Tuesday, January 22, 2019

BREAKING: Canada's New Food Guide Is Out - And It's A Giant Step Forward #CanadasFoodGuide

Though it would have been wonderful to not have had to wait 12 years for 2007's awful Food Guide's replacement, beyond how long it took, there's not much to complain about the 2019 edition and there's much to praise.

Whether it was consequent to past criticisms, or the insulation of the revision process from the food industry, or a change in leadership, or some combination of those and more factors, the 2019 Food Guide is incredibly different from all of its predecessors. Gone is dairy as its own food group (that doesn't mean the guide is recommending against dairy consumption), gone is wishy-washy language that excused refined grains, gone are explicit recommendations to consume 2 glasses of milk and 2-3 tablespoons of vegetable oils daily, gone is overarching fat-phobia, gone is juice being a fruit and vegetable equivalent, gone is the notion that sugar-sweetened milk is a health food, and gone is an antiquated nutrient-focused approach.

What do we have instead?

The new guide's primary recommendations are easy to summarize:
  • Regularly consume vegetables, fruit, whole grains, and "protein foods", where protein foods include everything from legumes, to nuts, to dairy, to meat, and where the guide suggests you consume plant-based proteins more often.
  • When you can, consume unsaturated fats instead of saturated fats (with the guide explicitly noting that there's no need to get caught up in the total fat content of your diet)
  • Make water your beverage of choice (with the guide explicitly mentioning that 100% fruit juice and sugar-sweetened milk are beverages that should be minimized)
  • Limit your consumption of processed foods and beverages that contribute excess sodium, free sugars, and/or saturated fat (the new guide recommends less than 2300mg/day of sodium and less than 10% of total daily energy intake from free sugars and saturated fats respectively)
  • Limit your consumption of alcohol
  • Plan your meals, cook more often, enjoy your food (here guide is speaking to consideration of culture and food traditions), and eat with others
  • Use food labels
  • Be aware that food marketing can influence your choices (and here I'd have preferred if they used the word "beware" which is clearly what they're getting at)
Now you may read those recommendations and wonder where the granularity is? How many servings should I have? Which foods precisely should I eat?

The thing is, we don't really have granular evidence of eat this food, not that food beyond the broad recommendations noted above. And servings wise, first off, everyone is different in terms of their needs, but more importantly, prior guides' emphases on servings were a known point of confusion - one that both the public, and health care professionals agreed should go. People don't weigh and measure their foods, and consequently, people tended to underestimate how many servings they were consuming, all the while being spurred on by the food industry to eat at least a certain number. Though it's possible that in some of the ancillary collateral published in the future (there will be a steady trickle of food guide related materials being published over the coming months), there'll be a more specific calculator, not having prescribed numbers of servings in the guide, and instead steering to a more healthful pattern of eating seems both wise and appropriate. It also allows for a much wider variety of diets with differing percentages and types of proteins, carbs, and fats (something those geared up to be furious because it doesn't espouse their particular diet over all others might want to reread).

And of course there's more than just a short document that outlines and supports those aforementioned recommendations, as also released today was the 55 page long Canada's Dietary Guidelines For Health Professionals and Policy Makers and it serves to flesh out the above and provide their rationale and evidence.

No doubt there will be complaints. Dairy champions will clearly be quite unhappy, as will those who are pushing meat and saturated fat as health foods, and my guess is, given there's strength in numbers, people upset about those two issues will likely support one another.

Here I'll simply remind you of the consensus piece on dietary fat published recently in the BMJ that concluded, with prominent low-carb researchers Drs. Ludwig and Volek's approval, that just as the new food guide recommends, "Replacement of saturated fat with naturally occurring unsaturated fats provides health benefits for the general population."

And remember too, science isn't a static set of facts, it's our best interpretation of data, and it can and does change over time. Will we see future research into the impact of saturated fat on health in individuals following low-carb-high-fat diets lead to a specific mention that on those diets it's less of a concern (or not at all)? Maybe. Maybe not. We're just not there yet.

Bottom line?

Our new food guide is a giant step forward and those responsible should be justifiably proud of themselves. Stay tuned the next few days for posts on why the food guide matters even if the majority of Canadians literally never look at it, its policy implications, and where there's room for further reform.

[Oh, and reporters who want to cover the sugar-sweetened milk angle, a reminder that Dominic Cardy, New Brunswick's Minister of Education, is your go to guy to be upset about it as just last month he asserted school based chocolate milk sales provided important calories to children, while helping to combat food insecurity and poverty, which presumably is why his government, the New Brunswick Conservatives, reversed the prior Liberal government's decision to stop its sale and provision in schools - something that clearly this food guide strongly supports]