Download may 13, 2015, 4:15 pm check against delivery

May 13, 2015
NOTES FOR REMARKS
JAN HUX, M.D., CHIEF SCIENCE OFFICER,
CANADIAN DIABETES ASSOCIATION
TO THE SENATE STANDING COMMITTEE ON SOCIAL
AFFAIRS, SCIENCE AND TECHNOLOGY
‘INCREASING INCIDENCE OF OBESITY IN CANADA:
CAUSES, CONSEQUENCES AND THE WAY FORWARD’
MAY 13, 2015, 4:15 P.M.
CHECK AGAINST DELIVERY
1
May 13, 2015
Dear members of Standing Committee, thank you for the
opportunity to speak with you today about a vital matter that
touches us all – the alarming increase in obesity in Canada.
I am the Chief Science Officer of the Canadian Diabetes
Association. I speak to you in that capacity because being
overweight or obese is a major risk factor for type 2 diabetes – a
disease that is imposing a large and growing burden on Canadian
society. Currently more than three million Canadians have been
diagnosed with type 2 diabetes - and 20 more will be diagnosed in
the next hour. Accordingly, the increasing percentage of our
population that is overweight or obese is a major worry for us. Let
me explain further.
Diabetes is a challenging disease to manage and the effort to do
so is aimed at the short-term control of blood sugar levels. That
effort is essential, but regardless of how well you do that, diabetes
puts you at risk for complications which cannot be reversed.
Diabetes sends thousands of Canadians to hospital emergency
2
May 13, 2015
departments every single day for heart attacks, strokes, kidney
failure, limb amputation and blindness. Because of these and
other complications, people living with diabetes can expect to live
five to 15 years less than someone without diabetes. People with
diabetes don’t die of their diabetes, they die of its complications.
We know that obesity is a major risk factor for type 2 diabetes
and, in turn, that growing rates of obesity are an important driver
of the diabetes epidemic. Reducing the rate of obesity is critical
for the health of Canadians and the sustainability of the healthcare system.
Certainly, Canada’s obesity problem is complex. Many people
oversimplify it to ‘eat less, move more.’ But the reality is that we
need solutions that meaningfully address the complexity of the
problem. Any solution set needs to recognize not only that
individuals, but also governments have roles to play. As the
success we have achieved on reducing smoking rates shows,
governments can act in ways that help us make healthier choices.
3
May 13, 2015
Now let’s look around us. As we experience every day, the world
we live in encourages us to gain weight. The two most obvious
factors are the calorie rich food we eat and our increasingly
sedentary lifestyle. I will focus my comments and
recommendations on promoting better food choices.
My first recommendation is to help Canadians reduce their
intake of sugar-sweetened beverages through taxation and
awareness.
The evidence is clear—consumption of sugar-sweetened
beverages is connected to obesity and type 2 diabetes. People
who consume more than one sugar-sweetened beverage and fruit
juice serving per day have a higher risk of developing diabetes.1 A
2004 study showed that women who consumed two to three
sugar-sweetened beverages per day had a 32 per cent greater
risk of developing type 2 diabetes compared to women who
consumed less than one sugar-sweetened beverage per month.2
4
May 13, 2015
Taxes are a way the federal government can influence
consumption. Several studies show that beverage consumption is
price sensitive. These studies estimate that a 10 per cent
increase in beverage prices reduces overall consumption by
approximately eight per cent.3 Revenues generated can be
invested in obesity prevention programs.4
On the awareness front, the “Drop the Pop” program from the
governments of the Northwest Territories, Yukon and Nunavut is
an encouraging example.5 The idea is that schools encourage
students to drink water instead of pop. The program is off to a
promising start. We are following it closely and are looking at
ways to support it. We hope that you, as federal representatives
with particular responsibility for our northern Territories and
Aboriginal Canadians, will support it as well.
The second recommendation is to offer ethical and accurate
nutrition information to Canadians.
5
May 13, 2015
We want to achieve two things: restrict marketing to children and
have clearer nutrition labels.
Current voluntary restrictions on advertising are not effective
enough. It’s time to be serious about protecting our children. Junk
food ads are everywhere—on TV and in movies, video games,
toys and children’s events. As a society, we are responsible for
protecting children who may not yet be able to critically interpret
and understand advertising information and its intent.
The CDA recommends an expansion of the Québec Consumer
Protection Act, in place since 1980. It prohibits all commercial
advertising directed at children under 13 years of age.
It is worth noting that, in 2007, the House of Commons Standing
Committee on Health recommended that the federal government:
 Assess the effectiveness of self-regulation as well as the
effectiveness of prohibition in the province of Québec, in
Sweden and in other jurisdictions;
6
May 13, 2015
 Report on the outcomes of these reviews within one year;
 Explore methods of regulating advertising to children on the
Internet; and,
 Collaborate with the media industry, consumer
organizations, academics and other stakeholders as
appropriate.
That was eight years ago. We still need leadership in this area.
Also dealing with the question of nutrition information is the need
for better labels that include the total amount of sugar in a
product, both natural and added.
The third recommendation is to reduce food insecurity and
promote healthy eating in vulnerable populations.
Food insecurity and obesity are strongly linked to low income.
Less healthy foods tend to be less expensive. Therefore people
with lower income face limited access to affordable and highquality food to stay healthy and avoid obesity.
7
May 13, 2015
However, a successful program that guides healthy eating is the
CDA’s Food Skills for Families program in British Columbia. It
targets low income, new immigrant, Aboriginal and seniors
populations. It educates participants about how to eat well by
creating easy meals using fresh, whole ingredients and by
learning how to read food labels. Expanding this program across
the country, especially in Aboriginal populations, would promote
economical and healthy eating.
Again, thank you for your interest in this vitally important topic and
for your invitation to speak to you. I look forward to continuing our
conversation and answering your questions.
8
May 13, 2015
Malik VS, Popkin BM, Bray GA, Despres JP, Hu FB. Sugar-sweetened beverages, obesity,
type 2 diabetes mellitus and cardiovascular disease risk. Circulation 2010;121:1356-64.
1
Schultz MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugarsweetened beverages, weight gain, and incidence of type 2 diabetes in young and middleaged women. Journal of the American Medical Association 2004;292(8):927-34.
2
Andreyeva T, Long MW, Brownell KD. The Impact of Food Prices on Consumption: A
Systematic Review of Research on the Price Elasticity of Demand for Food
Am J Public Health. 2010 February; 100(2): 216–222.
3
Andreyeva T, Chaloupka FJ, Brownell KD. Estimating the Potential of Taxes on Sugar‐
Sweetened Beverages to Reduce Consumption and Generate Revenue PrevMed 2011 52:6
413-416.
4
Health Promotion, Aboriginal Health and Community Wellness, Department of Health and
Social Services, Government of the NWT. Drop the Pop NWT. [ONLINE] Available at:
http://dropthepopnwt.hss.gov.nt.ca/. [Accessed 12 May 15].
5
9