Thank you.
Honourable members and invited guests, thank you for this opportunity to reflect on revisions to Canada's food guide.
Canada's food guide, which was first released in 1942 as Canada's official food rules, has been a pivotal document for both individual counselling and policy. As a representative of the Canadian Paediatric Society, the CPS, I wish to acknowledge our support of the government's commitment to review and enhance food policy in Canada, including ongoing assessments and revisions of Canada's food guide.
The CPS is a voluntary professional association representing more than 3,000 pediatricians, subspecialists, residents, and others who care for children and youth. The CPS is committed to advancing the health of children and youth by nurturing excellence in health care, advocacy, education, research, and support of its members. Our current strategic framework is guided by the principles of nurturing every child's promise, ensuring access to care, and achieving equity.
As professionals dedicated to improving the health of children and youth, we are acutely aware of the importance of healthy nutrition in optimizing children's health and development. We are also cognizant of the important influence that families and the food environment play in the quality and quantity of foods consumed.
Daily, we are confronted with the effects of poor nutrition on our children and youth. Non-communicable, nutrition-related chronic diseases place a staggering burden on Canadians and Canadian society. This is reflected by increased morbidity, increased health care utilization, decreased quality of life, premature mortality, and reduced economic productivity. Most important, these diseases are largely preventable and often begin in childhood.
It is through this perspective of maximizing beneficial impacts on the health of children and youth that I will focus many of my comments today.
The CPS has been following the current process for revisions to Canada's food guide. We are aware of Canada's healthy eating strategy, initiatives to reduce sugar consumption, and the nutrition north Canada program. The CPS has a history of working closely with Health Canada and other associations.
The CPS has been encouraged by Health Canada's process in revising Canada's food guide. Enabling significant public consultation and restricting the potential adverse influence of industry are positive components. Health Canada's proposed guiding principles are succinct, evidence-based, and comprehensive. The recognition of the importance of providing guidance in the Canadian context with the integration of the concepts of the socio-economic determinants of health, cultural diversity, and environmental sustainability is vital.
Specifically, we are supportive of the advice provided in the proposed guiding principles of encouraging water consumption, the regular intake of a diversity of fruits and vegetables, and increasing plant-based sources of protein. We are supportive of limiting the intake of processed and prepared foods high in sodium, salts, and saturated fats, as well as the avoidance of beverages high in sugars. We agree with recognizing the essential importance of food literacy and skills in selection and preparation. On an associated topic, we strongly support Health Canada's decision to prohibit the use of partially hydrogenated oils in foods.
It is our hope and expectation that the proposed guiding principles will be adequately reflected in the advice and tools developed by Health Canada in the revised Canada food guide.
There are, however, a few issues to highlight for specific attention. It is important that Canada's food guide continue to be framed as just one component of a national food strategy. Canada's food guide and associated tools must be evidence-based, address cultural variability, and allow practicality of use. It must remain a tool for policy development that can be leveraged to optimize food environments.
It is vital that implementation of the advice provided in Canada's food guide is inclusive of vulnerable populations, including those at risk because of age, literacy, finances, and/or culture. Tools need to be developed specifically to ensure vulnerable populations are reached. For children and youth, this may include formats designed for social media, web- and phone-based applications, and/or the school curriculum. These formats need to be multimodal and attractive for the users. Other groups that will need to be targeted include those consuming alternative diets, such as vegetarian, vegan, and/or gluten free.
Canada's food guide and the associated tools should enable individual users to understand nutrition quality and energy balance.
Youth will need to learn the skills to understand nutrition labelling. Portion size will be a key component to address. This is a complex issue and will vary based on age, gender, and food type. Related to this is the importance of ensuring that appropriate-sized portions are served in restaurants and other venues.
Stringent definitions of what constitutes healthy and unhealthy foods and beverages are vital to consumers and regulators. Specific advice around ways to increase fruit and vegetable intake is needed. This should include education around the benefits of fresh, frozen, and canned food choices when fresh foods are unavailable or more expensive.
Specific education and tools highlighting the beneficial role of adequate fibre in the Canadian diet should be developed.
Effective educational tools and messaging emphasizing the negative impact on health of processed foods high in sugar, salt, and saturated fats is important. Specific attention needs to be directed towards reducing sugar-sweetened beverages.
Consideration would need to be given to how best to present dietary advice in Canada's food guide. Central to this is the decision regarding whether to categorize based on food type, such as fruits and vegetables, grains, milk and alternatives, or in a manner similar to that utilized in the Brazilian dietary guidelines, in which categorization is based on the level of processing. While there are pros and cons to each approach, a hybrid system incorporating categorization by level of processing within each food type may be a useful model.
As outlined in section D of the proposed guiding principles, recognition of the impacts that food production, distribution, and consumption have on the environment is an important consideration. In addition to supporting health, food policies should promote sustainability of the food supply and minimization of the environmental footprint.
The CPS recognizes that industry plays an important role in shaping our food environment and economy. This role can at times be in alignment with favourable nutritional policy and at other times be contradictory to it. Nevertheless, to protect and promote optimal food environments, effective policies would need to be developed to promote optimal actions from industry.
Associated with this is the importance of protecting children from unfavourable influence from industry. To this end, the CPS supports measures to ban marketing of unhealthy foods to children, the use of taxation policy to discourage consumption of unhealthy foods, and the use of subsidies to encourage consumption of healthy foods.
Policies should also be designed to reduce and eradicate poverty, as this is tightly related to food consumption.
The CPS recognizes that many of these issues are being explored by the present government, such as through Bill S-228.
Policies and tools should encourage and facilitate communities and industries to embrace changes designed to improve the food environment. These would include banning unhealthy foods near and in schools, redesigning grocery and corner stores to present fruits and vegetables in a more attractive setting, supporting the proliferation of local farmers' markets, and increasing access to community centres and fitness facilities. It is hoped that such policies will foster a collegial atmosphere in which all stakeholders, including consumers, policy-makers, and industry, are committed to optimizing and strengthening the living environment for Canadians, that being a healthy population with a high quality of life, living in clean environments, and working in robust economies.
Government must leverage policy and, when needed, legislate mandatory and enforceable regulations on industry to effect the desired changes. We believe such activity can be achieved while enabling a strong Canadian economy. Importantly, Health Canada would need to maintain and enhance its commitment to monitoring the effects of implemented interventions to ensure that the desired changes to food consumption and food environment were achieved. To this end, sufficient funding and even expansion of the Canadian health measures survey on chronic disease and nutrition quality will be needed.
In summary, one of our biggest challenges will be using the knowledge and guidance provided by a revised Canada's food guide to effect the individual and societal changes necessary to maximize health benefits for all Canadians. Considerable thought will need to be invested in developing policy, legislation, tools, and messaging that effectively communicate key information on topics such as nutrient quality, portion size, and healthy, active living. Reaching vulnerable populations, including those separated by education, poverty, language, and/or culture, will need to be a high priority. Education, increased nutritional literacy, development of basic cooking skills, and improved food environments will be needed.
Despite these current issues, Canada sits in a relatively enviable position moving forward. We have some understanding of the magnitude of the problem facing us. We have some understanding of the root causes. We have a fair idea of where we want to be. We have evidence to guide us in making the needed interventions to effect those changes, but it won't be easy. For any complex problem, altering human behaviour and environments can be challenging. There can be inertia to change. There can be opposition to change. Interventions will need to be varied, multi-focal, and integrated. Interventions need to be effective, evidence-based, and inclusive.
Disenfranchised and vulnerable populations need to be specifically targeted. Fortunately, Canada is a country rich in financial, intellectual, and human resources. We have shown a willingness and we have a capacity to effect favourable change for all Canadians. We have a responsibility to do so. Health Canada has been engaged in this process and their continuing leadership is vital.
Thank you.
