Health Committee on Feb. 8th, 2011

[The Acting Chair, Conservative, Tim Uppal]

Welcome, ladies and gentlemen, to the Standing Committee on Health, meeting 48. Pursuant to Standing Order 108(2), this is the study on healthy living.

We do have witnesses with us today. I'd like to welcome them. We have the Association pour la santé publique du Québec, Émilie Dansereau-Trahan and Lucie Granger. Welcome. With the Canadian Association of Occupational Therapists, we have Natalie Macleod Schroeder and we also have Elisabeth Ostiguy. With the Canadian Medical Association, we have Dr. Anne Doig and Jill Skinner. With the Canadian Nurses Association, we have Barb Mildon and Lisa Ashley. And with the Public Health Agency of Canada, we have Judith Bossé and Jean-Marc Dupont.

We will begin with the Association pour la santé publique du Québec. We'll have opening statements, for five minutes.

[Lucie Granger, Director General, Association pour la santé publique du Québec]

Thank you.

Good afternoon. I am Lucie Granger, Director General of the Association pour la santé publique du Québec, which is one of the 10 provincial and territorial public health associations in Canada. We also have ties with the Canadian Public Health Association.

The association was established in 1946. It is a not-for-profit, autonomous, multidisciplinary group that contributes to the promotion, improvement and maintenance of the health and welfare of Quebec's citizens.

[The Acting Chair, Conservative, Tim Uppal]

Excuse me. We're going to work on the translation here. There's no translation.

I think we should just start again.

[Lucie Granger]

Not a problem.

I am Lucie Granger, Director General of the Association pour la santé publique du Québec, which is one of the 10 provincial and territorial public health associations in Canada. We also have ties with the Canadian Public Health Association.

Established in 1946, the ASPQ is a not-for-profit, autonomous, multidisciplinary group that contributes to the promotion, improvement and maintenance of the health and welfare of Quebec's citizens.

We take action in various areas, including perinatal, tobacco-control and weight-related issues, more specifically weight-loss products, services and methods, often known as WLPSM.

We are also involved in urban planning, the food available in schools, and energy drinks, just to name a few issues.

Without further ado, I will now turn the floor over to Émilie Dansereau-Trahan, who is responsible for the issues related to WLPSM at the ASPQ.

[Émilie Dansereau-Trahan, Responsible for the file on weight-loss products, services and methods, Association pour la santé publique du Québec]

Around the world, weight-related issues have multiplied over the past 20 years. According to a recent Canadian study, 24% of the adult population is obese and 37% of Canadians are overweight.

As well, the overweight issue seems to be particularly worrying among young people, aged 2 to 17 since, over a period of 20 years, the obesity rate has more than doubled among this group, from 3% to 8% between 1978 and 2004.

At the same time, the phenomenon of excessive concern regarding weight is just as worrying, particularly among women and girls. According to a survey, in Canada, 56% of women with a healthy weight want to lose weight and 30% of young girls, aged 10 to 14, go on a diet every year.

Weight loss is also a concern for people who are overweight, and a number of those people may be tempted, at some point or another, to turn to commercial weight-loss products, services, and methods.

The ASPQ believes it is crucial that the excessive concern regarding weight be incorporated in the strategies developed to promote healthy lifestyles and to reduce the number of problems related to obesity and overweight.

Given the popularity of commercial weight-loss programs, we can infer that a lot of people who wish to lose weight use weight-loss products, services, and methods.

The Association pour la santé publique du Québec is concerned about the use of weight-loss methods, since, in most cases, they pose many health risks.

There are so-called minor risks, such as digestive problems, headaches or sleep issues, and then there are major risks, such as arrhythmia, cardiac arrests or even death.

In addition, studies show that 95% of people who follow a diet regain the weight lost, even adding more pounds, during the five years after their attempt. This is called the “yo-yo” effect and it constitutes a risk factor associated with obesity. Therefore, diets are often counterproductive as a solution to weight-related problems.

Finally, it is important to mention that most natural health products for weight loss, available over the counter, have not necessarily been reviewed by Health Canada. So they are available over the counter, even though their impacts on health have not been studied and their efficacy has not been proven. As a result, these products are a potential risk for users' health. The ASPQ asks that a monitoring process be implemented for weight-loss products, services, and methods in order to protect the public health and monitor fraudulent practices in the weight-loss industry.

Overweight is constantly blamed for the poor health of much of the public. The association believes that current strategies promoting healthy lifestyles influence individuals' choices to use unhealthy weight management methods that are potentially dangerous for their health.

We are currently talking a lot about the fight against obesity and the obesity epidemic, which are very strong words. At the Association pour la santé publique du Québec, we believe that the use of such words contributes to the stigmatization of people who are overweight rather than the promotion of a healthy lifestyle.

Overweight is in fact a consequence of another issue, of lifestyle. People are less active, eat larger quantities of lower-quality food because they no longer pick up their own hunger and satiety signals. They are also more stressed, more rushed, have a lot of difficulty sleeping, and so on.

All these elements are factors that affect the health and, therefore, the weight of our population. We must take action and address all those issues. As long as weight-loss methods that make promises of quick and painless weight loss are on the market, making healthy life choices won't be as appealing for people.

Weight-loss products, services, and methods are a risk for the health of Canadians and an obstacle to the development of healthy lifestyles.

Therefore, the association’s recommendations are: to include excessive concern about weight in programs that target weight-related issues; to address healthy lifestyles, regardless of weight, rather than weight as a measure of lifestyle; to conduct an analysis of the positive and negative impacts of public health messages conveyed with regard to weight-related problems, based on a benefit approach; to implement a monitoring process for the WLPSM industry; and to enforce the strict and integral application of the Natural Health Product Regulations and analyze their efficacy.

Thank you.

[The Acting Chair, Conservative, Tim Uppal]

Thank you very much.

We now have the Canadian Association of Occupational Therapists for five minutes.

[Natalie MacLeod Schroeder, Representative, Board Director for Manitoba, Canadian Association of Occupational Therapists]

Good afternoon, ladies and gentlemen.

My name is Natalie Macleod Schroeder. I'm an occupational therapist representing Manitoba on our association's board of directors. With me today is Elisabeth Ostiguy, director of professional affairs.

The Canadian Association of Occupational Therapists is pleased to participate in this consultation on physical activity guidelines. CAOT believes that being active is important for Canadians through all stages of life. However, the complexity of Canadians' day-to-day lives challenges the government in its attempt to promote healthier lifestyles. To encourage Canadians to be more engaged in their well-being, appropriate guidelines are needed.

Occupational therapists are health professionals who promote the therapeutic use of and participation in self-care, work, and play activities to achieve maximum health and quality of life. Occupational therapists recognize the importance of a holistic approach to well-being for a successful transition to more active living regardless of personal limitations and environmental conditions.

Active living contributes to the well-being, functional capacity, and quality of life of all Canadians. It needs to be part of everything that people do during the course of everyday life and throughout their lifetime. A focus solely on prescribed physical activity, such as 30 minutes of cardiovascular exercise, will not necessarily result in Canadians being more engaged in healthy lifestyles.

Research demonstrates that day-to-day realities influence the possibility of engagement. Canadians must address barriers to their good intentions. These challenges include finding the time, accessing the right activity, and fitting in all the demands. Better outcomes will be realized through an active living guide that provides a variety of easily identifiable approaches.

Occupational therapists believe that providing broad guidelines without addressing the challenges will not meet overall goals of attaining a healthier society. An active living guide needs to be about the total person, reflective of their realities and their stage of development.

The World Health Organization defines active living as “a way of life in which physical, social, mental, emotional, and spiritual activities are valued and are integrated into daily living”. Health flourishes when people have access to activities that hold personal meaning, are publicly valued by the society in which they live, and lead to productive and satisfying lifestyles. All Canadians must be active participants in their own well-being.

Moving beyond physical activity guidelines to an active living guide will engage Canadians in their positive health outcomes, while ensuring a greater possibility for sustainable commitments. To change Canadians' habits for the better, the government needs to create a vision of possibilities. An active living guide will provide advice on the best ways to ensure balance in life and encourage activity to enjoy a full and enjoyable life.

The guide goes beyond what kinds of activities could be considered, such as gardening, dancing, and jumping rope, to include suggestions on how to make changes and stay engaged. The following are examples of what else could be included: how to set the right goals; making involvement in an activity easier; and making the right choice of activity.

Therefore, CAOT recommends that the federal government create an active living guide, along the same lines as Canada's Food Guide. It would identify the range of activities and strategies to promote healthy living.

According to the Coalition for Active Living, the trend to physical inactivity is reaching epidemic proportions today. The coalition believes that while most Canadians recognize the benefits of physical activity to their overall well-being, they remain inactive.

A number of barriers discourage physical activity among the economically disadvantaged. These include fees for programs and facilities. As a result, they will have fewer opportunities to develop patterns of healthy living.

Programs that encourage Canadians to be active should not be a luxury that cannot be afforded. As such, CAOT recommends that the federal government increase the application of the child fitness tax credit to the economically disadvantaged to facilitate participation in active living programs.

The Canadian Association of Occupational Therapists believes in ensuring active participation in everyday living to foster health and well-being. An active living guide, supported by selected tax credits, will support the government's vision of a healthier society.

Thank you for your attention. We would be pleased to answer any questions.

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

We will now have the Canadian Medical Association for five minutes.

[Dr. Anne Doig, Past President, Canadian Medical Association]

Thank you.

I would like to thank the committee for inviting the Canadian Medical Association to appear on this important topic.

As a family physician in Saskatoon and the past president of the CMA, I can assure you that Canada's physicians have an acute interest in drawing attention to the health consequences of poor nutrition and lack of physical activity and the challenge of obesity.

We know that obesity is a contributor to a number of chronic diseases, such as diabetes, cardiovascular disease, hypertension, and liver disease, as well as breast, colon, and prostate cancer.

We know that over-consumption of salt, sugars, and saturated fats and transfats can be a factor in hypertension, cardiovascular disease, stroke, and kidney disease. And we know that Canadians have become dramatically less physically fit in recent decades.

As a country, we need to espouse a culture of health and wellness based on good nutrition and physical activity. Finding solutions will require a collaborative, system-wide approach involving all levels of government--the health, education, industry, finance, and transportation ministries--and the private sector.

We know that if provided with support when young, children can adopt healthy lifestyles. That is why the CMA continues to call on governments across the country to work with school boards to provide at least 30 minutes of active daily physical education for all primary and secondary grades, given by trained educators in the field; to provide access to attractive, affordable, healthy food choices and clearly post the nutrition content of the foods they sell; and to ban junk food sales in all primary, intermediate, and secondary schools in Canada.

The CMA has advocated policies and regulations for food safety and promoted healthy eating and physical activity as key components of healthy living and the prevention of disease. The CMA policy statement “Promoting Physical Activity and Healthy Weights” calls for a Canada-wide strategy for healthy living that includes information and support for Canadians to help them make healthy choices, support for health professionals in counselling patients on healthy weight and in treating existing obesity, community infrastructure that makes healthy living choices easier, and public policies that encourage healthy eating and physical activity.

All Canadians need access to nutritious food at affordable prices. The price of milk, produce , and other healthy foods varies greatly in different parts of Canada. In remote areas, they are even more expensive because of high transportation costs. In urban areas, nutritious food may be unaffordable for people on low incomes and unavailable as grocery stores move to the suburbs, thus creating food deserts.

Among other strategies, governments should consider implementing school meal programs and taking into account the cost of nutritious food when setting social assistance levels.

The proliferation of packaged, prepared foods and fast foods has contributed to excess amounts of salt, sugar, saturated fat and transfat, and calories in our diet. While we welcome the federal government's support for the reduction of transfats and sodium levels in processed foods, reliance on the food industry to reduce these ingredients voluntarily has not been successful. We believe that regulation is needed to safeguard the health of Canadians.

Healthy living begins with an awareness of the impact of food and exercise on health. While individuals must take responsibility for making healthy choices, the CMA believes that governments have an obligation to provide guidance on healthy eating and physical activity that can be incorporated easily into daily lives. We commend the federal and provincial and territorial governments for their recent “Framework for Action to Promote Healthy Weights”. Physicians were also pleased to see the revised Canada's Food Guide in 2007 and the recent update to Canada's Physical Activity Guides.

The CMA supports nutrition and caloric labelling on packaged foods to help Canadians make informed food choices. The federal nutrition labelling awareness initiative is useful to consumers, but we think information can be simplified. For example, the U.K. is testing front-of-package “traffic light” coding for fats, salt, sugar, and calories. The CMA has also called for a clear display of caloric counts and sodium, transfat, and protein levels on restaurant and cafeteria menus.

The CMA believes encouragement of active transportation, that is, walking and cycling, is a way to increase physical activity. Communities need to make it easier for Canadians to be physically active in their day-to-day lives by providing sidewalks and pedestrian-friendly intersections, bike lanes, paths and parking spaces, and trails, parks, and green spaces.

One area that we believe warrants further study is the use of incentives to promote healthy behaviours. By transferring funds or other benefits to an individual, incentives provide immediate rewards for behaviours that can lead to long-tern health gains. An example in Canada is the children's fitness tax credit, which is intended to help children be more active by offsetting some of the costs incurred by families for sports and leisure programs.

It is impossible to overstate the importance of nutrition and physical activity to our health. Encouraging Canadians to make healthy choices requires a wide-ranging, long-term and collaborative approach. The CMA believes this challenge should be met urgently. Canada's physicians are more than ready to work with governments to ensure that Canadians can improve and maintain their health.

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

Now we will have the Canadian Nurses Association.

[Barb Mildon, President-elect, Canadian Nurses Association]

Bonjour.

I am Barb Mildon, a registered nurse and president-elect of the Canadian Nurses Association. On behalf of Canada's quarter-million nurses, I wish to thank the members of this committee for the opportunity to speak.

As this committee is undoubtedly aware, there is compelling scientific evidence that shows regular physical activity improves health and quality of life, significantly reducing the risk of chronic disease, disability and premature death. Unfortunately, Canadians are paying dearly for rising rates of obesity and chronic illness. We are paying with our health dollars. We are paying with our health.

We all know why physical activity is important. The question we must ask is how do we get people moving?

I invite you to read the brief that CNA has put together for you on this subject. It contains a number of recommendations, but I will focus on just a few of them today, namely, that we should pay particular attention to the needs of youth and children, aboriginal Canadians and recent immigrants; place a stronger emphasis on health promotion and illness prevention; and expand our reach by increasing public health resources.

As with most public health initiatives, it pays to start with high-risk and vulnerable populations. First nations communities are being crippled by type 2 diabetes. Over one-third of Canadian children between the ages of two and eleven are overweight, and of them, about half are considered to be obese. Three out of five children and youth between five and seventeen years are not active enough for optimal growth and development. Overweight children are more likely to remain overweight or become obese in adulthood, and they are at greater risk for chronic disease and mental health problems.

For the first time in history, the current generation of young people is not expected to live longer than their parents. Despite life-extending breakthroughs in science and medicine, we are losing precious ground.

CNA therefore urges the federal government to increase funding for health promotion initiatives targeted at children and youth, aboriginal peoples, immigrants and refugees, and other vulnerable populations.

Day in and day out, public and community health nurses, educators and researchers are working with Canadians to promote healthy lifestyles, to prevent and manage chronic illnesses, to help people take charge of their health by staying active. We engage in preventive medicine that diverts health care costs away from far costlier acute care interventions down the road.

Inactive Canadians are at greater risk for heart disease, obesity, high blood pressure, osteoporosis, diabetes, cancer, and depression. Among Canadians age 45 and older, 70% report one or more chronic conditions directly related to physical inactivity.

Chronic diseases represent a huge cost to Canadian society, in terms of treatment--67% of all direct health care costs--and in terms of lost productivity. It makes good economic sense to invest in public health. You get a triple dividend: better health outcomes, lower health costs, and a more productive economy.

CNA therefore urges all levels of government to redirect health system funding toward preventive health care services and programs, particularly those addressing physical activity and nutrition education and counseling.

Given the huge scope of the issue, however, the public health sector needs more financial resources and more people to get the job done. Stable, long-term funding is needed to ensure proper integration of services and foster greater interprofessional collaboration. Successful programs need to be scaled up and extended deeper into the communities that need them.

CNA therefore urges federal, provincial, and territorial governments to make additional investments in the public health nursing workforce, and in the public health workforce generally, so that health professionals have the capacity to support increased health promotion, including the promotion of physical fitness and healthy living.

Registered nurses across Canada will of course continue to play an active role in promoting active lifestyles, but we want to step up the intensity. We can do this by drawing on the expertise of specialty nursing members, like the community health nurses, nurses in rural and remote communities, and aboriginal nurses who are working daily with individuals and communities to promote healthy lifestyles.

Through greater investment in public health, a stronger focus on health promotion and disease prevention, and special measures for children and other vulnerable communities, Canada could be taking a huge step in the right direction, a step towards an active and healthy future.

Thank you for your attention.

Merci.

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

We will now have the Public Health Agency of Canada for five minutes.

[Judith Bossé, Associate Assistant Deputy Minister, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada]

Mr. Chair, honourable members, thank you for the opportunity to speak at these important discussions about healthy living.

I'm pleased to be here today to build on those discussions with an emphasis on physical activity and healthy living.

As you all know, physical inactivity is one of the main modifiable risk factors for obesity and many chronic diseases. It is a global issue, recently identified by the World Health Organization as the fourth leading risk factor for global mortality, following high blood pressure, tobacco use, and high blood glucose.

As you also heard last week, the burden of chronic disease in Canada, as in many other countries, is significant and growing. Promoting physical activity and active lifestyles is one way to reduce this burden. Physical activity plays an important role in the health, well-being and quality of life of Canadians, particularly children and youth, and helps to prevent chronic diseases such as cancer, type 2 diabetes, and heart disease.

Physical activity is not just a public health issue; it also promotes the well-being of communities and is an investment in future generations. Unfortunately, most Canadians are not getting enough physical activity to promote good health. We need to do more to move toward active lifestyles.

Of course, we know that this is not as easy as it sounds. Getting people moving in a society that makes it easy to be sedentary is a challenging task. While leisure-time physical activity levels may appear to be higher than ever, we know that Canadians are not as fit as they were once. Over time, our workplaces, household chores, and transportation options have evolved so that requirements, or rather opportunities, for physical activity have been reduced. Counteracting these societal shifts often requires significant effort by individuals to be active.

Nevertheless, the Government of Canada is committed to addressing the growing problem of physical inactivity and its health implications among Canadians. As you have heard, federal, provincial, and territorial ministers of health and healthy living have recently endorsed a declaration on prevention and promotion, a commitment to helping Canadians lead healthier lives. FPT governments have also launched a framework for action to promote healthy weights, which includes a commitment to creating supportive environments for children for physical activity.

Given that the solution to physical inactivity does not rest with any one sector, we are making connections between the sport, physical activity, and recreational sectors and those responsible for health and education. PHAC is working through a forum of FPT ministers responsible for sport, physical activity, and recreation, who set physical activity targets for children and youth in 2008 and agreed in 2009 to focus specifically on increasing children's physical activity in the after-school time period; enhancing cross-government and intersectoral collaboration with, among others, provincial ministers of education; and aligning and coordinating physical activity social marketing messages across Canada.

The Government of Canada has made several investments to increase physical activity in partnership with PTs and NGOs, including for example ParticipAction and PHE Canada. In addition, the children's fitness tax credit helps parents increase their children's physical activity and participation in sport programs by offsetting some of the costs. The Recreational Infrastructure Canada program provides funding to municipalities to improve and develop sport and recreational facilities.

At the federal level, we have a specific role in providing leadership on public health issues and are promoting community-based intersectoral collaboration to support the kinds of fundamental changes that are needed to get Canadians moving. These include such things as promoting active and safe routes to school and pedestrian and bike-friendly community planning. The age-friendly communities initiative, in which five provinces are engaged, has Canadian seniors involved in planning and design with their own communities to create healthier, more active, and safer places for them to live and thrive.

These are some examples of how we are raising awareness about the health impacts of community design with a view to encouraging a legacy of health-promotion communities.

The Government of Canada also has an important role to play in ensuring that our policies and programs are grounded in evidence. Canada is considered a world leader in the measurement of physical activity and in the development of evidence-based guidelines. The newly released physical activity guidelines are based on evidence funded by the Public Health Agency of Canada, evidence that was also used in the development of the WHO guidelines.

We acknowledge that there are still gaps in our understanding. We are partnering with the Canadian Institutes of Health Research to support knowledge syntheses on physical activity, sedentary behaviour, and health.

Lastly, we know that it is critical to continue to raise levels of awareness and education about the importance of physical activity and healthy eating. The agency will continue to work with stakeholders to develop additional tools and resources to help Canadians become and stay physically active.

At the root of physical activity specifically, and healthy living generally, is the importance of making healthy choices easier for Canadians. While there is much work to be done, we believe that we are on the right track.

Thank you for the opportunity to present today.

[The Acting Chair, Conservative, Tim Uppal]

Thank you very much.

We will go into our first round of questioning now. We'll begin with the Liberals, with Dr. Duncan for seven minutes.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Mr. Chair.

Welcome, everybody, and thank you for your presentations.

I'm going to pick up on what Dr. Doig was talking about, which is children.

We have the 2003 Physical Activity and Sport Act and we have the integrated pan-Canadian healthy living strategy. These are good goals; they're good strategies. I want to know what difference they make at the community level, and more particularly, at the individual level. If we can teach children to have good nutrition and be involved in physical activity, we'll have healthier adults.

My concern is that not all children get a chance at a healthy diet. Probably 600,000 Canadian children go to school hungry. Hungry children cannot learn. We know we have good breakfast programs. I was the vice-chair in Toronto, and we fed 110,000 children every morning. That means that one out of four of our kids goes to school hungry. I think that's unconscionable in Canada. And we're the only industrialized country without a national breakfast program.

I understand that education is a provincial jurisdiction, but I think there is an opportunity for federal leadership to develop a national breakfast program, building on what is currently there. I feel the same thing about exercise. Although we talk about tax credits, there are some children who simply cannot afford to participate, and the only physical activity they will get will be in school. I think the two biggest things we could do are to provide nutrition and to provide that exercise at school.

I'll give the example from my own riding. We have the highest rate of type 2 child diabetes in the province of Ontario. It's linked to poverty. We're the fifth most diverse riding in the country. We have many newcomers, and my families are working two and three jobs just to put food on the table, and if the choice is between a five-dollar litre of orange juice and a two-dollar double litre of orange pop, the choice is clear.

Having said all that, I guess my question is, how do you feel about a national breakfast program and a national commitment to 30 minutes of physical activity in our schools?

It can open up to everybody.

[Dr. Anne Doig]

Since you named me in the preface to your question, perhaps I'll take the prerogative of speaking first in response.

A number of the things that you've said, Ms. Duncan, are echoes of what I said in the presentation. The specific strategies, whether it be a national breakfast program at the school level or a national lunch program at the school level, we can argue about. The point is that children are undernourished and underactive.

To your point about the two-litre carton of...something—I'll say milk, rather than orange juice—being priced at more than double the price of a two-litre bottle of pop, I saw that first-hand when I did a trip up to northwestern Ontario last year during my presidency and visited Kenora. It's disgraceful. There is no reason. Transportation costs don't cut it, when we're talking about two things that are each in two-litre bottles. Yes, there are some refrigeration and up-front production costs for the milk, but basically we have a pricing system and we have policy and advertising that allow parents and children to believe that these are good choices. These are not good choices. Milk is a good choice; water is a good choice. Pop, energy drinks, fruit-flavoured water are not good choices.

What is needed—I think you're correct—is a national strategy that brings all of the FTPs on board and says this is what Canadians need; this is what Canadian children need; this is the activity level and the nutrition level that are acceptable across Canada.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thanks, Dr. Doig.

My concern, as you know, is that not every family can even afford to buy nutritious food. So if we could provide, as you say, a snack, lunch, or breakfast, the point is that if you want to reach all children, the place to do it is at school. It's at school.

[Dr. Anne Doig]

The other piece is to make sure, as I said in my presentation, that there are no impediments to the amount of assistance provided to those families that require assistance to eat a healthy diet. I can't tell you the number of times I get asked to fill out a form to allow someone on social assistance to have special diet provisions. They're ludicrous. I'm not a nutritionist. But the little tick boxes I have to fill out simply to allow someone to have a few extra dollars to try to purchase healthy food are ludicrous.

[The Acting Chair, Conservative, Tim Uppal]

Ms. Mildon, did you want to get in?

[Barb Mildon]

Thank you very much, and I also thank you for your question.

In our CNA brief, we speak to the scientific or research evidence that the programs you mention do make a difference. That can be demonstrated. The other thing I wanted to say is that your comments speak to the need to marry whatever happens in terms of these recommendations to the continuing effort to eradicate child poverty. Without the two working in tandem, it's not going to be as effective.

Thank you.

[Natalie MacLeod Schroeder]

I'll leave the breakfast program to my colleagues. However, you talked about physical activity within the school system. From our point of view, we need to move beyond it being 30 minutes of physical education, which often winds up being quite sedentary. It focuses on an educative approach. Look at integrating activity throughout the day that is physical. If we're going to have focus sessions, they should be physical activity sessions, not just physical education sessions, so that it becomes a lifestyle. It is not a separate activity that I have to go do; it is something that is part of the everyday life of every child in Canada.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I thank you for saying that. As a coach all my life, I know that it is about activity, and it needs to be part of how you get through your day.

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

We will now go on to Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you very much, Mr. Chair.

Thank you to this large group of important witnesses.

My first question is for the representatives from the Association pour la santé publique du Québec. I am trying to understand something. In your view, where is the problem, the real risk? Is it the weight-loss products themselves or the way in which people can use them?

[Émilie Dansereau-Trahan]

I would say that it’s the weight-loss products themselves. Of course, use and product go hand in hand. I tend to talk about weight-loss products, services, and methods all in one. If we only refer to weight-loss products, the simple fact that they exist will distract people from making healthy life choices. Saying that you’re going to lose weight quickly is much more desirable. As I said, these products can have minor effects on health, causing digestive problems, for example. But they can also have major and serious effects both on physical health and psychological or mental health.