Thursday, October 22, 2009

Overweight Canadian kids not eating enough according to Canada's Food Guide


So yesterday I detailed the results of the Ipsos Reid based milk advertisement that concluded, surprise, that Canadians should be drinking more milk, but buried in the story is the fact that the survey determined that Canadians were not eating enough of any food group according to Canada's Food Guide.

Let me repeat that. According to the survey, Canadians don't eat as much food as the Food Guide recommends.

But wait, aren't 65% of Canadians overweight? And they're not eating as much as the Food Guide thinks they should? I wonder what would happen to the remaining 35% if suddenly they did start eating what the Food Guide recommended.

I detailed ad nauseum (really, it was nauseating how much I detailed it) how the Food Guide causes weight gain - you can read those pieces by clicking here here, and here, but interestingly this is not the first time I've noticed studies or surveys that reported Canadians don't eat enough according to the Food Guide and that if you did you'd likely gain weight.

The first time I posted on a study published out of Nova Scotia whereby the vast majority of overweight and obese children didn't meet the daily recommended number of servings from the Food Guide.

Here's the second round of data. I received an email from a loyal blog reader named Dana. She attended a lecture put on by Dr. Lise Dubois who presented data from the Quebec birth cohort showing that showing the odds ratio for overweight was 8.8 for 4.5 year old children who consumed 4 grain servings/day. and 7.1 for those consuming 1 serving of meat per day.

Yet Canada's Food Guide recommends 4.5 year olds consume 4 servings of grain per day and 1 servings of meat (thanks for the correction commenters - I had looked at the milk column).

I emailed Dr. Dubois for comment some time ago, but never heard back from her but it would seem to me that according to her data if your 4.5 year old followed the Food Guide's recommendations to consume 4 servings of grain and 1 serving of meat that their risk of obesity would be markedly increased.

Great job Health Canada!

Here's a thought - maybe Food Guides shouldn't be recommending minimum patterns of consumption in a country where it is now abnormal to have a healthy body weight and where research has shown people don't know what serving sizes are?

Just a thought.

(BTW, I checked with Ipsos Reid - the way this survey was conducted was that people reported the quantities of food consumed and then dietitians calculated the number of Food Guide servings therefore you can't make the argument that in the survey Canadians just didn't know what a serving size wise, and while I can't claim it with certainty, I'd be very surprised if Dr. Dubois' research was any different in that I'm certain she knows what a Food Guide serving represents)

St John M, Durant M, Campagna PD, Rehman LA, Thompson AM, Wadsworth LA, & Murphy RJ (2008). Overweight Nova Scotia children and youth: the roles of household income and adherence to Canada's Food Guide to Healthy Eating. Canadian journal of public health. Revue canadienne de sante publique, 99 (4), 301-6 PMID: 18767276

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Posted by Yoni Freedhoff at 5:30 AM

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13 comments:

  1. There are many foods - such as those high in fat, sugar and salt or sauces/condiments - that are not considered part of any of the 4 food groups of Canada's Food Guide. When studies talk about people not eating enough of the 4 food groups, that does not necessarily mean that they are under-eating. In fact, they very well could be over-consuming calories, and yet not meeting the minimum serving recommendations of each food group due to consumption of "other" foods that do not fit within the food groups.

    I would also be very skeptical of any self-reported data as people typically under-report consumption.
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  2. I agree with CK. Just because the studies show people aren`t eating enough servings from the food guide, doesn`t mean they aren`t overeating foods that aren`t actually on the food guide.

    People often have no idea what they are eating in a day and unfortunatly most of the foods they are eating aren`t healthy. I analyze menus for nutrition coordinators and I am often amazed at how little nutrition I see in these menus. Many Canadians have a very different understanding of what healthy eating is and how we should be eating. I often reject their menus because they simply are too high in fat, salt and sugar and contain too many foods that have no place on the food guide nor on their menus. They also often lack meal balance and do not contain proper proportions of macronutrients. Only after considerable education and reinforcement of the healthy eating guidelines do these coordinators get the message.

    I like the food guide and think that Health Canada and Registered Dietitians could do a MUCH better job of educating Canadians on how to really use it.

    Keep non food guide foods to the `choose least often` instead of daily consumption and you`ll see obesity rates change. Get back to really healthy foods with protein, healthy fats, fibre and low glycemic carbohydrates and you`ll see how your weight and body fat distribution changes. Of course that in order for this to be done, we need to demolish our obesogenic environment (just like the smoking movement did with essentially making smokers the outcasts of society) and make all these fast, unhealthy, and cheap foods much more expensive and less desireable to eat.

    There is so much more work to do!
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  3. I ran a days' worth of suggested food from the Canada Food Guide (for an adult woman, not a child) through my nutritional analysis program and came up with 3300 calories.
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  4. I agree with both Michelle Archer RD and CK. Many of the clients I see are not eating food from the four food groups rather much of their daily intake comes from the foods that are recommeded to limit. We need to educate canadians on how to use the food guide properly.
    Also, the food guide recommends that 4.5 year old children eat 1 serving of meat, not 2.
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  5. Can you people read?

    Do you think Dr. Freedhoff isn't aware of the fact Canadians eat too much of everything else? Do you think he doesn't know that it's the calories from "other" foods that are the major problem?

    What he's trying to say is that given the FACT that Canadians get up to 35% of their total daily calories from other foods and the likelihood that's not changing anytime soon, that we shouldn't have a Food Guide that tells people they should consume "minimum" amounts of anything because then stupid milk ads come out sponsored by dietitians that lead people to think that they should be adding food to their already overfilling troughs.
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  6. Even though the study can be biased it points to a big problem. Eating a lot does not necessarily mean getting right nutrition. I live in US and I see all these people eating. The food US people got used to eat, that is mainly ready to eat foods, frozen meals, extremely processed and deprived of all the "good" in food. The obesity, I believe, is equally due to eating a lot AND eating junk.
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  7. Anonymous

    I know Dr. Freedhoff can read. He is also very good at not presenting both sides or the total picture in order to elicit a strong response. That is why we post our comments!

    His statement was not that other foods are the problem but the food guide recommendations are the problem. If people would follow the food guide, they`d do just fine nutritionally. It`s often that simple.

    Julie: are you sure you inputted the correct food amounts when calculating the total calories? (common mistake by the masses is misunderstanding or misguessing a portion size) That seems awfully high to me. Off the top of my head, I`d say closer to 1500-1700 calories. That`s using nutrition estimation tools most dietitians know.

    Michelle
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  8. Hi Michelle,

    I suspect that the "top of your head" is not in fact the same as the nutrition tools you mention.

    Our dietitian used such nutrition tools to calculate Food Guide calories ages ago. You can review her calculations yourself here.

    She was easily able to put together a 3,000 calorie Food Guide day and when trying to get to your top of your head numbers found the menu to be rather bland.

    Perhaps you could share your calculations with us as well.
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  9. I have to agree with Michelle, and I would say that Dr. Freedhoff's dietician's sample calculations are based on some the poorer food choices one could make, and as such biased and not fairly representing the food guide. Some simple substitutions would dramatically decrease the caloric intake for a given day. Furthermore, one day is not a fair representation as people don't gain weight in a single day. I find it interesting that this blog only offers critique, and Dr. Freedhoff being a self proclaimed expert, never offers solutions or suggestions only criticism.
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  10. What a bunch of whiners.

    Dr. Freedhoff regularly offers solutions and suggestions.

    There is nothing "poor" in the choices of his RD's high calorie diet. Bulger, avocado, oatmeal, raisins, frozen vegetables, yogurt, cheese, V8 and figs are poor choices?

    All I see are a bunch of RDs who don't like it that he calls out RDs.
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  11. Dr. Freedhoff
    When I get some downtime, I'll be happy to recalculate using Food Guide portions and see if I was off in my calculations.

    I used the old diabetes exchanges which are almost identical to the Food Guide portions (Grains, Veg/Fruit), and adjusted for when they aren't (Meats/protein). Because diabetes educators don't use these calculations quite like we use to, the calculating was off the top of my head.

    Love your blog even if I don't always agree!
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  12. Thanks for the kind words Michelle, and indeed, there's no need for everyone to always agree.

    That said, I'm always perplexed by how angry some RDs get with me. Our RD is invaluable to our office and a good RD is a fantastic resource.

    Corporate RDs are a whole different breed but I'd bet that there are probably some great ones out there - unfortunately the ones that tend to get the media's attention are the ones willing to say anything.

    I also get perplexed when RDs take issue with my stances on the Food Guide. I'd be willing to wager that most RDs out there will counsel their patients to preferentially choose whole grains while simultaneously minimizing refined, minimize red meat and if possible eliminate processed meat, avoid trans fats, and increase nuts, legumes and fish. The reason most RDs'll do that is because that's what the nutritional evidence suggests we should do. The thing is, the Food Guide doesn't make any of those recommendations. How can RDs and DC defend a document that from the get go fails to make some of the most basic evidence-based recommendations to the public?

    Calorie wise, when you calculate Food Guide calories I'd recommend not using old references. As I detailed in one of the links above (the first one I believe that refered to the Food Guide and obesity), food has had a tendency to grow over the years and the older databases underestimate calories.

    Better still, use actual food labels - that's what we did.

    Yoni
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  13. I would love to see you do a "supersize me" - like movie with the Canada Food Guide.
    ReplyDelete

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