Table - Food and Nutrition Surveillance in Canada: An Environmental Scan

• Food and agricultural policy
• Health policy and programs

• Amounts and types of food available for consumption
• Nutrient composition of available foods
• Size and composition of the population
• Recommendations for dietary and nutrient intake

• Food Consumption in Canada
• Canadian Nutrient File
• Canada's Guidelines for Healthy Eating
• Recommended Nutrient Intakes

• Public health policy, programs and services
• Regulatory policy governing food production and processing

• Chemical and microbiological contaminants in food and water
• Other potential health risks, e.g. genetically modified foods
  
• Food intake of the population

• Total Diet Studies
• Canadian Food Inspection Agency surveillance of various food commodities for safety, including contaminants
• Some federal pesticide residue monitoring
• See below for data sources re: food intake

• No systematic, comprehensive national surveillance of environmental exposures, food contaminants and risks
  
• See below for information gaps re: food intakes

• Regulatory policy governing food and food products
• Health policy, programs and services
• Social welfare policy, programs and services

• Data on key technological and regulatory influences and changes
• Food intake and nutritional status of the population and vulnerable groups
• Health status of the population and vulnerable groups

• Various ad hoc federal activities to monitor food-related technological and regulatory change
  
• See below for data sources re: food intake and nutritional and health status

• No systematic monitoring of food related technological and regulatory changes
  
• See below for information gaps re: food intake and nutritional and health status

• Social and economic policy and programs
• Food and nutrition policy and programs

• Cost of foods at local level
• Availability and adequacy of food supply at local level
• Household food expenditures
• Individual and household income

• Food Expenditure Survey
• Survey of Family Expenditures

• Almost no systematic or comprehensive national information on food accessibility
• Agriculture and Agri-Food Canada National Nutritious Food Basket discontinued in 1995

What foods do Canadians eat? What nutrients are consumed and in what amounts?

What proportion of the population and vulnerable sub-populations consume a diet consistent with current dietary recommendations?

What is the prevalence of nutrient inadequacy or excess in the population?

Which population sub-groups are at greatest risk of nutrient inadequacy or excess?

• Food and nutrition policies, programs and services
• Health policy and services
• Social and economic policy

• Food and nutrient intake (dietary and supplement form) of population, all ages
• Food and nutrient intake (dietary and supplement form) of sub-populations with different dietary habits, and vulnerable sub-populations
• Source of foods consumed
• National dietary guidelines and recommendations
• Recommendations for nutrient requirements

• Nutrition Canada Survey
• Apparent per capita intake calculated from Family Food Expenditure Survey data by Agriculture & Agri-Food Canada (AAFC)
• Provincial Nutrition Surveys
• Food Habits of Canadians Survey

• Nutrition Canada data 3 decades out of date.
• No commitment to regular gathering of information over time.
• Little consistency across sources or over time in information from past activities. Children, seniors and aboriginal populations excluded.
• No recent national physical measures or data on biomarkers
• Provincial nutrition surveys spread over 10 years, methodologies not completely consistent. Children, seniors, aboriginal and other vulnerable populations excluded.
• Sample size in recent Food Habits of Canadians survey too small for regional and local application.

• Child health policy, programs and services
• Food and nutrition policy
• Social and economic policy

• Prevalence and duration of breast feeding for general population and vulnerable groups

• Canada's Health Promotion Survey
• National Population Health Survey (NPHS), Nutrition Supplements
• National Longitudinal Survey of Children and Youth (NLSCY)

• Poor consistency across sources and over time in information from past activities
• NLSCY includes only breast feeding data, no other nutritional information

• Development, targeting and evaluation of health promotion policies, programs and services
• Development, targeting and evaluation of specific nutrition and nutrition education policies and programs
• Social and economic policy

• Nutrition related knowledge, attitudes, skills and behaviors
• Food acquisition, storage and preparation facilities and practices
• Household food insecurity and determinants of food insecurity
• Socially and culturally determined food habits and preferences

• Canada's Health Promotion Survey
• National Population Health Survey, Nutrition Supplements
• Provincial Heart Health Surveys
• Provincial Nutrition Surveys
• Canada Fitness Survey
• Campbell's Survey on Wellbeing in Canada
• Tracking Nutrition Trends
• Canadian Community Health Survey (CCHS)
• Ad hoc analysis of food bank and poverty statistics to define population at risk for food insecurity

• No commitment to regular gathering of consistent information over time.
• Nutrition not a core part of NPHS. Questions on NPHS nutrition supplements not consistent over time. Some nutrition questions will be included in future CCHS.
• Little coFinansistency across sources or over time in different surveys.
• Virtually no national information on food insecurity
• Discontinuation of AAFC Nutritious Food Basket hinders food insecurity surveillance

• Development and evaluation of health promotion and nutrition policies and programs
• Provision of health services

• Weight and height for population and vulnerable sub-populations
• Longitudinal weight and height data for children, to track development

• Nutrition Canada Survey (NCS)
• Canada Health Survey (CHS)
• Canada Fitness Survey (CFS)
• Provincial Heart Health Surveys
• Provincial Nutrition Surveys
• National Population Health Survey
• National Longitudinal Survey of Children and Youth
• Food Habits of Canadians Survey (FHCS)

• NCS, CHS, CFS, provincial heart health surveys and provincial nutrition surveys collected anthropometric measures
• NPHS, NLSCY and FHCS use self-reported height and weight, with associated biases
• Need for much stronger national capacity for physical measures and biomarkers.

What is the prevalence of specific nutrient deficiencies and excesses in the population, and in vulnerable sub-populations?

What are the population trends in diet-related health conditions and how do these relate to trends in food and nutrient intake?

What is the potential need for and impact of fortification of foods on the nutrient and health status of vulnerable groups?

• Food and nutrition policies and programs
• Health policy and services
• Regulatory policy governing food and food products

• Nutritional status (from dietary intake and biological measures) of the population and sub-populations at greatest risk of inadequacy/excess
• Health outcomes for conditions whose occurrence and severity is related to diet and nutrient status
• Capacity to link nutritional status with health status data

Nutritional Status:

• Nutrition Canada Survey
• Canada Health Survey
• Provincial Heart Health Surveys
• Provincial Nutrition Surveys
• Food Habits of Canadians Survey

Health Status:

• Chronic disease mortality and morbidity data bases
• Canada Health Survey
• National Population Health Survey
• Canadian Community Health Survey (CCHS)

• All the same limitations of data on food and dietary intake apply
• Biological measures not gathered on most surveys
• Nutrients from supplements not included on existing nutrition surveys
• Virtually no capacity to link nutritional status and health status data at the individual level, and very limited capacity at the population or sub-population level

What are the relationships between nutritional status, health status and key socioeconomic, environmental, biological and genetic determinants of health?

• Social, economic, environmental and health policies and services

• Data on basic demographics, income, employment, education, social supports, physical environment, lifestyle, biological and genetic characteristics and health care utilization
• Capacity to link nutritional status, health status, and health determinants data

• Basic demographic data are gathered on virtually all surveys

Determinants of health data:

• National Population Health Survey
• Canadian Community Health Survey

• No common agreement on determinants of health data to be collected, to ensure consistency.
• Extremely limited capacity in existing activities to link nutritional status, health status and determinants data at the individual or population level.