Canada’s Food Guide Consultation – Phase 1 What We Heard Report

On this page:

• Introduction
• 1.0 Format of Consultation Material
• 2.0 Who did we hear from?
• 3.0 Reading this report
• 4.0 Summary of Key Themes
• 5.0 What We Heard from Contributors
  • 5.1 Interest in Healthy Eating Recommendations and Use of Guidance
  • 5.2 Most Useful Types of Guidance
  • 5.3 Communicating Recommendations on Amounts of Food
  • 5.4 Usefulness of Current Canada's Food Guide Food Groupings
  • 5.5 Interest in Healthy Eating Recommendations Based on Level of Food Processing
  • 5.6 Usefulness of Approaches in Helping to Reduce Sugar Consumption
  • 5.7 Improving Uptake and Use of Health Canada's Healthy Eating Recommendations
• 6.0 Closing Remarks
• 7.0 Next Steps
• 8.0 Appendices
  • 8.1 Conducting the analysis
  • 8.2 Key question areas

Introduction

Through Canada’s Food Guide, Health Canada provides practical, evidence-based, healthy eating recommendations to help Canadians make food choices. Health Canada is revising Canada’s Food Guide to reflect new evidence and meet the needs of various audiences who use healthy eating recommendations.

In support of this initiative, Ipsos was commissioned by Health Canada to conduct Canada’s Food Guide Consultation, which seeks to inform Health Canada’s development and communication of healthy eating recommendations.

Canada’s Food Guide Consultation is being conducted over 2016/2017 and 2017/2018 in two phases. The findings of the consultation will contribute to the development and communication of a new suite of dietary guidance products that best support public health and is relevant and useful to stakeholders, including:

• the general public
• health professionals
• policy-makers

The feedback collected throughout this consultation is one input into the revision.

This report presents a summary of what we heard from Phase 1 of Canada’s Food Guide Consultation. Ipsos analysed and reported on feedback submitted by participants via an eWorkbook that was available and completed online between October 24, 2016 and December 8, 2016.

The feedback presented in this report reflects submissions made by:

• individual members of the general public with an interest in healthy eating recommendations for themselves or their family
• professionals with an interest in the food industry, health, health promotion, health research, and health monitoring or surveillance, including:
  • health professionals
  • educators
  • representatives of organizations from various sectors, including:
    • government
    • food industry (from producers to manufacturers and retailers)
    • schools/daycares
    • research/academia
    • hospitals/health care facilities
    • private practice/consulting
    • health/nutrition organizations
    • community groups

In total, 19,873 submissions were made to the consultation. While the results are not considered to be representative of the views of Canadians in general or the participating population, the nature of such a consultation provides a mechanism for collecting feedback from interested contributors. This consultation is one input into the wider revision.  Participants were able to submit feedback on more than one occasion, if desired, and therefore the feedback accumulated is an amalgamation of all input received. Questions within the eWorkbook were not mandatory, allowing contributors to provide feedback on questions relevant to them. Not all contributors may have answered all questions.

1.0 Format of Consultation Material

The eWorkbook, divided into separate versions for general public participants and participants contributing as a professional or organization, included questions developed with Health Canada. The questions addressed areas within Canada’s Food Guide identified for review and revision. Each question was available for consideration and response for the seven-week consultation period.

The questions focused on several key themes, including:

• main interest in healthy eating recommendations
• how healthy eating recommendations are used
• type of healthy eating recommendations that are used for different tasks
• useful ways to communicate amounts of food
• need to tailor healthy eating recommendations for different groups of people
• helpfulness of healthy eating recommendations based on level of food processing
• usefulness of approaches to encourage a reduction in the consumption of sugars
• usefulness of current food groupings within Canada’s Food Guide
• sources of healthy eating information

2.0 Who did we hear from?

Participants in the consultation came from a broad background and ranged from members of the general public, to professionals and organizations who use healthy eating recommendations at work.

Those who participated in this consultation phase (as a member of the general public, professional or representative of an organization) each have a particular interest in healthy eating recommendations.

3.0 Reading this report

The summary of the discussion presented in this report reflects the views of those who contributed to Phase 1 of the consultation however is not representative of Canadians' views and does not reflect the perspectives of the broader general public. Rather, it offers a thematic overview of the feedback that was submitted through the consultation process by interested participants.

Individuals who participated in the online consultation are referred to in this summary as either "contributors" or "participants".

Participants referred to throughout this report include:

General Public Those who responded as a member of the General Public who engage with healthy eating recommendations for their own personal use or use by their family.

Professionals    Those who responded in their professional capacity as a user of healthy eating recommendations in their individual work.

Organizations   Those who responded on behalf of an organization that they represent which uses healthy eating recommendations in the work of the organization (organizational response).

4.0 Summary of Key Themes

General Public Participant Views

• Many indicated that their main interest in healthy eating recommendations is a healthy lifestyle for their family, while for others it is for a healthy lifestyle primarily for themselves.
• Healthy eating recommendations are most often used to choose the types of foods to eat every day, to prepare a healthy meal, to plan meals, to help with grocery shopping or to assess eating habits.
• The most useful healthy eating recommendations were those based on nutrients to limit, like sugars, sodium, and saturated and trans fats.
• The easiest descriptions to understand for recommendations on amounts of foods are by proportionality per meal and frequency per day, followed by recommendations on portion size.
• Current food groupings (such as Vegetables and Fruit, Grain Products, Milk and Alternatives, and Meat and Alternatives) were considered useful, to at least "some extent", due to their simplicity, however less useful to some because of their departure from the nutritional components, lack of applicability to all circumstances and needs such as for a vegan or vegetarian lifestyle or dietary restrictions.
• Most indicated recommendations based on the level of processing of foods would be helpful as there is a desire for information about the effects of the level of processing of foods, health risks and safety concerns, content and nutritional value of processed foods.
• Several approaches presented to help Canadians reduce their consumption of sugars were considered "useful" including more information on food labels about sugars, messages about how to reduce consumption of sugars, and restricting the marketing of foods high in sugar to children.
• Education was considered a key tool for Health Canada to improve the uptake and use of its healthy eating recommendations, as well as targeted messages for high risk groups, developing recommendations specific to institutional environments (hospitals, schools) and creating greater awareness through advertising and messages, as well as mandating clearer and more accurate food labelling.
• General public participants also highlighted the importance of communicating consistent messages about healthy eating in order to form a new narrative around people's relationship with food.

Views of Participating Professionals and Organizations

• Most indicated their main interest in healthy eating recommendations is health promotion.
• Healthy eating recommendations are most often used for individual nutritional counselling and assessment, group education, tool and resource development, or to develop policy and guidelines.
• Recommendations on the types of foods or beverages to consume and to limit would be the most useful across several activities that contributors participate in.
• Participants considered the easiest descriptions for communicating amounts of food are proportionality per meal, frequency per day and recommendations on portion size.
• Current food groupings were generally considered useful to some extent, however participants called for a greater emphasis on (or de-emphasis of) certain foods as a way to improve the usefulness of the food groupings.
• An overall emphasis was placed on the importance of basing healthy eating recommendations on scientific evidence and research.
• Participants indicated that it is "essential" or "very important" for Health Canada's dietary guidance to include content related to the impact of ultra-processed foods in order to combat public confusion about which foods are processed, level of processing, importance of limiting processed foods and to improve/enable better consumer decision-making when purchasing food
• Several of the approaches presented by Health Canada to help Canadians reduce their consumption of sugars were considered useful.
• Education was also identified as a key tool for Health Canada to improve the uptake and use of its healthy eating recommendations, as well as using scientific research to support the development of recommendations, implementing strategies to help tackle food product marketing which appeals to children specifically, and communicating consistent healthy eating messages.

5.0 What We Heard from Contributors

5.1 Interest in Healthy Eating Recommendations and Use of Guidance

Healthy eating recommendations, whether in the form of Canada's Food Guide or other sources of information, are considered essential for:

• many Canadians in their day-to-day lives; and
• professionals and organizations working to improve the health of Canadians and inspire healthy eating behaviours. 

General Public Participant Views

Many general public participants indicated that their main interest in healthy eating recommendations is a healthy lifestyle for their family, while for others it is for a healthy lifestyle primarily for themselves. A smaller number of participants indicated that they are interested in a healthy lifestyle for both themselves and their family.

Other personal interests in healthy eating recommendations that were mentioned by participants include:

• improving the health of all Canadians in general;
• having a focus on dietary choices such as vegetarianism and veganism;
• managing food intolerances/allergies;
• disease management/managing health conditions, such as diabetes;
• concerns about the environment or animal welfare;
• support for educational study; or
• to aid their own involvement in a social or community group related to personal wellbeing, such as:
  • a healthy lifestyle
  • fitness
  • weight loss

When asked how they use these recommendations, participants from the general public indicated they use healthy eating recommendations most often to:

• choose the types of foods to eat every day;
• prepare a healthy meal, to plan meals;
• help with grocery shopping; or
• assess how well they are eating.

Overall, fewer indicated they use healthy eating recommendations to manage weight or to help make healthy choices when eating food that isn't prepared at home, such as at a restaurant.

Many use such guidance across several different activities, such as:

• to inform their food choices;
• for food preparation;
• when food shopping; and
• for self-evaluation.

Fewer indicated that they most often use healthy eating recommendations to:

• determine how much food to eat every day or for meals or snacks; or
• help make healthy choices when eating food that isn't prepared at home.

Views of Participating Professionals and Organizations

Most participating professionals and organizations indicated their main interest in healthy eating recommendations is health promotion.

The use of healthy eating recommendations among participating professionals and organizations includes many different activities.

Participating Professionals

Among participants answering as a professional, those interested in health promotion were more likely to indicate the activity they use healthy eating recommendations for most often includes:

• for individual nutritional counselling and assessment; and
• for group education.

Those with a food industry interest were more likely to use such guidance for food product development or marketing.

Participating professionals working within the private practice/counselling sector indicated the activity for which they use healthy eating recommendations most often is for individual nutritional counselling and assessment.

Participating professionals working within the hospital/health care facility sector indicated the activities for which they use healthy eating recommendations most often are:

• for individual nutritional counselling and assessment; and
• for assessment of eating habits in research and surveillance/monitoring.

Participating professionals working within school/day care sector, research/academia or a health/nutrition organization indicated the activity for which they use healthy eating recommendations most often is for group education.

Participating professionals working within the government sector indicated the activities for which they use healthy eating recommendations most often are:

• to develop policies and guidelines;
• for tool and resource development;
• for program design; and
• for group training (in-service and train-the-trainer) .

Participating Organizations

Among participants answering on behalf of an organization, those organizations within the health/nutrition organization sector indicated the activities for which they use healthy eating recommendations most often are:

• for program design; and
• for individual nutritional counselling and assessment.

Participating organizations within the hospital/health care facility sector indicated the activity for which they use healthy eating recommendations most often is for individual nutritional counselling and assessment (34).

Participating organizations within the school/day care sector indicated the activity for which they use healthy eating recommendations most often is to develop policies and guidelines (34).

Participating organizations within the food industry sector indicated the activities for which they use healthy eating recommendations most often are:

• for food product development or marketing;
• to develop policies and guidelines; or
• for assessment of eating habits in research or surveillance/monitoring.

5.2 Most Useful Types of Guidance

Participants were very positive about the prospect of revisions to Canada's Food Guide. For some, the current format offers a simple way to structure thinking about healthy eating and encourages Canadians to think about healthy eating principles. Others felt that the current recommendations are misleading and that revisions would be helpful to ensure the recommendations are useful to a broader audience.

General Public Participant Views

General public participants were asked to consider the types of guidance that could be useful to support activities, such as:

• choosing the types of foods to eat every day;
• planning for and preparing heathy meals; and
• assessing healthy eating habits and managing weight.

They deemed the most useful recommendations were based on nutrients to limit, like:

• sugars;
• sodium; and
• saturated and trans fats.

Recommendations based on the types of foods or beverages to consume and to limit was also considered to be the most useful to support each of these activities.

Participants who use healthy eating guidance to choose how much to eat every day (such as for meals and for snacks) found recommendations on the amount of food and beverages to consume to be the most useful.

Views of Participating Professionals and Organizations

Participating professionals indicated that healthy eating recommendations on the types of foods or beverages to consume and to limit would be the most useful across several activities, including:

• individual counselling and assessment;
• policy and program development; and
• product development or marketing.

Other recommendations considered useful by many participating professionals to support their activities or work include:

• eating behaviours, like cook at home more often; or
• more general healthy eating tips, like enjoy a variety of foods

Conversely, among participating organizations, the healthy eating guidance deemed most useful differed by the activity for which it is used.  

Among participating organizations that use healthy eating recommendations for group education (the most frequently mentioned activity among these participants), the "most useful" type of guidance is:

• recommendations on the types of foods and beverages to consume and to limit; and
• general healthy eating tips like enjoy a variety of foods. 

Participating organizations that use recommendations to develop policies and guidelines also indicate that recommendations based on the types of foods and beverages to consume and to limit is "most useful".

Participating organizations that use recommendations for tool and resource development indicate that recommendations based on general healthy eating tips like enjoy a variety of foods is "most useful".

Participating organizations that use recommendations for individual nutritional counselling and assessment indicate that recommendations around the nutrients to limit like sugars, sodium, saturated and trans fats is "most useful".

Participating organizations that use recommendations for food product development or marketing indicate that recommendations on amount of food and beverages to consume is "most useful", followed closely by general healthy eating tips like enjoy a variety of foods.

Overall Views

Generally, participants from the public, professionals and organizations felt that dietary guidance should cover a broad range of needs. Feedback received from contributors on potential content of the guidance included:  

• more focus on audience specific recommendations, particularly for those with lower incomes, elderly Canadians and children;
• inclusion of guidance addressing a range of lifestyle choices/dietary restrictions; and,
• more details related to the nutrient requirements for positive health outcomes, such as a focus on macronutrients and micronutrients essential for health.

A few participants also commented on a need for broader changes to the food industry beyond guidance materials to more specific policy changes to improve the health of Canadians by limiting options that negatively affect human health.

Participants suggested that dietary guidance could be made available in two formats:

1. a overview that can be used as a simple and easy reference by the public to build awareness and to initiate healthy eating practices; and
2. a guidance document that introduces more complex concepts and provides more detailed information concerning the guidance.

This mirrors the way professionals indicate how they use guidance with clients, as well as the ways the public indicate they use current guidance available from other sources.

5.3 Communicating Recommendations on Amounts of Food

Among contributors, there is a desire for simple, straightforward, relatable approaches to the measurement of food, portion sizes and descriptions of what and how much to eat to maintain a healthy lifestyle.

General Public Participant Views

Regardless of activities for which healthy eating recommendations are used, general public participants indicated that the easiest descriptions to understand for recommendations on amounts of foods are by:

• proportionality per meal; and
• frequency per day

These are followed by recommendations on portion size. However, some general public participants suggested that recommendations based on such descriptions can be difficult to follow/use unless they relate to something they can easily compare to, such as:

• make half your plate vegetables and fruit, as shown in the Eat Well Plate;
• eat vegetables and fruit at all meals and for snacks;
• eat smaller portions of these foods; or
• snacks should be the size of your fist.

Views of Participating Professionals and Organizations

Participating professionals and organizations indicated the easiest descriptions to understand for each activity they participate in is:

• proportionality per meal;
• frequency per day; and
• recommendations on portion size.

This is in line with the descriptions general public participants found to easiest to understand.

The pattern was similar among participating organizations, except for those that use healthy eating recommendations for food product development or marketing. Participating organizations involved in this activity indicated that in addition to recommendations for amounts of foods based on proportionality per meal being useful, measured amounts of food to eat per day or per meal was also useful.

Additional descriptions to present recommendations on amounts of food to consume put forward by participating professionals and organizations included:

• diagrams of serving sizes/comparisons with unhealthy portion sizes;
• advice around "intuitive eating" and "hunger cues," such as eat until you are 80% full;
• how to build a healthy meal or snack;
• Hand guide/practical comparable examples for portion sizes, such assnacks should be size of your fist, meals should be slightly larger;
• food weight measurements;
• macronutrient counts or percentages, including:
  • proteins
  • carbohydrates
  • fats
• calories per day in relation to physical activity;
• food labels which contain nutritional facts based on portion sizes recommended in Canada's Food Guide;
• Eat Well Plate/Healthy Plate visual tools; and
• types of foods people should be eating most often.

Some suggested the above descriptions should be tailored to specific audiences as well, such as measurements for:

• children, by stage of life, such as:
  • babies
  • toddlers
  • preschoolers
  • early childhood
  • middle childhood
  • teens
• adults, with variations for active/in-active adults; and
• the elderly

5.4 Usefulness of Current Canada's Food Guide Food Groupings

General Public Participant Views

Many general public participants indicated that the current food groupings were useful to them, to at least "some extent". They often cited the simplicity of the groupings as a good foundation for building awareness of healthy eating habits. Others felt the groupings were not useful due to their:

• departure from the nutritional components (micro and macro nutrients) in foods essential for positive health outcomes; and
• lack of ability to apply the groupings to all circumstances and needs, such as for:
  • vegan or vegetarian lifestyles
  • other dietary restrictions

Views of Participating Professionals and Organizations

While the current food groupings were deemed more useful, than not useful overall, several participating professionals indicated the current food groupings were only useful to "some extent" (much like the feedback received from the general public participants). Yet, participating organizations were divided in terms of how useful they consider the current food groupings to be (with a similar number indicating "to a great extent" and "to some extent"). 

Participating professionals working within the school/day care sector, hospital/health care facility sector and government sector were more likely to indicate that the current food groupings are useful in their work. Among participating professionals that do not find the current groupings to be helpful, these participants were more likely to work in private practice/consulting, health/health nutrition organization sector, research/academia, or food industry sector.

A greater emphasis on (or de-emphasis of) certain foods was recommended by participating professionals as a way to improve the usefulness of the food groupings. For example, some contributors suggested this could include:

• a greater emphasis on vegetables, rather than fruits; or
• a de-emphasis of meat or milk

While Canada's Food Guide should provide simple, relevant and succinct advice, participating professionals and organizations placed an overall emphasis on the importance of basing healthy eating recommendations on scientific evidence and research.

5.5 Interest in Healthy Eating Recommendations Based on Level of Food Processing

General Public Participant Views

Most general public participants indicated that healthy eating recommendations based on the level of processing of foods would be helpful to them as there is a desire for information about:

• the effects of the level of processing of foods;
• health risks and safety concerns about processed foods;
• the content of processed foods, such as whether they contain:
  • artificial ingredients
  • genetically modified organisms
  • preservatives
• the nutritional value of processed foods, such as the:
  • nutrients
  • sodium/sugar content
  • saturated/trans fats
  • calories

Participants called for general health and nutrition advice in relation to:

• processed foods to make better food choices; and
• guidance to encourage behaviours, such as:
  • buying locally grown foods
  • cooking at home more often

Two opposing points of view were put forward by contributors:

1. That processed foods are convenient (widely available and easy to prepare) and therefore guidance should include recommendations based on the level of food processing; and
2. Among those who indicated such guidance would not be helpful, that processed foods should not be consumed at all, and therefore recommendations should not include a reference to them.

Identifying what foods are processed and details about processing methods were an area where guidance was requested.

Views of Participating Professionals and Organizations

Participating professionals and organizations indicated that it is "essential" or "very important" for Health Canada's dietary guidance to include content related to the impact of ultra-processed foods on healthy eating. This content is particularly important to those who use such guidance for:

• individual nutritional counselling and assessment;
• group education; or
• the assessment of eating habits in research or surveillance/ monitoring.

Participating professionals and organizations acknowledged, like the general public participants, that processed foods were a choice for many due to their:

• convenience; and
• availability and ease of preparation.

Therefore, guidance on the level of food processing would be helpful to:

• combat public confusion about:
  • which foods are processed;
  • the level of food processing;
  • the importance of limiting processed food in the diet; and
• improve/enable better consumer decision-making when purchasing food.

In addition, participants were asked to identify other "essential" or "very important" potential topics for inclusion in dietary guidance, such as:

• eating behaviours;
• role of food skills; and
• enjoyment of eating.

Among participating organizations, there was more variance on the topics deemed essential/very important. Several participating organizations that most often use healthy eating recommendations for individual nutritional counselling and assessment or for group education considered content on the impact of ultra-processed foods as essential/very important.  While those that most often use recommendations for tool and resource development considered content on eating behaviours and role of food skills as essential/very important.

Participating organizations that most often use recommendations for program design considered content related to the impact of ultra-processed foods, eating behaviours and role of food skills, as essential/very important. Participating organizations that most often use such recommendations for food product development or marketing considered content related to food security, enjoyment of eating, eating behaviours, and role of food skills as essential/very important.

5.6 Usefulness of Approaches in Helping to Reduce Sugar Consumption

General Public Participant Views

General public participants considered several approaches presented to help Canadians reduce their consumption of sugars as "useful". In particular, the approaches considered "very" or "somewhat" useful by the highest number of contributors were:

• more information on food labels about sugars;
• messages about how to reduce consumption of sugars; and
• restricting the marketing of foods high in sugar to children.

These were followed closely by:

• a recommended limit on amount of sugars to eat each day;
• a Health Canada policy position on sugar-sweetened beverages; and
• targeting messages to the highest consumers of sugar-sweetened beverages.

Views of Participating Professionals and Organizations

Similarly, participating professionals and organizations considered several of the approaches presented to help Canadians reduce their consumption of sugars as useful. Among these participants, relatively fewer considered the approach of "more information on food labels about sugars" to be useful. 

5.7 Improving Uptake and Use of Health Canada's Healthy Eating Recommendations

General Public Participant Views

Education was considered a key tool by general public participants for Health Canada to improve the uptake and use of its healthy eating recommendations. Participants called for more education on:

• healthy eating practices;
• portion size and the amount of foods and beverages to consume; and
• food preparation skills, with recommendations supported by transparent, reliable information based on research.

Suggestions put forward by contributors to improve uptake included:

• targeted messages for high risk groups,
• developing recommendations specific to institutional environments (hospitals, schools),
• creating greater awareness among the general public through advertising and messages from healthcare professionals, as well as mandating clearer and more accurate food labelling.

General public participants also highlighted the importance of communicating consistent messages about healthy eating in order to form a new narrative around people's relationship with food. Mixed messaging, such as sugary breakfast cereals with targeted advertising to children, were seen to undermine efforts to teach healthy eating practices.

Most general public participants indicated they looked for healthy eating information in the past year by consulting websites, such as:

• web pages;
• blogs; and
• news articles.

Fewer have consulted:

• print materials, such as:
  • magazines
  • factsheets
  • newspapers
  • posters,
• social media, like Twitter, Facebook and Pinterest; or
• web/mobile based applications/interactive tools for such information.

Views of Participating Professionals and Organizations

Participating professionals and organizations also identified education as a key tool for Health Canada to improve the uptake and use of its healthy eating recommendations. These contributors also placed an emphasis on:

• using scientific research to support the development of healthy eating recommendations;
• implementing strategies to help tackle food product marketing which appeals to children specifically; and
• communicating consistent healthy eating messages.

Similar to general public participants, participating professionals and organizations indicated they predominantly use online sources for healthy eating information. These contributors also tended to use printed materials, web-based applications/ interactive tools and social media for this type of information.

6.0 Closing Remarks

While there are mixed perspectives, both positive and negative, on the value of Canada's Food Guide in its current format (including the content and recommendations specifically), many general public and professional/organizational participants agree that Canada's Food Guide may no longer be reflective of the increasingly varied diets of Canadians today.

There are different, more varied food types on the tables of Canadians than ever before, due to the rise of trends, such as:

• community gardening;
• gluten-free products;
• an emphasis on whole foods and plant-based diets; and
• the greater variety of traditional cuisines of Canada's multicultural population.

There is a call for healthy eating recommendations to be expanded to:

• reflect this greater variety;
• provide a basis of scientific evidence;
• provide more details to Canadians about the foods they are consuming; and
• create guidance to inform healthy eating behaviours.

7.0 Next Steps

 In mid- 2017, Phase 2 of Canada's Food Guide Consultation will be conducted online to collect input from Canadians and interested stakeholders on proposed healthy eating recommendations, which Health Canada will then develop into consumer messages and other tools and resources for a new Canada Food Guide Online Platform. 

8.0 Appendices

8.1 Conducting the analysis

 The number of contributions at each question within the consultation eWorkbook varied as questions were not mandatory and could be skipped. Only submissions that were submitted by the contributor are included in the analysis. Incomplete or non-submitted contributions have not been included in the analysis effectively allowing those who had begun a submission to withdraw their contribution if not officially submitted.

A formal coding and manual review of a random selection of verbatim comments collected within the eWorkbooks was undertaken by the Ipsos team. In addition, IBM SPSS Modeler text analytics software was utilized to provide a more in-depth view of all the verbatim feedback accumulated during Phase 1 of the consultation. In tandem with a manual review to theme and code each mention, text analytics uses computer processing techniques to identify and quantify the main themes and sentiment in text data, customized and analyzed by trained Ipsos consultation analysts. The analysis resulting from these models has also been included and explored within this report.   

8.2 Key question areas

General Public – Canada's Food Guide eWorkbook - English

Q1. My main personal interest in healthy eating recommendations is? 

Select one.   

• Healthy lifestyle for myself
• Healthy lifestyle for my family
• Other

Health Canada's healthy eating recommendations address the amounts and types of food to eat and, specific advice for your stage of life. We would like to understand the types of guidance that will help you make healthy eating choices.

Q2. What activities do you use healthy eating recommendations for most often? 

Select up to three. 

• To manage weight
• To prepare a healthy meal
• To assess how well you are eating
• To choose how much to eat every day
• To choose the type of foods to eat everyday
• To plan meals or help with grocery shopping
• To determine how much to eat at meals and for snacks
• To help make healthy choices when eating food that isn't prepared at home, such as at a restaurant

ANSWER FOR EACH RESPONSE SELECTED AT Q2

Q3. Which of the following types of guidance are most useful to you?

Select all that apply.

• General healthy eating tips like enjoy a variety of foods
• General recommendations on eating behaviours like cook at home more often
• Recommendations on the amount of food and beverages to consume
• Recommendations on the types of foods or beverages to consume and to limit
• Nutrients to limit like sugars, sodium, saturated and trans fats
• Other

It's been a challenge to communicate recommendations on amounts of food.  We would like to understand how much information you need on the recommended amounts of food to make healthy eating choices.

Q4. For healthy eating recommendations about the amounts of food people should eat, which of the following descriptions do you think is the easiest to understand?

Select all that apply.   

• Proportionality per meal (for example, make half your plate vegetables and fruit as shown in the Eat Well Plate
• Frequency per day (for example, eat vegetables and fruit at all meals and for snacks, or eat an orange coloured vegetable every day)
• Measured amounts of food to eat per day or per meal (for example, grams, cups or millilitres)
• Recommendations on portion size (for example, eat smaller portions of these foods)
• Calories per day
• Other

Health Canada is aware that there is a lot of interest in the healthy eating recommendations provided by some other countries based on the level of processing of food, like minimally processed and ultra-processed.

Q5a. Would healthy eating recommendations based on the level of processing of foods be helpful to you?

Select one.   

• Yes
• No
• Unsure

Q5b. Why do you say that?

Sugar consumption has become a concern for many people. Some countries and international health organizations have set limits on sugars. With more evidence on sugar-sweetened beverages' effect on health, Health Canada is considering ways to encourage Canadians to reduce their consumption of sugars.

Q6. How useful would the following approaches be to help Canadians reduce their consumption of sugars? 

Select one response for each statement.

• Very useful
• Somewhat useful
• Not very useful
• Not at all useful

(DESCRIPTIONS)

• A recommended limit on amount of sugars to eat each day
• A Health Canada policy position on sugar-sweetened beverages
• Messages about how to reduce consumption of sugars
• More information on food labels about sugars
• Restricting the marketing of foods high in sugars to children
• Targeting messages to the highest consumers of sugar-sweetened beverages

Grouping foods is important to communicate healthy eating recommendations. Health Canada is exploring different options to grouping foods to help you understand and use the recommendations.

Health Canada’s current healthy eating recommendations classify foods into the following groups:

• Vegetables and Fruit; 
• Grain Products; 
• Milk and alternatives; and, 
• Meat and alternatives.

Additional recommendations are provided on:

• Limiting foods and beverages that are high in calories, fat, sugar and/or salt; 
• Including a small amount – 30 to 45 mL (2 to 3 Tablespoon) of unsaturated fat each day.

Q7a. To what extent are the current food groupings useful to you?

Select one.   

• To a great extent
• To some extent
• Not very much
• Not at all

Q7b. Why do you say that?

Q8. People get healthy eating information in a number of different ways.  From the following list of sources, which have you used to look for healthy eating information in the past year?

Select all that apply.

• Social media like Twitter, Facebook, Pinterest
• Websites like web pages, blogs, news articles
• Web / Mobile based applications/ interactive tools
• Print materials like magazines, factsheets, newspapers, posters
• Other sources
• None of the above

This consultation workbook has asked about your use and perspectives on healthy eating recommendations and some of the challenges we aim to address with the revision of these recommendations.

Q9. What else can Health Canada do to help improve the uptake and use of its healthy eating recommendations? 

Tell us a little bit more about yourself:

Select one response for each question. 

(Responses)

• Yes
• No
• Prefer not to respond

(Descriptions)

• Are you a youth (less than 18 years of age)?
• Are you living in a household where there’s at least one child younger than 18 years of age?
• Are you First Nations, Inuit or Métis?
• Are you a newcomer to Canada?
• Are you a senior citizen (65 years of age or older)?

[END]

Professionals and Organizations – Canada’s Food Guide eWorkbook - English

Q1. Which of the following best describes you? 

• Member of the general public 
• Health professional, educator or representative of an organization 

Q2. Are you answering this questionnaire on behalf of an organization?

• Yes
• No

Q3. The sector I / my organization belong(s) to is:

• Government
• Food industry
• Schools/day cares
• Hospitals/Health care facility
• Research/academia
• Private practice/consulting
• Health/nutrition organization
• Other

Q4. What is your / your organization’s main interest in healthy eating recommendations?

• Food industry
• Health promotion
• Health research/monitoring/surveillance
• Other

Health Canada’s healthy eating recommendations address the amounts and types of food to eat and, specific advice for your stage of life. We would like to understand the types of guidance that will be useful for your or your organization’s work related to healthy eating.

Q5. For which activities do you / your organization use healthy eating recommendations most often?

Select up to three.

• For program design
• To develop policies and guidelines
• For tool and resource development
• For food product development or marketing
• For group training (in-service and train-the-trainer)
• For individual nutritional counselling and assessment
• For group education (for example, school, college or university, community)
• For assessment of eating habits in research or surveillance/monitoring
• Other

ANSWER FOR EACH RESPONSE SELECTED AT Q5

Q6. Which of the following types of guidance are most useful to you / your organization?

Select all that apply.

(FOR EACH RESPONSE TO Q5)

• For program design
• To develop policies and guidelines
• For tool and resource development
• For food product development or marketing
• For group training (in-service and train-the-trainer)
• For individual nutritional counselling and assessment
• For group education (for example, school, college or university, community)
• For assessment of eating habits in research or surveillance/monitoring
• Other

(THE TYPES OF RECOMMENDATIONS)

• General healthy eating tips like enjoy a variety of foods
• General recommendations on eating behaviours like cook at home more often
• Recommendations on the amount of food and beverages to consume
• Recommendations on the types of foods or beverages to consume and to limit
• Nutrients to limit like sugars, sodium, saturated and trans fats
• Other

It’s been a challenge to communicate recommendations on amounts of food.  We would like to understand how much information you need on the recommended amounts of food to be useful for your or your organization’s work.

ANSWER FOR EACH RESPONSE SELECTED AT Q5

Q7. To inform your / your organization’s work, what is the most useful way to present recommendations on amounts of food?

Select all that apply.

(FOR EACH RESPONSE TO Q5)

• For program design
• To develop policies and guidelines
• For tool and resource development
• For food product development or marketing
• For group training (in-service and train-the-trainer)
• For individual nutritional counselling and assessment
• For group education (for example, school, college or university, community)
• Other

Select all that apply.

• Proportionality per meal (for example, make half your plate vegetables and fruit as shown in the Eat Well Plate
• Frequency per day (for example, eat vegetables and fruit at all meals and for snacks, or eat an orange coloured vegetable every day)
• Measured amounts of food to eat per day or per meal (for example, grams, cups or millilitres)
• Recommendations on portion size (for example, eat smaller portions of these foods)
• Calories per day
• Other

As part of the revision of Canada’s Food Guide, Health Canada will develop a dietary guidance policy report for health professionals and policy makers.  The report will translate complex science about nutrition into clear and concise healthy eating recommendations.

Proposed topics for healthy eating recommendations came out of the evidence review and from early discussions with stakeholders. The topics include consumption of vegetables and fruit, whole grains, milk products, water, legumes like pulses, nuts, seeds, fish, red meat, processed meat, juice, and sugar-sweetened beverages.

Population health considerations will help provide context to apply the recommendations.

Q8. Please rate the importance of including content on each of the following topics to support your / your organization’s work related to healthy eating.

Select all that apply.

(RESPONSES)

• Not at all important
• Not very important
• Somewhat important
• Very important
• Essential

(DESCRIPTIONS)

• Dietary patterns – such as Mediterranean, vegetarian, Dietary Approaches to Stop Hypertension (DASH)
• Impact of ultra-processed foods on healthy eating
• Role of food skills (for example, cooking) in supporting healthy eating
• Eating behaviours (for example, eating together, mindful eating)
• Impact of the food environment on food choices
• Enjoyment of eating
• Impact of eating habits on the environment
• Traditional food, food access and other factors among Indigenous populations
• Food security

Other, specify:

• Somewhat important
• Very important
• Essential

Health Canada is aware that there is a lot of interest in the healthy eating recommendations provided by some other countries based on the level of processing of food, like minimally processed and ultra-processed.

Q9a. Would healthy eating recommendations based on the level of processing of foods be helpful to you?

• Yes
• No
• Unsure

Q9b. Why do you say that?

Consumption of sugars has become a concern for many people. Some countries and international health organizations have set limits on sugars. With more evidence on the health effect of sugar-sweetened beverages, Health Canada is considering ways to encourage Canadians to reduce their consumption of sugars.

Q10. How useful would the following approaches be to you in your / your organizations work? 

Select one response for each statement.

• Very useful
• Somewhat useful
• Not very useful
• Not at all useful

(DESCRIPTIONS)

• A recommended limit on amount of sugars to eat each day
• A Health Canada policy position on sugar-sweetened beverages
• Messages about how to reduce consumption of sugars
• More information on food labels about sugars
• Restricting the marketing of foods high in sugars to children
• Targeting messages to the highest consumers of sugar-sweetened beverages

Grouping foods is important to communicate healthy eating recommendations. Health Canada is exploring different options to grouping foods to help you understand and use the recommendations.

Health Canada’s current healthy eating recommendations classify foods into the following groups:

• Vegetables and Fruit; 
• Grain Products; 
• Milk and alternatives; and, 
• Meat and alternatives.

Additional recommendations are provided on:

• Limiting foods and beverages that are high in calories, fat, sugar and/or salt; 
• Including a small amount – 30 to 45 mL (2 to 3 Tablespoon) of unsaturated fat each day.

Q11a. To what extent are the current food groupings useful to you in your / your organizations work?

• To a great extent
• To some extent
• Not very much
• Not at all

Q11b. Why do you say that?

Q12. People get healthy eating information in a number of different ways. From the following list of sources, which have you used to look for healthy eating information in the past year?

Select all that apply.

• Social media like Twitter, Facebook, Pinterest
• Websites like web pages, blogs, news articles
• Web / Mobile based applications/ interactive tools
• Print materials like magazines, factsheets, newspapers, posters
• Other sources
• None of the above

Q13. How often do you / your organization work with the following client populations?

(Responses)

• Always
• Often
• Sometimes
• Rarely
• Never

(Client groups)

• Older adults
• Children/youth
• Indigenous peoples
• Low income earners
• Newcomers to Canada
• Individuals with a low literacy level

Q14. What should Health Canada know about tailoring messages or resources for healthy eating recommendations to these audiences?

This consultation workbook has asked about your use and perspectives on healthy eating recommendations and some of the challenges we aim to address with the revision of these recommendations.

Q15. What else can Health Canada do to help improve the uptake and use of its healthy eating recommendations?

[END]