Food Guide, to Where?
Do you know where your food comes from? Many people are making an effort to buy organic, look for farm-direct or local options, and educate their families about healthy choices and food origins.
And do you know what to eat? A fad-diet gurus’ best selling book, that lady at work who keeps telling you she lost 10 lbs (that same 10lbs she loses and gains again each week), and some talk show MD are frequent sources of dietary info. Surely there is a more credible place to go. Our doctors only get a few hours of nutrition in the med school curriculum. Your friendly, free local nutritionist doesn’t exist. And our government? They are concerned! They have task forces to discuss and statistics to show that the epidemic of obesity is real and it’s bad. It’s really bad. We know it.
‘Fat’ people know they are fat. Their doctors and kids are starting to nag them. None of us make the choice to maximize our waistline. Only the exception enjoys being overweight and accepts the negative health outcomes and social stigma that comes with it. If you don’t, what are you to do?
The provincial government tell us to exercise. The Feds revised the food guide, bringing it up to date and making it more culturally inclusive. But does it tell us we are fat? No. Does it tell us to eat less? Not really. Obesity experts argue that following it will only make us fatter. What?!
The new food guide continues to incorporate industry pressure and the inertia of tradition into what is potentially the only ‘reliable’ source of nutrition information that makes it into the homes of Canadians. This fabulous CBC article shares the history of the guide and how it has been developed over time. With roots in an era of malnourishment, it would be easy to understand why the current edition is so dramatically different. However, it isn’t.
Portions are confusing and probably too numerous in the grains and meats department. Unhealthy choices are not clearly and prominently condemned. I struggle to not wonder if the current guide is a recipe for failure, rather than a beacon for healthy change. If you read the article, you might be outraged at learning that the committee, bowing to industry pressure, downgraded their recommendations against unhealthy foods in a previous iteration. That bias persists.
Growing up, the iconic rainbow of food utopia hung on our fridge and said to me: “no one’s perfect, but if we were, we’d eat like this.” Was I wrong? It’s the same idea as any physician guideline that the provinces release, like the one I follow for the management of hypertensive patients in my care. I’m not perfect and many aspects of the guideline don’t incorporate the unique aspects of the patient, like the allergies or side effects they may experience from the suggested medications. However, together, we stick as close as we can to the guide to ensure evidence-informed decisions tailored to the needs of the patient, namely not wanting a heart attack or stroke to rip into their life. The guideline wasn’t influenced by drug companies and it doesn’t have a rainbow or pretty pictures. It is the inspiration to strive to do the best we can versus the crappy problem of elevated blood pressure.
Obviously Canada’s Food Guide has plenty of merits. It might be a good first step in getting a person interested in what they eat, and it might enable another to start changing how they choose or what portions they intake. I remain leery. My profound displeasure at hearing about the evolution of Canada’s Food Guide triggered my desire to share the concern and reject the validity of this ‘modern’ tool. Sadly, it wasn’t the first time encountering an obviously – excuse my Bill and Tedness – bogus justification for weakening the food guide.
In Nunavut, a territorial food guide which incorporates traditional aspects of the Inuit diet has been around for years. In 2011 it was revised to be more simple and to better reflect the varying degrees with which people blend store-bought and “country food” components to create their diets. We were asked to read over the new guide and were given opportunities to question the nutritionist who visited our health centre to help us adopt this new guide. It looks nice, it’s simple enough to be practical and a good teaching tool, and it emphasizes the healthful aspects of a traditional diet. Unfortunately, it is egregiously ineffectual at highlighting the harms of processed foods; these get a little section on the last page that uses no indication of harm other than the word “Unhealthy.” In my mind this is insufficient acknowledgement of the tendency of many to, for example, drink upwards of 6 cans of pop daily [*This is my anecdote, which I expect most HCPs in Nunavut would corroborate. The studies haven't been done; one study from 20 years ago shows that Alaskan Inuit youth drank 4x the North American average of pop.]
Although it was only my first or second time in Nunavut, my naivete was not sufficient to suppress my outrage at certain details. The most telling? The fact that they had incorporated “Pilot biscuits” – nothing but flour, lard, and sugar in cookie form – in the wheat & grains section of their guide. “Why?,” we asked. “Well the Inuit on the committee indicate that has been a staple in their diet for decades. We suggested it be removed but they told us that doing so would ensure alienation of most Inuit. We had to leave the cookies in.”
Eye rolls. Guffaws. Anger. Distrust. We in the room are mostly not Inuit. I am hardly an expert regarding Inuit or aboriginal people. Admittedly, being politically correct matters less to me than facilitating others to be healthy and informed. Some might say it is culturally insensitive to not accommodate the Inuk request. However, it seems even more insensitive to create double standards for health and, even in the subtlest way, to deny anyone the best opportunity for health by providing them with half-measures. Even though the guide a good start when you’ve got nothing else, it pains me to recommend it because I am not confident in the process that created it.
The bottom line is this: Just as in guidelines against hypertension, we don’t write:
be sure to add lots of salt to your food, because we know you like it and will do so anyway,
we shouldn’t promote unhealthy foods or directives in our healthy food guide. If people chose to eat them, no problem, that’s their choice, but we all deserve the guidance of a perfect
rainbow food guide.
- What do you think?
- Readers aware of food insecurity in Nunavut, formalized outrage is forthcoming – the more I learn, the more I seethe and the more I write!
- The inspiring article: The politics of food guides – Health – CBC News http://www.cbc.ca/news/health/story/2012/07/27/f-food-guide-70.html – (p.s. thanks CBC for shakin’ it up)