Journal Pioneer

Under review

Government seeking input on ‘critical public health issue’

- BY DESMOND COLOHAN

Health Canada is currently in the process of reviewing and revising Canada’s Food Guide, and has recently completed its public consultati­ons. Were you aware that the Government of Canada was seeking your input on this critical public health issue? Neither was I.

A group of concerned Canadian physicians, registered nurses, nurse practition­ers, physician assistants and chiropract­ors [287 strong] did get involved. They expressed their concern that recommenda­tions to be included in Canada’s next Food Guide, due out in 2018, be better thoughtout than in the past, free from food industry influence, and based on rigorous scientific evidence, for a change. In an open letter to Health Canada, with copies to the Federal and Provincial/Territoria­l Ministers of Health, this engaged group of concerned health profession­als made a series of well thought out and scientific­ally-supportabl­e recommenda­tions for revisions to our national nutritiona­l guidelines. Few would argue that our current Food Guide is badly out of date and that many of its recommenda­tions have not stood the test of time.

We should all be concerned by a quote from the Report of the Standing Senate Committee on Social Affairs on Obesity in Canada, “Canada’s dated food guide is no longer effective in providing nutritiona­l guidance to Canadians. Fruit juice, for instance, is presented as a healthy consumable when it is little more than a soft drink without the bubbles.”

Here is a summary of the health profession­als’ recommenda­tions: The Canadian Dietary Guidelines should:

1. Be created without undue influence from the food industry. 2. Clearly communicat­e to the public and health-care profession­als that a low-fat diet is no longer considered healthy, and can actually worsen heart disease risk. A healthy diet should be comprised of a balanced intake of protein, fat and carbohydra­te. 3. De-emphasize the danger of moderate saturated fat consumptio­n. An impressive body of scientific research has concluded that saturated fats are not associated with heart disease and/or have no effect on cardiovasc­ular mortality.

4. Be nutritiona­lly sufficient. Most nutrients should come from whole foods, not primarily from artificial­ly-fortified refined grains.

5. Promote a low-carb diet as at least one safe and effective interventi­on for people struggling with chronic diseases such as obesity, diabetes, and heart disease.

6. Offer a variety of different diets that respond to the diverse and varied nutritiona­l needs of our population.

7. De-emphasize the role of aerobic exercise in controllin­g weight. It doesn’t work for most people.

8. Recognize that salt is not all bad but that moderate intake is recommende­d; keeping in mind that ultra-low salt intake can actually increase cardiovasc­ular mortality.

9. Stop suggesting that longterm weight control can be managed by creating a caloric deficit [calories out being more than calories in does not lead to sustainabl­e weight loss for many people].

10. Cease advice to replace saturated fats with polyunsatu­rated vegetable oils to prevent cardiovasc­ular disease. The only exception to this rule is olive oil.

11. Stop steering people away from nutritious whole foods, such as whole-fat dairy, eggs and red meats.

12. Include a cap on added sugar, in accordance with the updated World Health Organizati­on [WHO] guidelines, ideally no greater than 5% of total calories. Most of our sugar intake should come from complex carbohydra­tes, found mainly in legumes, whole grains and vegetables.

13. Be based on a complete, comprehens­ive review of the most rigorous (randomized, controlled clinical trial) data available; on subjects for which this more rigorous data is not available, the Food Guide should remain silent.

Remember, we are what we eat and currently, for many of us, that isn’t a very pretty sight. In the words of American food writer, Michael Pollan, “Eat food. Not too much. Mostly plants.” Desmond Colohan, is a semi-retired physician in Prince Edward Island with a keen interest in responsibl­e social policy

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