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FindingsAt home, at work or at school, in a five-star restaurant or in a neighbourhood take-out, Canadians can chooose from an ever-increasing variety of foods. Grocery stores offer an abundance of imported products, along with frozen meals that can be ready in minutes to satisfy the needs of time-crunched households. Fresh fruits and vegetables once considered exotic are now available throughout the year. And today, fast food has become part of a typical diet. In the midst of this array of choices, just what are Canadians eating? The 2004 Canadian Community Health Survey (CCHS) — Nutrition was the first national survey of Canadians’ eating habits since the early 1970s. It was the largest and most comprehensive survey of its kind ever conducted in Canada. Throughout 2004, over 35,000 people were asked to recall what they had eaten during the previous 24 hours. They were also asked when they ate — breakfast, lunch, dinner and snacks — and where the food they ate had been prepared — at home, in a restaurant, or in a fast-food outlet. This article is based on the initial results of the 2004 CCHS — Nutrition. It presents an overview of what Canadians are eating: how many calories they consume; whether they eat the daily minimum recommended5 number of servings of vegetables and fruit, milk products, meat and alternatives, and grain products; and what percentage of their total calories come from fat, protein and carbohydrates. To provide historical context, results from the last national survey of Canadian dietary habits, the 1970-1972 Nutrition Canada Survey,9 are also presented (see Methods, Definitions and Limitations). Calorie intake Calorie intakeCalories are a measure of the amount of energy in food. An individual’s energy needs — the calories he or she must consume to remain healthy — vary according to a number of factors, notably, age, sex, weight, height and activity level.10 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; a sedentary 65-year-old woman who is 1.55 metres tall (5 feet 1 inch) and weighs 60 kilograms (132 pounds) needs 1,600 calories a day; and 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. Calorie consumption is highest during adolescence and declines with age (Chart 1). In 2004, males aged 12 to 19 averaged 2,800 calories a day, and females, just over 2,000 (Table 1). Among seniors, average daily intake was 1,950 calories for men and 1,550 calories for women. The last time comparable information was gathered was the 1970-1972 Nutrition Canada Survey.9 While the 2004 data cannot be strictly compared with those for 1970-1972 (see Limitations), an examination of results of the two surveys suggests that Canadians’ average calorie consumption has not increased. On the contrary, initial findings indicate 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 1995-2000.11 Choices determine a balanced dietFood choices determine the degree to which an individual’s diet is balanced. Since 1942, Health Canada has published a food guide12 to help Canadians make healthy choices. 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,5 had been released in 1992. The Guide identified four food groups: vegetables and fruit, milk products, meat and alternatives, and grain products. An “other foods” category covered foods that are mostly fats, oils or sugar; high-fat and/or high-salt snack foods; beverages; and herbs, spices and condiments. In 2004, grain products were the top energy provider for both children and adults, supplying 31% of daily calories at ages 4 to 18, and 28.5% at age 19 or older (Chart 2). The “other foods” category ranked second, providing, on average, 22% of daily calories for both children and adults. For each of the four food groups, the Guide recommended a range for the number of servings per day. “Other foods,” according to the Guide, should be eaten in moderation. On average, Canadians consumed the recommended daily number of servings of most food groups (Appendix Table A). However, average consumption hides the fact that substantial shares of the population were not within the suggested ranges. Not enough vegetables and fruitThe 1992 Food Guide recommended at least five daily servings of vegetables and fruit. One serving would be, for example, a medium-sized apple, two stalks of broccoli, or 125 millilitres (1/2 cup) of juice. In 2004, 7 out of 10 children aged 4 to 8 had less than five servings of vegetables and fruit a day (Chart 3). At ages 9 to 13, 62% of girls and 68% of boys did not meet the minimum. Consumption was somewhat higher among adults, but around half fell short of the five-serving minimum. One in three children below minimum for milk productsMilk products include not just milk itself, but also foods such as cheese and yogourt. The 1992 Food Guide recommended 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 would be 250 millilitres (1 cup) of milk, 50 grams of cheese, or 175 grams (3/4 cup) of yogourt. In 2004, more than one-third of children aged 4 to 9 did not consume the minimum recommended two daily servings of milk products (Chart 4). By ages 10 to 16, 61% of boys and 83% of girls did not meet their recommended minimum of three daily servings. And at age 71 or older, about 80% of both men and women had less than two servings of milk products a day. Meat and alternativesThe 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 1992 Food Guide suggested two to three daily servings from this group, the equivalent of 100 to 300 grams of cooked meat. One serving would be 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. Among males aged 14 to 70, average daily consumption of meat and alternatives was at least 200 grams (Appendix Table A), and about one in four had more than 300 grams (data not shown). No female age group averaged more than 200 grams of meat and alternatives a day. As well, 14% to 18% of girls aged 9 to 18 had less than 100 grams, as did 15% of women aged 71 or older (data not shown). Grain productsThe 1992 Food Guide recommended 5 to 12 servings a day of grain products. A serving would amount to one slice of bread, 30 grams of cold cereal, half a bagel, or half a cup of cooked pasta or rice. In 2004, more than a quarter of children aged 4 to 8 did not eat the recommended daily minimum of five servings of grain products (data not shown). And for each sex, the proportion of people not meeting the minimum rose with age. By age 71 or older, 43% of men and 66% of women had less than five daily servings of grain products. “Other foods”“Other foods” covers foods and drinks 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 1992 Food Guide recommended moderate consumption of “other foods,” 22% of the total calories consumed by Canadians in 2004 came from this category (Chart 2). For adolescents aged 14 to 18, the figure was 25% (Appendix Table B). Although a wide range of foods and beverages make up “other foods,” a relatively small number of specific items accounted for most consumption. In fact, the 10 most commonly consumed “other foods” represented two-thirds of the calories obtained from this category. Soft drinks ranked first, followed by salad dressing, sugars/syrups/preserves, beer, and oils/fats (Table 2). Given the high sugar and fat content of the top 10 “other foods,” this category’s sizeable contribution to daily calorie intake is not surprising. Macronutrient balanceIn a 2002 report, the Institute of Medicine, an independent, non-government organization in the United States, specified “acceptable macronutrient distribution ranges” (AMDR) for the percentage of total calories supplied by fat, protein and carbohydrates, the three “macronutrients.”10 Intake within an AMDR is associated with reduced risk of chronic diseases and provides adequate consumption of essential nutrients. These AMDRs have been adopted by health officials in Canada On average, the Canadian diet in 2004 was within the AMDRs (Appendix Table C). Averages, however, conceal the fact that large proportions of the population fell outside the AMDRs. Many exceed upper limit for fatFat is a source of energy and an important part of a healthy diet. The AMDR for fat intake is 25% to 35% of total calories for children and teens, and 20% to 35% of total calories for adults aged 19 or older. If 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 then averaged about 40% of calories9 (Table 3). By 2004 an appreciable change was evident, with fat accounting for an average of just over 31% of daily calories (Appendix Table C). While this average was within the AMDR, substantial shares of the population surpassed the suggested maximum. Excess fat consumption peaked among people aged 31 to 50, over a quarter of whom obtained more than 35% of their total calories from fat (Chart 5). At older ages, around one person in five got more than 35% of his or her calories from fat. The meat and alternatives group was the primary source of fat in 2004 (Chart 6). Adults got almost a third of their fat from the meat group, and about a quarter from “other foods.” Among children, meat and alternatives, milk products and “other foods” each accounted for nearly the same percentage of fat: 24% or 25%. The fat that Canadians consumed came from a relatively small number of specific foods. The main contributor, accounting for 15.9% of fat intake, was what can be classified as the “sandwich” category, consisting of items such as pizza, sandwiches, submarines, hamburgers and hot dogs (Table 4). This was followed by sweet baked goods, such as cake, cookies and doughnuts (8.5%). Proteins in acceptable rangesProtein 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. In 2004, Canadians’ average daily calorie intake from protein was within these ranges. Among children and adolescents aged 4 to 18, protein accounted for an average of 14.5% of total calories; for adults, 16.5% (Appendix Table C). Almost no one fell below or above these ranges. Carbohydrates primary source of energyCarbohydrates are the body’s most important source of energy. They may be obtained as sugars, starch or fibre. The AMDR for carbohydrates is 45% to 65% of daily calories. On average, carbohydrates accounted for 55.4% of the calories consumed by children and adolescents in 2004; for adults, the percentage was 50.1% (Appendix Table C). More calories from snacks than breakfastDespite the nutritional benefits of CCHS eating breakfast,14,15 close to 10% of Canadians reported that they had not had breakfast the day before they were interviewed for the (data not shown). Men aged 19 to 30 were the least likely to have eaten breakfast: 19% of them had not done so (data not shown). On average, Canadians consumed about 18% of their daily calories at breakfast in 2004; lunch made up another 24%; and dinner, 31% for children and adolescents and 36% for adults (Appendix Table D). Snacks, that is, food or drinks consumed between meals, accounted for more calories than breakfast and about the same percentage as lunch: 27% for children and adolescents and 23% for adults. The proportion of daily calories eaten as snacks peaked among 14- to 18-year-olds, at 30% for males and 28% for females, and then fell with advancing age to around 16% among seniors aged 71 or older (Chart 7). The “other foods” category accounted for 41% of the calories that Canadians ate as snacks in 2004 (Chart 8). One-quarter consuming fast-food itemsA quarter of Canadians reported that on the day before their interview they had eaten something that had been prepared in a fast-food outlet (Table 5). Among 14- to 18-year-olds, the figure was one-third, and at 39%, the percentage was highest among men aged 19 to 30 (Chart 9). 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 a salad without dressing. Even so, 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 of all Canadians reported that all the food they ate on the day before their interview had been prepared at home. For children aged 4 to 8, the figure was 61% (Table 5). Elderly women were the most likely to have eaten only food prepared at home: 76%. By contrast, among young adult men, the figure was 38%. Diet and incomeIn some respects, food consumption patterns were associated with household income, especially among adults. For example, the percentage of calories that adults derived from fat tended to rise with income. While 15% of those in the lowest income households exceeded the AMDR for fat (more than 35% of their total calorie intake), this was the case for 25% of adults in the highest income households (Chart 10). Among children and adolescents, the percentage of calories derived from fat generally did not differ by household income. Adults in the highest income households were less likely than those in the lowest to have fewer than five daily servings of vegetables and fruit: 41% versus 58% (Chart 11). Again, there were no significant differences by household income in the proportion of children and adolescents eating less than five servings of vegetables and fruit each day. For people of all ages, the likelihood of having eaten something from a fast-food outlet tended to increase with income. On the day before their interview, 31% of adults and 28% of young people from the highest income households had something that had been prepared in such an establishment, compared with 19% of adults and young people from the lowest income households (data not shown). Concluding remarksResults of the 2004 Canadian Community Health Survey — Nutrition show that when averages are considered, Canadians were generally within acceptable ranges for the number of servings from the four major food groups and for the percentage of calories from fat, protein and carbohydrates. But averages mask the substantial proportions of chidren and adults who did not have a balanced diet. The majority of Canadians did not eat the recommended daily minimum of five servings of vegetables and fruit. Over a quarter of men and women in their thirties and forties derived more than 35% of their calories from fat. One-third of children aged 4 to 9 did not have the recommended two servings of milk products a day, and among seniors aged 71 or older, the proportion surpassed 70%. Canadians of all ages obtained over a fifth of their calories from “other foods,” and on a given day, a quarter of adults and children ate or drank something from a fast-food outlet. This overview of Canadians’ eating habits represents only part of the information collected during the 2004 CCHS. This new national database on nutrition offers an unprecedented opportunity to examine many other topics, including beverage consumption and vitamin and mineral intake, as well as interrelationships between diet, physical activity and weight.
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