Guiding Canadians Towards Healthy Eating - National Nutrition Leadership
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Table of Contents
The 1980s and the Need for Consistent
Guidelines
An Important Innovation...Two Advisory
Committees
The 1990s and a Revised Food Guide
Policy Development Continues...A Work
in Progress
A New Era Begins...
Promoting healthy and nutritious eating habits among Canadians has been
a priority in Canada over many years. As knowledge of the role of nutrition
in health has expanded, dietary advice to consumers has evolved. The long-standing
objective of prevention of nutrient deficiencies was enhanced in the 1970s
by a desire to minimize nutrition-related risk factors for the development
of chronic diseases. By the early 1990s, dietary considerations that promoted
good health and prevented disease had been integrated.
The process of nutrition policy development and adaptation has always
involved a partnership of people inside and outside the federal government.
Extensive consultations have incorporated the advice and experience of
a broad cross-section of Canadians, including provincial and community
perspectives, academics, food industry, health and nutrition professionals,
and consumers.
This report examines Canada's approach to public health policy related
to dietary guidance.
The 1980s and the Need for Consistent Guidelines
Consistent dietary messages to the public are important. During the 1980s
the unified front of consistent national nutrition guidelines began to
crumble. Individual medical researchers and health organizations had begun
issuing their own opinions and guidelines to consumers. Public confusion
resulted.
It became evident that comprehensive, coordinated nutrition policies
were needed. Demand grew for a single set of dietary guidelines, to be
adopted by health professionals, educators, governments and industry,
which would send out a clear and consistent message to consumers.
In May 1986, representatives of government, industry, professional associations
and voluntary agencies with an interest in dietary guidelines, met in
Ottawa to develop a collaborative process to revise existing nutrition
recommendations. Participants included the Canadian Cancer Society, the
Canadian Heart Foundation, the Canadian Diabetes Association, the Canadian
Dietetic Association, the Osteoporosis Society, the Hypertension Society,
the Canadian Public Health Association, the Consumers' Association of
Canada, the Grocery Products Manufacturers of Canada, Agriculture Canada,
and Health and Welfare Canada.
The participants agreed to base new recommendations on the best possible
scientific knowledge, and that the resulting advice to Canadians must
be clear and consistent.
Thus, in 1987, Health and Welfare Canada undertook a review of the system
for guiding Canadians on their food choices. The process took several
years to complete, introduced important scientific advances and improved
public consultation.
An Important Innovation...Two Advisory Committees
In a departure from past practices, the government appointed two advisory
committees, to work in parallel, yet in partnership, with each other.
The first was the Scientific Review Committee. It reviewed the 1983 Recommended
Nutrient Intakes and the 1977 Nutrition Recommendations
in order to describe the dietary pattern that would provide sufficient
nutrients for Canadians and at the same time reduce the risk of nutrition-related
chronic disease.
The second advisory committee was the Communications and Implementation
Committee. It undertook to translate the scientific findings into useable
concepts and language for the Canadian public and to recommend a comprehensive
implementation plan.
Over the next several years, this innovative process resulted in a number
of documents, containing important new concepts. These were eventually
melded into a completely modernized set of consumer guidelines for healthy
eating, a revised food guide and companion documents that expanded key
messages for specific target audiences.
After examining research evidence available on nutrition and public health,
the Scientific Review Committee issued a report in 1990 called Nutrition Recommendations. The report provided balance to two nutrition goals
that had competed in the past: an appropriate diet must deliver adequate
essential nutrients for health, and at the same time reduce the risk of
certain chronic diseases.
Thus, Nutrition Recommendations included
both updated Recommended Nutrient Intakes and a scientific description
of the characteristics of a healthy dietary pattern.
Specifically, the report recognized the role of physical activity in
controlling weight, recommended adjusting the proportion of energy consumed
as fat, saturated fat and carbohydrate, and urged reductions in sodium.
Responding to consumer issues of the day, non-nutrient components were
examined for the first time and recommendations to moderate alcohol and
caffeine consumption were included.
Meanwhile, the Communications and Implementation Committee translated
these scientific findings into understandable guidelines, and outlined
implementation strategies for action by governments, health organizations,
the food industry, the food services sector, and the general public. Their
report is entitled Action Towards Healthy Eating
(1990).
Canada's Guidelines for Healthy Eating are
key messages which translate Nutrition Recommendations
into positive, action-oriented messages for the average consumer. The
Guidelines state:
- Enjoy a variety of foods.
- Emphasize cereals, breads, other grain products, vegetables and fruits.
- Choose lower-fat dairy products, leaner meats and foods prepared with
little or no fat.
- Achieve and maintain a healthy body weight by enjoying regular physical
activity and healthy eating.
- Limit salt, alcohol and caffeine.
Giving consumers nutrition information was not enough; Canadians also
needed help to incorporate that advice into their daily lives. And, in
fact, there was evidence that certain barriers to healthier eating existed
among some sectors of society, particularly those with lower education
and income, and families headed by single parents.
The report identified an extensive list of strategies to help Canadians
adopt the new recommendations. They included encouraging the development
of multi-sectoral, community-based nutrition interventions; creating supportive
environments in schools, workplaces, restaurants and supermarkets; changing
policies and legislation where necessary; and boosting nutrition research
and surveillance. The implementation plan called on all sectors, national,
provincial and local governments, the food industry, as well as non-government
organizations and consumers to promote nutritious eating practices among
Canadians.
Three technical groups of outside experts aided the Communications and
Implementation Committee. They included the Task Group on Food Consumption,
and the Task and Technical Groups on Canada's Food Guide. These groups
reviewed Canada's Food Guide, and analysed the updated Nutrition Recommendations in light of Canadian eating habits, buying patterns,
and food production practices.
The result of these reviews is contained in the document, Action
Towards Healthy Eating: Technical Report (1990), which suggested
that Canada develop a "total diet approach" towards healthy
eating. The minimum nutrient requirements of previous "foundation
diets" were extended to include all sources of energy derived from
food. Further, a total diet approach would give consumers a better idea
of eating patterns associated with reducing the risk of developing chronic
diseases.
All this work was captured in Nutrition Recommendations:
A Call for Action, a 1990 summary report issued jointly by the
Scientific Review Committee and the Communications and Implementation
Committee. Key players, including the provinces and non-governmental agencies,
such as disease-related and health professional organizations, endorsed
these reports.
The 1990s and a Revised Food Guide
The Health Department undertook to revise Canada's Food Guide in accordance with the recommendations of its two advisory
groups. There had already been numerous revisions to the guide, first
published as Canada's Official Food Rules
in 1942 - everything from the name and stylistic presentation, to the
content and science within. Over the years, this tool to encourage Canadians
to adopt healthy eating patterns evolved to reflect improved understandings
of nutrition, as well as changing consumer tastes, preferences and values.
The food guide, a high profile element of Canada's nutrition policy,
is used by educators, health professionals, food marketers and consumers.
Modern versions are flexible and describe a broad path to healthy eating
with a limitless combination of foods.
Consumer research and extensive advice from stakeholders identified the
need for a revised food guide that was simple, positive, clear, adaptable
to individual needs, and acceptable to the public. Along with its partners
in the public and private sectors, the government established criteria
to meet these needs.
After considerable research and consultation, the newest version of the
food guide was launched in 1992.
Entitled Canada's Food Guide
to Healthy Eating,
the new guide was presented in an accessible tear-sheet format. An explanatory
document called Using the Food Guide accompanied
it. This most recent version of the guide promotes dietary diversity,
reducing total fat intake, and an active lifestyle. It also offers consumers
a pattern for establishing healthy eating habits in their daily selection
of foods.
Moreover, the guide introduces a number of new concepts. A range of servings
from the four food groups accommodates the wide range of energy needs
for different ages, body sizes, activity levels, genders and conditions
such as pregnancy and nursing. The wide range of servings in grain products,
vegetables and fruits is designed to give consumers a better idea of the
type of diet that would help reduce the risk of developing nutrition-related
chronic diseases.
In addition, the guide introduces a category of "other" foods
such as sweets, fats such as butter, and drinks like coffee, that, though
part of the diets of many Canadians, would traditionally not have been
mentioned in a food guide. The guide recommends moderation in the consumption
of these foods and acknowledges their role, along with the wide range
of servings in grains, vegetables and fruits, as a "total diet approach"
to healthy eating.
In 1992, the government also released some companion materials to ensure
the key messages were getting out. The series, Food
Guide Facts, provides background information or nutrition professionals,
health educators, home economists, communicators and others.
Policy Development Continues...A Work in Progress
The publication of Canada's Food Guide
to Healthy Eating in 1992 was accompanied by the development of a number of
supporting policies. Several related documents have since been put together,
to expand on the nutrition concepts that were shaped through the late
1980s and early 1990s, and to investigate new issues.
In particular, the government recognized the importance of providing
consumers with an environment that supports healthy eating. Whether they
are shopping for groceries, or selecting from a dining menu, consumers
need suitable information to make healthy choices.
Thus, in 1993, the government published a booklet of consumer tips entitled
Using Food Labels to Choose Foods for Healthy Eating.
Also, an intersectoral group developed policies for advertisers on how
to promote healthy eating in a document called Guidelines
for Health Information Programs Involving the Sale of Foods (1992
and 1995).
In a typically Canadian twist, the government also responded to challenges
from groups and organizations on specific aspects of its Nutrition Recommendations. When the Canadian Paediatric Society, among others,
queried the dietary recommendations on fat consumption in children, the
Society was invited to join Health Canada in researching the issue. The
result was Nutrition Recommendations Update: Dietary
Fat and Children (1993), which adjusted the recommendation of appropriate
levels of dietary fat for growing children.
Subsequently, Canada's Food Guide to Healthy Eating:
Focus on Preschoolers, (1995) was issued as a background paper
for educators and communicators. It interprets the food guide and recommendations
on dietary fat in the context of pre-schoolers.
More recently, Health Canada has sought to position nutrition in a broader
health context, which includes physical activity and a positive outlook
on life. One result of this new, more comprehensive approach was the Vitality
Leaders Kit (1994), intended to help community leaders promote
healthy eating, active living and positive self- and body-image in an
integrated way.
A New Era Begins...
The job of keeping Canada's nutrition policy and consumer guidelines
up-to-date is unlikely ever to end. New scientific research on nutrition
and health uncovers new relationships and connections between them. Tastes
in foods vary in response to prevailing fashions and shifting demographics.
Global trade exerts an influence.
With 60 years of history, the federal government knows that change and
modernization of its nutritional advice is both necessary and desirable.
But the challenge for the future, when a harmonized North American nutritional
standard becomes inevitable, will be to finesse the transition without
relinquishing those aspects of Canada's nutrition policy, and policy development
process, that are valued as uniquely Canadian.
The cornerstones of that policy have been, and will likely continue to
be, a strategic combination of Nutrition Recommendations
and Canada's Food Guide to Healthy Eating. There is a vital place
for continuing national leadership in researching, defining and communicating
an accurate and comprehensive nutrition policy for Canada.
To be effective and credible, however, the federal government must work
with partners. It must promote and adhere to a process that is grounded
in meaningful consultation with external advisers, experts and stakeholders.
The process must begin with an understanding of the needs of the Canadian
public, which demands a sensitivity and responsiveness to the community.
The hallmark of the resulting policy is that it is scientifically sound,
and gives Canadians a clear, consistent and accurate message about the
role of food in health. Partners include educators, health professionals
and a spectrum of governmental and non-governmental agencies who help
to convey the latest nutrition messages to Canadians.
New knowledge, pressures and challenges mean that just as dietary advice
is published, the cycle of revision and renewal begins again.
Indeed, the next cycle will recognize that the world has become a global
village and that the science underlying nutrition recommendations knows
no borders. An increasingly complex knowledge base on nutrients, food
and health, global trade and international agreements requires increased
efforts to work internationally.
As a first step, the National Academy of Sciences has initiated a review
with American and Canadian scientists with the aim of achieving a set
of harmonized dietary reference intakes for both countries. This opportunity
represents yet another exciting development in the evolution of guiding
Canadians towards healthy eating.
July 1997
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