We'll call our meeting to order. Welcome, everybody, to meeting number 85 of the Standing Committee on Health.
Today we're going to continue our study on Canada's food guide.
We welcome all our witnesses, both those who are present and those who are here by video conference.
Today our witnesses include, from the Heart and Stroke Foundation of Canada, Mr. Manuel Arango, director, health policy and advocacy; from Diabetes Canada, Joanne Lewis, director, nutrition and healthy eating; and, as an individual, Dr. Benoît Lamarche, chairholder of the chair in nutrition at Université Laval, by video conference from Quebec.
Welcome, all of you. We'll go in the order mentioned, and we'll start with the Heart and Stroke Foundation. We like to have 10-minute opening statements at a maximum.
If you'd like to start, you're on.
Thanks for the opportunity to testify today.
In my role as the director of health policy and advocacy at Heart and Stroke, my team and I have had the pleasure of engaging with many of you at this committee one-on-one on the subject of Canada's healthy eating strategy. We appreciate the ongoing commitment to enhance Canada's food environment.
We also applaud Health Canada's recent step to eliminate industrial trans fats in our food supply. Heart and Stroke is proud to have co-chaired the trans fat task force and to have worked with government and other partners to make this health policy a reality. This was an important step because trans fat levels are still high among certain vulnerable populations, including our children, in the food they consume. In foods such as processed baked goods and restaurant foods, levels are still high.
On the study of Canada's food guide, the committee is hearing from some of our partners on this subject. Our common agreement is that the healthy eating strategy and particularly the soon to be revised Canada food guide provide an unprecedented opportunity to make meaningful changes to our food environment and to support Canadians to make healthy choices.
In building on the comments made by my colleagues, my testimony today will focus on the following key components: the nutrition status of Canadians and the relationship between nutrition and chronic diseases; the importance of robust revisions to Canada's food guide; and, as well, Heart and Stroke's specific recommendations for the food guide.
Nutrition is a key impetus for our work at Heart and Stroke. We know that up to 80% of heart disease and stroke can be prevented by adopting healthy behaviours, including a healthy diet. While the causes are numerous, poor diet, excess caloric intake, and inadequate access to important nutrients are leading factors driving chronic disease and obesity.
The situation is not ideal in Canada. Currently, more than 60% of adult Canadians and more than 30% of children and youth are overweight or obese. Approximately 70% of Canadians age 18 years and above and youth 12 to 17 years of age did not eat the recommended servings of vegetables and fruits in 2016.
Also very worrisome, ultra-processed food consumption is on the rise. Almost 50% of Canadians' energy intake comes from ultra-processed foods. It's even higher, 60%, for kids nine to 13 years of age. This was highlighted in a report that the Heart and Stroke commissioned through the University of Montreal just last week.
What concerns Heart and Stroke in the context of today's discussion is that this could be the first generation of kids to have a shorter lifespan than that of their parents as a result of premature death related to chronic disease, including obesity.
The annual cost of diet-related disease is $26 billion annually, and unhealthy diets are the number one risk for death in Canada in 2016. Without public policy intervention, the situation will only get worse.
Whether you or your caucuses agree or disagree with how the food guide should be revised, we can all agree that in the last 10 years since the release of the last food guide, social behaviours and consumption habits have changed, technology and information access have evolved, and scientific evidence related to nutrition has also progressed, all of which necessitate a re-examination and revision of how Health Canada is advising Canadians to consume foods and beverages.
Canada's food guide was once a central resource for Heart and Stroke, both for the development of policy papers and for the creation of consumer resources. However, in the last few years, we have increasingly moved away from utilizing and referencing the food guide due to inconsistencies between the food guide and Heart and Stroke's messages on healthy eating. We hope that will be resolved with the revision of the food guide.
Heart and Stroke is supportive of and in agreement with many of the key principles proposed by Health Canada during the consultation phases for the food guide. Broadly speaking, we support the consumption of whole real foods, mostly plant-based foods, but certainly not at the exclusion of a moderate amount of some animal proteins, which can certainly be part of a healthy diet. Here, we're talking about fish, eggs, lean meat, low-fat milk, unsweetened milk, etc. We also support the proposals to limit or avoid highly processed and ready-made foods and beverages high in sodium, sugars or saturated fat, and to avoid all sugary drinks, because these are certainly not part of a healthy diet. Let me elaborate on some of the specifics.
With respect to dairy, Heart and Stroke recommends that the food guide should contain a statement about including lower fat unsweetened milk, milk alternatives, and yogourt as part of your diet. We see value in ensuring that dairy products be identified for their efficient delivery of calcium and vitamin D. For example, we think whole milk should be encouraged for children one to two years of age who are not being breastfed. Furthermore, we recommend the continued monitoring of emerging evidence on the impact of high-fat dairy products on cardiovascular health.
With respect to saturated fat, Heart and Stroke agrees that the government should promote the consumption of foods that contain mostly unsaturated fat, instead of foods that contain mostly saturated fat. Research clearly indicates that saturated fats raise the risk of heart disease and stroke, whereas the replacement of these saturated fats with other types of healthy fats decreases the risk of these conditions. Our advice to Canadians is that the best way to avoid unhealthy saturated fats is to avoid consuming highly processed foods. There is emerging evidence that it's not just the fat itself but the type of food that the fat is found in that can affect heart health. If Canadians are eating a balanced amount of whole real foods, cooking from scratch, and avoiding highly processed food, then they will likely have managed any risk posed by saturated fats.
With respect to beverages, Heart and Stroke agrees with satisfying our thirst with water and plain milk. Safe, clean water should be readily available to all Canadians. Heart and Stroke firmly believes that sugary drinks of any sort, including 100% fruit juice, should not be included in dietary recommendations to Canadians. They should not be considered alternatives to fruit. Sugary drinks have little to no health benefits but many health risks. The 100% fruit juice is metabolized in virtually the same way other sugary drinks are, and juice can have the same amount of or up to 33% more sugar than soda pop does. Canadians should eat their fruit, not drink it. We know that excess sugar consumption is associated with adverse health effects.
With respect to food preparation and ultra-processed foods, Heart and Stroke agrees that Canadians should be advised to limit their intake of highly processed or ready-made prepared foods. Ultra-processed foods are a major source of saturated fat, and are also high in calories, sodium, sugar, and sometimes trans fats. These all raise the risk for heart disease and stroke. Therefore, Heart and Stroke believes, it's important to have a clear definition of “processed foods”, since many foundational foods are minimally processed, such as frozen and canned unsweetened and unsalted fruits and vegetables. We need to advise Canadians that these are good foods to eat. It's important for the consumer to clearly understand which foods to limit.
With respect to food knowledge, Canadians need support and education on planning and preparing healthy meals and snacks, and we hope that the revised food guide will do this. Additionally, having the food literacy skills to make healthy selections requires a good understanding of how to read and understand nutrition facts tables. We also support the federal government's efforts to institute front-of-package labelling that provides interpretive, simple, highly visible, and easy-to-understand information about the risks of products high in sodium, sugar, and saturated fat. Evidence from other jurisdictions indicates that front-of-package labelling is a necessary step toward making it easier for Canadians to eat healthy food.
Finally, with respect to determinants of health, cultural diversity, and the environment, Heart and Stroke believes it is essential that any new or revised directive on eating habits in Canada take into account access to and availability of nutrition and food in a culturally appropriate manner. This includes acknowledging the importance of food sovereignty and reflecting cultural preferences and food traditions. As Health Canada works to develop the indigenous food guide, which, it is our understanding, will be tailored to include traditional and country foods, and will be translated into a host of indigenous languages, we strongly urge that the department work towards releasing both food guides simultaneously if possible. We also recommend that this committee hear from indigenous-led organizations about the progress of that document. Furthermore, in terms of the overall process, we also encourage Health Canada to publicly articulate their proposed schedule for releasing the various components of the revised food guide, and to ensure that the tools for Canadian consumers and the direction for health professionals be released concurrently.
To conclude, consistent with our participation in the consultative process, Heart and Stroke supports the healthy eating strategy, including a robust updated food guide, front-of-package nutrition labelling, trans fat regulations, and restrictions on the marketing of unhealthy foods and beverages to kids in Canada. This strategy will help to reduce the number of heart attacks and strokes in Canada.
Thank you very much for taking the time to listen to our input today. I welcome your questions.
Thank you for the opportunity to speak to you today about Canada's food guide, and respond to any questions that might assist you in your study.
My name is Joanne Lewis. I am a registered dietitian and the director of nutrition and healthy eating for Diabetes Canada.
Diabetes Canada is a national health charity representing the 11 million Canadians living with diabetes or prediabetes. A number of people at this table are already very well acquainted with the work of our organization and are diabetes champions themselves on the Hill and in their communities back in their constituencies.
On behalf of all Canadians affected by diabetes or prediabetes, I'd like to thank all of you for your hard work and devotion to our cause, and for inviting me to be here today. We are so grateful for your support in helping us achieve our mandate to end diabetes. In particular, we wish to acknowledge the commitment of Sonia Sidhu, who is part of this committee and is also the chair of our all-party diabetes caucus.
About one in three Canadians is living with diabetes or prediabetes. It is an astounding statistic. There is a new diabetes diagnosis being delivered to someone every three minutes. Globally, Canada's diabetes rate is among the highest in OECD countries. Our growing, aging, and ethnically-diverse population, high levels of overweight, and an increase in sedentary living have contributed to an over 50% increase in diabetes prevalence within the last 10 years. Ninety per cent of people with diabetes have type 2. Once a disease of older individuals, type 2 diabetes is now being diagnosed in Canadians at a younger age, impacting people in the prime of life. The rate of diabetes is projected to continue to rise over the next decade. It is estimated that close to 13 million Canadians will have diabetes or prediabetes in 2027, at a direct cost to the health care system of $4.6 billion.
You have all heard of diabetes. It is well known but it is not known well. Few people fully realize the devastating consequences that this progressive illness can have on the health, mind, family, and pocketbook of those afflicted. Diabetes contributes to 30% of strokes, 40% of heart attacks, 50% of kidney failure requiring dialysis, and 70% of non-traumatic limb amputation. It is also the leading cause of vision loss and blindness. Furthermore, people with diabetes are at much greater risk of depression and other mental health challenges compared to the general population. It is a disease that people live with 24 hours a day, seven days a week, 365 days a year, with no breaks. Medication, equipment, devices and supplies required to treat diabetes can cost people thousands of dollars annually. The personal and economic toll is enormous.
Prediabetes is a condition that is equally not known well. Those with prediabetes have abnormally elevated blood sugars that are not sufficiently high to constitute a diagnosis of diabetes. With lifestyle changes and modest weight reduction, half of the people with prediabetes can re-establish normal blood sugar levels and stave off diabetes.
We know that regular physical activity is extremely important for chronic disease prevention and good health. However, to tackle the obesity and diabetes epidemics, we really must address our food and beverage intake and options in a serious way. Now more than ever Canadians need guidance to make healthy choices that will help to reduce the prevalence and burden of chronic disease in this country.
In October 2016, Health Canada launched its healthy eating strategy. As part of this initiative, it undertook to revise Canada's food guide. Leading Canadian and international experts in nutrition, medicine, public health, and policy advised on the proposed new food guide, and developed population-level healthy eating principles that are based on rigorous scientific research. Diabetes Canada applauds Health Canada's efforts in this process. We endorse broad, meaningful stakeholder engagement in policy-making, and feel that consultations on the food guide to date have been extensive and inclusive of professionals, scientists, the private sector, and the Canadian public generally. As powerful a tool as it is, the food guide in isolation is not enough to turn the tide on diabetes and chronic disease in Canada. This is why Diabetes Canada supports the healthy eating strategy, a multi-pronged approach to safeguard the health of Canadians.
More informative front-of-package labelling, an easier to use and understand nutrition facts table on food and beverages, restrictions on the marketing of unhealthy items to children and youth, and the elimination of industrially produced trans fats from the Canadian food supply, alongside the food guide, will help make the healthy choice the easy choice, and will slowly start to change the food environment in our country.
The healthy eating strategy, including the food guide, must be directed to the population to reorient our society toward good health. People will always have the individual freedom to make decisions within the framework of their personal context. To see the bold results we so desperately need when it comes to improving the health of Canadians, change is needed and a population approach is required to facilitate this change.
People with diabetes or prediabetes and those at high risk have a large stake in the food environment and healthy eating. Diabetes Canada has developed and disseminated clinical practice guidelines for the prevention and management of diabetes in Canada since 1992. This includes nutrition recommendations. The most recent guidelines say:
|| In general, people with diabetes should follow the healthy diet recommended for the general population in Eating Well with Canada's Food Guide. This involves consuming a variety of foods from the 4 food groups (vegetables and fruits; grain products; milk and alternatives; meat and alternatives), with an emphasis on foods that are low in energy density and high in volume to optimize satiety and discourage overconsumption. This diet may help a person attain and maintain a healthy body weight while ensuring an adequate intake of carbohydrate (CHO), fibre, fat and essential fatty acids, protein, vitamins and minerals.
A balanced diet is good for Canadians and good for people with diabetes. The emphasis in the new food guide on whole foods consumption is one our organization strongly supports. The food guide recommends a regular intake of vegetables, fruits, and whole grains. Many of these foods are good sources of dietary fibre and have a low glycemic index. Studies have shown a diet that includes fibre-rich, low-glycemic index foods can help improve blood sugar control and may decrease cardiovascular risk, which is high among people with diabetes and prediabetes.
The food guide supports intake of legumes and nuts. Regular consumption of these foods is associated with lower fasting blood glucose and hemoglobin A1c in people with and without diabetes, and improvements to blood lipids in those with diabetes. Lean meat, eggs, and dairy products are healthy items that can absolutely be included as part of a balanced diet as per the food guide.
Diabetes Canada supports the recommendation to limit saturated fat and aim to consume unsaturated dietary fats. For people living with diabetes who are two to three times more predisposed to developing coronary artery disease, restricting saturated fat can help to mitigate this risk. Sodium, sugar, and saturated fat are nutrients of public concern. Diabetes Canada is strongly in favour of a reduced consumption of these in the Canadian diet. Eating patterns that feature foods low in sodium, sugar, and saturated fat have been associated with lower blood pressure, fasting blood glucose, weight and waist circumference, and unhealthy blood cholesterol in people with diabetes, compared to other eating patterns. Aiming for whole food, cooking at home more, and limiting intake of processed food will help Canadians to limit nutrients of concern.
Healthy hydration is extremely important to Diabetes Canada. Sugary beverages represent the single greatest contributor of sugar in the Canadian diet and provide little to no nutritional value. Over the next 25 years, sugary drinks in Canada will be responsible for 300,000 cases of obesity, a million cases of diabetes, 300,000 cases of heart disease, 100,000 cases of cancer, 63,000 strokes, and $50 billion in health care costs. Diabetes Canada encourages water as the beverage of choice, and we are very pleased that Health Canada is also promoting this through the food guide.
Diabetes Canada recognizes that enhanced knowledge and skills are needed to navigate the complex food environment. We are pleased the food guide will encourage Canadians to select nutritious food when shopping and eating, plan and prepare healthy meals and snacks, and share meals with family and friends whenever possible.
In order for Canadians to be able to apply the food guide principles in their everyday lives, they require supports, resources, and infrastructure. Diabetes Canada wishes to ensure that there are systems in place to facilitate uptake of the food guide. To this end, we propose the following to the Government of Canada: ensure that the food guide and Agriculture and Agri-Food Canada's food policy for all complement one another; continue to partner with all levels of government to reduce the burden of food insecurity on Canadian households; work with the provinces and municipalities to increase the availability of clean, safe, free drinking water in homes and public spaces across the country.
In conclusion, Diabetes Canada is supportive of the direction Canada's food guide is taking. As part of an integrated strategy, it has real potential to transform our obesogenic, disease-promoting environment and positively impact the eating decisions of Canadians, significantly influencing their heath trajectory. Imagine a Canada with less chronic disease, fewer health care costs, and a more productive society. That is within our reach. Diabetes Canada looks forward to continuing to work with Health Canada to promote healthy eating and improve the health and quality of life for all.
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.
I'll take that. Dr. Lamarche might want to add more later.
As a dietitian, products like Ensure, Boost, and other similar products—Glucerna—have been pretty much reserved for people who are unable to eat whole foods. In the past, they were reserved for individuals who were just not well enough to consume whole foods on a regular basis. They were supplementary calories or a meal replacement for somebody who is elderly and unable to consume whole food. In recent years, they've taken on a whole new direction, with the understanding, or misunderstanding, that it's just as good as having a whole food breakfast or a whole food snack. I certainly would not suggest that it's a great alternative.
I'm guilty as charged. Once in a while, if I don't have time to plan something for breakfast, I'll grab one and go. I think that's fine. It's when these things become the norm, that's absolutely not recommended.
Certainly when you look at food, it is more than just a bunch of nutrients. It's a bunch of nutrients put together in some kind of cohesive format. When you isolate those nutrients and put them in a beverage—amino acids, various carbohydrates, whatever it is—you're losing something. If a whole food is healthy—the sum of its parts—and you take it out and you put into a liquid, is it still healthy? I don't think we have evidence to prove that it is as healthy.
I think we've seen various scientific research that has showed us that when you pull something out of the food and you give it in a capsule.... Is it going to have the same health outcomes? No, because that something was part of a bigger something, and it's all those things working together that make it a healthy food.
I want to thank the witnesses, whose testimony was rather eloquent.
I am the critic and phantom minister for agriculture and agri-food. We can all agree that the agriculture and agri-food industry plays a major role in the Canadian diet. Unlike money, which doesn't grow on trees, food grows in fields. Agricultural products have to be looked after and processed.
Mr. Arango, I liked one of your comments. You said you wished food manufacturers would innovate. You are sure that those people should have a say in the development of the new food guide. They can actually help contribute to improving the Canadian diet.
Ms. Lewis, although I am getting a bit off topic, I want to thank you, as well as the other Diabetes Canada representatives, for the important work you have done with the opposition parties on the tax credits for people with type 1 diabetes. Together, we have managed to have the government listen to reason. Today, hundreds of people are very happy with the work we have done together.
I want to thank the government for changing its position in this case. It is a good thing that the Liberals have recognized that a step in the wrong direction was made.
Mr. Lamarche, I will give you an opportunity to speak a little French. I am sure it will be good for you. During your presentation, you mentioned science several times. I got the impression that, in your opinion, a number of other elements should be taken into account before the next food guide is developed and distributed. Am I wrong?
I completely agree with you, Mr. Lamarche. That is why I am here today.
People have done a lot of work and research on nutrition, food and food processing. Those people are agri-food industry stakeholders and farmers. Institutes for research on agriculture have conducted clear research. There has been a tremendous amount of research on food. Unfortunately, from what I see, the Standing Committee on Health has planned two meetings to discuss Canada's Food Guide. However, there aren't any witnesses from the agri-food industry or the agricultural sector. To me, that's unbelievable.
The Conservative Party of Canada is very close to the rural world, and it believes that food should come from Canada's regions. We think that those people have a say in this study. We would have really liked to hear their testimony and their explanations on how they process food and what the level of research on food processing is. We would have liked to know where we are headed. I think all those people want what is best for Canadians.
For example, we talked about juice. Is it a matter of quantity or is juice itself bad? People could have come to explain what stage the research in this area is at. That is why, Mr. Chair, I will move the following motion:
||That, pursuant to Standing Order 108(2), the Standing Committee on Health extend its study on Canada's Food Guide, and hear specifically from agriculture and agri-food stakeholders; and that the Committee report its findings to the House prior to the release of Part 1 of the new dietary guidance policy report.
Mr. Chair, I will let you distribute the motion. If I may, I will explain why I have put it forward.
I hope the witnesses understand that I have to make this extremely important presentation. It is not only for agriculture and agri-food sectors, but also for Canadians who expect the next food guide to contain all the information and take into account all the scientific data at their disposal, including data from the very sector that ensures that we have food to put on our plate and eat every week. Perhaps we could learn from those companies what efforts are being made in this direction.
Mr. Chair, the Standing Committee on Agriculture and Agri-Food, of which I am a member, has studied the food policy. A report was tabled last week in the House of Commons. I would like to talk to you about an element of that report that seems very relevant to me. By the way, the report was adopted unanimously by the committee members. The Liberals, the New Democrats and the Conservatives agreed on the entire report and on some of the recommendations.
The recommendation I want to discuss is about building bridges between producers and consumers. In food policy, it is important for people to know what they are eating, where it comes from and why they are eating it. In our study, witnesses pointed out that there was a great divide between producers and consumers because consumers are often unaware of how food is produced. We believe that public confidence is one of the priority principles of the agriculture and agri-food sector. In the report, we highlight the fact that farmers are proactive in this area. They organize visits to their farms and invite Canadians to meet with them to better understand how they produce food. The executive director of the Canadian Association of Fairs and Exhibits said that agricultural fairs are the ideal meeting place for the agricultural community and people from the city who want to know and understand where their food comes from. That is crucial.
You were talking about the Mediterranean diet earlier. I have visited Mediterranean countries, where I saw that people eat a lot of cheese. If there is one place where people eat a lot of cheese, it is around the Mediterranean. However, I did not see many obesity problems in the places I visited over there.
People don't have to go very far, since producers are close to markets. Consumers can talk to producers daily. That closeness to producers does not exist here, and I think it would be important to create it.
According to a number of witnesses who have participated in our study, education is key in food policy to building those kinds of relationships between producers and consumers. According to some, the food policy can provide an opportunity to refute various myths on modern agriculture and promote the sector as a producer of food in a responsible and environmental friendly way that also focuses on animal welfare.
I have actually been told that those concerns were taken into account when the food guide was developed. The guide is about the health Canadians, but it wants to take their impact on the environment into account. So it would be important for producers to come tell the committee members how hard they have been working, for years, to minimize the impact of their production on the environment.
Allow me to read a quote:
||If designed and implemented properly, Canada's food policy has an opportunity to bridge the gap between the Canadian public and modern Canadian agriculture. As an industry, we understand that building public trust is very important, and that we need to reconnect with consumers and the public. This initiative has the potential to bring the public and farmers and ranchers together to find shared values in Canada's food and agricultural systems.
That statement was made by Dan Darling, President of the Canadian Cattlemen's Association.
Why don't the members of this committee want Mr. Darling to come talk to them about the efforts those people are making to build bridges with Canadians and to understand their tendencies?
Canadians want to eat better, and ranchers know that. If they want to continue to sell their products, they have to adapt. I would have liked for the committee members to take a few minutes to hear from the representatives of the Canadian Cattlemen's Association.
The food guide also talks about labelling. That is causing a lot of concern in the industry among retailers and dairy producers because they don't know what will be put forward. However, Mr. Arango told us earlier that people wanted very specific facts and figures to know what they are eating. I think that all producers and other stakeholders from the agri-food sector agree on that. They want to avoid disincentives that may lead to people being just as afraid of consuming a food product as of buying a cleaning product. This is a source of concern. I believe that those people would have wanted to come share their position on labelling.
Mr. Arango's foundation is working very hard with retailers to find a balance. That would make it possible to provide people with information on what they are eating and to prevent heart disease. Unfortunately, this committee does not seem to be interested in people from the agri-food industry explaining to them the consequences poor labelling may have on consumer choice. I would have liked those people to come explain to you that consumers' choices that are meant to be informed are not really informed
Mr. Lamarche, who is a research chair in nutrition at the Université Laval, told us earlier that, if we were not careful, some products would not be labelled correctly and they could be more harmful to health than some labelled products because they contain natural sugar. So that is a major issue.
I think it would be important for the committee and you, Mr. Chair, to give those people an opportunity to share their opinion on those issues.
The recommendation of the Standing Committee on Agriculture and Agri-Food reads as follows:
||The Committee recommends that the new food guide be informed by the food policy and include peer-reviewed, scientific evidence and that the Government work with the agriculture and agri-food sector to endure alignment and competitiveness for domestic industries.
It's simple. Another House of Commons committee, made up of Liberals, Conservatives and New Democrats adopted this recommendation unanimously. No one was against it. All the Liberals accepted it. The report was tabled and has been well received.
Since the food guide is related to health, I sincerely believe that its consideration is the responsibility of the Standing Committee on Health, which could follow up on that recommendation with the Standing Committee on Agriculture and Agri-Food.
As I already said, I am moving this motion today to give producers, ranchers and dairy farmers an opportunity to be heard.
How much time do I have?
Voices: Oh, oh!
Dr. Benoît Lamarche: I'll try to answer the first one quickly.
I think the front-of-pack approach—it's been mentioned previously—is efficient. However, I've mentioned that we have some reservations regarding the sugar target, which is total sugar. Of course, this may change the behaviour of people, but it has an impact on industry as well. Industry will react to these labels and try to get below the target, of course, and not have the warning signs on their product.
The question then becomes, is this the right number? Are we safe with 15 grams or 15% daily...? For me, the science is not that strong behind that actual number. We can debate that all day, but I have some concerns regarding the total sugar target, as opposed to the added sugar target.
Regarding inequities in socio-economic status, I'm a strong proponent of getting access to healthy foods as a more efficient way to improve the health status of Canadians. Communication and education are going to work, but access is key. If we don't give people access to healthy food, it's going to have very little effect, irrespective of how we communicate.
At the risk of sounding redundant or repetitive, I think it's going to take a multipronged approach. My understanding is that the largest consumers of sugar-sweetened beverages are teenage youth, and the major purchaser of sugar-sweetened beverages to bring them in the home is the parents. It's going to take a combination of education modalities to reach the various target groups with respect to sugar-sweetened beverages, reducing the intake of that and increasing the intake of healthier foods.
One thing I've learned in my practice is that everybody is motivated by something different, so there won't be a one-size-fits-all. People don't change behaviour all based on the exact same information or reason to change behaviour. I think it's up to the school system, the parents, the communities, or the Internet, wherever the various populations are, to get those messages out there.
I have to give kudos to the SodaStream company. They have a commercial—you've probably seen it—where they're standing outside drinking sugar-sweetened soda as though it's the smoke break and everybody's outside smoking, and then they have to go in. One woman says, “I've been trying to kick the habit”, and the habit she's been trying to kick is drinking sugar-sweetened beverages. I really think that for that message to be strong enough, we almost have to treat it like smoking. To be caught with soda in your grocery cart.... You almost want to cover it with your other groceries so people don't know you're buying soda.
I'm always amazed.... I'll tell you this secretly. I take secret pictures of people's shopping carts when soda is on sale, and the stacks of soda cans in a cart.... It's still very acceptable to buy it in large quantities, especially if it's on sale. The message isn't out there yet; this is still happening. I think the only way we're going to get that message out is to treat sugar-sweetened beverages, especially the regularly sweetened sodas, as though it's smoking, something you would be embarrassed to be doing.
Thank you for mentioning glycemic index.
Diabetes Canada has been a supporter and proponent of the glycemic index for a number of years. The reason for that is when people consume a diet with a lower glycemic index.... For those of you who may not be aware, glycemic index measures or ranks foods according to how high blood sugar is raised after consuming those foods or beverages. Foods with a low glycemic index take a much longer time to raise blood sugar. Foods with a high glycemic index raise blood sugar levels immediately, so that would be the difference between having lentils, which are low glycemic index, versus pure sugar or glucose, which has a high glycemic index.
The impact of consuming a more low glycemic index diet is that the outcomes of studies have shown that people have a much quicker sense of satiety, so they tend to eat less. It contributes to lower incidence of cardiovascular disease, and it can help people to lose weight. Much to our benefit at Diabetes Canada, it can help to prevent diabetes.
We would love Canadians to have more foods with a low glycemic index. Right now, it's very difficult for Canadians to identify foods that are low glycemic index, because it's not written anywhere on the package, and it's very hard to find a list of which foods are low glycemic index.
In a culture where we are demonizing carbohydrates, and people are talking about no carbs and low carbs, and “I don't eat carbs after 4 p.m.”, we need to look for alternatives that are what we call healthy carbs or quality carbs, because they are a great source of energy as well as fibre. Having more of the right carbs is really the direction we should be going in as opposed to telling people to eat no carbs or fewer carbs.
Yes, the glycemic index was invented in Canada, so we have to be proud of the Canadian researchers who invented it, David Jenkins and his team, and Tom Wolever.
I think the issue in the field with the glycemic index, as good as it may be, is an issue of using it. As mentioned, this is hard, because we don't have this information. At the end of the day, if you consume whole-grain products, you're leaning towards low glycemic index products. If you consume vegetables, you're leaning towards low glycemic index products. If you look at the Mediterranean diet and at the DASH diet, they generally have a low glycemic index, so it's another way to look at a healthy diet.
It's extremely useful, I think, for the management of type 2 diabetes, but from a practical perspective, since we don't have this information, it's really hard for the public to use it if we don't have the information on a product.
We could argue whether it's a good strategy from a public health perspective. We understand a lot about food because of this discovery, but from a public health perspective, are we ready to change the whole landscape of labelling and so on to provide information on this? For me, that's a big question.