Ontario Society of Nutrition Professionals in Public Health Nutrition Exchange May 31, 2007

1. Ontario Society of Nutrition Professionals in Public Health Nutrition Exchange May 31, 2007 Presentation by: Mary Bush Office of Nutrition Policy & Promotion Health Canada

2. Outline • Research, monitoring and evaluation • Policy and standard setting • Canada’s Food Guide update • Principles for use of Food Guide content in labelling and advertising • Sodium Calcium and Vitamin D updates

3. Research, Monitoring and Evaluation • Current Projects include: • Dietary Reference Intakes • Approach to the generation of evidence to support healthy eating and dietary guidance • Canadian Community Health Survey (CCHS) • Food Guide Evaluation

4. Dietary Reference Intakes • Establishment of the Canadian Interdepartmental/Interagency DRI Steering Committee • IOM workshop on the DRIs review • September 18-20, 2007 • Jointly supported by US and Canadian governments • Dietary Reference Intakes: The Essential Guide to Nutrient Requirements • Summary report commissioned by Health Canada • National Academies Press website: www.nap.edu

5. Approach to the generation of evidence to support healthy eating • Coordinated and systematic approach for identifying and prioritizing information needs within our Office • Mapping solution-oriented evidence needs and approaches • Reflects population health approach • Aligns with our strategic directions • Goes beyond the medical model

6. Canadian Community Health Survey (CCHS) • Leadership and advocacy role to include food and nutrition on any future CCHS • Food and Nutrition Surveillance System Working Group • Capacity building role: • Analysis of CCHS 2.2 data • CCHS 2.2 Users group • Knowledge transfer and dissemination role: • Report on Income-related Household Food Security • Health & Nutrition Atlas • Report on Nutrient Estimates from Food • Report on Vegetable and Fruit Consumption • Fact sheet on what Canadians eat and drink

7. Food Guide Evaluation • Draft framework to evaluate and monitor Eating Well with Canada’s Food Guide has been developed • Assessment of framework underway - 2 evaluations suggested • Near Future: to assess effectiveness and efficiency of revision work (outcome: to provide a roadmap for future revision efforts) • Over time: qualitative and quantitative data collection from Canadians at large and stakeholders on the use and usefulness of Eating Well with Canada’s Food Guide

8. Policy and Standard Setting • Action to define healthy eating through the establishment of policies and standards related to dietary guidance for Canadians. • Canada’s Food Guide • Nutrition for Healthy Pregnancy Guidelines • Nutritious Food Basket

9. Policy and Standard Setting • Action to support healthy eating by ensuring nutrition considerations are integrated into national and international policies and initiatives • Global Strategy on Diet, Physical Activity and Health • WHO School Policy Framework • Pan-Canadian Healthy Living Strategy • Food Policy • Standing Committee on Health Report “Healthy Weights for Healthy Kids” • Government Response

10. Canada’s Food Guide - Update • Over 6 million Food Guide copies distributed since the launch • Distribution challenges • Healthy Eating TV campaign • Post-launch Food Guide meetings across Canada • Powerpoint presentations for use with intermediaries and consumers to be posted this month • Nutrition Reviews article: • published in April issue • posted on Food Guide Web site

11. Labelling principles – Use of Food Guide content • General principles in place to provide guidance on the use of content from the 2007 Canada's Food Guide resources and web site on food labels or in advertisements • Goal: to encourage consistent messaging about healthy eating to avoid misleading consumers and enable them to make informed choices for healthy eating • Available at www. hc-sc.gc.ca/fn-an/food-guide-aliment/gen_prin_e.html

12. MyFood Guide Servings Tracker – new feature on Health Canada website

13. Canada’s Food Guide – Next Steps • Multicultural versions of Food Guide print-out (11 different languages): Chinese (traditional and simplified), Punjabi, Arabic, Spanish, Tagalog, Russian, Persian (Farsi), Tamil, Urdu and Korean • Needs assessment (focus groups) with intermediaries working with multicultural groups – Summer 2007: Target audience: new Canadians • What is their need for additional materials beyond the new Food Guide package • What information gaps/challenges immigrants have in integrating/adopting healthy eating practices in the Canadian context

14. Sodium: What We Heard During Consultations • Draft Food Guide was inadequate to inform the public on this important dietary issue • Strengthen messages on sodium by providing clear messages and practical tips to help consumers reduce sodium intake

15. Sodium Simulation results • Median sodium content of simulated diets exceeds Upper Tolerable Intake Levels for many age/sex groups; UL = 2300 mg for adults • Simulation results = median at 2300-3000 mg • Ubiquitous presence of sodium in food supply • Only so much can be done through messaging and food choices

16. How we have addressed sodium • Include guidance in Vegetables & Fruit, Grain Products and Meat and alternatives food groups to: • Compare Nutrition Fact table on food labels to select foods that are lower in fat sugar or salt or; • Select foods prepared with little or no added fat, sugar or salt; • Request nutrition information when eating out.

17. Calcium Simulation results

18. Calcium simulation results • AI for calcium for pregnant and non-pregnant women is the same: 1300 mg/day (14-18 y); 1000 mg/day (19-50y) • Maternal skeleton is not used as a reserve for fetal calcium needs during pregnancy. • Calcium-regulating hormones adjust maternal calcium absorption efficiency • AI does not have to be increased during pregnancy • 2 Food Guide Servings of Milkfor women 19 to 50 years supplies adequate calcium during pregnancy and lactation

19. Vitamin D Requirements • Requirements increase at age 51 years and again at 71 years • AgeDaily Recommendation • 19-50 200 IU • 51-70 400 IU • Over 70 600 IU • Upper tolerable intake level 2000 IU • More vitamin D is needed by people over the age of 50 years than can be obtained from following the Food Guide

20. Vitamin D Benefits • In older adults, higher serum concentration is associated with: • greatest calcium absorption • highest bone mineral density • improved muscle strength • reduced fracture rates • reduced rates of falling • improved mobility • Potential Benefits • preventive of some cancers • protective against certain autoimmune disease

21. Vitamin D Consultations • Issue paper developed and reviewed by external experts • Options assessed • Fortification of food supply: • not retained • would require extensive safety assessment • reference value for vitamin D may be revised • Supplements: • Difficult to meet recommendation for people 50+ without recommending unrealistic amounts of some foods • Supplement will complement food intake to achieve recommended dietary intake levels

22. Discussion • Comments • Questions • Visit our website: http://www.healthcanada.ca/nutrition