Good morning, Madam Chair. It is a great pleasure for me to be here this morning.
Good morning.
This is probably one of the more important clinical conversations that I have had this year. I say that because I want to have a conversation with you. I'm not going to be speaking from prepared notes.
Probably one of the most useful things that I can do as a physician is to accelerate the development of an environment in which healthy behaviours become easy behaviours. Probably one of the most important things I can do as a clinician is to look you squarely in the eye and tell you that you can do things with your pens, your signatures, and your legislation that will dramatically enhance the health of our community in ways I cannot even dream of.
In one day, as a consequence of thoughtful deliberation, you can transform the environment such that the health of Canadians becomes significantly improved and enhanced.
For more than 40 years, we've known about the deleterious health consequences of sodium. I would argue, perhaps being a little provocative, that for 40 years we've shrugged our shoulders and wrung our hands and asked what we can do. That's despite the fact that there is evidence from around the world where communities very similar to ours have addressed this problem in ways that are thoughtful, engaging, constructive, and that have shown dramatic changes in terms of enhancing the safety--and I want to underscore the word safety--and quality of our food supply.
Daily in my position at the University of Ottawa Heart Institute, I see people who suffer from cardiovascular disease. The nature of the expression of that disease is changing. We've done a very good job, if I may pat my profession on our backs--and Dr. Bennett can also wallow in the approbation I'm offering ourselves--in reducing the incidence of heart disease since the 1960s. On the other hand, there are still very large numbers of Canadians who have heart disease, and as they get older the incidence of heart failure is going to increase dramatically.
Why is that germane and important to our discussion today? It's very simply that one of my patients can leave my clinic, walk down the stairs or take the elevator in the Heart Institute, have a simple lunchtime snack, which he or she perceives to be healthy, from a fast-food enterprise in the foyer of my institute, and as a consequence of the sandwich and soup be in the emergency department eight hours later. He or she could be admitted for several days as the consequence of the fact that the sodium intake represented by that simple lunch tips that individual into unstable heart failure, requiring days of admission in a hospital setting.
I'm also conscious that when I speak to you about these issues, I'm not only speaking about the health of Canadians, in some respects I'm addressing the viability of our health system.
I'm constantly assailed by the rhetoric that speaks to the need for prevention. Prevention is more than fridge magnets and catchy little posters. It's the development of an environment that makes healthy behaviours easy behaviours--and I know I'm being repetitive.
You can tell by my grey hair that I'm now approaching the twilight of my career. Throughout the course of my career, I have been involved in a number of endeavours designed to enhance the health of Canadians. Each time I have heard that we can't do this, this is going to take time, the public isn't ready, it's going to require thoughtful consideration over the course of several years. Substitute seat-belt legislation, reducing the blood alcohol levels for drinking and driving, the time that it took us to get a handle on tobacco legislation, and you see where I'm coming from.
Sodium intake contributes dramatically to blood pressure, which as you heard from my colleagues at the Heart and Stroke Foundation contributes dramatically to the incidence of stroke and coronary artery disease, and deaths from both of those situations. It also contributes dramatically to what is an emerging, pressing public health problem, which is end-stage kidney disease. Nobody anywhere is talking about how we are possibly going to be able to provide dialysis services to the countless Canadians who in the years ahead, as a consequence of their kidney failure, will require dialysis. They will require that dialysis because their kidneys have been destroyed as a consequence of the degree to which hypertension has supervened in their particular personal health setting.
We know that salt is an issue, and most Canadians agree this is an important public health issue. I wish I could share an article with you that my colleagues and I will be publishing in the Canadian Journal of Cardiology a few weeks hence. It is currently under--whatever that word is--embargo. But it shows—