Background to the New Canada Food Guide Draft

This article is to provide background information to the article posted yesterday (available here) about the proposed changes to the new Canada's Food Guide.

As I thought yesterday, I can confirm now that the source of the draft version of the new Canada’s Food Guide was from the Earnscliffe Strategy Group’s report titled “Healthy Eating Strategy – Dietary Guidance Transformation – Focus Groups on Healthy Eating Messages, Visuals and Brands Research Report which was released on October 31 2018.

Health Canada has confirmed that the draft of the new food guide is not the final version.

Media stories about the new guide first began last week (January 4, 2019) after a draft of the new food guide was referred to by the French media outlet LaPresse in their article titled “Les produits laitiers largement écartés du nouveau Guide alimentaire” (translation: “Milk products are largely removed from the new Food Guide”).

English language media stories cited in the article I posted yesterday also relied on the Earncliffe report.

According to this report, Health Canada is planning to release a Canada’s Food Guide (CFG) “suite of products” to meet the needs of a variety of audiences.  The “look and feel” of the final concept will be applied across the suite of products (pg. 1 Healthy Eating Strategy – Dietary Guidance Transformation – Focus Groups on Healthy Eating Messages, Visuals and Brands – Final Report).

This past June, Ann Ellis who is Manager of Dietary Guidance Manager at Health Canada spoke at the Dietitians of Canada conference on Vancouver Island and shared the specific “suite of products” that will be rolled out.

For the general public the focus of the new guide will be on “how to eat” (eating with others, taking meals to school or work, food shopping) rather than on “what to eat“. Guidance with regards to the types of foods and number of servings will be provided to healthcare professionals such as Dietitians rather than to the general public.

The first set of resources that were supposed to be released this past fall but will probably be release in early 2019 will be;

  1. Canada’s Dietary Guidelines for Health Professionals and Policy Makers: A report providing Health Canada’s policy on healthy eating. This report will form the foundation for Canada’s Food Guide tools and resources
  2. Canada’s Food Guide Healthy Eating Principles: Communicating Canada’s Dietary Guidelines in plain language
  3. Canada’s Food Guide Graphic: Expressing the Healthy Eating Principles through visuals and words
  4. Canada’s Food Guide Interactive Tool:  An interactive online tool providing custom information for different life stages, in different settings
  5. Canada’s Food Guide Web Resources: Mobile-responsive healthy eating information (fact sheets, videos, recipes) to help Canadians apply Canada’s Dietary Guidelines

The second set of resources that were to be released in the spring of 2019 but will probably be pushed back to the summer are;

  1. Canada’s Healthy Eating Pattern for Health Professionals and Policy Makers:  A report providing guidance on amounts and types of foods as well as life stage guidance
  2. Enhancements to Canada’s Food Guide: Interactive Tool and Canada’s Food Guide (Web Resources): Enhancements and additional content to Canada’s web application on an ongoing basis

As far as “timelines” for release of the new Canada Food Guide, the following was available from the Health Canada website;

Key dates

The revision of Canada’s food guide will be completed in phases.

In early 2019, we will release:

  • Part 1 of the new dietary guidance policy report for health professionals and policy makers, which will consist of general healthy eating recommendations
  • supporting key messages and resources for Canadians

Later in 2019, we will release:

  • Part 2 of the new dietary guidance policy report, which will consist of healthy eating patterns (recommended amounts and types of foods)
  • additional resources for Canadians
It is very good news that healthy eating patterns with recommended amounts and types of foods will be released to health care professionals, but why not to the general public?

Phase 1 of market research was targeted to five different audiences and focused on a variety of healthy eating topics. The five different audiences included;

  1. adults experienced in food preparation
  2. adults with minimal experience in food preparation
  3. seniors responsible for food preparation
  4. parents of children who are responsible for grocery shopping and food preparation
  5. youth aged 16 to 18

Market research included a series of 10 focus groups that were held in English in Ottawa (March 20 and 21) and in French in Quebec City (March 21 and 22).

Phase 2 of market research was to test the visual elements for the new Canada’s Food Guide to assess:

  • effective use of text and graphics/images
  • credibility, relevancy and perceived value to the audience
  • acceptance
  • appeal, usefulness and appropriateness
  • relevance and engagement
  • memorability (eye-catching and general visual appeal)

Audiences for Phase 2 included:

  • those at risk of marginal health literacy
  • those with adequate health literacy
  • primary level teachers
  • community level educators
  • registered dietitians working in public health or community nutrition
  • registered dietitians working in clinical/private practice/media/bloggers
  • registered nurses working in public or community health.

In addition, 10 focus groups were conducted with members of the general public in five Canadian cities:

  • Toronto, ON (June 5, 2018)
  • Quebec City, QC (June 6, 2018, in French)
  • Calgary, AB (June 7, 2018)
  • Whitehorse, YK (June 11, 2018)
  • St. John’s, NL (June 14, 2018).

Fifteen (15) mini-groups were conducted with health professionals and educators in 3 Canadian cities:

  • Toronto, ON (June 4, 2018)
  • Calgary, AB (June 6, 2018)
  • Quebec City, QC (June 18, 2018, in French)

The following note appeared in the introduction to the Earnscliffe report;

“It is important to note that qualitative research is a form of scientific, social, policy and public opinion research. Focus group research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn and findings cannot reliably be generalized beyond their number.”

The following topics on “how to eat” were explored for each of the following audiences during Phase 1:

Adults experienced in food preparation
 Healthy eating at work
 Grocery shopping
 Eating on the go

Adults with minimal experience in food preparation
 Healthy eating at home
 Beginner cook
 Celebrations

Seniors responsible for food preparation
 Building healthy meals & snacks
 Eating on a budget
 Healthy eating for seniors

Youth
 Eating on the go
 Building healthy meals & snacks
 Eating out

Parents responsible for food preparation
 Planning & preparing healthy food with the family
 Packing healthy lunches
 Eating out

It does not appear that any of the focus groups were consulted about the decision to eliminate the Meat and Alternatives and Milk and Alternatives food groups. The senior’s focus group was consulted about the “justification” for particular messages related to these. “Non-meat protein options” and “healthy fats” were considered “new information for which they would like to understand the justification” therefore “providing a rationale was felt to be useful“.

Regarding these “justifications“;

“the placement of the justification seemed to be pertinent.

For example, participants reacted favourably to the statement, “Eggs are a very convenient and versatile protein food. Prepare them poached, scrambled or made into an omelette with your favourite chopped vegetables.” because the justification (that eggs are convenient and versatile) was provided at the outset.

By way of contrast, reactions to “Eat meatless meals more often! Instead of meat have baked beans, lentil chilli or an egg sandwich. They cost less!” were less favourable because the justification was provided at the end (they cost less).

Some argued that as a result, this statement came across more as a directive to avoid something they enjoy (eating meat).

(pg. 18 Healthy Eating Strategy – Dietary Guidance Transformation – Focus Groups on Healthy Eating Messages, Visuals and Brands – Final Report).


Topics that were explored for each audience (teachers, dietitians, nurses and people with literacy issues) during Phase 2 included:

  • reactions to the draft look-and-feel elements
  • reactions to the draft visual elements

Two drafts of the new Canada’s Food Guide appeared in the report under the section of “visual elements“;

“At-a-glance” Visual Concept A

“At-a-glance” Visual Concept B

Participant’s feedback on these visual elements are worth noting;

When asked, some could delineate that because vegetables/fruits occupied a larger space visually, or in the example of Visual Concept B that vegetables/fruits were displayed at the top, that most of the food they should consume should come from this category. Others (but not many) inferred from the messaging, “plenty of vegetables and fruit”, that much of what they eat in a day should be vegetables/fruit.

However, all of this was not obvious and most indicated that they would have preferred a more direct reference to either specific proportions or, at a minimum, an image of a plate or a pyramid, in which the appropriate proportions of vegetables/fruits, grains, and protein were illustrated.

(pg. 34 Healthy Eating Strategy – Dietary Guidance Transformation – Focus Groups on Healthy Eating Messages, Visuals and Brands – Final Report).

It would seem that the draft guide’s focus on “how to eat” left focus group participants wanting more direction on “what to eat” which is primarily what Canadian’s look to the Canada Food Guide for. They wanted to know specific proportions of vegetables and fruit, grains and protein to eat and as a bare minimum wanted an image of a plate or a pyramid in which the appropriate proportions were illustrated.

Some final (personal) thoughts…

As mentioned yesterday, I believe that the role of a national food guide is to enable a country’s population to eat as optimally as possible and without providing guidance as to how much food and how often it should be eaten, the public will be left wanting.

It is clear from the reaction of the senior’s group that they wanted to know why they should eat less meat and less saturated fat and as I expressed yesterday, I believe that before Canadians are discouraged from eating meat and milk that the government should provide current, scientific evidence that eating saturated fat contributes to cardiovascular disease. The public doesn’t need nicer worded “justifications”, but the evidence related to limit saturated fat and to what degree.

To your good health!

Joy

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Author: BBDN

Joy Y Kiddie MSc., RD - I'm a Registered Dietitian in private practice in British Columbia, Canada that provides services in-person in my Coquitlam office, as well as by Distance Consultation (using Skype / telephone).