Health Committee on May 4th, 2010

[Dr. Mary L'Abbé]

To three months. The important thing is all food has to be changed. You have to be exposed to the same level of sodium in all food, because if you have some low, some high, you don't acclimatize.

[Megan Leslie, NDP, Halifax, NS]

Right. Of course.

Dr. Pipe, I was wondering if you could take the rest of my time, frankly, to just lay out, get it on the record, what is happening in other jurisdictions. We've heard about Finland here at this committee. How do we do this? It is possible. Remarkable things have been done in other jurisdictions.

[Dr. Andrew Pipe]

I would defer to some of the expertise that's also resident at this table. The two classic examples would be what has been taking place in Finland, which I alluded to earlier, and also more recently what has taken place in the United Kingdom.

The United Kingdom has adopted an approach that involves product labelling in a very clear way so individuals clearly understand the amount of sodium in a particular food purchase. They do that using a so-called traffic light system so there are red, green, or amber signals on the front of food packages, which very clearly communicate the amount of sodium in those packages.

That has been a very successful undertaking. It built on the experience of Finland, where Finland used a combination of education, voluntary leadership from the food industry--and there are very significant examples of very specific leadership being provided by the food industry, and we see it here in Canada--and regulation.

Frankly, one of the things regulation does is create a level playing field. It makes it much easier and it does not penalize members of the food industry who might be out there exhibiting dramatic leadership in terms of the way in which they're reformulating their particular products.

I think those would be two jurisdictions that could be looked at very carefully and very closely for examples of how one could thoughtfully develop these kinds of initiatives.

I know my colleague from the Heart and Stroke Foundation probably has something that might add to that discussion. Stephen.

[Stephen Samis]

One of the things Finland did was require a label on foods that were high in sodium. If you didn't meet a certain threshold you had a warning label put on your product that this food is high in sodium. Government can do a variety of things, both in voluntary education but also in regulation.

I think Andrew's point is a very good one: it does create a level playing field. It rewards those companies that are already making a difference and it takes the laggards, who simply can't be bothered, and pulls them in. We've seen the same thing with trans fats. There are companies that have removed all the trans fats from their products, and companies that haven't removed the trans fats at all or very little. It creates a level playing field, not only for the food industry but also for Canadians.

[Megan Leslie, NDP, Halifax, NS]

Thanks.

To sum up--to use your words, Dr. Pipe--would you both agree that intelligently designed health policy requires regulation?

[Dr. Andrew Pipe]

I would certainly agree that some element of regulation will be required, for the reasons that Mr. Samis just outlined.

[Megan Leslie, NDP, Halifax, NS]

Great. I think those are all my questions right now. Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Leslie.

We'll now go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

I want to take this opportunity to thank all our witnesses here today for their leadership. I know the sodium working group has been working the last couple of years. It's pretty much unprecedented that we would have a body like this looking at such an important issue for Canadians and Canadians' health, so I'd like to thank every one of you for your different perspectives and your input into this important thing we're moving forward.

We have been hearing a lot about the sodium working group. I think our last meeting on it was in November. Madame L'Abbé, would you be able to update the committee a little bit more specifically on what you've accomplished in these last six months? You said the report is coming up fairly soon. Can you give us a little update?

[Dr. Mary L'Abbé]

We announced our interim target to really help boost the process, to get it going while we were deliberating.

Secondly, a couple of things have occurred. As I mentioned earlier, we had three subcommittees as part of the working group, each of them tasked with developing strategies for our three-pronged approach. One developed the targets for the food supply, and Health Canada has been, since the fall, discussing draft targets with the food industry. The view was that if those targets were reached, we would then have food intakes by Canadians that met the goals of the working group. So that work has been ongoing, fine-tuning the targets. We heard from the dairy industry and they mentioned some concerns, but that work is ongoing.

Our education group has helped develop an education program that would address the needs of the consumers but also the needs of the industry to reduce sodium.

In the third group, we partnered with the Canadian Institutes of Health Research, but also the National Sciences and Engineering Research Council, agriculture, and the food industry, to come up with the types of research that we would need, because some of the answers aren't out there yet.

All three groups have been working together, and as a group we've also crafted our recommendations. That's the final stage of that report that we hope to have ready for the minister early this summer.

[Colin Carrie, Conservative, Oshawa, ON]

Excellent. I think everybody around the table here is looking forward to that.

In regard to my next question, I've been following this for quite some time, and I've noticed even in my own life that when my kids were younger, baby food, for example, was extremely high in sodium. My wife and I used to make our own baby food. It seems that companies have already taken huge steps to make certain foods much more healthy for the Canadian consumer.

Another thing is potato chips. I'm one of those guys who just loves his snacks and crunchy potato chips. I've noticed that they've decreased the sodium in potato chips voluntarily.

I'm going to pose the question to Mr. Reaman and Ms. Tanaka. Where are some of the areas of greatest difficulty in reducing sodium? What are some of the challenges that we have to get over in bringing these levels down?

[Ron Reaman]

There are many, many challenges. There are also lots of opportunities, and as you quite rightly highlighted, there have been many companies, on specific products, that have made some great progress to date.

That said, within the food service environment we have a whole host of issues. Earlier Dr. Pipe raised sodium as an issue of food quality and food safety. I'd have to be in violent agreement with Dr. Pipe that it is an issue of both food quality and food safety. Sodium acts as a flavour enhancer, absolutely, but it also acts as a preservation agent and an anti-microbial agent.

There are many functions with respect to food safety: shelf life, food sitting out on trays, etc. These are all very genuine concerns that my industry is grappling with on a daily basis with our food offerings.

[Colin Carrie, Conservative, Oshawa, ON]

That's part of the average Canadian's lifestyle now, too. We have an ordinary family. I work and my wife works. We use a lot more prepared foods. We actually go out a lot more than generations in the past. We've heard of the Americans doing different things, but at the end of the day, if things don't taste very good, if people don't like those products, we always have that salt shaker on the table and we can just add it to them.

[Ron Reaman]

You're absolutely correct, and I guess it's another point where I would like to draw the distinction between the transfat issue and the sodium issue.

Sodium is an essential nutrient; it's in our food and it's never going away. Transfat we all agreed we were trying to rid from our food supply. That's not the case with sodium. So it's a different approach that we have to take.

[Colin Carrie, Conservative, Oshawa, ON]

Okay.

[The Chair, Conservative, Joy Smith]

You have a few more minutes, Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

I wonder if Ms. Tanaka would comment on that.

[Phyllis Tanaka]

I'd just like to support earlier remarks I made. Sodium is a more complex issue or a more complex nutrient to take control of in the food supply. It has several functions in food, and finding replacements for those functions is not straightforward or simple. Taste is one of them, but it's not the only one. As we all know, taste is paramount in the consumer's world or acceptance of a food product. That's where time is going to be required, not just to change products or to find other solutions, but to adapt the whole population's palate towards a lowered sodium taste profile.

Yes, it may only take three weeks in a controlled study to change the palates of a group of people, but to Dr. L'Abbé's point, we're talking about changing the palate of the whole population, and that's not going to take just three weeks.

[Colin Carrie, Conservative, Oshawa, ON]

I think there are huge challenges there, because as a health committee we've heard of all kinds of health difficulties and challenges that Canadians have. Look at the issue of obesity, for example. Many Canadians are looking for prepared foods that are low in fat, but sometimes these low-fat, low-calorie foods have high sodium. Is there research going on right now on how to balance the taste, the low fat? You don't want to pit one disease against another. We don't want to say high blood pressure is worse than obesity, but is there research going on right now on different additives you can add that will do what you said, Mr. Reaman, for the preservatives and all these other functions that salt does?

[Ron Reaman]

Thank you again for raising another excellent point. There is no question that when we look at reformulations of products, we have to consider the holistic approach to that particular product and balancing off sodium versus calories and fat, etc. To Dr. L'Abbé's point earlier, the working group did convene through the CIHR, the Canadian Institutes of Health Research, a research conference to look at some of these very issues. One thing that came out of that conference--I participated in it--was the realization that we really are missing a fair number of chunks in the research. That group was tasked with identifying some of the research goals and objectives so that we can start to fill in those gaps. My understanding is that the research is ongoing, and we will look to see some results on that shortly, I hope.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Reaman.

We'll now go into our five minutes of questions and answers. Please keep in mind that it's five minutes per question and answer.

We will begin with Dr. Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair.

Thank you to all the witnesses for coming.

Dr. Pipe, I really appreciate your remarks about the safety and quality of the food system. I think Mr. Reaman used food safety in a very different way from how you used food safety.

I do not want to see education, voluntary reductions, and research used to slow down real action. We've known for 40 years that salt is an issue. We knew tobacco was carcinogenic for a hundred years, and we knew sunlight was, before we took real action. We did take action and things got done.

We know salt is an issue and 90% of patients know salt is an issue. They know that processed food is a concern.

Dr. Pipe, is there any other community that you would like to highlight, other than Finland, that has done important work this committee should learn from?

[Dr. Andrew Pipe]

Thank you for your question.

I probably would draw attention to what's taking place in the United Kingdom. Our colleagues in Australia also are grappling with this issue. I think in the questions that were raised earlier, people were talking about the report of the U.S. Institute of Medicine. The academic community in the United States is looking at this issue very carefully. So there are examples and there are ways in which we can move more expeditiously to begin to apply the solutions on which I think there would be a shared consensus, certainly among the clinical and scientific and public health community.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

How do you feel about the goal of the 2016 target? We've heard today that it is aggressive and challenging. It's 2,300 milligrams, and that's at the upper limit of the daily recommended dose, not that there is a daily recommended dose for salt.

[Dr. Andrew Pipe]

Well, as you know, if we were free-grazing homo sapiens, we probably would require only between 1,200 and 1,500 milligrams of sodium a day, but the nature of the food environment as it has evolved over the last 50 years has been such that we now have very significant increases in sodium intake. I do think it will require some period of time before we can adjust a population's palates to an appropriate level, but 2,300 milligrams is a very significant first step. While there are purists and idealists who could say our physiology is equipped to deal with much less than that, I think that would be to ignore reality. I think this is remarkably consistent with the kinds of recommendations that the World Health Organization has been proffering. I think it makes life appropriately easier for international food manufacturers. I'm not unsympathetic to their particular needs and their particular concerns, but it allows for more consistency across borders. If the kidneys and the hearts and the circulatory systems of English citizens are important, why aren't they just as important among Canadian customers of those same companies? So I think it is a reasonable first step.