who we are. Mr. Merrifield is aware of us, given his involvement in the agriculture sector, but I thought it would be worth while just to talk about the canola industry for a second.

There are 52,000 farmers, almost all of them in western Canada, who grow canola. They grow it on 13 million acres, which is about 18% of the arable land. Canola represents 33% to 50% of the revenue derived by farmers every year, so this crop is incredibly important to the agriculture industry. We have an overall value of $11 billion, and essentially employ 215,000 to 216,000 people across Canada. So essentially, we are the largest group of cash-producer farmers in Canada. That's who we are.

I'd like to talk about what we bring to the table, and I mean that literally in this case. Canola is considered one of the healthiest oils for human consumption around the world. In fact, we've just received an FDA-qualified health claim, one of only five granted for foods in the United States, on the basis of prevention of coronary heart disease. For the Canadian marketplace, we represent about 45% of the salad oil and cooking oils consumed, but we also are a major supplier to the processed foods that our children are eating.

We know that dietary fat does play an important role in nutrition. It is a concentrated source of energy. It does provide essential fatty acids. It's a carrier for fat-soluble vitamins and it does contribute to the overall palatability of food. In addition, some types of dietary fat can actually have health benefits, including reducing the risk of heart disease and diabetes. However, too much fat is bad. And we know that. So we have been taking a lot of time and making an effort to talk about not just too much, but what fat. What's a good fat? What is a bad fat? How do these fats contribute to the overall nutrition profile?

Essentially, there are three fatty acids, and these three families are saturated, monounsaturated, and polyunsaturated. Each has a different effect on health. Canola has 7% saturated fat. It is the lowest of the saturated-fat oils. We have 32% of polyunsaturates and 61% of monounsaturates. So it's a well-balanced fat.

I don't need to explain to this group that how you tell saturated from unsaturated is whether or not it's solid. That's essentially what clogs the arteries. So the less saturated the fat, the less clogging of the arteries.

Because it is rich in monounsaturated fat, canola has been shown to be very effective in reducing heart disease. In addition, we are finding that monounsaturated fats have a favourable effect on blood glucose levels and in controlling type 2 diabetes, which is a disease that is increasingly prevalent in children. In addition, canola oil contains both omega 3 and omega 6 fatty acids, and those are the essential fatty acids. Canola has ALA, alpha-linolenic acid, and that has been shown to lower the risk of heart attacks and strokes.

We also have a role with respect to vitamin E. Canola is a natural source of vitamin E, which again reduces the risk of heart disease, cancer, and memory loss.

When it comes to health, perhaps the breakthrough we've had is the creation of a new kind of canola. This is called high-stability canola oil, which allows us to replace partially hydrogenated vegetable oils, essentially eliminating transfat.

I don't know how many of you may have watched the news in the last few days, but Kentucky Fried Chicken just announced that it will eliminate transfat in their restaurants, and they've chosen high stability canola oil to do that. Essentially they've made this change in response to customer demand, and we're very proud to have been able to provide the product that solves the problem.

We would like to commend the government for the work it's done on the food guide. There will be notification of both healthy and unhealthy fats, and we appreciate that. We agree. We were consulted extensively during the food guide development process, and we believe the food guide will send a very important signal to all Canadians.

But I'd also like to say—and this is something completely different from the health committee—that government can play a helping role in the creation of these innovative health-based food products, by continuing to support science-based regulation and promote research and development in this country.

Canola is the world's only made-in-Canada crop, and we have now provided the first solution for transfats.

This is not an exhaustive list of what the government might do, but we would strongly encourage continued pressure on the system to provide healthy eating choices for young people, as well as for us middle-aged people. We are an agriculture-based country, and we can be part of the solution for obesity.

[The Chair, Conservative, Rob Merrifield]

Thank you for both of your presentations. Both were very good.

Ms. Davidson, you have the floor.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you to both of our presenters. Both were very interesting.

My question to start with is to Stephen. I think you started out by making a statement, if I heard it correctly, that there was a higher incidence of childhood obesity in Atlantic Canada. Was that correct?

[Stephen Samis]

Yes, that's correct.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Is there a reason for that?

[Stephen Samis]

I would be speculating if I gave a reason, but I think we have seen correlations between family socio-economic status and obesity. We know that generally family socio-economic status is lower in Atlantic Canada than in other parts of the country, so you might be able to make that association as one particular connection.

The other thing is that generally the demographics of Atlantic Canada are that it's more of an aging population. This would be more for the adult rates of obesity.

A lot of younger people leave Atlantic Canada. But I think childhood rates of obesity might relate to socio-economic status, and the availability and affordability of healthier foods.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

You also talked about developing an advertising strategy. Do you think that it's feasible to introduce a television advertising ban in Canada?

[Stephen Samis]

Quebec has one, so it is feasible. I think we should explore that through the federal government as well.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Does it work in Quebec?

[Stephen Samis]

Whether it works in Quebec or not, I don't think we have any casual evidence right now, but we do have some associational evidence. Quebec has one of the lowest rates of childhood obesity in the country, compared to other provinces.

We have seen evidence through food surveys that the kinds of food kids eat tend to be better in Quebec than in other parts of the country.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Is that ban just on television, or is it on Internet and printed material?

[Stephen Samis]

I don't believe it is on the Internet; it's on television.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Not printed material either?

[Stephen Samis]

I don't believe so. I believe it's television.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

How do you put this ban on television when the CRTC only regulates Canadian broadcasting? It doesn't regulate what we get that's coming in on an American station, for example. It's only what's broadcast through a Canadian broadcaster.

[Stephen Samis]

Right. That is an issue. On the other hand, a lot of Canadians do watch American programming on Canadian television stations—

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Then it's regulated?

[Stephen Samis]

—and then it would be regulated.

The CRTC would have to look at the kinds of ads that are coming into the country. I believe that even on American television—at least this used to be the case—a lot of the advertisements were Canadian advertisements, even though those American stations were broadcasting American TV content. Those kinds of ads would still be caught, the ones that are produced in Canada.

[The Chair, Conservative, Rob Merrifield]

For the committee's information, we are trying to get Quebec to come as a panellist to be able to answer some of the questions specific to Quebec and what they're doing with regard to obesity. Actually, they have the second lowest in Canada, I believe, according to Stats Canada, second only to Alberta. It's probably because of canola oil. It has to be.

Madam Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you so much.

I want to congratulate the CDPAC for coming here. I think it's been a long time coming, but we needed to look at integrated ways of dealing with chronic disease. All you need to now do is add the Arthritis Society to your group, and you're there.

[Stephen Samis]

They've actually approached us, so that's good.

[Hedy Fry, Liberal, Vancouver Centre, BC]

For those of us who have been running around the health promotion and disease prevention circuit for the last 30 years, as I have been, one of the things we are hearing from you and from the last panel is that in fact the only way to deal with changing behaviour, especially with children, is to look at sequential, integrated, and comprehensive ways of achieving that behavioural change.

I think it's important, and I'm saying this because I really feel this is key. We have known now for the last 25 to 30 years that poverty is the single greatest indicator of health, and yet we have never directed any health promotion and disease prevention into looking at poverty and eradicating poverty and dealing with social issues. We've never done it. To give a tax credit doesn't help, because only if you pay taxes do you get a tax credit. If you're poor and you don't pay taxes and you are in that income group, then you have no access. Good solid infrastructure, as we heard earlier on, is a key piece.

The idea that municipalities need to have a huge role to play in this is also important--and I didn't get to ask that last time--because municipalities have a key role to play, as do school boards. Some of us at the level of the British Columbia Medical Association and the Canadian Medical Association have been trying for the last 20 years to get quality daily physical education in the schools. This is not just phys. ed. for half an hour, where they run around a room or whatever. It's about beginning that sequential and integrated activity and teaching young people about changing their way of life.

I think it's important. I'm interested in the idea, because I firmly believe that the federal government has and must have a responsibility to deal with disease prevention and health promotion in this country. This is a federal role if ever there was one, and I wanted to support you in that.

I want to talk about surveillance, as well. We need to have a federal surveillance model. This is a role the federal government has to embrace. Setting measurable goals comes with having the data and having the breakdown of data across the country. You asked just now why it is that the Maritimes have such a high rate of childhood obesity, and you said you didn't know. We need to know why one region is more prone to certain things than others, and therefore be able to apply the appropriate things.

I want to tell you that I feel it's important that as we look at childhood obesity, we listen to you carefully. I think the issue of poverty, the issue of working within the schools, the issue of working with the municipalities for city planning to be able to have facilities and infrastructure for young people to become more active, and the ability to look at daily physical education and quality education in the schools are key, but advertising is the one I want to ask you about.

I have a bill, which is sitting somewhere at the bottom of the list of bills, on advertising as a federal issue. When our children sit around on a Saturday morning while the parents try to get an extra hour's sleep, they watch TV and see all these wonderful sugary products being promoted. We see that children are so influenced by television and the Internet, etc. It's really key for us to deal with advertising.

Do you have a suggestion for how you see the federal government playing a role in working with the provinces and with the CRTC to deal with this issue?