Opinion: Canadian Food Guide Falls Short for Aging Seniors

Heather Keller wrote . . . . . . . . .

“What do you think of the new Canada’s Food Guide?” is a question I have been asked a lot since Health Canada launched new guidance on how the country should eat. The guide recommends a plant-focused diet, but not to the exclusion of animal products — an approach consistent with the Mediterranean diet that has been studied extensively and shown to promote good health.

The guide is well designed for the healthy among us. That’s good news. But what about those living with chronic illness or frailty? Canada’s Food Guide has traditionally been used to plan menus for hospitals and care residences, despite the fact that it was not intended for this purpose.

When someone is frail, they have poor function in many areas of their life and are vulnerable to bad health outcomes; even a minor stress can result in a crisis. The new food guide is not specific enough to meet the essential dietary needs of aging seniors living with chronic illness or frailty.

What’s the difference?

As we get older, we start to lose our muscle mass because of our sedentary lifestyles and also because of what we eat. Muscles allow us to get out of a chair, pick up our grandchildren, balance so we don’t fall. It is now recognized that older adults need more protein, and specifically quality protein, than other age groups to maintain their muscle and prevent frailty.

So what is enough?

Experts recommend one to 1½ grams per kilogram of body weight per day. So, someone who weighs 80 kg (around 175 lbs.) should have 80 to 120 g of protein per day. But what do I mean by “quality protein”? This is protein that contains the essential amino acids that our body cannot make; it needs to come from what we eat.

Animal products, such as meat, poultry, fish, eggs and milk products, provide all of these essential amino acids in the right amounts, but not all plants do (an exception is soy). So if you avoid animal products, this means eating a variety of plant sources every day to get the right mix of essential amino acids. This takes education, planning and often cooking your own food; this can be challenging for older adults at risk for frailty, such as those living alone.

For older adults, getting enough of those essential amino acids without blowing their calorie requirements is also a challenge. Most plant sources are not as efficient as animal sources for attaining requirements; we need to eat more lentils, beans and nuts to get the protein we need.

Take the humble egg, with six grams of protein and 70 calories; the same amount of protein from peanut butter will double your calories. A chicken breast with no skin (three ounces) has around 30 grams of protein in under 200 calories. To get the same amount of protein from soy would mean more calories.

Also, some key nutrients known to mitigate frailty (calcium, vitamin D, omega-3 fatty acids) are more often found naturally in animal products.

We know that menus in long-term care often miss the mark on almost half of necessary nutrients, in part because the 2007 Food Guide was used for planning. A dietitian is the best resource for guiding those who are sick in hospitals or frail in residences.

With malnutrition common in hospitalized patients, many of whom are older adults, this means we need to work toward a standard for health-care institutions that promotes recovery from illness and prevents more malnutrition and consequent frailty. The good news is that the Canadian Malnutrition Task Force with the Canadian Nutrition Society is working towards this goal.

As a Canadian Frailty Network investigator, I have been advocating for some time that dietary reference intakes, which provide specific recommendations by sex and age group for vitamins, minerals and protein, should be the starting point for hospital and residence menus to prevent deficiency and chronic diseases. So, do I like the new food guide? I do. I am, however, waiting for more information on how this guide can be adapted to vulnerable populations, including older adults living with frailty and those living in our health-care institutions.

Heather Keller is the Schlegel Research Chair in Nutrition and Aging and a professor in the department of kinesiology at the University of Waterloo. She is also a researcher with Canadian Frailty Network.

Source: Winnipeg Free Press

A Dietitian’s Perspective on the New Canada’s Food Guide

Vincci Tsui wrote . . . . . . . . .

Health Canada released its latest update to Canada’s Food Guide on Tuesday, 12 years after the previous version was released. At the press conference, health minister Ginette Petitpas-Taylor joked that the iPhone hadn’t been invented yet when the last food guide came out.

Though not a perfect document, early feedback has been overwhelmingly positive. Here are some of the biggest improvements to Canada’s Food Guide, plus some areas that still need a bit of work.

What the New Food Guide does Well

Goodbye rainbow, hello plate

The most obvious change can be found on the front of the food guide. Instead of a rainbow graphic depicting the four food groups, Canadians are now greeted by a colourful plate featuring vegetables and fruit, protein foods, whole grain foods, and a glass of water, which we’re told should be our “drink of choice.”

The protein foods section of the plate shows a variety of choices, including beef (ahem), dairy (ahem), and various plant-based proteins, like legumes, nuts, and tofu.

The food guide has also done away with recommended serving sizes and number of servings of different types of food per day. I think this is a reflection that one size doesn’t fit all when it comes to nutrition, and that many eating patterns can be health-promoting.

A focus on how we eat, versus what we eat

In addition to the plate, Canada’s Food Guide includes seven recommendations under Eating Habits:

  • Be mindful of your eating habits
  • Cook more often
  • Enjoy your food
  • Eat meals with others
  • Use food labels
  • Limit foods high in sodium, sugars, or saturated fat
  • Be aware of food marketing

This section of the food guide has received the most praise, as it shows a shift away from what and how much we eat toward how and why we eat, echoing the Dietary Guidelines for the Brazilian Population that also received an overwhelmingly positive response when they were released in 2014.

More than just a handout

While the Canada’s Food Guide Snapshot will likely be what will pop up in doctor’s offices near you, Health Canada has developed a host of resources on its website. Beyond details on the plate and healthy eating recommendations, the website includes recipes, healthy eating tips including meal planning and cooking, as well as more specific recommendations for different life-stages and environments. Petitpas-Taylor stressed that Canada’s Food Guide will be constantly updated instead of the static document of versions past. In fact, there is a plan for another release later this year that provides more specific recommendations on amounts and types of foods.

Where the New Food Guide Can Improve

More flexibility and cultural sensitivity

Although the plate image and lack of recommended serving sizes and amounts is far less rigid than previous editions of the food guide, there are also parts that can be interpreted as being less flexible. While the beef and dairy industries have been up in arms about being grouped together with plant-based proteins, I’m curious how companies will feel about “grain products” being turned into “whole grains.” Despite the lack of recommended serving sizes and amounts, at the press conference, Petitpas-Taylor highlighted that Canadians should aim to eat foods in the proportions indicated on the plate: filling half your plate with vegetables and fruit, a quarter with protein foods, and a quarter with whole grains.

As a person of Chinese background, I also hope that future updates will be more culturally-sensitive, not only showing token pictures of “ethnic” foods, but also recognizing that many cultures eat foods served family-style, and that a plate may not be an helpful reflection of how people eat.

Mindful eating

For me–someone who literally wrote a book on mindful eating–the recommendation to “be mindful of your eating habits” actually sent up red flags. “Mindful eating” is often misconstrued as “careful eating,” like “I’m being mindful of my portion sizes;” when really, it’s about being present in the eating experience without judgment. While the more detailed section on that recommendation is more in alignment with what mindful eating actually is, I think that the “be mindful” wording and the fact that it’s being presented in a food guide takes away from the spirit of non-judgment. “Practice mindful eating” or “practice mindful eating principles” may have been a more appropriate and neutral choice.

Make resources more available and accessible

While Canada’s Food Guide is a huge improvement on previous editions, sadly, a lot of the “good stuff” is only on the website, which means a certain level of literacy, access to a computer, and time to review the information is necessary in order to get all that the food guide has to offer. Even though most Canadians won’t be using the food guide every day (nor is that how the food guide is intended to be used), as the second-most downloaded government document (behind tax forms), Canada’s Food Guide will have far-reaching impacts on our food environment and how we think about food, nutrition, and health. I hope the hard work that has gone into this document doesn’t get lost in oversimplification.

Source: Eat North