Title: Canadas Food Guide Promoting Health or Protecting Wealth
1Canadas Food Guide --Promoting Health or
Protecting Wealth?
- Bill Jeffery, National Coordinator
- Centre for Science in the Public Interest
- at
- Think Again
- A conference sponsored by the
- Canada Millennium Scholarship Foundation
- Parliament Hill, Ottawa
- September 16, 2005
2About the Centre for Science in the Public
Interest (CSPI)
- Is an independent health advocacy organization
focussing on nutrition policy issues. - Has offices in Ottawa and Washington, with
Canadian staff based mostly in Toronto and
Ottawa. - Is funded in Canada by over 100,000 subscribers
to the Canadian edition of the Nutrition Action
Healthletter. - Does not accept funding from industry or
government. - Coordinates a coalition of two dozen non-profit
groups collectively representing 2 million
Canadian citizens and health professionals. - Founded the International Association of Consumer
Food Organizations (IACFO), an officially
recognized observer at the WHO/FAO Codex
Alimentarius Commission, and two other global
consumer protection alliances. - A summary of our public policy recommendations
to improve diet (and increase physical activity)
-- such as shifting sales taxes from nutritious
to junk foods, prohibiting advertising to
children, improving nutrition labelling on
restaurant menus and prepackaged food labels, and
including preventative nutrition counselling
under medicare -- can be found at
http//cspinet.org/canada/pdf/PanCdn_EffectiveStra
t.pdf
3My goals, this morning
- 1. Underscore that the Food Guide is a key
staging ground for conflict between public health
and the commercial interests of, primarily, the
food industry. - 2. Summarize some evidence establishing the
importance of nutrition for health and economic
well-being. - 3. Discuss the implications for CFG of an expert
report of the World Health Organisation. - 4. Canvass CSPIs recommendations for reforming
Canadas Food Guide (CFG). - 5. Make some observations about the vulnerability
of the CFG review process to those vested
interests. - 6. Consider whether the 1992 Canadas Food Guide
actually helped cause, not prevent, rising
obesity rates. - 7. Make recommendations for fixing the advisory
committee process.
4 - 1. Amending Canadas Food Guide is extremely
contentious.
5Advice in Canadas Food Guide has implications
for most of an agri-food industry with financial
interests in 100 billion in annual sales.
- In an undated 2004 memo (Memo ref. 04-10-18-26-9)
to the Minister, Health Canada officials stated
6Recommended reading for biological, social and
political scientists as well as citizens and
eatersMarion Nestle, Food Politics, (Los
Angeles U. of Calif., 2003)
- Managing Editor, 1986-88 of the US Surgeon
Generals Report on Nutrition and Health - Professor of Nutrition at New York University
7As Professor Nestle put it
- Food companies are not health or social service
agencies, and nutrition becomes a factor in
corporate thinking only when it can help sell
foodMy first day on the job to edit the US
Surgeon Generals Report on Nutrition and
Health, I was given the rules No matter what
the research indicated, the report could not
recommend eat less meat as a way to reduce
saturated fat, nor could it suggest restrictions
on intake of any other category of foodAgency
officials had learned to avoid such interference
by resorting to euphemisms, focusing on nutrients
rather than foods that contain them, and giving a
positive spin to any restrictive advice about
food. (Nestle2-3)
8For a brief account of food industry
practices, see the alternate food guide (pyramid)
prepared by Dr. Walter Willett, Professor of
Epidemiology and Nutrition, Harvard School of
Public Health. http//www.hsph.harvard.edu/nutriti
onsource/Printer20Friendly/Food20Pyramids.pdf
9 - 2. Nutrition is very important for health and
economic well-being.
10Canadian annual costs of diet-related disease
- An average of nearly 5 years of healthy life
expectancy is lost due to six diet-related risk
factors. (See World Health Organization, The
World Health Report 2002, (Geneva WHO, 2002).
Esp. see Table 4 in the annex which shows that
loss of healthy life expectancy due to all risk
factors is 9.4 disability-adjusted-life-years
averaged for Canadian men and women at
http//www.who.int/whr/2002/en/whr2002_annex4.pdf)
and Table 10 which shows that, in developed
countries, 50 of all-risk-attributable
Disability-Adjusted Life Years (DALYs) were lost
due to blood pressure, cholesterol, overweight,
low fruit and vegetable intake, and certain rare
types of childhood and maternal undernutrition at
http//www.who.int/whr/2002/en/whr2002_annex9_10.p
df). So, 50 of 9.4 years is 4.7 years.) - More than 25,000 premature deaths annually are
caused by diet-related disease. (See, for
example, the extrapolation from published figures
in endnote 11 at http//cspinet.org/canada/pdf/En
g_CSPI_Finance.pdf) - A total of 6.6 billion per year from the
Canadian economy as a whole (health care costs
plus lost productivity) (See Diane Gorman,
Assistant Deputy Minister of Health, Speech at
the Stakeholder Meeting on the Review of Canadas
Food Guide to Healthy Eating, (Ottawa Health
Products and Food Branch, Health Canada, January
20, 2004) at 3 estimating the value of health
care costs and lost productivity due to
diet-related disease to be 6.6 billion annually
in Canada. Available on the Internet at
http//www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgps
a/pdf/food-guide-aliment/pres_speech_adm-pres_cont
exte_sma_e.pdf and see Health Canada (2003)
Economic Research Analysis Section, Policy
Research Division, Strategic Policy Directorate,
Population and Public Health Branch. Custom
tabulations).
11The de facto nutrition education in Canada
- Over 720 million was spent to advertise
restaurants, food and alcohol in 1998. (McElgunn
J. Canada's top 25 advertising categories.
Marketing Magazine September 27, 199944.) - The average Canadian child sees 350,000 TV
commercials before graduating from high school,
spends nearly as much time watching TV as
attending classes. - Whats on the menu? nutritional weaklings like
soft drinks, sugary cereals, candy, french fries,
fast food, condiments, and activity-limiting
products such as video games, movies, and
television shows. - In a 1991 survey of programming, less than 9 of
food ads were for dairy, fruits and vegetables
(excluding french fries) (Østbye T, Pomerleau J,
et al. Food and Nutrition in Canadian Prime
Time Television Commercials. Canadian Journal of
Public Health 84(6) 370-74.)
12 - 3. The World Health Organisation published an
expert report - with important implications for Canadas Food
Guide.
13Report of the Joint World Health
Organization/Food and Agriculture Organization
Expert Consultation on Diet, Nutrition, and the
Prevention of Chronic Diseases, (Tech. Rpt.
916)(WHO Geneva, 2003) available at
http//whqlibdoc.who.int/trs/WHO_TRS_916.pdf
14Foods with demonstrated effects on health
- Protective Effects fruits, vegetables, whole
grain cereals, non-starch polysaccharides (from
whole grains, fruits and vegetables), legumes,
fish, fish oils, unsalted nuts (in moderation)
water (as an indicator of energy density) and - Causative Effects free sugars, preserved and red
meat, salt preserved foods salt (as distinct
from sodium), hydrogenated oils, Chinese-style
salted fish. - This is important because
- people eat foods, not nutrients (cf. Dietary
Reference Intake reports), and - many of the health benefits of certain types of
foods are not yet definitively attributable to
well-known nutrients (e.g., fruits and
vegetables). - ...But also controversial because singling out
foods for reduction or elimination is effective
advice and decidedly bad for the business of
affected companies.
15Put yet another way, by the WHO/FAO Technical
Report No. 916...
16Contribution of Macronutrients and Alcohol to
Apparent per Capita Energy Consumption(Adapted
from a slide on the Health Canada web-site with
information from elsewhere on the HC and WHO
sites)
17 - 4. These are CSPIs three key recommendations
- for reforming Canadas Food Guide.
18First, dont counsel over-eating.
- Reconsider the significant 1992 increases in the
numbers of servings for all food groups, - except vegetables and fruit. (see discussion
below).
19Second, revise food group titles to reflect and
reinforce dietary goals, not industry commercial
objectives.
20Third, make dietary guidance in the Canadian
Guidelines to Healthy Eating clear and specific.
21 - 5. Protecting the review of Canadas Food Guide
- from the influence of vested interests?
22The first step in forming the expert advisory
committee was
- Health Canada contracted the former C.E.O of the
National Institute of Nutrition, a body whose
members consisted of large food companies, and
which recently merged with the Canadian Institute
for Food Information to form to form the Canadian
Council of Food and Nutrition. - NIN patrons and benefactors were Thomas D.
Smyth, Bestfoods Canada, George Weston Limited,
Griffith Laboratories, H.J. Heinz Company of
Canada Limited, Kellogg Canada Inc., Loblaw
Companies Limited, Nestlé Canada Inc., Sobeys
Canada Inc., Redpath Industries Limited, J.M.
Schneider Inc., Unilever Canada Limited, Suzanne
Hendricks, The Canadian Salt Company Limited,
Kraft Canada Inc., Manulife Financial, Maple Leaf
Foods Inc., Parmalat Canada, Proctor and Gamble
Inc., Robinhood Multifoods Inc., Scotts
Restaurants Inc. - CCFN members are Advertising Standards Canada
(an industry association), Beef Information
Centre, California Walnut Commission, Canada
Pork, Canadian Egg Marketing Agency Canadian
Restaurant and Foodservice Association, Canadian
Salt Co. Ltd., Canadian Sugar Institute, Canadian
Turkey Marketing Agency Cantox Health Sciences
International, Chicken Farmers of Canada, Council
for Biotechnology Information, Dairy Farmers of
Canada, Fleishmann Hillard Public Relations
Canada, Freeman Mandel Associates, GCI Group,
General Mills Canada Corp., George Weston Ltd. -
home of Loblaw Co. and Weston Foods Inc., Hain
Celestial Canada, Heart and Stroke Foundation of
Canada, Kellogg Canada Inc., Kraft Canada Inc.,
Langdon Starr Ketchum, McCain Foods Canada,
Nestlé Canada Inc., Nicole Doucet Communications
Inc., Ontario Society of Nutritional
Professionals in Public Health, Pepsi - QTG
Canada, Pioneer Hi-Bred, The Art of Living Well
Catering, Wyeth Consumer Healthcare).
23And...
- All three nominations by the Ontario Society of
Nutrition Professionals in Public Health - -- perhaps the only nutrition group independent
of the food industry to file a formal nomination
directly with Health Canada -- were rejected.
24Consumer representation?
- A Health Canada official solicited input from
colleagues on a question asked by the consultant - The reply from two Health Canada officials was
- and
25Composition of 12-member Advisory Committee
(and indicia of the institutional capacity,
relevant expertise, and potential conflicts of
interest)See http//www.hc-sc.gc.ca/fn-an/food-g
uide-aliment/revision/fg_advis_com-com_cons_ga_e.h
tml
- Private Interest
- The Director of Scientific and Regulatory Affairs
of the Food and Consumer Product Manufacturers of
Canada representing 180 member companies - The President of the Vegetable Oil Industry
Council representing 85,000 oilseed growers - The Nutrition Manager of the BC Dairy Federation
-
- Public Interest Reps
- Four community dietitians for small towns
municipal governments (Dieppe, Vaudreuil-Dorion,
Prince Albert and St. Johns two have
populations of less than 15,000, and one less
than 35,000) - A professor of nutrition at one of the smallest
universities in Canada - A professor of nutrition who is an advisor to the
sugar industry - An untenured assistant professor of social
psychology (with interests in physical activity
and nutrition research) - The (general) Director of Prevention at Alberta
Cancer Board - A policy researcher with the Manitoba Government
interested in cultural aspects of food with a
bachelors degree in nutrition
26 - 6. Did 1992 CFG actually contribute to
over-eating - and rising rates of obesity?
27Canadas Food Guide (front image)1982
....1992
28Canadas Food Guide (back image)
1982.....1992
29From E. Goddard, et al., Dept. of Rural Economy,
University of Alberta, 2005 in their speech
Canadian Agricultural Policies and Health An
Example from the Meat Sectorhttp//www.coop.re.u
alberta.ca/symposium_2005/Presentations/egoddard1.
pdf.
30Changes to average number of recommended servings
by CFG food group, 1982-1992(Table prepared by
CSPI based on comparison of 1982-92 CFGs.)
31Foundation Diet vs. Total Diet
- According to Health Canada
- Predecessors to the current (1992) Food Guide
were based on a "foundation diet" approach. This
approach was replaced with a "total diet"
approach when the current Food Guide was released
in 1992. The total diet approach provides
guidance to meet nutrient recommendations across
a range of energy intakes, in contrast to the
foundation diet approach in which minimum food
intakes were suggested to provide essential
nutrients in amounts recommended. - But, the 1975 and 1982 CFGs also recommended
ranges of servings for most food groups. - Whether one accepts this explanation or not, lets
look at indications of possible consequences of
this approach at a minimum, maybe there are
better ways to corral the bricklayers and
basketball players than with ranges.
32Overall, the distribution of nutrients in the
diet did not change.
33Changing Apparent Per Capita Food Consumption,by
commodity group, 1992-2002 (Consumption of
nearly all major commodity groups increased
during the period.)Note Interpret data with
caution due to changes in data collection
introduced between the time points studied
(e.g., data collection of 'Oils and Fats')
Source Statistics Canada, Canada Food Stats
November 2003. Waste-adjusted data.
34Changes to actual consumption by CGF food group,
1992-2004(Table prepared by CSPI based on
Statistics Canada Food Disappearance data Food
Consumption in Canada, 2005 table Food Consumed
by Major Group per Person)
35 - Health Canada distributed approximately
- 24 million copies of the Guide 1992-2004.
36Could Canadas Food Guide 1992 revisions have
actually contributed to rising obesity by
promoting higher calorie intake?Note Interpret
data with caution due to changes in data
collection of 'oils and fats' introduced in 1995
Source Statistics Canada, Canada Food Stats
November 2003. Waste-adjusted data.
37 - 7. CSPI has some recommendations for re-thinking
- the advisory committee process.
38Recommendations for reform to the advisory
committee process.
- 1. TRANSPARENCY Government decisions should be
based only on stated evidence which, with rare
exceptions, should be made available to the
public. One way of assuring transparency is by
making available transcripts of committee
deliberations as House of Commons committees,
courts and numerous administrative tribunals do. - 2. CONSUMER INVOLVEMENT Representatives of
independent consumer groups should be included in
the consultation process and their input valued. - 3. CONFLICTS OF INTEREST While anyone ought to
be entitled to make transparent representations
to government about public policy, NOBODY with
significant financial conflicts of interest
(company stocks, employment, research grants,
etc.) should serve on government appointed expert
advisory bodies. It is nothing short of bizarre
that government policy requires nominees to
disclose conflicts of interest but conflicts, no
matter how great, are not (yet) barriers to
appointment, and disclosure forms are kept
confidential despite the obvious public interest
in their release. - 4. ASPIRE TO ADVANCING THE PUBLIC INTEREST, NOT
APPEASING AND COUNTER-BALANCING PRIVATE
INTERESTS Public policy reforms, like revisions
to Canadas Food Guide, should be based on the
best available evidence, and designed to further
the public interest they should not be aimed at
appeasing vested interests. When it comes to
conflicts of interest, we should expect no less
of scientific and policy advisors than we do of
MPs, Senators, judges (or any government
decision-maker), or even hockey referees, namely
demonstrable freedom from bias.
39Parting thoughts
- 1. Encourage (or form) independent health and
citizens groups to join CSPIs coalition of two
dozen health and citizens groups collectively
representing over 2 million Canadians. See
http//cspinet.org/canada/pdf/PanCdn_EffectiveStra
t.pdf for a summary of recommendations and list
of members. - 2. Subscribe to Nutrition Action Healthletter at
https//www.cspinet.org/cgi-bin/join.cgi?countryc
anada - 3. Subscribe to our grassroots action coalition,
NAHAlert, by sending an e-mail to
nahalert_at_istar.ca with join in the subject
line. - 4. Always inquire Who benefits?
40Contact info
- Bill Jeffery, L.LB., National Coordinator
- Centre for Science in the Public Interest
- Suite 4550, CTTC Bldg.
- 1125 Colonel By Drive
- Ottawa, Ontario K1S 5R1
- jefferyb_at_istar.ca
- Tel. 613-244-7337
- Fax 613-244-1559
- Website http//www.cspinet.org/canada/