Health Committee on April 23rd, 2018

[Tracey Ramsey, NDP, Essex, ON]

Okay. I want to get an answer from some of the others.

Do you not think that having the Supreme Court weigh in on this would simply end that question that's hanging about here today? Does anyone else have a response?

[Corinne Voyer]

I have a short comment.

I do not know whether that answers your question, but the Quebec legislation clearly shows the legal approach and the need, the relevance, of having legislation governing advertising directed at children. If you use the criteria set out in the Quebec act, which has gone through all the stages of the legislative process, there is a good chance that a federal bill could have a positive outcome.

[Tracey Ramsey, NDP, Essex, ON]

Thank you.

[The Chair, Liberal, Bill Casey]

That's completes our normal round, but we have a little time and so I'm going to propose that we do another round with three minutes each. We'll have one Liberal, one Conservative, one NDP, and then a Liberal again for three minutes. I have to ask you to keep your questions and answers to three minutes, but we all value your testimony so much and we want to hear more.

We're going to start off with Mr. McKinnon for three minutes.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you, Mr. Chair.

Mr. Lund, in your testimony I believe you took some exception to the language of “healthy” versus “unhealthy”. You wanted it clarified more in terms of percentages of specific things, like cholesterol, fat, and so forth. Is that correct?

[Ronald Lund]

No. What we said is that “healthy” and “unhealthy” are terms that are not currently anywhere in the health initiatives with Health Canada. They're also not anywhere that we can find in the food guides, etc. They're not terms that are normal.

To say all of a sudden that a food is unhealthy, demonizes products. What we said is we'd like to take the “unhealthy” term and at minimum, if it's just not going to go away, replace that with “high in”, because indeed that's where the parts of the legislation that we agree with are going, and that would be high in fats—not cholesterol, fats—sugars, and sodium.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Okay. I guess that's what I understood from your testimony before.

Dr. Warshawski, would you agree with that sort of clarification of the language.

[Dr. Tom Warshawski]

I don't really know if it's a clarification or an obfuscation. I mean, when we look at risk, we say once you cross a certain threshold, the relative risk of heart disease or type 2 diabetes increases by 20% to 30%. We would use the term “unhealthy” so people could understand that it correlates with an evidence base.

If you say “high in”, I suppose that just adds to consumer confusion. People have said that when they look at the current nutrition facts tables on the back of a box, they wonder what the heck it means, what does percentage of daily value really mean.

I think for consumers to make educated choices, they have to know where the evidence base lies.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

In terms of the law and in terms of saying what is a healthy food versus what is an unhealthy food, would it not be helpful to be able to measure that against specific criteria, to say healthy means x amount, x percentage or less of cholesterol, and/or x percentage or less of something else?

[Dr. Tom Warshawski]

I think what is being proposed in the Health Canada document is around the daily values, in three areas in particular. There are daily values for vitamins, etc., but these are daily values around saturated fat, sodium, and sugars. That rests upon an evidence base, in terms of when risk begins to increase for heart disease, type 2 diabetes, hypertension, etc., with those particular ingredients.

That also rests upon the assumption of a 2,000-calorie-per-day diet. That is for adult women, around 2,000 calories per day. For children it's significantly less than that. That's where you begin to get into nuances, and the more nuance you require of a consumer, the more fuzzy the messaging gets. There are definitions, daily values, and percentages: they're evidence based.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you.

[The Chair, Liberal, Bill Casey]

Ms. Gladu, you have three minutes.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chair.

Mr. Lund, you mentioned there was not enough time to prepare with the constraints of this legislation. How much time do you need?

[Ronald Lund]

What we did was we married it up with the front-of-package side. When you look at the sponsorships, for instance, which we've heard there could be grave impact, sponsorships can be five years or 10 years in the making for an Olympic sponsorship. When you go down the totem pole to less popular ones, it might be two or three years. That's a big part of it. We're not going to get 10 years, so I'm not asking for 10. We are at least saying that if there is going to be messaging to consumers, there should be a concerted effort that it makes sense, that there's not one piece of legislation over here that says, "This is unhealthy,” and then when it comes back on the front of the pack it's going to have “high in”.

Again, going back to the language, “high in” and “low in” have been in the food guides for many.... Low was below five, high was higher than 15%. With all due respect to Mr. Warshawski, these are known to the consumers, versus causing confusion. Causing confusion is going to be introducing new nomenclature that is not required.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

I am interested to know more about the experience in Quebec. Did the rates of obesity fall? Do they continue to fall for children in Quebec under your program?

[Corinne Voyer]

Quebec is one of the provinces with the best results in terms of the obesity problem. I have a note of caution, however. The Quebec act, which dates from 1980, was not passed to reduce obesity, but for ethical reasons and because of the vulnerability issues involving all forms of advertising. In terms of data on obesity, we were unfortunately unable to measure them in the past.

Obesity is a multifaceted problem. There is no single, unique solution; a host of solutions and strategies will have to be established. The healthy eating strategy that Health Canada is in the process of rolling out is a good way to deal with the problem, if efforts are increased. So, yes, advertising is one of the factors that have to be included, but, as regards the data in Quebec, I cannot give a specific answer.

[Ronald Lund]

May I make a comment on that?

I think a very important point was just made: that it is a multi-faceted problem. In fact, in terms of how fast it exploded and where it is today, the rates of obesity and overweight in Quebec are basically not statistically different from the rest of Canada. I think it's off the website now, but you can still find the link on Quebec's ministry of health's own website. They talk about the great increase since 1978, and they add that the good news is that it's not significantly different from the rest of Canada. Despite a homegrown test, the obesity rates in Quebec are not dramatically different.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

If would be great if you could send the link to the clerk.

[The Chair, Liberal, Bill Casey]

Ms. Ramsey.

[Tracey Ramsey, NDP, Essex, ON]

Thank you, Chair.

I think the crux of today is to have something that's in the best interest of kids and the next generation coming behind us.

In a brief to this committee, UNICEF argued that this bill should follow a similar model to Quebec. Their position reflects the belief that children have the right to grow up in a commercial-free environment, and the difficulty of distinguishing healthy from unhealthy food. Are you confident that Health Canada and the Minister of Health , in this legislation, will have the ability to define unhealthy food in a manner that successfully protects children in our country?

Anyone who wants to respond, go ahead.

[Dr. Tom Warshawski]

I'll take it.

As the chair of the Stop Marketing to Kids Coalition, I am confident that they will be able to define healthy versus unhealthy, and that these steps are indeed a step in the right direction.

I have one further observation, if I can, at the discretion of the chair. In terms of Quebec legislation and whether or not obesity has decreased, in that age range where the legislation actually applied, age six to 11, they do have a lower rate of obesity. Once they get out of that protection zone, they are adolescents and they're marketed to, that protection is no longer in effect. It actually doesn't surprise me, given the amount of advertising that goes to adolescents. They are just as vulnerable and are just as affected.

[Tracey Ramsey, NDP, Essex, ON]

Does anyone else want to comment on how we determine what is healthy or unhealthy food, and what you see as being a proper capture of both scientific and evidence-based science to determine this?

[Corinne Voyer]

In our opinion, the science is conclusive in terms of sugar, salt and saturated fat. It has clearly been demonstrated that those products have a negative effect on health and that there are repercussions. Targeting those factors to a small degree will not result in a perfect definition, but 90% of the food items with advertising directed at children have little nutritional value.

What do we find in grocery stores? The boxes of cookies that attract children show chocolate chips, for example, like Chips Ahoy! There are sugary drinks and cookies shaped like bear paws. All these food items are very high in sugar and targeted directly at children. The labelling on the front of the package has to match. I was not able to say this earlier, but we have to make sure that the recommended maximum intake is not in the order of 15% but rather 5% for children, so that children are not consuming quantities designed for adults.

We feel that the labelling on the front of the package has to match; that would have a positive effect.

[The Chair, Liberal, Bill Casey]

Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you, Mr. Chair.

Mr. Lund, initially Ms. Ramsey asked a question about the Heart and Stroke Foundation study regarding the failure of self-regulation. You said that was not valid.