Bulging Waistlines a Canadian Killer

The National - Abu Dhabi Feb 15, 2009

Blake Lambert 

TORONTO // In a country where nearly one in four people is obese and the number of children at risk from weight-related diseases is growing, Canada has been criticised for failing to take seriously the ever-expanding waistline of its population.

Obesity is identified as the second-leading cause of preventable death in Canada, according to the US-based Center for Science in the Public Interest, leading to diseases such as cancer, stroke, heart and gallbladder problems, and Type 2 diabetes.

Yet there is no central public health policy on obesity in the country, said Yoni Freedhoff, who operates the Bariatric Medical Institute in Ottawa.

“Canada has gone out of its way to avoid labelling obesity as a disease,” he said. “So if it’s not labelled a disease, then nobody needs to officially do anything about it.”

The “piecemeal” measures taken by the government involve politically acceptable ideas such as banning transfat, the unsaturated fat known to increase the risk of heart disease, in public schools and a nationwide programme promoting physical activity, he said.

Obesity rates in children have nearly tripled in the past 25 years, he said, showing that there is a need to focus on prevention activities as well as treatment.

Arya Sharma, the scientific director of the federally funded Canadian Obesity Network and a medical professor at the University of Alberta, said the availability of treatment varies across the country from no access to poor access.

He also said there is no national strategy to tackle obesity in the country, a fact he attributed to the multiple causes of obesity, which have to be addressed at the policy levels of food, transportation, structure and infrastructure of communities, health and social services.

Because of the dynamics of power-sharing between the federal and provincial governments – such issues as education and health policies are set by the provinces – the myriad responsibilities are divided among the two levels of government.

“The focus of many of the federal government’s activities has been on preventing obesity by promoting physical activity and healthy eating,” said Philippe Brideau, a spokesman for the Public Health Agency of Canada.

At the same time, Dr Sharma said the provinces have established their prevention initiatives, while the Canadian Obesity Network is connecting researchers with policymakers and health practitioners.

British Columbia, for example, runs a “dial-a-dietician” service for residents and healthcare professionals, and Ontario established the same about three years ago to enable residents to have access to credible nutrition information.

Although Dr Freedhoff advocates empowering consumers with information about calories, he remains sceptical of government efforts that place the onus solely on the individual to change his or her eating habits.

He says getting people to think about exercise is only part of the solution, and that physical activity on its own will not help with reducing diabetes rates. “What’s changed in the last 50 years is not genetics, it’s the availability of high-calorie foods and the increased pace of life,” he said.

People are eating more frequently in restaurants, portion sizes have grown and such inexpensive ingredients as high-fructose corn syrup, used in processed foods and beverages, and oils are prevalent in restaurant and home-cooked meals.

“We’re eating far too many calories,” he said.

Without tackling obesity as a disease of the environment instead of the individual, Dr Freedhoff said he doubted the ability to make gains in treatment or prevention.

One of the reasons that the government has not made obesity a disease was because the federal government would then be obligated to pay for weight-loss programmes, he said.

Current weight-loss programmes are part of an unregulated industry that has flourished even as waistlines have grown.

The public health agency said there is an ongoing dialogue about whether obesity should be considered a disease.

Mr Brideau said it has been recognised as a very crucial risk factor for several chronic diseases.

Dr Freedhoff urges the government to take more decisive action to counter current obesity trends. He cited an estimate that one third of Canadian children born since 2000 are going to develop Type 2 diabetes and live shorter lives.

Then there are costs to productivity, such as days off and greater use of sick time. “If we don’t [act], we’re going to cripple our health system,” he said. “We’re already on that road.”

blambert@thenational.ae

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