Recently, we caught up with Mister and Missus Average Canadian. Like classmates at our high school reunions (but Hey, not us of course!), they’ve changed a lot over the years, thanks in no small part to our federal government’s health policies.
Back in the day, Mister Average Canadian was a lean, mean, hockey-playing machine who was pretty fit and healthy. The missus was an avid ringette player. In fact, they met at the arena. But 25 years on, they’re fat, hypertensive, smoking, diabetic couch potatoes. Years of inaction by the federal government have helped shape the Canadians into people who can barely heft a hockey or ringette stick, let alone play a game.
The Canadians sleep easy (well, not quite, because of their obstructive sleep apnea) thanks to a government that lets the products they love onto the market unfettered. Their favourite diet, high in trans fats and sodium, is not affected by regulation of the food industry, because the current government ignored calls from public health officials to ban trans fats and reduce salt and broke up the advisory panels that advocated for those changes.1 It also dragged its feet to renew and increase graphic labelling on cigarette packages — and thank goodness, because having to look at images of lung and oral cancers is just such a downer when you want a hit of nicotine.2
The Canadians are something of an institution in their neighbourhood — and a growing one; two-thirds of their neighbours, like them, are overweight or obese.3 It’s the inevitable result of a steady diet of processed foods and meals at restaurants that rarely give nutritional information but love to serve up giant portions.
Through either convoluted or absent labelling, the Canadians are rarely aware of the nutritional content of their food, either in grocery stores or restaurants. Making healthy food choices can be difficult, and evidence shows that helpful, consumer-friendly labels on all consumer and restaurant food products can help people make healthy food choices.4 Largely unaware of these benefits, the Canadians had no idea why groups such as the Canadian Institute for Health Information, Centre for Science in the Public Interest and the Heart and Stroke Foundation called for mandatory food labelling.
Because some information can’t be avoided, the Canadians do know their systolic blood pressure is closing in on their bowling average of 220. They don’t know, however, how that’s been helped along by the food industry, which loves loading food up with salt, to make otherwise unpalatable cheap food taste good, prolong shelf life and keep the food industry rich.5 Also, like many tired parents, the Canadians just want happy children, and the billion-dollar junk-food industry helps by marketing its products to them, promising joy by the salty, sugary and fatty serving. That lets the Canadians give their children everything they missed when they were young — incidentally putting them on track to outdo their parents in obesity and hypertension. There’s little fear of an interruption in that trajectory — their federal government had proposals for regulating sodium that would have saved health care costs and lengthened lives,6 but decided the financial and flavour consequences were too high and instead disbanded Health Canada’s Sodium Working Group.7
If the Canadians lived in the United Kingdom, their consumption of sodium and trans fats would be on its way down.8 If they were from California, they would have access to proper food labelling, even in restaurants. If they were from Australia, their government would be introducing legislation to cover entire cigarette packages with generic warning labels. In short, their government would have already implemented some simple policies that have a substantial impact on the public’s health.
In Canada, individual preference, industry influence and ideology all militate against evidence-based public health policy. This has created a population-health time bomb — which can and should be defused. As health professionals and role models, we must help our patients make healthy choices and do so ourselves. As health advocates, we need to put more energy into “nudging” governments into developing effective public health policies. The goal should be to make it easy for Canadians to improve their nutrition, make healthy choices and stay fit.
Footnotes
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Competing interests: See www.cmaj.ca/site/misc/cmaj_staff.xhtml. None declared by Daniel Rosenfield and Jane Coutts.