January 1, 2019
Use this policy pack to support evidence-informed policy interventions to increase healthy eating
Inside this healthy eating policy pack
- Background evidence: healthy eating and cancer
- Evidence-informed policy actions to increase healthy eating
- Key statistics: healthy eating in Canada
- Public and policymakers’ perceptions of healthy eating in Canada
- Economic evidence to support healthy eating policy
- Indicators to measure progress on healthy eating policy
Policy has been shown to be an effective strategy for promoting healthy eating and limiting unhealthy eating.1 This policy pack analyzes policies from the Prevention Policies Directory and assesses the level of adoption of evidence-informed healthy eating policy actions that promote and improve healthy food consumption in Canadian cities, provinces and territories.
Up to one-third of cancers could be prevented by healthy eating and physical activity.2,3 Diet is associated with increased or decreased risk of certain cancers. There is strong evidence demonstrating:4
- processed meat increases the risk of cancer of the bowel and stomach
- red meat increases the risk of bowel cancer
- foods preserved with salt increase the risk of stomach cancer
- non-starchy vegetables decrease the risk of cancer of the mouth, pharynx, and larynx
- fruit decreases the risk of cancer of the mouth, pharynx and larynx
- foods high in fibre and wholegrains, and dairy products and calcium, decrease the risk of colorectal cancer
In addition, conditions related to unhealthy eating, including obesity4 and food insecurity,5 are also linked to cancer. Food insecurity is the strongest predictor of nutritional inadequacies.6 Compared to adults who are food secure, adults experiencing food insecurity eat significantly fewer servings of vegetables and fruit,5,7 a behaviour that is linked to cancer risk.
Using policy to improve healthy food consumption
A scoping review of the potential effectiveness of policy actions to improve healthy food consumption found that “increasingly strong evidence is highlighting potentially powerful policies to improve diet and thus prevent [non-communicable diseases], notably:
- multi-component interventions
- elimination and perhaps trade agreements 8
Similarly, systematic reviews assessing the effect of healthy food/beverage subsidies and unhealthy food/beverage taxation found that taxation and subsidy intervention influenced dietary behaviors.9,10,11,12 Finally, in a review of food environment research in Canada, the authors found associations between features of the food environment and residents’ diet-related outcomes, even after adjusting for important confounding variables.13
Policies that create more supportive environments are generally more effective than one-on-one approaches in improving population health, given their increased reach, scalability and sustainability. Policy approaches also tend to be more equitable. Policies usually impact everyone within a population; as such there is less need for special efforts directed toward underserved populations.
The term “policy” encompasses legislation, regulations, policies of public sector agencies and providers, workplace policies, local bylaws, as well as operating procedures, professional standards and guidelines, incentive programs, etc.
Policy can be enacted at federal, provincial/territorial, and/or municipal/local levels. In some cases, certain types of policy are in the jurisdiction of one level of government. More often, one level of government might be the most obvious actor for policy, but other levels might implement policy solutions along with, or instead of, the most obvious level.
1 World Cancer Research Fund / American Institute for Cancer Research. Policy and Action for Cancer Prevention. Food, Nutrition, and Physical Activity: a Global Perspective. Washington DC: AICR, 2009. https://www.wcrf.org/sites/default/files/Policy_Report.pdf
2 World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007.
3 Cancer Prevention and Survival. Summary of global evidence on diet, weight, physical activity & what increases or decreases your risk of cancer. WCRF, 2017. https://www.wcrf.org/sites/default/files/CUP_Summary_Report_Sept17.pdf
4 World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018. Available at dietandcancerreport.org
5 Cancer Care Ontario. Cancer Fact: Understanding regional food insecurity helps set system-level prevention priorities. June 2015. Available at cancercareontario.ca/cancerfacts. https://www.cancercareontario.ca/en/cancer-facts/understanding-regional-food
6 Vogt J, Tarasuk V. Analysis of Ontario sample in Cycle 2.2 of the Canadian Community Health Survey (2004). Toronto: Public Health Research, Education and Development (PHRED) Program; 2007.
7 Kirkpatrick SI, Tarasuk V. Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. J Nutr. 2008 Mar;138(3):604–12.
8 Hyseni L, Atkinson M, Bromley H, Orton L, Lloyd-Williams F, McGill R, et al. (2016). The effects of policy actions to improve population dietary patterns and prevent diet-related non-communicable diseases: Scoping review. European Journal of Clinical Nutrition, DOI: 10.1038/ejcn.2016.234.
9 Niebylski M.L., Redburn K.A., Duhaney T., & Campbell N.R. (2015). Healthy food subsidies and unhealthy food taxation: A systematic review of the evidence. Nutrition, 31(6), 787-795.
10 Thow A, Downs S, & Jan S. (2014). A systematic review of the effectiveness of food taxes and subsidies to improve diets: Understanding the recent evidence. Nutrition Reviews, 72(9), 551-565.
11 Alberta Policy Coalition for Chronic Disease Prevention (APCCP). (2018). Alberta’s Nutrition Report Card on Healthy Food Environments for Children and Youth. Retrieved from: http://abpolicycoalitionforprevention.ca/evidence/albertas-nutrition-report-card/
12 Alberta Policy Coalition for Chronic Disease Prevention (APCCP). (2015). Evidence synthesis: Impact of economic incentives on sales and consumption of healthier foods, and body weight status. Retrieved from: http://abpolicycoalitionforprevention.ca/evidence/evidence-reviews/economic-incentives/
13 Health Canada. (2013). Measuring the food environment in Canada. Retrieved from: http://publications.gc.ca/collections/collection_2013/sc-hc/H164-155-2012-eng.pdf