Tuesday, March 26, 2019

Eat more plants, less meat - improve your health and save the planet

Canada's Food Guide revamp is good for people and the planet, thanks in great part to a new information-gathering process

By Courtney Howard
and Ian Culbert
What is a healthy diet?
New Year's diet conversations still abound around water coolers Canada-wide as people debate the merits and shortcomings of sugar, gluten, meat, dairy, tofu and other edibles. Scientific articles, shiny celebrities and representatives of various groups who produce, transform and sell food all compete for our attention as we try to figure out what to eat.
How is anyone supposed to know who to listen to?
Canadians' traditional solution to this conundrum has been to turn to Canada's Food Guide - that familiar rainbow of foods that many of us learned about in elementary school.
Courtney Howard
Click image to download
The last version of the guide was published in 2007, so it's time for a revamp to reflect new information. Health Canada has been looking at the most recent research and consulting with various stakeholders.
So who should Health Canada listen to in its efforts to come up with the best diet recommendations for Canadians?
They've taken a prudent stance: feeling that industry's participation in past food guide development undermined the public's confidence in the guide, this time Health Canada has prioritized information from sources that don't stand to profit from the outcome. In opting not to meet one-on-one with industry groups, Health Canada has given itself the best chance of producing a guide that puts the health of Canadians first and that will be, and be seen to be, a trusted source of information.
As trust in conventional information sources wanes, it's an approach that Health Canada would do well to consider expanding ministry-wide.
The guiding principles of the draft food guide were released in 2017 and include recommendations to reduce our intake of processed foods; share meals with family and friends; and shift our diets towards "a high proportion of plant-based foods without necessarily excluding animal foods altogether."
This is all sound and evidence-based advice. However, there are now reports that the meat and dairy industries in Canada are expressing concerns that they weren't adequately consulted by Health Canada. They have turned to Agriculture and Agri-Food Canada and Innovation, Science and Economic Development Canada officials to register their complaints.
As representatives of organizations dedicated to human health, we believe that Health Canada's recommendation that we eat more plants and less meat positions Canada as a leader in both the health of people and of the planet. Strong support for these principles was one of the main recommendations of the jointly-produced Lancet Countdown-Canadian Public Health Association policy brief.
Plant-rich, low-meat diets have been shown to have modest benefits in terms of all-cause mortality, to decrease our risk of colorectal cancer, and cardiovascular disease and to improve glycemic control in people with diabetes. Low-meat diets also reduce greenhouse gases, and land use and water consumption by a median of 20 to 30 per cent across studies, which is critical to maintaining planetary health and sustaining our ability to feed ourselves as we move through the 21st century.

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Friday, March 22, 2019

There are far too many barriers to following Canada's Food Guide, including the Gwyneth Paltrow effect

By Sylvain Charlebois
Atlantic Institute for Market Studies
and Simon Somogyi
University of Guelph
Will Canadians use the new version of Canada's Food Guide and will it cost us more to follow the new recommendations it contains?
The guide, introduced a few weeks ago, advocates a diet focused more on plant-based eating and reductions in meat and dairy consumption. As such, it has gained much attention, particularly among the animal protein and dairy sectors that were the focus of previous iterations of the guide.
Sylvain Charlebois
Sylvain Charlebois
Rather than giving attention to the food sovereignty agendas of the agricultural sector, the guide's new mantra is: Canadians need to eat better and here is what you should eat.
The guide is strewn with glossy pictures of healthy food. It has replaced the previous suggested serving sizes with food groups, plus the suggestion to cook more of our food at home, and to drink water instead of juice. All of the recommendations centre on the health and well-being of Canadians.
But as well-meaning as the suggestions are, what will be the result of this new guide?
A recently-released report by Dalhousie University and the University of Guelph explored Canadians' perceptions of the new guide by comparing it with the last version and providing cost comparisons.
According to the report, most Canadians know of the food guide and know that there's a new version. They also know that by following portion sizes and food recommendations, at least in the short term, the new guide would save the average family money on their food bills. The report says following the guide would save a family of four $1.98 a day. One in eight Canadian households are food insecure, so such savings are welcome.
Simon Somogyi
Simon Somogyi
But the savings may not last. Predictive models suggest the differential between the previous guide and the new one will narrow significantly within a few years and may even disappear.
Our domestic agricultural economy just can't provide what the guide suggests. So, in time, Canadians' vulnerability to monetary fluctuations and regions stricken by major climatic events will become more apparent.
Facing the possibility of a new food strategy for a nordic climate like ours, we will certainly have some work to do.
The report also paints a less than rosy picture as to whether Canadians will follow the guide. The guide is rated as the sixth most important source of information for nutritional advice, yet it's often eclipsed by recommendations by family and friends, general research, social media and celebrities, and television programs.
That's right - Gwyneth Paltrow is more influential when it comes to dietary advice than our own food guide.
Affordability, compatibility with taste preferences and the fact that it requires you to do your own cooking cause further barriers to adopting the new guidelines.
Another concern is that the report mentions that having more money and a higher level of education increases your likelihood of following the new guide, which highlights its somewhat elitist nature.
Health Canada should be applauded for updating a guide that was more than a decade old and for focusing on advocating for the health of Canadians rather than providing a soap box for the agri-food sector.
However, it's important to remember that Canadians aren't just patients in a health care and nutrition formula. We're consumers with families, busy providing for mortgages, bills and putting food on the table, and not necessarily in that order.
Publishing a guide that advocates the impractical ideas of generating no waste and cooking every meal at home is troublesome at best.
So the new Canada's Food Guide is a step in the right direction. But it's an ideal for the nutritional elitist, not a practical day-to-day guide. While the Dalhousie-Guelph report suggests that people are interested in following its new ideas, that won't necessarily be enough to make Canadians bite.
The nutritional roadmap the new guide offers is sound, yet it has little to do with most Canadians' kitchen habits and culinary traditions.
So Health Canada needs to make its case that the new guidelines are worth pursuing to a greater extent than some celebrity chef's advice.
Sylvain Charlebois is scientific director of the Canadian Agrifood Foresight Institute, a professor in food distribution and policy at Dalhousie University, and a senior fellow with the Atlantic Institute for Market Studies. Simon Somogyi is the Arrell Chair in the Business of Food at the University of Guelph.

Wednesday, March 20, 2019

National pharmacare can hurt patients more than it helps

Will likely result in reduced access to new drugs, and delay research and development

By Kristina Acri
Senior Fellow
The Fraser Institute

The federal government's pharmacare advisory council released a report last week outlining the "foundational" elements of a national plan. And Tuesday's federal budget may include more details. Unfortunately, there's a lot of misinformation and misunderstanding regarding core aspects of the pharmacare debate.
Given that proponents in Canada often cite government-funded pharmacare programs in the United Kingdom, Australia and New Zealand, it's helpful to evaluate these programs and their impact on patients.
While these programs have reduced government expenditures and the average price paid per drug, they've produced some unintended consequences. A recent Fraser Institute study spotlighted four issues Canadians should ponder.
First, a national pharmacare program will likely result in reduced access to new drugs as pharmaceutical companies delay or withhold the production of certain drugs if the price offered through the government program isn't satisfactory.
Among 20 comparable Organization for Economic Co-operation and Development (OECD) countries, New Zealand ranks last for access to innovative medicines. And of all the drugs approved in the country from January 2009 to December 2016, barely 16 per cent were added to the public drug formulary, the worst result among 31 comparable countries.
Even after New Zealand agrees to list a drug, it can take more than 13 years before it's covered by the country's pharmacare plan, as the budget ceiling is reached. Among 13 comparable countries, New Zealand ranks last in access to cancer medicines.
In the U.K. between 2012 and 2014, the National Health Service rejected 22 new cancer drugs comprising 61 per cent of cancer treatments analyzed over that period. That's not surprising since numerous studies have shown that access to new and innovative medicines in the U.K. is delayed compared to other industrialized countries.
Second, a national pharmacare program could decrease pharmaceutical innovation in Canada.
A national pharmacare program will likely require pharmaceutical companies to cut their prices, essentially institutionalizing price controls through the program. This is a major problem. Historically, as revenues to finance research and development are reduced, innovation suffers.
The United States has always been the global leader in new drug development, and that lead widened after Japan and Germany imposed price controls over the past few decades. The result is that all major international pharmaceutical companies, without exception, have established research and development and commercial operations in the U.S. to take advantage of its pricing environment.
Moreover, the percentage of new chemical entities (new drugs that have not previously been approved) originating from U.S.-based companies rose from 31 per cent in the 1970s and '80s, to 42 per cent in the 1990s to 57 per cent in the 2000s.
In the mid-'80s, pharmaceutical research and development by European companies was 24 per cent higher than in the U.S. Following the adoption of price controls, European pharmaceutical research and development grew at half the U.S. rate and today substantially trails American research and development.
Canadians can also expect tax hikes to pay for the government drug program. In late 2017, an analysis by the parliamentary budget officer estimated a national pharmacare program would cost around $20 billion a year. And former federal budget officer Kevin Page says that without tax increases, governments will see their shortfalls balloon and deficits double.
Lastly, and worst of all, the evidence suggests a national pharmacare program may produce poorer health-care outcomes for Canadians.
Again, the experiences of other countries are illustrative.
Relative to Canada, access in New Zealand to histamine H2-receptor antagonists (used to treat ulcers) and new oncology and rare disease drugs are much lower. The resulting health consequences are striking. Again, relative to Canada, mortality rates for acute myocardial infarction, cerebrovascular disease, chronic obstructive pulmonary disease, musculoskeletal conditions and peptic ulcers in 2011 were more than 30 per cent higher in New Zealand.
In the U.K., lower access to certain drugs has contributed to lower survival rates for various cancers compared to other developed countries. According to a 2015 report, the U.K. ranks among the worst of all developed countries for survival rates for the 10 types of cancers analyzed. In the case of liver and lung cancer, the five-year survival rate is half the Canadian rate.
As the Liberal government pushes for a national pharmacare program, with an eye on the October federal election, Canadians should understand the experiences of other countries.
Canada must cautiously approach any policy change - including the introduction of national pharamacare - that puts patients, innovation and innovative industries at risk.
Kristina M.L. Acri is an associate professor of economics at Colorado College and a senior fellow at the Fraser Institute.

Friday, March 15, 2019

Coconut-Pecan Bars


6 tbsp (90 mL) butter or margarine, softened
1/4 cup (50 mL) granulated sugar
1/4 tsp (1 mL) salt1 cup
(250 mL) all-purpose flour
2 eggs
1 tsp (5 mL) vanilla
1 cup (250 mL) packed brown sugar
2 tbsp (30 mL) all-purpose flour
1/2 tsp (2 mL) salt1 cup
(250 mL) coconut
1/2 cup (125 mL) chopped pecansInstructions

Heat oven to 350ºF. In small bowl, beat butter, granulated sugar and 1/4 teaspoon salt with electric mixer on medium speed until light and fluffy. Stir in 1 cup flour. Pat in bottom of ungreased square pan, 9x9x2 inches. Bake 12 to 17 minutes or until very light brown.

Meanwhile, in medium bowl, beat eggs slightly with wire whisk. Stir in vanilla. Gradually beat in brown sugar just until blended. Beat in 2 tablespoons flour and 1/2 teaspoon salt; mix well. Stir in coconut and pecans. Carefully spoon coconut mixture evenly over baked layer.

Bake 20 to 25 minutes or until golden brown and filling is set. Cool 10 minutes. Run knife around edges of pan to loosen. Cool completely, about 1 hour. For bars, cut into 4 rows by 4 rows.Special Touch: Add a new shape to your cookie tray. Cut bars diagonally in half to make 32 triangles.

Special Touch: Add a new shape to your cookie tray. Cut bars diagonally in half to make 32 triangles.