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Overview of Canadians' Eating Habits
Choices determine a balanced diet
Not enough vegetables and fruit
One in three children below recommended minimum for milk products
Consumption of meat and alternatives high among men
Consumption of grain products declines with age
Many exceed upper limit for fat
Canadians within acceptable ranges for protein
Carbohydrates primary source of energy
More calories from snacks than breakfast
A quarter eat food prepared in fast–food restaurant
Regional consumption patterns
Adult diet linked to household income
Children’s diets less closely tied to income
Calories are a measure of the amount of energy in food. An individual’s energy needs, that is, the number of calories he or she must consume to maintain health, vary according to a number of factors, notably, age, sex, weight, height and activity level (Institute of Medecine 2005).
For example, a moderately active 30-year-old man who is 1.75 metres tall (5 feet 9 inches) and weighs 75 kilograms (165 pounds) needs 2,750 calories a day (Institute of Medecine 2005). A sedentary 65-year-old woman who is 1.55 metres (5 feet 1 inch) and weighs 60 kilograms (132 pounds) needs 1,600 calories a day. An active 12-year-old boy who is 1.5 metres tall (4 feet 11 inches) and weighs 46 kilograms (101 pounds) needs 2,625 calories a day.
Results for 2004 indicate that calorie consumption is highest during adolescence and declines with age (Chart 1). Males aged 12 to 19 average 2,800 calories a day, and females, just over 2,000 (Table 1). By age 65 or older, the corresponding figures are 1,950 and 1,550. At all ages, men tend to consume more calories than do women.
The only other similar national survey was the 1970-1972 Nutrition Canada Survey (National Health and Welfare 1977). Although it, too, was based on individuals’ recall of their food consumption the previous day, the collection method differed substantially from that employed in 2004. In 1970-1972, collection was done manually by dieticians/nutritionists, whereas in 2004, trained interviewers used an automated system. As well, the 1970-1972 response rate (47%) was much lower than that obtained in 2004 (77%).
While the 2004 data cannot be strictly compared with those for 1970-1972 (National Health and Welfare 1997), an examination of results from the two surveys suggests that Canadians’ calorie consumption has not increased. On the contrary, initial findings suggest that the trend is down among males aged 12 to 64, and essentially stable among women and older men (Table 1). This is counter to the situation in the United States, where calorie intake rose between 1971-1974 and 1995-2000 (Trends in intake of energy and macronutrients 2004).
Food choices determine the degree to which an individual’s diet is balanced. Since 1942, Health Canada has helped Canadians make healthy choices by publishing a food guide (Health Canada 2002). The version that was in effect when the 2004 CCHS was conducted, Canada ’s Food Guide to Healthy Eating for People Four Years Old and Over (Health Canada 1997), had been released in 1992.
The Guide separates foods into four groups: vegetables and fruit, milk products, meat and alternatives, and grain products such as bread and cereals. An “other foods” category covers foods that are mostly fats, oils or sugar; high-fat and/or high-salt snack foods; beverages; and herbs, spices and condiments.
The calories that individuals consume each day can be classified according to these food groups. Grain products are the top energy provider for both children and adults, supplying 31% of calories at ages 4 to 18, and 28.5% at age 19 or older (Chart 2). The “other foods” category ranks second, providing, on average, 22% of daily calories for both children and adults.
For each of the four food groups, the Guide recommends a range for the number of servings per day. “Other foods,” according to the Guide, should be consumed in moderation.
The Food Guide recommends a minimum of five daily servings of vegetables and fruit for people of all ages. One serving would be, for example, a medium-sized apple, two stalks of broccoli, or 125 millilitres (1/2 cup) of juice.
Even the averages indicate that Canadians’ vegetable and fruit consumption tends to be low (Table 2). Children and adolescents have an average of 4.5 servings a day; for adults, the average is 5.2 servings.
In fact, at most ages, a majority of Canadians eat fewer than five servings of vegetables and fruit a day (Chart 3). Seven out of 10 children aged 4 to 8 do not meet the five-serving minimum. At ages 9 to 13, the figures are 62% for girls and 68% for boys. Consumption is somewhat higher among adults, but around half of them fall short of the five-serving threshold.
Among people aged 14 to 50, males are significantly less likely than females to have fewer than five servings of vegetables and fruit a day.
However, around 20% of all age-sex groups have between four and five servings of vegetables and fruit a day (data not shown).
Milk products include not only milk per se, but also foods such as cheese and yoghurt. The Food Guide recommends two to three daily servings for children aged 4 to 9; three to four servings for 10- to 16-year-olds; and two to four servings for people aged 17 or older. One serving from this food group amounts to 250 millilitres (1 cup) of milk, 50 grams of cheese, or 175 grams (3/4 cup) of yoghurt.
On average, children and young teens consume the recommended daily number of servings of milk products (Table 2). However, by their late teens, Canadians’ average consumption is below the recommended level. Moreover, figures on average consumption hide the fact that a substantial share of every age group is below the recommended levels.
The 2004 CCHS found that more than one-third of children aged 4 to 9 do not have the minimum recommended two daily servings of milk products (Chart 4). By ages 10 to 16, 61% of boys and 83% of girls do not meet their recommended minimum of three daily servings.
As well, the majority of seniors do not get the suggested minimum number of servings of milk products: about 80% of men and women aged 71 or older have less than two servings of milk products a day.
The meat and alternatives group includes beef, pork, lamb, chicken and fish; legumes such as beans and lentils; soy products such as tofu; and eggs.
The Food Guide suggests two to three daily servings from this food group, the equivalent of 100 to 300 grams of cooked meat. One serving from this food group would be, for instance, a chicken leg or a beef patty, 125 to 250 millilitres (1/2 to 1 cup) of beans; 100 grams (1/3 cup) of tofu, or one or two eggs, depending on their size.
Regardless of their age, Canadians’ meat consumption averages at least 100 grams a day (Table 2). Among males aged 14 to 70, average daily consumption is at least 200 grams, and about one in four has more than 300 grams of meat a day (data not shown).
At all ages, women eat less meat than men do, and almost no women consume more than 300 grams a day (data not shown).
Grain products are the principal source of calories (Chart 2) and include foods such as bread, cereals, pasta and rice. The Food Guide recommends 5 to 12 servings a day. One serving would amount to, for example, one slice of bread, 30 grams of cold cereal, half a bagel, or one cup of cooked pasta or rice.
More than a quarter of children aged 4 to 8 do not eat the recommended daily minimum of five servings of grain products (Chart 5). And for both sexes, the proportion of people not meeting the minimum tends to rise with age.
At all ages, females are much more likely than males to fall short of the recommended level. For instance, at ages 14 to 18, 33% of girls, compared with 6% of boys, have fewer than five daily servings of grain products. By age 71 or older, the corresponding figures are 66% and 43%.
“Other foods” is a broad category covering foods and beverages that are not part of the four major groups. Included here are: fats and oils such as butter and cooking oils; foods that are mostly sugar such as jam, honey, syrup and candies; high-fat and/or high-salt foods such as chips (potato, corn, etc.); beverages such as soft drinks, tea, coffee and alcohol; and herbs and condiments such as pickles, mustard and ketchup.
While the Food Guide recommends moderate consumption of “other foods,” this category accounts for 22% of the total calories consumed by Canadians (Chart 2). For adolescents aged 14 to 18, 25% of all calories come from “other foods” (Table 3).
A wide range of foods and beverages make up the “other foods” category, but a relatively small number of specific items account for most consumption. In fact, the ten most commonly consumed “other foods” represent two-thirds of the calories derived from this category. Soft drinks rank first, followed by salad dressing, sugars/syrups/preserves, beer, and oils/fats (Table 4). Given the high sugar and fat content of the top ten “other foods,” the sizeable contribution of this category to daily calorie intake is not surprising.
In 2002, as part of the Dietary Reference Intakes project, the Institute of Medicine (IOM) published a report titled Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (Institute of Medecine 2005). The document specifies ranges for the percentage of calories that should come from the three macronutrients: fat, protein and carbohydrates. These “acceptable macronutrient distribution ranges” (AMDR) have been adopted by health officials in Canada. An AMDR is a range of intakes for a particular energy source that is associated with reduced risk of chronic diseases while providing adequate intakes of essential nutrients. An increase in the proportion of total calories from one macronutrient necessarily reduces the proportion from one or both of the others.
On average, the Canadian diet falls within the AMDR. This is generally true for both sexes, all age groups, regions, and household income groups (Table 5). Averages, however, conceal the fact that many people fall outside the AMDR.
Fat is a source of energy and an important part of a healthy diet. The AMDR for total fat intake is 25% to 35% of calories for children and teens, and 20% to 35% of calories for adults aged 19 or older. When fat accounts for more than 35% of calories, this may pose a potential health problem.
One of the recommendations stemming from the results of the 1970-1972 Nutrition Canada Survey was that Canadians reduce their fat intake, which at that time averaged about 40% of calories (National Health and Welfare 1977) (Table 6). By 2004, an appreciable change was evident, with fat accounting for an average of just over 31% of Canadians’ daily calories (Table 5).
While this average is within the acceptable range, substantial shares of the population exceed the suggested percentage of total calories from fat. Among children aged 4 to 8, the figure is about 7% (Chart 6). Excess fat consumption peaks among people aged 31 to 50. More than a quarter of men and women of these ages derive more than 35% of their total calories from fat. At older ages, although the percentage declines somewhat, around one person in five gets more than the recommended share of their calories from fat (Chart 6).
The meat and alternatives group is the primary source of fat for both children and adults (Chart 7). However, children get nearly equal percentages of fat from meats and alternatives, milk products, and “other foods” (24% or 25%). Adults get almost a third of their fat from the meat group, and about a quarter from “other foods.”
The fat that Canadians consume comes from a relatively small number of specific foods. The main contributor, accounting for 15.9% of fat intake, is what can be classified as the “sandwich” category, consisting of items such as pizza, sandwiches, submarines, hamburgers and hot dogs (Table 7). This is followed by sweet baked goods, such as cake, cookies, and doughnuts (8.5%).
Protein is required for growth and is a source of energy. It is needed to maintain the structure, function and regulation of the body’s cells, tissues and organs. Important sources of protein include meat, poultry, fish, eggs, dairy products and beans.
The AMDR for protein is 10% to 30% of calories for children and adolescents, and 10% to 35% of calories for adults. According to the results of the 2004 CCHS, Canadians’ average daily calorie intake from protein is within these ranges. The average for children and adolescents aged 4 to 18, is 14.7% of total calories; for adults, 16.8% (Table 5). Almost no one falls below or above these ranges.
Among children and teenagers, boys derive a larger proportion of their calories from protein than do girls. At older ages, this difference disappears.
Carbohydrates are the body’s most important source of energy. They may be obtained as sugars, starch or fibre. According to the IOM, 45% to 65% of daily calories should come from carbohydrates.
Canadian children and adolescents, on average, derive 55.4% of their calories from carbohydrates; adults, 50.1% (Table 5). Both figures are within the suggested range.
At all ages, women get a larger percentage of their calories from carbohydrates than do men.
The nutritional benefits of eating breakfast include higher intake of fibre, vitamins and minerals (Tietyen, Fleming 1995). As well, breakfast consumption has been associated with a lower likelihood of being overweight (Song, Chun, Obayashi et al. 2005). However, close to 10% of people reported that they had not had breakfast the day before they were interviewed for the survey (data not shown). Men aged 19 to 30 were least likely to have eaten breakfast: 19% of them had not done so (data not shown).
On average, about 18% of daily calories are consumed at breakfast (Table 8). Snacks, that is, food or drinks consumed between meals, actually account for more calories: 27% for children and adolescents and 23% for adults. Lunch makes up another 24% of daily calories, and dinner, 31% for children and adolescents and 36% for adults.
The proportion of calories derived from snacks peaks among 14- to 18-year-olds at 30% for males and 28% for females, and then falls with advancing age to around 16% among seniors aged 71 or older (Chart 8).
When Canadians eat between meals, more than 41% of these calories come from the “other foods” category (Chart 9). Even so, snacks are not necessarily foods and beverages that are high in sugar, fat and calories. Vegetables and fruit make up just 13% of calories from snacks, but such foods tend to be low in calories. Consequently, this relatively small proportion of calories does not represent the number of times that Canadians choose snacks from this food group.
Overall, a quarter of Canadians reported that on the day before their interview they consumed something that had been prepared in a fast-food outlet (Table 9). Among 14- to 18-year-olds, the figure is one-third; at 39%, the percentage is highest among men aged 19 to 30 (Chart 10).
Of course, “something” prepared in a fast-food outlet is not invariably a high-fat, high-calorie item. It might have been as little as a cup of coffee, or as healthy as a salad without dressing. However, 40% of patrons of fast-food establishments chose a pizza, sandwich, hamburger or hot dog, and 25% had a regular (as opposed to diet) soft drink (data not shown).
The apparent popularity of fast food notwithstanding, more than half the population reported that all the food they ate on the day before the interview had been prepared at home. For children, the figure was 60% (Table 9). Elderly women were the group most likely to eat only food prepared at home: 75% had done so. By contrast, among young adult men, the figure dropped below 40%.
Canadian diets are generally similar across the country, although each region has consumption patterns that distinguish it from the others.
In the Atlantic provinces, and also in the Prairies, relatively high proportions of residents eat fewer than five daily servings of vegetables and fruit. The figures for the Atlantic region are 79% of children and adolescents and 67% of adults, and for the Prairies, 75% and 57%, respectively, compared with 64% and 49% for Canada overall (Chart 11). On the other hand, in Quebec, relatively low percentages of residents have fewer than five daily servings of vegetables and fruit: 51% of children and adolescents and 37% of adults.
The proportion of children aged 4 to 9 in the Atlantic region who have less than the minimum recommended three servings of milk products a day is low: 26% compared with 37% for this age group nationally (Chart 12).
Residents of the Atlantic region get a significantly large percentage of their calories between meals. Children and teens in that region consume 32% of their calories as snacks, compared with 28% of calories for this age group in Canada as a whole (Table 8). Snacking accounts for 26% of calories consumed by adults in the Atlantic region, compared with 23% of calories for Canadian adults overall. In the Prairies, too, relatively high percentages of children’s and adults’ calories come from snacks. This is also the case for children in British Columbia. By contrast, Quebec residents get a comparatively small proportion of their calories from snacks: 23% for children and teens, and 20% for adults.
A significantly low percentage of Quebec residents eat food prepared in fast-food outlets. On the day before their interview, 19% of children and adolescents and 18% of adults in that province had eaten something that had been prepared in a fast-food establishment (Table 9). The comparable national figure is 25% for both age groups.
A relatively high percentage of Quebec children and teens get more than 35% of their calories from fat: 22% versus 11% of children and teens in Canada overall (Chart 13).
With almost 40% of the country’s population, it is not surprising that Ontario has few divergences from the national food consumption profile. However, significantly high proportions of Ontario residents—27% of children and adolescents and 29% of adults—reported having consumed something prepared in a fast-foot outlet on the day before their interview (Table 9).
In several respects, adults’ food consumption is associated with their household income.
For example, the percentage of calories from fat tends to rise with income. While 25% of adults in the highest income households get more than 35% of their total calorie intake from fat, this was the case among 15% of those in the lowest income households (Chart 14).
Adults in the highest income households were significantly more likely than those in any other income group to report having eaten something from a fast-food outlet the day before their interview (Table 9).
Adults in the highest income households are less likely than those in the lowest to have fewer than five daily servings of vegetables and fruit: 41% versus 58% (Chart 15).
Compared with adults, children’s and teens’ diets are less closely linked with household income. Except for those in upper-middle income households (among whom the percentage is significantly low), the percentage of calories that children and adolescents derive from fat does not differ significantly by household income (Chart 14). As well, there are no significant differences by household income in the proportion of young people who have fewer than five servings of vegetables and fruit each day (Chart 15).
The consumption of milk products does not vary with household income among children aged 4 to 9. However, at ages 10 to 16, 62% in the highest income households consumed fewer than the recommended minimum of three daily servings, compared with about three–quarters of youth in the other household income categories (Chart 16).
As is true for adults, the likelihood that children and adolescents will have something from a fast-food outlet tends to rise with income. On the day before their interview, 28% of children from the highest income households ate something that had been prepared in such an establishment, compared with 19% of children from the lowest income households (Table 9).
When averages are considered, Canadians are generally within acceptable ranges for the number of servings from the four major food groups and the percentage of calories from fat, protein and carbohydrates. This is generally true for both sexes, all age groups, by region, and by household income.
But averages mask the fact that many people do not have a balanced diet. The majority of Canadians do not eat the recommended daily minimum of five servings of vegetables and fruit. More than a quarter of men and women in their thirties and forties get more than 35% of their calories from fat. More than one-third of children aged 4 to 9 do not have the recommended two servings of milk products a day, and among seniors aged 71 or older, the proportion surpasses 70%. Canadians of all ages get more than a fifth of their calories from “other foods,” and on a given day, a quarter of Canadians, adults and children alike, eat something that was prepared in a fast-food outlet.
This report is the first to examine the nutrition data collected in the 2004 Canadian Community Health Survey (CCHS). As an overview of the results, the report shows only a small part of the wealth of information that was collected. Obviously, each of the topics presented here requires much more in-depth analysis. As well, other topics have yet to be addressed: for instance, beverage consumption; salt intake; specific types of fat consumed; vitamin and mineral intake; the relationship between diet, physical activity and weight; food insecurity; etc. The CCHS offers researchers an unprecedented opportunity to examine these and other aspects of the dietary habits of Canadians.