Mixed reviews for Canada's new food guide

Dear Editor

I am responding to your recent article “Mixed reviews for Canada’s New Food Guide” published in CMAJ March 13, 2007: 176 (6): 752-53. Dietitians of Canada (DC) is on record as supporting Eating Well With Canada’s Food Guide as an important educational tool for promoting healthy food choices among Canadians. Criticism leveled at the Guide in this article, does not take into account the evidence that underpins the recommendations nor the extensive consultation with a range of stakeholders, including focus testing with consumers and educators, to ensure the messaging in the Guide is understood. Speculation regarding the potential “obesogenic” nature of the Guide is also unfounded.

• The Evidence Underpinning the Guide - The food intake pattern (describing amounts and types of food) recommended in the revised Food Guide is based on current nutritional science. The pattern has been developed to meet nutrient standards (Dietary Reference Intakes) recommended by nutrition scientists in the US and Canada and to be consistent with evidence linking food and risk of chronic diseases.

The food intake pattern recommended for each age and gender category in the Guide was developed through an extensive modeling process that took into account the nutrition composition of representative foods in the Canadian diet, the food intake pattern for each of 16 age and gender groups and the DRI reference values for each age and gender group.

• Consultation with stakeholders - Throughout the revision, Health Canada consulted extensively with a variety of stakeholders, including dietitians, scientists, physicians, public health experts with an interest in health and chronic disease prevention, consumers and industry. Ongoing advice and guidance came from three expert committees: an external Food Guide Advisory Committee, an Interdepartmental Working Group and the Expert Advisory Committee on Dietary Reference Intakes.

The Food Guide also underwent two rounds of focus testing. The resource for educators and communicators and the web-based resources were also tested with end users. It is noteworthy that feedback received from this consultation did not support a focus on communicating about calories, but rather that the focus should be on strengthening the messages and practical advice on the types of foods to choose and those to limit as well as including messages on physical activity.

• Energy Composition of the Guide - The issue of calories provided by the Food Guide pattern was carefully considered. Simulated diets that followed the food intake pattern, including the statements describing types of foods to choose within each food group, yielded satisfactory results relative to reference Estimated Energy Requirements (EERs). Reference EERs were calculated for each age and sex based on median height, weight derived from median normal BMI, and using a sedentary level of activity. A sedentary level of activity was considered most appropriate so that there was no overestimation of energy requirements.

Guidance on how many calories any one individual would need must be dealt with carefully, preferably on an individual basis in consultation with a registered dietitian. An individual’s daily caloric requirement depends on height, weight, body composition, activity level and genetics. Focusing on calorie counting alone can result in very unhealthy dietary practices. To find a registered dietitian consult the DC public website at http://www.dietitians.ca/public/content/find_a_nutrition_professional/find_a_dietitian.asp

Dietitians of Canada EATracker tool at www.dietitians.ca/eatracker is linked from the Health Canada website. This tool allows users to track their day's food and activity choices. It is designed to provide personalized feedback on total intake of energy and essential nutrients and compare this to what is recommended in the Food Guide and the Dietary Reference Intakes.

The Food Guide is a fundamental tool for health educators, but it cannot be expected to meet all educational needs. It is not designed as a therapeutic diet or weight loss regimen, but rather it promotes a pattern of healthy eating and daily physical activity over a lifetime. Canadians who are the least active will have to follow the guidance closely, including the advice to limit foods and beverages that are high in calories, fat and sugar.

Regards,

Lynda Corby MSc, MEd, RD, FDC Director Public Affairs, Dietitians of Canada

Conflict of Interest:

None declared