In 2019, the Canadian Food Guide sent shock waves across the nation when the Canadian government published its latest version. After Income Tax forms, the Food Guide is the most downloaded form on our government's website and our most recent version has been met with lots of controversy and push back.
"How could a Food Guide be controversial?" you might ask. Well, for one, this document is consulted by millions of people, all of which are on a wide spectrum of culture, education, goals, nutritional literacy, cooking skills and financial security. Producing a document that is made to be relevant to such a wide variety of citizens is no easy task. Some might ask if Food Guides are relevant at all. In my humble opinion, I believe they most definitely are! National Food Guides are necessary to set national standards for nutritional programs across the country. Schools or hospitals need clear guidance on how to appropriately feed those who use their services in order to avoid nutrient deficiencies and to reduce the risk of nutrition related diseases. The general public, and healthcare professionals, also need clear evidence-based recommendations about what a healthy and balanced diet should look like.
In order to be relevant, a national Food Guide should promote evidence-based dietary patterns proven to prevent nutritional deficiencies and chronic diseases. It should be free of industry influence, easy to read, easy to understand and be easily accessible by the majority of the population. Also, healthcare providers should quickly be made aware of any new updates and content in order to spread them across their profession as well as to their clients or patients. In 2019, when the latest version of the Canadian Food Guide came out, I was surprised to see that my medical colleagues had not been informed about the updates. Since I was already closely following the news surrounding the new guide, I was happy to spread this information to patients and colleagues, but still disappointed that somehow the message never made it to New-Brunswick doctors. How is it that Health Canada can diffuse a newly discovered rare adverse event caused by medication to doctors across the country but forget to mention that our food guidelines have received a complete makeover? If an attempt to communicate this to local New-Brunswick doctors was made, many unfortunately didn't get the memo.
Nutritional Knowledge Versus Food Behaviors
One of the major challenges still seen with the updated food recommendations is the relative disconnect between nutritional knowledge and food behaviors. People seem to understand which foods are healthy in general, but this doesn't always translate to making good choices. The path of least resistance often leads us towards convenience and lower costs and away from whole foods. As a whole food plant-based advocate, I was thrilled to see a new simplified Food Guide containing fewer food groups and I was particularly delighted to see it based on science rather than being industry influenced. I was even happier to see the meat food group removed. Also, with estimates of 50-75% percent of the world's population being lactose intolerant, it was also a reasonable decision to favor water over milk as the beverage of choice. Something as simple as this was ground breaking and an extremely courageous move that was met with much resistance from the dairy industry. The new guide focused on consuming healthier types of fat and on plant-based sources of protein. It included recommendations for people everywhere all along the life cycle, including pregnancy. The new food guidelines are also more in line with oral health recommendations by suggesting a reduced consumption of added sugar. It also made recommendations to make food choices that were more environmentally sustainable and gave tips on how to be more eco-friendly. It even has a section warning consumers of how food marketing can affect food choices! How could anyone disagree with that?!
As mentioned before, when creating a document that will be read by millions of people, all with very different levels of nutritional education, literacy, financial security and cooking skills, you're bound to not satisfy everyone. Although the guide isn't perfect, it's a major improvement and step in the right direction. Simply trusting science, expert opinion and public consultation and leaving industry bias out of the equation was a major achievement. The latest food guide also did an amazing job at educating consumers on how to be more mindful about their food habits, like eating slowly, understanding hunger and fullness cues and cooking at home more often. I love that they made further recommendations and customized them according to age groups and even eating environments, by giving suggestions about healthy eating behaviors at school, work and at home. They even gave some consideration to how culture and food traditions affects food choices. That being said, in future versions I would definitely love to see further improvements in how the guide communicates basic cooking skills and recipes to the population. I will detail some of my suggestions in the next section!
But first, take a look at the evolution of our Canadian Food Guide from 1942 to 2007.
Space For Improvement
Firstly, simply getting new recommendations out there to the general public is not an easy task, but by taking a "top-down" approach and educating healthcare providers, doctors, dietitians, nutritionists, etc., these professionals can assist the government in spreading new food guidelines. I was disappointed to notice that most of the healthcare providers in my immediate surrounding didn't seem to be aware that a new Food Guide had even been released and this makes me wonder if healthcare professionals even discuss nutrition with their patients at all.
Studies seem to suggest that those who have a Food Guide readily accessible are more likely to consult it and then more likely to consume more fruits and vegetables. It could be reasonable to invest more into promoting the guide to the public. Creating a smart phone app, like "Dr. Greger's daily dozen", where users can check food boxes and see their nutritional requirements being met, might help motivate and better illustrate foods where people should focus more attention. An interactive food log on a smart phone could not only log the food you eat, but then make personalized and real-time recommendations and suggestions on what foods you should focus on next, in order to meet macro and micronutrient requirements. The app could give immediate feedback on which foods to favor if your fiber intake was particularly low on that day. It could then guide you towards recipes and even link videos that show you how to prepare your next meal. Almost like having your very own chef and dietitian available 24/7.
As stated earlier, there's a disconnect between food awareness and food behavior. Workbooks, videos and other resources teaching basic cooking skills are great ways to engage with consumers. Having a section on "freezer friendly" recipes might help with those looking for quick, convenient and microwavable meals and a section describing the ever growing list of food preparation tools might be useful. Air fryers, pressure cookers, food processors, blenders, etc., are all valuable tools for those looking to take their food preparation to the next level. Considering that these gadgets can get quite expensive, it could be useful to add a section where consumers can learn how to choose a good one, without breaking the bank. I do understand that this might create unwanted pressure from companies looking to have their products advertised. Learning to better navigate through marketing tactics could also be a more thoroughly detailed section in a future version of the Food Guide.
In order to help more people move towards plant-predominance, I would also like to see a section describing specific nutrients in order to educate the public about the health impacts of saturated and trans fats, as well as excessive salt and added sugar consumption. I'm a numbers and data person, and many people might benefit from knowing that when looking at 3100 different foods, researchers found plants to have an average of 64 times the levels of health promoting antioxidants than animal products. Although a random fact, it is one that might encourage more people to choose plants over animals. Excessive caloric intake, calorie density and nutrient density are concepts that could be added to future guides to provide further information and education to those who are interested in learning more about the science behind nutrition, since these concepts are all deeply connected to the current obesity epidemic and chronic disease crisis.
My Food Guide Summary
Personally, I believe that the foundation of a good Food Guide is basing it on science and minimizing industry influence. This is where the Canadian Food Guide shines. I'm sure that many others will follow suit and that more countries will do the same with their guides. Once we've normalized the fact that eating plant-based is the best way towards optimal health at a population level and the best way to ensure environmental sustainability while feeding an ever-growing population, the next step will be to educate the public on how to navigate the modern world's food environment. By implementing nutritional programs in schools, daycares and hospitals that are in line with the Canadian Food Guide, future generations will be better educated on what consists of a healthy dietary pattern. Plant-based sources of protein and healthy fats won't be as confusing. As I discussed in last week's graded discussion, reducing friction during lifestyle change is a major determinant of long term success. Finding quick and convenient ways to prepare and cook healthy plant-based meals is important, as well as spreading this information to the population through today's modern media outlets. Facebook, Instagram and YouTube, as well as smart phone apps, must be considered if we are to communicate healthy food choices to a growing population more dependent on electronic devices. For many, the simple act of going to the GOC website and downloading the Food Guide is already one step too many, and in a world of one-click purchasing, we must adapt to meet the needs and demands of our population. Personally, when scrolling through social media, I'd love to see a government sponsored add about the Canadian Food Guide instead of a ketogenic meal plan guaranteed to take pounds off your waist and years off your life. Although social media isn't for everyone, we must not ignore the fact that most people now get their news from these sources, and that we, as professionals, can also use these tools to promote evidence-based nutrition. So although the current Canadian Food Guide isn't perfect, when one takes a hard look at previous versions dating back to the second World War when nutrition guidelines were first implemented, we quickly notice that we have made considerable improvements! I'm truly proud of living in a nutritionally avant-garde country that recognizes that the foundation of health starts with the foods we put in our bodies and I'm honored to live in a country that listens to science instead of industry when making food recommendations.
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In a province with a shortage of health care providers, and a significant elderly and ailing/obese population, urgent intervention is needed to keep our residents as healthy as possible Kudos to you Dr. Cormier for pressing forward with a common sense and practical strategy for preventing, reducing and reversing so many chronic health issues. Small steps on the Canada Food Guide but at least moving forward!