Canada's Food Guide encourages Canadians to consume a diet high in fruits and vegetable and whole grains (lots of fibre), and with a diversity of protein foods (shifting from animal to more plant-based sources). Foods with healthy fats (poly and mono unsaturates) are strongly preferred over saturated fats. We are urged to reduce our consumption of processed foods, especially those high in sugars, salt and saturated fats, and to drink water rather than sugary drinks. These recommendations are based on widespread international consensus about what diets, for most people, constitute a healthy approach (see also for a summary of key optimal daily intake recommendations from key international reports, Jeffery, 2019d). There is significant evidence that adherence to robust national healthy eating guidelines and related programming, part of a strategy to transform the food environment, can reduce diet-related risk factors and obesity (Franco-Arellano et al., 2019).
Although Canadian food consumption data is relatively weak, what we do have tells us that only a limited percentage of Canadians are actually eating this way (Nishi et al., 2018). We consume:
1. Too many calories (and too much fat) - In general, average calorie intake for young adults (both genders) is suitable if one has a high activity level. But most of us are somewhat sedentary so calorie consumption is above optimal levels. Excess calorie intake (relative to activity level) increases as we get older (scroll down to see chart 1, Garriguet, 2006; Health Canada Estimated Energy Requirements). These are average population estimates and a significant percentage of young people under 18 have notably excessive calorie intake. A big part of the problem is too much fat consumption. For middle aged adults, some 30% are consuming fat above the recommended levels (scroll down to see chart 6, Garriguet, 2006). The main contributors to excess fat consumption are meat, fats and oils, sugars, snacking and eating fast food (Garriguet, 2006). According to Moubarac et al. (2013), more than 60% of population energy consumption comes from ultra processed foods, and these foods typically carry many nutrient and health claims with significant impacts on consumer purchasing patterns (Franco-Arellano et al., 2019). The average chain sit-down restaurant meal contains over half the daily recommended calorie content, almost a full day's worth of fat and saturated fat and exceeds sodium recommendations (Scourboutakos et al., 2013). Obesity often results from excess calorie consumption and is associated with heart disease, diabetes, hypertension, arthritis, thyroid problems, asthma, back and other skeletal problems (Statistics Canada, 1999). Six in 10 adults and about one in three children are overweight or obese, largely due to unhealthy diets (Roberts et al., 2012).
2. Too few fruits and vegetables - Across all age-sex combinations, vegetable consumption is significantly below recommended levels. The problem is particularly acute in young people, with 53-71% below recommended levels (see chart 3 Garriguet, 2006). Fruit and vegetable consumption improves somewhat as we age, but about half of us do not meet the requirements.
3. Too much salt - Although there have been modest improvements the last few years, all age groups have significantly exceeded recommended salt intake for years (Garriguet, 2007). A 2017 report evaluating sodium reduction efforts highlighted that:
- 25% of Canadians live with high blood pressure
- 80% of Canadians consume too much sodium
- 93% of kids aged 4 to 8 years consume too much sodium
Some dietary experts maintain that Canada's guidelines of tolerable intake are far too high, in which case we may be consuming double what is optimal for health. The majority of salt intake for the average Canadian comes from processed foods (77%) (Sodium Working Group, 2010) and the food industry has only made modest improvements in salt levels since the Task Force report was issued. The average meal in a fast food restaurant contains almost 70% of the daily recommended level (1500 mg) (Scourboutakos and L'Abbe, 2013).
4. Too few whole grains - International reports are not always specific on optimal daily intake, and Canadian surveillance of whole grain intake is weak. We are encouraged to eat more, but without specific target ranges. Working from Global Burden of Disease data, Jeffery (2019d) estimates that if all Canadians consumed 100-150 g of whole grains daily, it would result in avoiding almost 12000 deaths.
Jeffery (2019a) working from Global Burden of Disease project data, estimates that dietary risks in Canada are responsible for some 20% of deaths, or some 49,000 deaths in 2016, as well as some 820,000 disability-adjusted life years lost. This mortality figure is 200 times the deaths associated with food poisoning, but government investments in food safety far outweigh those devoted to nutritional health.