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The Perspective
The Perspective

February 8, 2019

Three takes on Canada’s new food guide

Dr. Lennox Huang, Chief Medical Officer and Vice President, Medical and Academic Affairs, Daina Kalnins, Director of Clinical Dietetics, and Mary McAllister, Associate Chief of Nursing, sat down to give their unique perspectives on the new food guide released January 2019.

1. What do you like about Canada’s new food guide?

DK: I like the emphasis on fresh rather than processed foods and the encouragement of more plant-based foods as protein sources. In consulting with our SK dietitians, they also say that the visual of the plate is an effective and intuitive way to educate the population on portion size and variety of foods that can fit within a ‘group’. Dietitians have been using the plate model for years and many of us are pleased to see this reflected in a public health initiative.

LH: I agree that this guide is clearer than past guides. Overall, it’s definitely a step in the right direction. The importance of emphasizing water over fruit juices or flavoured milk products can’t be overstated. I particularly like how the guide promotes these kinds of healthy choices in a way that still provides flexibility for families. It also takes a more holistic approach to healthy eating by acknowledging the importance of the eating environment and how we eat rather than just what we eat.

MM: There are many things I like about the new guide including the intake of plant-based proteins as Daina said. Not only is this good for us, it also adds variety to our diet, and variety is the spice of life! Reducing our reliance on animal protein is also said to be better for the environment, something that I find very compelling and important to consider. What’s crucial is that the guide is evidence-informed. From what I’ve read, the authors reviewed and drew their recommendations from more than 100 systematic reviews and did not include food industry reports, reducing the risk of conflicts of interest.  This approach is consistent with how we as health-care professionals generate our own patient care recommendations.

DK: Absolutely. This guide better represents current nutrition evidence while giving families practical advice. The educational resources provided by the guide, such as meal planning, grocery shopping and food safety, all contributes to our food literacy, which empowers families to make healthy nutrition choices.

2. What do you think could still be improved in the new guide?

LH: The new guide provides recipes, which many families may find helpful, but a great deal of families rely on elements of pre-made ready-to-go options. Not everyone is able to cook from scratch for dinner every day. The guide could point to some healthy pre-made meal choices and examples of healthier options that are available from fast food-like restaurants. It also could have even more emphasis on healthy activity for kids. Guidelines around the recommended time for play and exercise could particularly help those families that might not be able to create homemade meals for dinner every night.

MM: I think that overall the efforts that have been made to provide recipes and principles that support healthy eating, such as shopping and budgeting tips, are admirable. However, more can still be done to enhance this information and give it higher profile in the guide, which would also address the problem that Lennox highlighted. I also think that while the new guide accommodates more cultural variation, this aspect could be further enhanced.

DK: In my opinion, there are some gaps in the guide where it comes to children less than two years of age. The guide doesn’t effectively address some important minerals required by children, such as iron and calcium, and doesn’t provide guidance on portion sizing for children in this age category. We have been taught for years about the importance of an adequate calcium intake though milk so more education needs to be provided on the different ways to meet calcium needs now that this is no longer a food group on its own.

3. Why is it so important that the food guide is kept updated?

MM: This guide has been a long time coming. It hasn’t been revised in a number of years and, as is the case with the health sciences field, the evidence is always evolving. Therefore, it’s crucial the guide is reviewed regularly and often.

DK: Diet and health are so strongly correlated. We must continue to gather good data by way of regular nutrition surveys on how and what the population is eating, and how to correct the negative habits that can impact health. We need to better understand the deterrents to healthy eating, whether it is affordability, availability, time or other factors. As one of my dietitian colleagues said to me, “science evolves and so must the food guide”.

LH: I couldn’t agree more. Evidence changes all the time and we need to stay up to date with what we know about nutrition science. Our patterns of eating also change. Canada is more diverse now than ever and it’s important to incorporate the continually increasing diversity in the foods that Canadians are eating into the guide so it’s accessible. The guide can shift the long-term health of our population through what we teach, and what we offer our children.

4. What do you think is the most important message for parents and how can they implement the new food guide in their eating habits?

DK: Incorporating food variety, less processed foods and educating their children on food preparation early is so important. A lot of my colleagues were happy to see the emphasis on eating together as a family because this is a great opportunity for parents to set examples themselves by eating heathy.

LH: Similar to what Daina said, what I’ve heard from other dieticians at SickKids is that teaching children what are “everyday” vs. “sometimes” foods is a key takeaway from the guide for parents. Excluding juice and chocolate milk are excellent examples of this. It’s also important for parents to teach their children about food marketing and how to look for healthy choices themselves as they get older.

MM: I think families do their best to integrate healthy choices, but it can be challenging given the costs of food and time restrictions that may not permit time to cook together. Parents should keep it simple and remember everything in moderation. The guide is just that – a guide – but if I were to pick out particular recommendations, I would give special consideration to the  recommendations on water vs. juice, introducing more plant sources of protein on occasion and cooking and eating together as a family, as these are all ‘recipes’ for improved health.

5. Will the new guidelines for health-care professionals change care at SickKids? If so, how?

LH: Families look to us for guidance, so especially for front line providers, familiarity with the guide means that we can help shape healthy living for our patients and families.

MM: I agree, I think that our clinicians will use the guide when teaching healthy habits with children, youth and families, for example in our Diabetes Education Centre. I know that Daina and her dietitian colleagues, along with our food services colleagues will also be paying close attention.

DK: We certainly are! I think SickKids dietitians will continue to educate patients and families on the importance of varied food choices and choosing water and milk as the beverages of choice. Now, we will likely need to increase education for families on how to achieve adequate iron and calcium intake for younger children. There could also be some changes in the food offered on the patient menu or in the cafeteria, though these efforts were already underway. The new guide represents a great opportunity for nutrition conversations for our patients and families as well as staff.