Everything from advertising to school cafeteria menus can affect whether children develop lifelong healthy eating habits, according to the sixth annual Nutrition Report Card for Alberta, which was released today.
The report evaluates 39 indicators in five food "environments"-physical (what food is available?), economic (how affordable is healthy food?), communication (what messages are children getting about food through education and advertising?), social (how acceptable is it to make healthy food choices?) and political (what policies are in place to support all of the other environments?)
These food environments present opportunities and barriers to children's healthy eating, according to principal investigator Kim Raine, distinguished professor at the University of Alberta's School of Public Health.
"Kids and families are not to blame," said Raine. "Often 'choices' are driven by what's available, what's affordable, or what is promoted-that's where the food environment comes in."
Raine pointed out that a poor diet is second only to smoking as the top behavioural risk factor for premature mortality in Canada.
Ways to make the grade
The report card recommends that voluntary healthy food policies should be made mandatory, implemented fully and monitored for results.
For example, Alberta has had voluntary guidelines for foods served in schools, child-care centres and recreation facilities for more than a decade, but only a limited number of school districts have mandated them, Raine said.
"Making policies mandatory is a sign of their importance, and is a first step to raising the grade," she said.
"A mandated policy has little value if it remains on paper or a website but isn't put in place," Raine said. "Implementing policy means someone must be responsible for making it happen-if there are no ramifications for not adhering to it, the mandated policy has no teeth and can easily drop off the priority list."
Better food options needed at schools, rec centres
One indicator evaluated in the report is whether schools across the province meet the guideline that 75 per cent of the food offered in vending machines, cafeterias and lunch programs is healthy.
Raine reported 72 per cent of Alberta's 51 school boards had a voluntary healthy food policy in 2020, but available data indicate they are not meeting the mark.
Publicly funded recreation centres fall even further short, according to Raine.
"We're trying to go for 75 per cent healthy food options and it's exactly the opposite-it's 75 per cent unhealthy," she said.
Raine said many rec centres fear they will lose money if they don't offer junk food for sale, but pointed out that research shows that's not the case.
"Parents will bring their own food to a recreation facility because they don't want to feed kids pop and chips," she said. "But once they realize there are healthy options available, they start purchasing food at the recreation facilities, which can actually increase the customer base."
Raine noted the 2020 Nutrition Report Card was prepared using data collected in the first quarter of the year, but it's likely the COVID-19 pandemic has since made it even harder for some children to eat well. For example, free meals provided by the Alberta School Nutrition program were suspended when schools closed in March.
"We believe that nutrition vulnerabilities have been exacerbated by COVID-19," she said. "With more families unemployed and reliant on government support, there is research showing that people are finding it more difficult to afford a healthy diet in this crunch time."
Taxes, warning labels for junk food may be coming
Alberta's annual nutrition report card is funded by Alberta Innovates and is prepared in partnership with the Alberta Policy Coalition for Chronic Disease Prevention, which has 16 member organizations including Alberta Health Services, Diabetes Canada, and Heart and Stroke. A national expert working group reviews new data and comes to consensus on the grades each spring.
Raine noted that poor diet can lead to chronic illnesses such as heart disease, diabetes and cancer, which are costly on both a personal level and to the health-care system.
She suggested it's time for a sea change in Canadian attitudes toward unhealthy food, much like what occurred over the past 50 years with tobacco reduction strategies. That may mean restrictions on marketing unhealthy foods to children, extra taxes on products such as sugar-sweetened beverages, and warning labels on food.
"The future health of our population is at risk," Raine said. "While tobacco has been denormalized, we've seen the exact opposite with nutrition, and it's become normal to consume huge portions of junk food every day.
"Let's create environments where the healthy choice is the easy choice."