“Sodium levels in many foods served at Canadian restaurant chains exceed the amount an adult should take in during a day, a new study finds.” (1)
“Obesity rates are still climbing in Canada” (2)
Wow! Last week was a rough week for health reporting in Canada! This flies in the face of our Southern neighbours, where they seem to be having a lot more success tackling obesity and sodium. By at least addressing the “Salt Issue” through the National Salt Reduction Initiative, Mayor Bloomberg (NYC), Deputy Mayor for Health and Human Services Gibbs, and Health Commissioner Farley announced that 21 companies have voluntarily made and met targets to reduce the sodium (salt) content in their products.
The US is also reporting some positive news on the obesity front. Adult obesity rates seem to, at least, be plateauing (3). The US has also reported a reduction in childhood obesity rates in some areas. For example, Michelle Obama was just in Mississippi – declared the most obese state in the Nation – to congratulate them on the 13 percent drop in child obesity rates! Overall the US still has higher absolute rates of obesity (35.7% of US adults were obese in 2010) than Canada (25.3% in Canada)* but we think the trends are almost important!
We acknowledge that the US is not the “healthiest” country BUT they do have a few programs that could be viewed as templates for Canadian initiatives. We believe Canada desperately needs to do something – or many somethings – to prevent increases in obesity and unhealthy lifestyles in general. We also don’t think we should wait until we get to the current US rates before intervening.
Sodium and obesity SHOULD be two of our top public health concerns given their negative impacts on health. Obesity is linked to several chronic diseases including cardiovascular diseases, type 2 diabetes, certain cancers, and an overall reduction in quality of life. Sodium famously has been linked to hypertension, which can increase the risk of stroke and heart attack. Perhaps less known is the possible link between sodium and obesity – either directly or indirectly – through increased consumption of sugary drinks (4) and stomach cancer (5).
The Sodium Story
A recent study by Scourboutakos et al. (6) looked at 20 major sit-down restaurants and 65 fast-food restaurants across the Canada (2010 data) and evaluated the nutritional information provided to determine the sodium content of 4,044 items. On average the sit-down restaurant menu items contained 1455 mg of sodium; this is very close to the recommended intake (1500 mg) for an ENTIRE DAY for adults! Conversely, for the fast-foods, the average sodium in the meal items was 1011 mg. Side dishes were also high in sodium with an average of 736 mg regardless of if it was a sit-down or fast-food restaurant.
Even more alarming is the fact that the children’s meal items had an average sodium content of 790 mg, 66% of their recommended 1200 mg/day.
Some of the key culprits for excess sodium in restaurant foods, including some promoted-as-healthier options, are: sandwiches and wraps, ribs, stir-fries, fries, tacos and burritos, and pastas containing meat or seafood.
Salad entrees tended to be the lowest in sodium – makes sense if you can control the sodium in the dressing. Check out the CBC report for a chart based on the Canadian Journal of Public Health article (6).
In Canada, the Federal government has set a target of lowering average daily sodium intakes from 3,400 mg to the current upper limit of 2,300 mg. They aim to do this by 2016… but have not set any clear guidelines as to how they intend to achieve this goal. They state the government is working to:
- Increase awareness and education on healthy eating including reducing sodium intakes.
- Supporting research related to sodium reduction.
- Provide guidance to help the food industry lower the sodium in processed foods. They do have guiding benchmarks for sodium reduction for industry but these are voluntary (7).
Unfortunately, we feel more forceful measures are going to be required to reduce sodium intake in the Canadian food supply. Since disbanding the Sodium Working Group, let’s just say our faith in the Canadian government getting serious about sodium has wavered.
Where is our Michelle Obama?
Gotay et al. (8) looked at Canadian obesity rates from 2000 to 2011 and estimated the prevalence of obesity in adults. They found that rates have continued to increase – they now exceed 30% in the Atlantic provinces, and in the Northwest Territories and Nunavut.
First Lady Michelle Obama has made childhood obesity one of her primary focuses. She has been a strong advocate for the National Let’s Move program that focuses on reducing childhood obesity. At the very least, she has successfully raised awareness for the problem and hopefully there will be many more positive outcomes from her efforts.
In Canada, there is certainly a strong community of researchers involved in the prevention and treatment of obesity BUT would the support of an influential, big name advocate make a difference? A variety of different programs are being piloted, however, at present a uniform and aggressive national strategy is not in place (to our knowledge – we’d love to be corrected!). If you are interested in learning more about what is being done in Canada, you can check out the Canadian Obesity Network.
We certainly hope that this “tale” ends well with Canada observing the trends in the US and evaluating any strategies they find to be successful. We certainly hope that it does not end poorly with apathy resulting in continual decline in health.
*For more information on Canadian Obesity Rates, you can view the obesity maps developed by Dr. Gotay from the University of British Columbia.
- CBC. Sodium in Canadian restaurant foods ‘alarmingly high’; 2013. Retrieved March 1 from http://www.cbc.ca/news/health/story/2013/02/27/sodium-restaurant.html
- CBC. Obesity rates at historic levels in Canada; 2013. Retrieved March 1 from http://www.cbc.ca/news/health/story/2013/02/27/obesity-canada.html
- Time. U.S. Obesity Rates Remain Stubbornly High; 2012. Retrieved March 1 from http://healthland.time.com/2012/01/17/u-s-obesity-rates-remain-stubbornly-high/
- Grimes CA, et al. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics 2013; 131:14-21.
- Zhong C, et al. Sodium intake, salt taste and gastric cancer risk according to Helicobacter pylori infection, smoking, histological type and tumor site in China. Asia Pac J Cancer Prev 2012; 13:2481-4.
- Scourboutakos MJ, et al. Sodium levels in Canadian fast-food and sit-down restaurants. Can J Pub Health 2013; 104(1) [epub ahead of print].
- Health Canada. Sodium in Canada; 2012. Retrieved March 4 from http://www.hc-sc.gc.ca/fn-an/nutrition/sodium/index-eng.php
- Gotay C, et al. Updating the Canadian obesity maps: An epidemic in progress. Can J Pub Health 2013; 104(1) [epub ahead of print].