Evidence of meeting #83 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was well.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Jeff Critch  Chair, Nutrition and Gastroenterology Committee, Canadian Paediatric Society
Hasan Hutchinson  Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health
Nathalie Savoie  Chief Executive Officer, Dietitians of Canada
Karin Phillips  Committee Researcher

4:15 p.m.

Chief Executive Officer, Dietitians of Canada

Nathalie Savoie

Maybe Dr. Hutchinson can go.

4:15 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

With respect to milk products, I want to point out that in our consultation we recommend milk foods. When we're talking about proteins, we are encouraging people to have more eggs, fish, shellfish, poultry, lean meats, lower-fat yogourt, cheeses that are lower in fat and sodium, and lower-fat milk as well.

4:15 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Cheese is still there? That's good.

4:15 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

I sometimes think the response we got in the media took away from the words we actually had in the consultation, but it has become obvious to us that there was a problem of interpretation. We are taking the advice we've heard, and we've heard it from other places as well. We're looking at that.

Secondly, with respect to high-fat milk for young children, in no way or form do we want to restrict high-fat milk, when you're actually giving milk. That's certainly something our other witness has been involved with, nutrition for healthy-term infants. We're very clear on that as well.

As to where you go with really high in saturated fats, there is very strong and convincing evidence for wanting to reduce saturated fats, but by substituting in unsaturated fats. I think we got into problems before with the messages that were out there over the last 25 to 30 years to decrease total fat. What that did, as things became reformulated, was to substitute in sugars and salt, so you fixed one thing but then you created all sorts of other problems.

We want to make sure that we don't go down that particular road. That's partially what's behind our thinking in terms of focusing on those three nutrients of public health concern at all times. Again, our proposal for front-of-pack is that by having both of those there, you wouldn't see switching from one nutrient and public health concern to the other, and then just reformulating to make things bad. There is certainly that out there.

Now obviously with respect to research, you can basically find whatever you want out there when you go out and search. On this particular question, when we're talking about dietary fats and cardiovascular disease, there is something from the American Heart Association, which put out its position point just earlier this year. It concludes strongly that lowering intake of saturated fat and replacing it with unsaturated fat, especially polyunsaturated fat, will lower the incidence of cardiovascular disease. That's at that particular level and everyone has been supporting it.

But they also put out the point that, to the best of their knowledge, and there was quite a large list of experts working with the American Heart Association, no information from controlled studies supports the hypothesis that fermentation adds beneficial nutrients to cheese that counteract the harmful effects of its saturated fat.

Again, one can get different sorts of evidence out there. But when we look at the types of evidence, where we look at these bodies of academics who are evaluating the different types of evidence, where you're sort of grading the evidence, and it's coming from a body that is not being supported by industry, those are the ones that come through quite strongly.

4:15 p.m.

Liberal

The Chair Liberal Bill Casey

Now we go to Mr. Davies.

4:15 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you, Mr. Chair, and thank you to the witnesses.

Dr. Critch, to what extent does the food guide presently reflect industry versus evidence-based influence?

4:15 p.m.

Chair, Nutrition and Gastroenterology Committee, Canadian Paediatric Society

Dr. Jeff Critch

Thank you for the question.

Do you mean the revised guiding principles again or the current food guide?

4:15 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

I guess you can comment on both.

4:15 p.m.

Chair, Nutrition and Gastroenterology Committee, Canadian Paediatric Society

Dr. Jeff Critch

We don't really know what the revised food guide is going to be, but we have some idea from the guiding principles.

We do feel that it accurately reflects the evidence base that's there. Certainly, principles one and two, when they talk about the nutrients that we are worried about and trying to reduce, and those we think are more beneficial and trying to increase in the diet, it certainly reflects the evidence base.

4:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Hutchinson, the food guide has been regarded as the most downloaded document in the federal government.

4:20 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

Tax forms might take a bigger hit. Mind you, I don't know who downloads tax forms anymore either. I'm not sure.

4:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

It's up there.

The food guide for healthy living is obviously as helpful to consumers who want to try to eat healthy as their ability to know what they are purchasing and consuming. I'm talking about labelling.

We can do our best to eat well but if we go into a store and we can't tell on a package, in an accurate way, what exactly is in that package in terms of the sugars, everything.... How closely does your department or the food guide work with the other branches of government to make sure the labelling aspect of foods is going to help Canadians actually realize the goal and potential of the food guide?

4:20 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

I can say that we are basically joined at the hip on this. With the whole healthy eating strategy, which of course is a combination of regulatory approaches, standards approaches, guidance approaches, we have a team that used to meet three times a week—I think we're down to twice a week—to follow this progress as we go along. Anything that we do with respect to the dietary guidance, their folks are looking at that. Anything that they're doing with labelling, our folks are involved in the creation of that.

Labelling is an interesting one, because once the labelling is done, I'm responsible to do the health promotion on that. We've actually done a lot of health promotion on how to understand the present label.

We are very well connected. We of course have the same bosses as well, whom we meet with on a very regular basis on these. There's a lot of consistency, and that's what we're trying to do across all the initiatives so that they're very complementary.

The baseline evidence for all of our initiatives is really the evidence review that we have done.

4:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Okay.

I hear a lot from consumer groups who believe that labelling could and should be much more revelatory. Take sugar, for example. Some suggest that sugar—which is such a major cause of obesity in this country, particularly with young people—should be prominently labelled on the front in its totality, and not the separate fructoses and glucoses and cornstarches and all the separate constituents.

Is there any move in the department to more prominently label sugar on the front of packages so that consumers can actually tell what they're eating?

4:20 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

As part of the healthy eating strategy, one of those has to do with the development of front-of-pack labels. Once again what we're doing there is focusing on these three nutrients of public health concern, one of them being sugars. The idea is that on the front of all packaged foods, if they have high amounts, if they're high in any of those things, you would have a label that would point that out. That would then make it much easier in the shopping environment. When you're making that decision in about 1.7 seconds as to which food you're going to choose, it's right there, as well.

That's, of course, coupled with the changes I started to talk about, which would be on the side of the package or the back of the package with respect to the ingredient list, where we're trying to make it a lot easier to tell what sugars are there. Also, in the nutrition facts table, we've put a percentage of daily value into that for total sugars, so then it becomes easier as well. If you're looking at the nutrition facts table itself, where there's more information about the number of grams and stuff and you also have a percentage, that maybe makes it easier then to understand.

4:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Going back to the food guide itself, I represent an extremely multicultural riding. I think I'm 19th out of 338 for varied ethnicities. I have very large Chinese, Filipino, south Asian, and Vietnamese populations in my riding.

I'm just wondering to what extent the food guide reflects cultural tastes or preferences and habits, and could we do a better job on that?

4:20 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

Yes. I think with the latter, we can certainly do a better job at that.

When the last food guide was done, based on the census and who were the most recent people who had arrived, there were two sorts of things that we did. We did translations, of course, but straight translations based on the top 10 recent immigrants over the last 30 years. We worked on that census. We did that, and at least it was available in their language. That was just a straight translation; it was not an adaptation. I have to point that out.

The other thing we did—and I say “we”, but this was before I took over the shop, so it wasn't really my food guide at that point, though now I feel it's mine—when developing the choices of the foods that are available, foods that are on the diagram, we once again looked at who were the recent immigrants. You'll see that there was a much larger variety of different types of ethnic foods, we'll call it—foods that are available for all Canadians—in the 2007 food guide than what there was in 1992.

Also, when you go online, you can create your own food guide for yourself. There are hundreds and hundreds of different sorts of foods that you can select. If you go into the meat and alternative section, you can find all sorts of things, and there are a lot more diagrams. You can select the ones you want, make your own food guide that's particular to you, and you can also print that out in a dozen different languages as well.

We made an effort, and certainly I wouldn't consider that perfect, by any means. Since that time, and it's been a number of years now, we went out across Canada and had meetings with different cultural groups across the country to try to get a bit of a handle on what was working and not working with respect to the food guide and how they see themselves.

That's some of the background information we have to work on right now, as we're putting together this new suite of materials.

4:25 p.m.

Liberal

The Chair Liberal Bill Casey

Thanks very much.

Now we go to Mr. McKinnon.

4:25 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

Thank you, Chair.

I'm going to build on what Mr. Davies started, which is another way to say that he took my question.

4:25 p.m.

Some hon. members

Oh, oh!

4:25 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

There are a lot of ways to slice and dice this whole food guide thing. There are different age categories, different dietary requirements such as the need for gluten-free or diabetic kinds of diets and so forth, but they all reflect, subject to those categories of people, that we have the same nutritional requirements.

When we get into cultural diversity and ethnic diversity and religious diversity, we have to slice it a whole different way but still recognize those dietary requirements in all those categories. That seems to me to be a hugely complicated problem to be faced with in a food guide that we're trying to make really simple.

I wonder how deeply that's going to impact you and whether we will have a whole multitude of food guides to reflect those changes.

4:25 p.m.

Director General, Office of Nutrition Policy and Promotion, Health Products and Food Branch, Department of Health

Dr. Hasan Hutchinson

Welcome to my not quite nightmare but the dilemma we are always in as well. How do you keep something simple but make it so it also reflects the great variety of differences and the diversity we have in Canada?

Obviously, that's something we are looking at. With respect to the basic requirements for different sorts of nutrients, from all of our evidence reviews, I think that as a human species, we're fairly close with respect to the basic environments and I think there's enough latitude that there can be adaptations for different groups, from a straight macronutrient and micronutrient perspective.

What we are talking about right now has to do with our general recommendations, and behind all of this, we're really getting started on some very detailed modelling of healthy eating patterns in which we're trying to take all of those things, as much as we can, into consideration.

Whether we're going to have enough information about different groups is where we run into a data problem. Certainly we're hoping to have a pattern that is general enough that it can then be adapted for different sorts of folks. That's where I think one has to then work with the right types of people who interact with those ethnic communities and so on. Who should we be working with so that they understand the needs of those particular communities?

The other way of dicing that is that we have people from different chronic disease groups, and that's where we work with, once again, Heart and Stroke, Canadian Diabetes, and the cancer folks. It is a complicated problem and we're trying to, obviously, do something that has simple basic messages that are adaptable to everyday life, no matter whose everyday life it is. But you're right that it's not easy.

4:30 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

Indeed.

Would Ms. Savoie or Dr. Critch like to comment on this as well?

4:30 p.m.

Chief Executive Officer, Dietitians of Canada

Nathalie Savoie

I would just add that as Dr. Hutchinson said, this is a basis and then professionals who work with clients and patients can use that to customize it even more to that particular person they have in front of them, because there are food preferences, budgets, as we spoke about before, and all of those things that also need to be taken into consideration.

4:30 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

Thank you.

Dr. Critch.