It’s finally out! The new food guide for Canada is here and, although I avidly followed its lengthy development process, I found it hard to believe that the end-product would retain its foundation in the best available scientific research and not be swayed by the strong opinions of the food industry. But, remarkably, it has.
Canada’s Food Guide 2019 was created without the influence of any study or report that was commissioned by industry or an organization with a business interest. Inclusion and exclusion criteria for the new guide were clearly laid out. All reports that passed these criteria were also required to be authored by a health organization with the involvement of an expert panel and include original, systematic review of the evidence for a diet-health relationship (1). The group of experts involved in the creation of the new guide employed Health Canada’s Evidence Review Cycle for Dietary Guidance (ERC) as their benchmark for the strength of the data supporting healthy eating. The ERC is an ongoing collection of scientific investigations presented for the relationship between food and health that also provides in-depth analysis of its quality and relevance, ensuring that the Canada’s food guide is based only on the strongest science available (2).
The objectives of the new food guide are, as always, to promote healthy eating and overall nutritional well-being. Unhealthy food choices are one of the three primary disease risk factors for Canadians, along with tobacco use and high body mass index (3). Evidence shows that diet impacts some of the leading causes of premature death in Canada including ischemic heart disease, stroke, colorectal cancer, diabetes and breast cancer (3,4). Additionally, about one-third of direct health care costs in Canada are due to chronic disease (5). This situation is rapidly worsening in this era of high rates of obesity, increasingly sedentary lifestyle behaviours and confusion over what really constitutes a “healthy” food.
Let’s look at what the new food guide is all about and how it has changed from previous versions.
Most noticeable right off the top is the lack of defined food groups. Previous food guides revolved around specific groupings of food. The 2007 version had four such groups – Vegetables and Fruits; Grain Products; Milk and Alternatives; Meat and Alternatives. In contrast the 2019 version contains no food groups at all.
Nor does it suggest portion sizes or daily amounts as did previous versions.
Instead it emphasizes healthy food choices eaten in enjoyable and mindful ways. The new guide states that “Nutritious foods are the foundation for healthy eating” (1). The idea is that if you base your diet on the healthiest foods you’ll be getting all the nutrients you need for robust health.
So what does eating according to Canada’s Food Guide 2019 look like? The recommendations are not complicated. Simply eat a variety of nutritious foods each day – plenty of fruits and vegetables, some protein, whole grain foods and water. Check the photo at the top of this article. The healthy plate for the new food guide is a colourful one consisting of one-half vegetables and fruit, one-quarter whole grains and one-quarter protein. And the drink of choice to accompany this nourishing plate of food? Plain water. The new food guide relegates dairy products and animal proteins to the sidelines with an emphasis on choosing plant-based foods. Plant-based foods are associated with better health and lower risks of chronic disease. For example, fruits and vegetables are linked to lower risk of cardiovascular disease (6). Nuts and soy protein ingestion lead to lower LDL-cholesterol, a risk factor for cardiovascular disease (7,8). Plant-based foods as a class contain fiber which is associated with lower risk of cardiovascular disease, colon cancer and type-2 diabetes (7,9,10,11,12,13). Animal-based foods contain no fiber at all.
What are the foods to avoid as much as possible?
SATURATED FAT: The guide recommends that foods that contain mostly unsaturated fat should replace foods that contain mostly saturated fat. Since animal-based protein is almost always accompanied by saturated fat, its consumption needs to be minimized and any animal-proteins eaten should be low in fat such as lean meat, wild game and low-fat dairy. Saturated fats to avoid are animal-based fats such as cream, butter, cheeses and fatty meats and vegetable oils such as coconut and palm kernel oil and coconut milk. Replacement foods for these saturated fat-containing foods can be chosen from foods containing monounsaturated fat, polyunsaturated fat or whole complex carbohydrates. Note that the intention here is not necessarily to reduce total fat in the diet but to encourage healthier sources of fat through plant-based sources like nuts, seeds and avocados.
FREE SUGARS: Free sugars include those added by manufacturers as well as the natural sugars in some foods. Foods to avoid that contain added sugar include sugar-sweetened drinks both carbonated and uncarbonated, preserves, baked goods and desserts. Foods to avoid that contain natural sugars are fruit juices (including 100% fruit juice and fruit juice concentrates), honey and syrups such as maple syrup, corn syrup and agave syrup. Importantly, the food guide does not limit the eating of intact or cut fruit and vegetables as their naturally occurring sugars are not “free” but are bound up in the matrix of these foods so that they are digested by the body in a completely different way.
PROCESSED FOODS: Avoid processed meats (sausages, ham and other sandwich meats, hot dogs, corned beef) are linked to increased risk of colorectal cancer (14). Many other processed foods are high in saturated fat and their ingestion should be limited. These include deep-fried foods, biscuits and cake, confectioneries and many ready-to-heat packaged dishes. Replacing the saturated fat with unsaturated fat decreases total and LDL-cholesterol and reduces cardiovascular disease risk (15).
SODIUM: Sodium is an essential nutrient, however Canadians are ingesting too much of it. High sodium in the diet is associated with higher blood pressure, a risk for cardiovascular disease (15). The main contributors to sodium in our diet are manufactured processed foods such as processed meats, cheeses, bakery products, soups, sauces, dips, gravies and condiments.
Canada’s Food Guide 2019 is about more than just the food. It also takes into account the effect of dietary patterns on the environment. The more that plant-based foods replace animal-based foods, the less environmental impact there is on soil, water and air and the lower the production of greenhouse gases (16,17,18,19,20). Canada’s Food Guide 2019 also contains other recommendations for healthy eating, many of them are the lifelong habits of populations that live in Blue Zones where centenarians are the norm rather than the extraordinary.
Consider these additional suggestions for healthy eating;
Be mindful of your eating habits. Take the time to enjoy your food. Eat when you are hungry, not out of stress or boredom.
Cook more often. Involve others in the planning and preparation of meals.
Enjoy your food. Take the time to savour every bite.
Eat meals with others and eat at leisure, enjoying the companionship.
Read food labels so that you know exactly what you are eating. Choose healthy menu options when eating out.
Be aware of food marketing and how it can convince you to eat in an unhealthy way.
Canada’s Food Guide 2019 provides promising changes that are simple and easy to follow. With all the controversy surrounding the true meaning of healthy eating, this guideline offers a concise summary, based on the best nutritional science available, of how to do just that. Large-scale adoption of these recommendations will improve overall health, reduce obesity, decrease the incidence of many chronic diseases, increase the enjoyment of food and even reduce some stress in overly busy lives as we use mealtimes to relax and connect with friends and family. Moreover our Earth may have cause for celebration through reduction of some of the damage to the environment that our unhealthy food choices cause.
3 Institute for Health Metrics and Evaluation [Internet]. Seattle: Institute for Health Metrics and Evaluation; 2018 [cited 2018 Nov 28]. Global burden of disease (GBD) profile: Canada.
4 Global Burden of Disease 2013 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386(10010):2287-2323.
5 Public Health Agency of Canada. How healthy are Canadians? A trend analysis of the health of Canadians from a healthy eating and chronic disease perspective [Internet]. Ottawa: Public Health Agency of Canada; 2016 [cited 2018 Sep 14].
6 Health Canada. Summary of Health Canada’s assessment of a health claim about vegetables and fruit and heart disease. [Internet]. Ottawa: Health Canada; 2016 [cited 2018 Sep 14].
7 Anderson, T.J., Grégoire, J., Pearson, G.J., Barry, A.R., Couture, P., Dawes, M., et al. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016;32(11):1263-1282.
8 Health Canada. Summary of Health Canada’s assessment of a health claim about soy protein and cholesterol lowering. [Internet]. Ottawa: Health Canada; 2015 [cited 2018 Sep 14].
9 National Cholesterol Education Program Expert Panel (NCEP) on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final report. Circulation. 2002;106(25):3143-421.
10 Scientific Advisory Committee on Nutrition. SACN Carbohydrates and health report. Norwich: Public Health England; 2015.
11 Health Canada. Summary of Health Canada’s assessment of a health claim about ground whole flaxseed and blood cholesterol lowering. [Internet]. Ottawa: Health Canada; 2014 [cited 2018 Sep 14].
12 Health Canada. Summary of Health Canada’s assessment of a health claim about barley products and blood cholesterol lowering. [Internet]. Ottawa: Health Canada; 2012 [cited 2018 Sep 14].
13 Health Canada. Summary of assessment of a health claim about oat products and blood cholesterol lowering. [Internet]. Ottawa: Health Canada; 2010 [cited 2018 Sep 14].
14 World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity and colorectal cancer. Washington: American Institute for Cancer Research; 2018.
15 Eckel, R.H., Jakicic, J.M., Ard, J.D., de Jesus, J.M., Miller, N.H., Hubbard, V.S., et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129(25 Suppl 2):S76-S99.
16 Aleksandrowicz, L., Green, R., Joy, E.J.M., Smith, P., Haines, A. The impacts of dietary change on greenhouse gas emissions, land use, water use and health: a systematic review. Plos One. 2016;11(11):e0165797.
17 Nelson, M.E., Hamm, M.W., Hu, F.B., Abrams, S.A., Griffin, T.S. Alignment of healthy dietary patterns and environmental sustainability: a systematic review. Adv Nutr. 2016;7(6):1005-1025.
18 Agriculture and Agri-food Canada [Internet]. Ottawa: Government of Canada; 2017 [cited 2018 Sep 14]. A food policy for Canada.
19 Environment and Climate Change Canada. Greenhouse Gas Sources and Sinks in Canada: executive summary 2018. [Internet]. Ottawa: Government of Canada; 2018 [cited 2018 Nov 28].
20 Dietary Guidelines Advisory Committee. Scientific report of the 2015 Dietary Guidelines Advisory Committee: advisory report to the Secretary of Health and Human Services and the Secretary of Agriculture. Washington: U.S. Department of Agriculture, Agricultural Research Service; 2015.