Health Committee on Dec. 5th, 2017

[Dr. Jeff Critch]

I would pretty much echo those comments from everybody. I think trying to have diversity in a simple format is a complex task. It gets quite overwhelming pretty quickly.

Related to that, though, no matter what we put out there for all these different groups, is the importance of making the environment conducive to that. Right now our environments in Canada, when it comes to food, are not conducive to healthy eating in many ways, or certainly, if anything, the environment in a lot of places is probably more conducive to unhealthy eating.

Both of those things have to be done together. We have to have the knowledge and the communication about what a healthy eating pattern that supports health is and we also have to create the environments in which people can implement those in the appropriate way.

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

Thank you.

My next question is kind of broader. I'm not entirely sure this is the right place for it. I get a lot of questions from my constituents about GMOs. Is this something the food guide is going to address or present research on, one way or the other, or present any recommendations on with regard to labelling?

[Dr. Hasan Hutchinson]

This one is pretty simple for me. It's a simple “no”. That is not an aspect that we will be bringing into the food guide.

The reason for that is fairly simple. When one looks at the available evidence—and the connection with health is not there—it's not something where we have a strong evidence base for us to be able to bring it into our dietary guidance. As I think I stressed many times here, what we are trying to work on is where we have very strong convincing evidence to go in a particular direction. On that one, there is just not strong convincing evidence.

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

Thank you.

Those are my questions, unless Dr. Critch would like to opine on this. Do you have a response?

[Dr. Jeff Critch]

No, I'm good.

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

Okay, that's good.

[The Chair, Liberal, Bill Casey]

Thank you very much.

That completes our seven-minute round. We'll go to our five-minute round now, starting with Mr. Van Kesteren.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Thank you, Chair.

Thank you, all, for coming.

I remember as a kid getting the Canada health guide at school. I don't know if they still do that anymore. Do they still pass them out at school? I'd take it home, and I'd show my mother and I'd say, “Mum, we're not eating right” because—check the name—we were a Dutch immigrant family, and we didn't have that diversity. It must have been a pretty healthy diet we had because there was no obesity. We were as healthy as could be.

When I look back, I think that the mealtime really centred around suppertime. There were vegetables, and not a lot of meat. When breakfast was served, we consumed an enormous amount of milk, and I think it was whole milk at the time, too.

I'm not being an advocate for any different group. I guess what I'm trying to say is that it worked for us, for the most part. As we developed and grew out of our culture, we started to expand and see what the rest of the world was eating. Especially when we had a little bit of money, we experimented with so many other things.

It would occur to me at least that we, at this time, know what the human body needs. We should also know where that is available. I'm wondering if the food guide would reflect that and present to Canadians, “Here is your horn of plenty”. We have such a diverse country. It's so magnificent that we have all these different types of foods: “This is what your body needs, knock yourself out.”

Is that something along the lines of what we can expect in our food guide?

[Dr. Hasan Hutchinson]

Yes. We don't want you to knock yourselves out completely, of course, which sometimes happens.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

I should have maybe said, “Everything in moderation.”

[Dr. Hasan Hutchinson]

Yes. When I think of the input we got when we did the whole evaluation of the use and what people are understanding about it, what we got certainly for your Canadian is that when you are concentrating on so many servings of this particular size, it just becomes confusing. That's where we're trying to figure out how we can go beyond that and have actionable guidance that can be brought into your everyday life, so that when you are out shopping, you have the basic principles that make you choose those foods that are better for you; when you are at home, you know how to do the preparation; and when you are out in restaurants, you have the concepts. We have to have the basic concepts to make it easier for people to incorporate this into their daily lives. That's part of what we're going for.

Madam Savoie mentioned that guiding principle number one is really about a variety of healthy foods. When you said a horn of plenty, it made me think of our guiding principle number one. To a certain extent we were saying knock yourself out with these, have lots of the fruit and vegetables and whole grains. Again, in there we talked about lean meats and eggs and low-fat dairy and stuff like that. Those are the things that I think are foundational to what we want to have as a dietary pattern.

Our guiding principle number two came back to the types of things that we want to make sure have some restrictions, because the food supply is different from when we were younger. It's a while back for me here too.

There is a report out today from the Heart and Stroke that talks about—their terminology is a little different from what we use—“ultra-processed” food. These are foods with lots of these sugars and fats and sodium. They estimated that about in half of the food supply, this is really what you're eating.

We're trying to get people back to having those more basic foods and to preparing them themselves. Dietitians of Canada mentioned that as well.

To me, our guiding principle number three is all about health literacy and health skills. I'm thinking that's almost the most important part of what we're doing here right now. You want to be out there, and if you have family, to be shopping with them. You want to transfer those sorts of skills in food preparation to your family, to be eating together, and getting rid of phones and screens when you're eating, so you eat together as a family. You eat together all the time, and we get away from distracted eating.

That component of what we're bringing forward is as important as the individual types of food, and that's working with the different health professionals who can give that sort of advice. We're working with provinces and territories that can perhaps help in that as well by creating the right types of environments for that.

[The Chair, Liberal, Bill Casey]

Your time is up.

We now go to Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

Thank you very much.

I was wondering how often you think the food guide should be reviewed. I think it's been about a decade now. The research seems to be moving along quite dramatically on this one. Is a five year review...? If we were to advise on when this should be reviewed again, do you have a thought on that?

[Dr. Hasan Hutchinson]

Yes. We have established what we call an evidence review cycle, and we are committed to redoing this every five years.

[John Oliver, Liberal, Oakville, ON]

Will the five-year review be built into the recommendations coming out?

[Dr. Hasan Hutchinson]

We've already committed to that for the evidence review as well.

I hate to say we're going to do a food guide every five years because it depends on the evidence.

[John Oliver, Liberal, Oakville, ON]

The reason I'm asking is that I was looking at some other countries. Sweden is the first country that's rejected this low saturated fat diet and has gone to the low-carb, high-fat nutrition advice. The Swedish Council on Health Technology Assessment looked at 16,000 studies and has come up with contrary advice.

I don't think I'd want to debate saturated fats versus non-saturated fats and the benefits of that switch, but you're silent on carbs. There is lots of evidence that reducing our carb intake is probably more important to addressing obesity, addressing diabetes. It can help lower triglycerides, and in fact higher fat intake—healthier fats, I would assume—and a lower-carb strategy seem to be where some other countries are headed. I'm wondering how their research.... They looked at, as I said, 16,000 studies. You've come to a different conclusion here in Canada.

Where are you at on lowering our carb intake? The RDA seems to be staying the same in this. I don't see any change.

[Dr. Hasan Hutchinson]

Again, I don't want to be debating what it is, but certainly Sweden promotes patterns that have a high proportion of plant-based and—

[John Oliver, Liberal, Oakville, ON]

Yes, absolutely.

[Dr. Hasan Hutchinson]

They actually put forward a limit with respect to red meat consumption of less than 500 grams per week, and they have messages that say to eat less, as well.

[John Oliver, Liberal, Oakville, ON]

I am not arguing with that. I don't disagree, but is it more about reducing the carb count?

[Dr. Hasan Hutchinson]

What we are talking about, of course, is reducing the refined carbohydrates and the sugars. That's a very big part of what we are going forward with. That's where we have the strong evidence base, with respect to the refined carbs. We don't have a strong evidence base for just carbs overall.

[John Oliver, Liberal, Oakville, ON]

I get the switching from the sugars, but you are still recommending fruit, which is high-carb. It has high sugar—natural sugars—but it is still a recommended....

[Dr. Hasan Hutchinson]

Sure. Again, there is very strong evidence for that.

[John Oliver, Liberal, Oakville, ON]

Where are you at with reducing the RDAs? Was it 300 grams of carbs per day in a 2,000-calorie diet? Where are you at on that science? There seems to be an abundance of it that says we should be reducing our carb counts.