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I’m not Healthy Enough for Canada’s Food Guide: An ED RD’s View

Lucky me! I got randomly selected for extra security checking by the airline last week while en route to an eating disorders conference. After being thoroughly body checked, my carry-on bags were combed through. I watched my makeup brushes being dusted off, my computer wiped down and, finally, my food for the long flight unpacked. The young woman looked up at me at the end and said, “It must be hard to eat clean all the time.”

 

I chuckled to myself as I certainly didn’t feel like that a couple of weeks ago when Canada’s new Food Guide was released. On that day, I looked down at my family’s dinner, a stir-fried sesame-crusted tofu and broccoli pasta, and realised that I hadn’t prepared a healthy enough meal according to this new guide… I had used white pasta (not whole grain!) low sodium soy sauce (too much salt?) and maple syrup (Yikes! Too much sugar!) and not the right proportions. I adore my family and know that I had prepared a healthy dinner. I have three degrees focused on biology, biochemistry, physiology, metabolism and advanced nutrition. I think I can be trusted to make a nutritious meal. Or can I?

 

While I love that the new Food Guide promotes more plant-based eating, eating disorders dietitians across Canada have our concerns.  The dietitians of the Eating Disorders Association of Canada, myself included, met a couple of days after the release of our new food guide. We are all too familiar with extremes, perfectionism and black-and-white thinking. We are troubled by the unwanted and potentially dangerous consequences of the new guide, both in the treatment and prevention of disordered eating. Here’s why:

 

  • The New Canada’s Food Guide is Way Too Healthy!

In the new food guide, every single grain is whole. While we all should eat mainly whole grain food, many of our processed food items (such as white pasta and flour) are so highly fortified in Canada that they’re actually not terrible alternatives.

Emphasizing the importance of reducing sugar, fat and salt, without giving guidelines on how to include them, is stressful for those who want to get it right.

The plate represented in the Guide doesn’t look too different from the blogs of the dangerous clean eating protagonists. I say ‘dangerous’ as those wanting to be Uber healthy will not know how to feel OK about including less healthy foods into the diet without guilt. There actually is a need for comfort in not being so perfect.  It allows for flexibility, social connection and spontaneity. Having pizza with your friends in college, grabbing a less-than-ideal lunch on-the-go, or celebrating a birthday with cake is a key part of normal eating. The written caution to have these foods in “moderation” (whatever that means) is usually in the small print somewhere and can too easily be ignored.

  • The New Canada’s Food Guide is an Inadequate Educational Tool

Last year, my son was called out by his health teacher for having a vanilla Greek yogurt in his lunch. I usually don’t include much packaged food in my children’s lunches but I wanted to ensure he had adequate protein and some calcium.  He was told that the yogurt contained too much sugar (most was lactose which is natural sugar). In my experience as an eating disorders dietitian, I have confronted many clients concerning interpretations of the food guide and messages by school educators. Some clients even attribute part of the origins of their eating disorder to their attempt to eat healthier after health lessons at school.  This guide does not stress the importance of moderation, ‘The 7-day approach’, ’80:20’ or ‘All Foods Fit”. This paired with the inadequate training teachers receive about the guide and healthy eating in general can make for a dangerous situation. This is particularly concerning in the eating disorders world where exposure to all foods is vital for recovery.

 

  • The New Canada’s Food Guide Portrays Confusing Portion Sizes

The image in the guide demonstrate preferred proportions of foods on a plate, rather than portions. This has definite benefits: we’re moving away from prescriptive number of portion sizes per day. However, the portions are tiny, with the practical considerations of how to offer different options of foods in one picture. The problem is that some people are reading the diagram as smaller portions. For example, ½ slice of bread or a third of an egg. Many have been conditioned to read the picture as a cue to appropriate portion size from the previous food guide.  This of course is erroneous.

 

  • The New Canada’s Food Guide has No Independent Group of Calcium-Rich Foods

While it makes sense to include dairy products with the protein-rich foods from a macronutrient perspective, the milk and alternatives group has been dropped. The lack of stakeholder’s influence has been celebrated as the Dairy Farmers of Canada has historically been powerful in influencing policy. However, osteopenia and osteoporosis, a bone disease which is directly linked to low dietary calcium intake, especially in the teen years, is prevalent in Canada with numbers as high as 2 million Canadians affected. A small portion of yogurt doesn’t adequately address the need for this nutrient. There are good alternatives such as soy milk and canned salmon with bones which could be included in a calcium-rich group. Yes, leafy dark greens do provide calcium, but it is more poorly absorbed. It takes approximately 4 cups of broccoli to provide the equivalent of 1 cup of milk (that’s 300mg of calcium). Teens and adults require over 1000mg of calcium per day.  This is particularly concerning given the popularity of vegan diets, lactose-intolerance and general restriction. The long-term consequences of a calcium deficiency are irreversible.

 

  • The New Canada’s Food Guide Suggests Drinking Only Water

The biggest culprit for promoting childhood obesity is excessive soda and pop. Indeed, we need to replace these fluids with water. However, what about dairy and dairy-alternative based beverages? I am very committed to my morning latte – both because I enjoy it and because I know it’s a delicious way to ensure that I have my 300mg of calcium and 8g of protein in only 8oz of milk. Most of us need to increase our hydration but for some people, including milk, smoothies and even supplements may be far more valuable fluids. The reference to milk is only in the written section, almost as an afterthought.

Yes, I do work with eating disorders, but I also have 3 children and I try to ensure that we all have an optimal diet, which includes nutrient rich fluids, not water alone.

 

  • The New Canada’s Food Guide Challenges the Affordability of Healthy Eating

Let’s face it: getting adequate fresh fruit and vegetables to cover half your plate is challenging, especially in a country that has such a long winter. I have just returned from California and even in the middle of their winter, there are fruits hanging on the trees. Fresh produce in Canada is imported for most of the year, driving costs up further.  There are healthy alternatives that are more affordable. Frozen fruits and vegetables are cheaper, convenient, have no additives and they retain most of their micronutrients through the freezing process. In fact, I purchase organic frozen berries in the off-season when I would never spend the money on fresh berries. Produce is flash frozen just after harvesting so they have at least the same number of vitamins and minerals as those that have travelled for days or weeks in cold storage.  Dried and canned foods such as legumes (beans and lentils) and pumpkin or squash are affordable alternatives that are not represented.

 

The food guide needed an update – there hasn’t been a change since the 70s. Unfortunately, the perfect Food Guide for Canadians probably doesn’t exist given the diversity of our population. But when thinking about eating disorders, do consider this: the food guide is not meant as a therapeutic diet.  But, the goal of eating disorders treatment is the return to ‘normal eating’.  I’m not convinced that this food guide is the desired new norm. Furthermore, it does not stress moderation enough for those at risk of developing one.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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