In fact, such a compelling treatment already exists — access to nutritious food.
Earlier this year, one of the world’s most prestigious medical journals, The Lancet, published a study showing that 11 million people worldwide died due to poor diet. Canadians are not immune. A recent global report showed that foods sold in Canada contain close to twice the levels of salt than identical products sold internationally. High salt intake is linked to high blood pressure, heart disease and stroke.
Another major study showed that increasing the amount of fibre in our diets can seriously protect against chronic diseases like diabetes and heart failure and also prevent deaths from stroke, heart attacks, and cancer. Yet, on average, Canadians consume less than half the amount of fibre needed.
This yawning gap between evidence and the food we consume is in no way new. However, just this past year, Health Canada made a serious commitment to updating the Canada Food Guide with a heavy emphasis on science. This was a crucial step forward, yet how we actually deliver such evidence-informed diets to more Canadians remains a complex challenge.
The most obvious obstacle is poverty. More than 1-in-10 Canadians are worried they won’t be able to afford their next meal or are forced to skip meals or spend days without eating. And it is only getting worse.
Quite simply, the average Canadian is being priced out of access to a nutritious diet. And while this comes with a devastating toll on our health, there are also human costs when it comes to meaningfully engaging at school or work. Economic barriers to things that make us healthier are doubly wicked this way — they make our population sicker and poorer.
And as we rightfully look to extend access to medicines for all Canadians, we cannot lose sight of what is making us sick in the first place. Too many are being harmed outside our hospital walls each and every time they eat.
The cost-effectiveness of providing better nutrition is not lost in other health systems. A public health network in California has been piloting a tailored nutrition program with healthy meals for patients with chronic disease — and their preliminary results are already showing improved health outcomes and lower spending overall. Another trial from Massachusetts published in JAMA Internal Medicine also demonstrated fewer hospital admissions when nutritious meals were delivered weekly to patients’ homes.
While the evidence for integrating diet improvements for our patients is compelling, we must also find system solutions to the commercial interests that have long shaped our food choices. For example, the Canadian government’s proposed Child Health Protection Act is one policy measure that intended to curtail poor food options and advertising to children amidst rising obesity rates.
Prices are another undeniable driver when it comes to the decisions we make. Just as there have been effective public policy measures to reduce smoking through cigarette pricing, there is a growing body of evidence when the same principle is applied to sugary drinks — a major culprit of rising chronic disease and worsening overall health in Canada.
Remodelling the architecture of the choices around us when it comes to food will require a number of partners and policies. Canadian hospitals and health care organizations have an opportunity to lead by demanding healthy food options in public cafeteria spaces and by codesigning programs that better incentivize healthy eating for patients and providers. But to most effectively target our growing food insecurity problem, we must also advocate for meaningful poverty reduction writ large.
One of the fundamental principles of our medicare system is that every Canadian should have access to evidence-based treatments. But we are failing Canadians when it comes to one of the most essential medicines — access to nutritious and healthy food. We can no longer divorce the health of Canadians from nutrition in our health care system. Our health as a nation is depending on it.
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