Health Committee on March 3rd, 2011

[Nathalie Jobin]

In Europe?

[Niki Ashton, NDP, Churchill, MB]

I thought you had referred to Europe.

Do you want to add anything else?

[Nathalie Jobin]

I think providing free food to children would be a panacea only on the surface. There needs to be a great deal of education around the issue as well. We should also try to reach parents and get them involved in this education. I think that is very important.

Moreover, it would be a bad idea to isolate children in need from others. Everyone must be treated equally to avoid discrimination.

[Niki Ashton, NDP, Churchill, MB]

Mr. Décary-Gilardeau, you also mentioned grade school children and the challenges they face in getting appropriate nutrition. You addressed a number of aspects of this in your presentation.

Could you tell us a little more about what is happening with this student population?

[François Décary-Gilardeau]

Again, I think Ms. Jobin would certainly be better placed than I to discuss this matter.

These are our most vulnerable people. We must help children get a good start in life, regardless of family income. I really want to focus on this point. What worries me is that young people, starting in primary school, are disadvantaged because they are undernourished. This is a reality we often lose sight of because we operate in our own little areas. The reality is that some children do not eat before going to school. They are hungry and that will have an impact on everything they do. We should never forget that. It is part of the role of government to ensure that the most vulnerable in our society are our priority. I am thinking mainly of children. I do not think anyone could disagree with that.

[Niki Ashton, NDP, Churchill, MB]

The effect is on child development in general, not only the very young, but teenagers as well.

I'm also interested in the intersection between literacy and labelling and, given some of the challenges that many people face, ensuring that we have labelling that's accessible in terms of literacy.

Would anybody like to share some thoughts on where we are with that?

[Dr. Jeffrey Turnbull]

I'm happy to respond. I think literacy is an essential part of that. That's why we need a very simple and easily recognized approach that's standardized so that you can make comparisons. Literacy, cultural perspective, and all of those things are essential components of having an effective system.

As for which one we choose and which one helps us the most, I can tell you that if you happen to be a new immigrant or if you happen to be functionally illiterate, what you're seeing on the back of this product will not suffice. I can tell you that right now.

I would also add that as a physician who cares for a thousand of the homeless just within a mile of here, I can tell you that the biggest challenges these people face are such things as being a single mother unable to get to a grocery store, not being able to cook because they don't have a kitchen, or not having time because there's no money. These are huge impediments. Yes, labelling is an important issue and education is an important issue, but poverty, poverty, poverty--we've heard it all day long--is the greatest impediment.

[The Acting Chair, Conservative, Tim Uppal]

Thank you, Dr. Turnbull.

Go ahead, Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Mr. Chair.

Dr. Turnbull, I was wondering if you could comment on another thing for me. As a physician you treat a number of different patients, and there are a lot of individual differences. We're studying healthy living, and healthy eating is certainly part of that, but you're seeing different patients who maybe have different conditions. Maybe you see one patient with diabetes and then another one with high blood pressure. Well, maybe it's not such a good idea for the patient with high blood pressure to eat cheese, but for somebody else the nutrition in cheese is probably a good thing. Could you comment on the role of research in encouraging nutrition?

[Dr. Jeffrey Turnbull]

We need a strong research perspective and we need to have evidence informing the decisions we make. I recognize there's a commercial imperative, but at the same time, when we have a standardized and structured approach to reporting, that has to be based on evidence.

You're right that it's very difficult for people to navigate nutritional labelling when they have a unique problem, so if you are a diabetic, yes, you'll be drawn to the calorie count. Don't forget that diabetics have to watch their caloric intake as well as their fat intake. They have to balance these things, and we have to make that easy, as opposed to complex. These people are often elderly, and they're challenged in terms of their ability to move through the different information and make meaningful and informed comparisons.

Yes, we have to have evidence to guide this decision, and there is evidence; we have to then translate that evidence to meaningful packaging that can be interpreted.

Thank you for the question.

[Colin Carrie, Conservative, Oshawa, ON]

Anu, did you want to make a comment?

[Dr. Anu Bose]

Thank you, Mr. Chair.

I think research is a very good thing, but we must have empirical research. I don't think archival or theoretical research is what we need. We need evidence-based research, which has to be empirical.

People have to get out there. They have to run focus groups. They have to ask questions of the people we are trying to reach. Sitting in an office and crunching numbers isn't necessarily the best thing.

Thank you.

[Colin Carrie, Conservative, Oshawa, ON]

Madame Savoie, I had a question for you, because you raised something that I've put a lot of thinking into. You had this chart. At the last meeting, we had some conversation on what healthy is and on defining what healthy is. This chart really tells a bit of a story for me. You look at things like avocados, for example. I love guacamole, and there's very good fat in avocados, but I think a guacamole product would probably be labelled as poor. You have salmon down there. If you're looking at your omega fatty acids, I think that's a good choice. Almonds are a great snack we have around the house. There's olive oil. We like to cook with olive oil and put it in salads.

Can you tell me about the challenges? If government starts labelling things as healthy or unhealthy, what challenges can you see coming from taking that approach?

[Nathalie Savoie]

Well, if we take that to an extreme, someone could eat just green-light products and still have a very unhealthy diet. On the other hand, all the foods that you mentioned are part of what's called a healthy diet.

In the end, what's important is not really, from our perspective, defining healthy or unhealthy foods; it's defining what a healthy diet is, or a healthier diet. I think focusing back on foods and whole foods and nutritious foods is part of where we should go. Focusing in or zeroing in on nutrients or bad nutrients brings all those unintended consequences.

[Nathalie Jobin]

To continue in the same vein as Ms. Savoie, I would like to get back to the use of traffic lights. In my opinion, they worsen the problem of this distinction between good and bad foods. I think this distinction makes people anxious. It becomes complicated and upsetting in the extreme for consumers to eat, especially when they see the food in a red package, as if to say no, no, no.

We need to look at nutrition in a global sense. There are no good or bad foods. Everything has to do with frequency and quantity. Perhaps we should try to speak to consumers in those terms to avoid creating more confusion. Nutrition is actually becoming a religion for many people. I think we are going to extremes at the moment. We need to find a middle ground.

[Colin Carrie, Conservative, Oshawa, ON]

I think, though, one of the things we look at as regulators in government is that it's very easy for us to label foods and things like that, but to promote a healthy diet is a much more complicated thing. I think one of the things we are all picking up from these discussions is that it's not an easy thing to do.

Last night I was out doing my shopping. I went to a Loblaws chain store, and they have that Blue Menu logo, so to save myself time, I picked up a bunch of those products. They looked pretty good when I read them.

I was just wondering, Mr. Nighbor, if industry is starting to do that. We have heard the complicated issue of these different logos, but here is one company, Loblaws, that has the regular products and the brand-name products, and now it has gone off and made these Blue Menu products. I spoke with Loblaws, and they said that overall, these products are much better in terms of the things that most Canadians are looking to lower.

Is industry taking a leadership role in that regard, and is the market driving that?

[Derek Nighbor]

Yes, the market is driving it. Canadians are more educated. There is a lot of confusion out there, but we are more educated and aware, given the Internet. People are more aware of what's out there and what they're eating. There's still a lot of confusion, but consumers are demanding healthier options. Industry is responding by providing those options and alternatives in the marketplace.

The challenge with sodium is a really good example. I've talked to a lot of my member companies who have been very quietly lowering sodium and hoping nobody notices, because there's a risk that people will move away from that product. You don't want to demonize a certain product. Take cereal, for example. If somebody doesn't like it because there's way too much sodium out of it now, then they're going to miss a lot of the positive nutrients by moving away from that product. It is really a delicate balance.

The other thing is the dynamic between the makers of the food and the sellers of the food. In Canada, we have three grocery chains that have 80% of the market, so if you're not in one of those stores or if your product is not selling in those stores and not moving off the shelf, you might not be there for long. You may have the best of intentions in developing healthier-for-you options, but if those products don't pop in the marketplace, there's a risk that the product will not be sold and will be off the shelf.

There's a real challenge, and there's a responsibility right along the chain for all of us to work together to make sure that these options are in the marketplace and that Canadians have some choice and make that choice based on what they need.

[The Acting Chair, Conservative, Tim Uppal]

Go ahead, Mr. Murphy.

[Shawn Murphy, Liberal, Charlottetown, PE]

Thank you very much, Mr. Chair.

I want to thank all the witnesses for their presentation.

It's obvious that the overarching objective here is to effect change. How we go about it is the answer, and it is certainly obvious that nutritional labelling is only one part of that equation. It's a very complex issue. I've never really understood totally what to look for, and these percentages sometimes confuse me. Then you get the volumes. I looked at chips the other night, and I think it said 75 calories, but that was for only six chips. Who eats six chips? It's very confusing.

We're all trying to effect change. Is there any example we can look to internationally of other developed countries that have actually done a better job than Canada has? I don't think the United States would be the first place I'd look. Is there any other country that has actually done a good job in effecting behaviours in its citizens, a country to which we can look for best practices?

[François Décary-Gilardeau]

I can start.

I think a champion in food and food safety today is the U.K. They were over-eating salt in the U.K., but in the last few years they have reduced the average consumption of salt by 30%, so it was not just a certain pocket of the population. They were eating more than we do, and now they're eating about what we do, so maybe it was low-hanging fruit.

What I think is interesting about England is that they have a food standards agency that is playing a leadership role, and it's really refreshing to have a federal agency that's just going out and trying some things. Sometimes things don't work as well as they thought they would, but they do some really great research and they have a great communication strategy, which is something I think we lack here in Canada. Industry is playing a big role in communication to Canadians, but we don't have a champion on the federal side to tell us, “Cool down; even though many people are saying it's good, the science behind it might not be as strong”.

Sso I think we need to look at the U.K.

The second place I'd like to look at is the United States. There is certainly lots of competition in the United States in the food market, especially in retail stores. Some retail stores are innovating and helping consumers to make better choices, a bit like the Blue Menu example, but they are turning around and using the NuVal system, which I was explaining. It is a grading system from 1 to 100.

I think there are some good examples there. The United States is probably not the best example as a whole country, but there are some small retailers that are trying and fighting back to help their consumers make the healthy choice the easy choice.

[Derek Nighbor]

I just want to correct the record on the sodium example in the U.K.

François is correct that the U.K. did embark on a program. They were the second country. It took Finland 23 years to reduce sodium by 30%, and they're still out of the stratosphere, given where they are in the world. In the U.K. they have launched a program to reduce sodium, but they've reduced it by just 10% in seven years.

I'd be happy after the meeting to share that information through the clerk. We've been watching the U.K. very closely because our sodium reduction strategy in Canada is really leading-edge stuff, so we want to learn from others where we can.

Thanks.

[Shawn Murphy, Liberal, Charlottetown, PE]

This is perhaps outside the whole ambit of nutritional labelling we're talking about today, but does anyone advocate having negative ads like the ones on cigarette packages? We can go much more strongly in that direction. You can use tax incentives. You can use legislation. You can use public education. Should we as a country perhaps be looking much more closely at any of these areas than we are?

[Derek Nighbor]

I think the difference is that people need food, but they don't need tobacco. I think we need to make that first point of delineation there very clearly.

There's another thing I think we need to do. I don't know if the committee has followed some of the work Dr. Kellie Leitch has done with this through the Sandbox Project. I had a chance to be at the meeting with about 300 folks in Toronto a few weeks back, including NGOs, academics, and a whole host of multi-stakeholders. There was one speaker there who heads up the eating disorder section at SickKids in Toronto, and she was amazed at the number of eating disorders that they're seeing emerge among young people, often because of the demonization of “Don't eat that. Don't eat that. Don't eat that”.

I'm not a medical expert, so I'm not going to pose as one--

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

Ms. Davidson is next.

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

Thanks, Mr. Chair, aAnd thanks very much to each of you for being here this afternoon.

I want to come back to the nutrition fact label and the confusion it generates. I don't think I've ever talked to anybody who understands it, regardless of who they are or what their walk in life is. It's confusing.

I look at the example on the handout you gave us. We've got cracker A and cracker B: one is nine crackers, 23 grams; one is four crackers, 20 grams. The handout says that because the weights are similar, you can compare these nutrition fact tables. I don't know anyone who walks into a grocery store and says, oh, this is 23 grams and this is 20. I know lots of people who walk in, though, and say that if this is nine crackers and this is four, I'd better multiply this one by two and then I can start comparing them. I don't know anybody who compares them by grams.

I think we need to have a standardization when it comes to serving size, but I don't know what you use. Do you use Canada's Food Guide as a basis for amounts? Would you comment on that?