Canadas Food Guide Promoting Health or Protecting Wealth

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Canadas 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

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About 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

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My 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.

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• 1. Amending Canadas Food Guide is extremely
  contentious.

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Advice 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

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Recommended 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

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As 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)

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For 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

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• 2. Nutrition is very important for health and
  economic well-being.

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Canadian 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).

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The 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.)

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• 3. The World Health Organisation published an
  expert report
• with important implications for Canadas Food
  Guide.

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Report 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
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Foods 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.

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Put yet another way, by the WHO/FAO Technical
Report No. 916...
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Contribution 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)
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• 4. These are CSPIs three key recommendations
• for reforming Canadas Food Guide.

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First, 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).

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Second, revise food group titles to reflect and
reinforce dietary goals, not industry commercial
objectives.
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Third, make dietary guidance in the Canadian
Guidelines to Healthy Eating clear and specific.
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• 5. Protecting the review of Canadas Food Guide
• from the influence of vested interests?

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The 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).

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And...

• 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.

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Consumer 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

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Composition 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

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• 6. Did 1992 CFG actually contribute to
  over-eating
• and rising rates of obesity?

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Canadas Food Guide (front image)1982
....1992
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Canadas Food Guide (back image)
1982.....1992
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From 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.

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Changes to average number of recommended servings
by CFG food group, 1982-1992(Table prepared by
CSPI based on comparison of 1982-92 CFGs.)
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Foundation 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.

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Overall, the distribution of nutrients in the
diet did not change.
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Changing 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.

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Changes 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)
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• Health Canada distributed approximately
• 24 million copies of the Guide 1992-2004.

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Could 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.

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• 7. CSPI has some recommendations for re-thinking
• the advisory committee process.

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Recommendations 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.

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Parting 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?

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Contact 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. [phone]
• Fax [phone]
• Website http//www.cspinet.org/canada/