Thank you very much. I would like to thank the Standing Committee on Health for this truly great opportunity to provide my perspective on the healthy eating strategy. I think this is a very significant step towards a better food system, and perhaps better health in the long term for Canada as well.
I'm chair in nutrition at the Université Laval. I've been researching diet and health for 20 years. My main focus is on nutrition and heart disease, and obesity and diabetes. I do research from an epidemiological, big cohort perspective, clinical as well as mechanistic perspectives. I've studied all types of fat, as well as whole diets such as the Mediterranean diet, for example.
I think it's important for transparency to disclose that I've been funded by industry in the past, by the dairy industry and the Canola Council of Canada, both as part of the Agriculture and Agri-Food Canada clusters. However, I want to also emphasize that I have no particular agenda regarding food and health. I'm not a vegetarian. I don't like milk particularly. I'm allergic to fish and seafood. These are my disclosures, I guess.
I believe that my role as a researcher is to advance knowledge and to make sure the data are interpreted as they should be. For me, the revision process undertaken by Health Canada, which is based on the totality of evidence, is key. Again, as a researcher my role is to make sure we provide the best evidence possible for efforts like this to make the best decisions possible.
Finally, before I go to my perspective on the healthy eating strategy and the food guide in general, I'll note that I was fortunate to be involved in the evidence review cycle undertaken by Health Canada in 2015, and I provided my perspective on the evidence on which these decisions are based.
I commend Health Canada for undertaking this extensive review of the healthy eating strategy. This is not an easy task. There are high expectations. There are a lot of controversies in many of these areas. I'm sure that as consumers you're all aware of these controversies. This is not an easy task, and I think Health Canada.... It's been mentioned by the two previous speakers that the process—the transparency and the level of consultation—has been really amazing.
What I want to do in the next few minutes is take the guiding principles and provide some perspective on each of them.
The first relates to consuming a variety of nutritious foods and beverages as the foundation of healthy eating. There's a strong tendency around the world now to focus on food patterns, thereby promoting food patterns to the population. There are, of course, many different food patterns that can be healthy. I think this is well acknowledged. However, I don't understand how we can connect this strategy, which I think is great, to the focus that is given on each nutrient. We're going to hear a lot about food patterns—vegan patterns, the DASH type of diet, the Mediterranean diet—yet there will be a lot of focus on nutrients. We are going to have a front-of-pack strategy for nutrients, labelling the saturated fats, the sugars, the sodium. For me, this is not a direct connection with a food-based or a food pattern approach; we're still focusing on nutrients, thereby perhaps contributing to confusion among the public.
This is not easy, because over the last 20 to 30 years we have programmed the population to focus on nutrients. We have provided information on nutrients on the food labels. In the consultations with the public by Health Canada over the last couple of years, the population, the consumers, have been saying they want information about proteins, carbohydrates, lipids, and energy. This is really difficult, because we want to emphasize a whole diet approach, a whole food approach, yet we're going to still provide information on nutrients. This is a disconnect for me. I want to understand why we're going this way, because these two approaches are clearly different.
There is, of course, in the U.S. and in Canada this recommendation for a substitution of saturated fat versus unsaturated fat. I think we have a lot of evidence to support this recommendation, but again, it's a highly nutrient-based recommendation. I would hope Health Canada, through the revised guidelines, will not emphasize this. It's putting too much emphasis on the nutrients, whereas we want them to focus on foods. We want people to focus on food substitution.
Further, there is actually some controversy about this recommendation for substitution of saturated fat for PUFA; not from a cholesterol effect or health effect, but from a food-based effect, this is really hard to do. For example, if we say you have to substitute saturated fat for polyunsaturated fat, the bad fat for the good fat, how do you do that if you're consuming yogourt? You don't have yogourt high in unsaturated fat. Yogourt is going to be containing saturated fat as part of dairy fat. It's the same thing for cheese. This substitution is very difficult for the population to understand. Maybe we can address that in the question period. It's not as easy as it seems, and I think this is important to keep in mind.
Of course, all guidelines right now around the world are trying to address this issue by using the totality of the scientific evidence. I'm just curious, and I don't understand why everybody is looking at the same evidence and not coming to the same conclusion. We're talking about a low saturated fat, high polyunsaturated fat paradigm, because in Canada and in the U.S. we say that's what the science says. Yet the Dutch health agency is saying they don't have the evidence to support that, and we're all looking at the same evidence. For example, in the Netherlands, they don't have the recommendations to consume lower-fat dairy products because they're saying they don't have the evidence for that. Personally, I've done a lot of research on this and I can't find evidence, for example, showing that consuming a low-fat yogourt is better for health than consuming a high-fat yogourt. This is a leap of faith mostly based on the fact that high-fat dairy contains more saturated fat. But there is evidence that the food matrix may modify the effect of the food on health. It's quite interesting, as a scientist, to look at this evolving work around the recommendations. We're all looking at the same evidence and we're not coming to similar conclusions.
The whole issue on processed and prepared food I think is a great idea. Again, there is the risk of putting too much emphasis on some of these nutrients, and sugar is one of those. Just for your information, for sure, over-consumption of sugar is problematic; no one will argue against that, but I think we're putting a lot of weight on sugar. In some analyses around the world looking at nutrition factors contributing to the burden of disease, sugar, among all nutritional factors, comes in 10th place. It's just after fruit, nuts, sodium, processed meat, vegetables, trans fat, omega-3 fats, whole grains, and fibres—10th place for sugar. We are putting a lot of pressure on sugar. Maybe it's going to have an effect, but there are a lot of other areas in nutrition that could have a lot of effect on health.
On the front-of-pack approach to sugar—and we've discussed that among our colleagues here in Quebec at our research institute—using the total sugar of the food is problematic. I'll give you some examples. Several products, cereals, for example, which are high in sugar, are below the cut-off for the front-of-pack label for sugar. Mini-Wheats, Honeycomb—you can name a lot of them—are just below the 15 grams per serving size, so they won't have a label for high-sugar content, but they may be just at 14 grams. That's a pretty high sugar content. The added sugar versus the total sugar for us is a key issue. There is a lot of challenge in looking at added sugar, of course, but from a public health perspective, I think this is something we need to consider as well.
I'll say a word on juice. Of course, over-consumption of juice, over-consumption of sugary beverages, is not good for health, not good for obesity, and not good for cardiovascular disease. We feel, and I have discussed this with my colleague, again, avoiding wording related to juice intake is pretty strong. For me, I don't think we have evidence that zero millilitres of juice is any better than a little bit of juice. We have evidence that too much juice is not good, but there are nuances there, and from a public health messaging perspective, again from my scientist's perspective, we're lacking some evidence there.