ARE SCHOOLS MAKING THE GRADE - OCASC ~ Ottawa Carleton ...€¦ · Ottawa advocacy efforts are supported by more than 100,000 subscribers to the Canadian edition ... to foods distributed

ARE SCHOOLS MAKING THE GRADE?

SCHOOL NUTRITION POLICIES

ACROSS CANADA


SCHOOL NUTRITION POLICIES

ACROSS CANADA

OCTOBER 2007

This report was written by Aileen Leo, Senior Policy Advisor, Centre for Science in the Public Interest, Ottawa, Canada. CSPI wishes to thank provincial and territorial government officials for their helpful input and the ten external reviewers from universities and health- and education-related NGOs who generously provided comments on an earlier version of this report. Their advice improved our analysis. The author also wishes to thank Bill Jeffery, LL.B., National Coordinator; Joy Johanson, Senior Nutrition Project Associate; Bruce Silverglade, J.D., Director of Legal Affairs; and CSPI Executive Director Michael F. Jacobson, Ph.D., for reviewing this report. Any defects or omissions are the responsibility of the author. The Centre for Science in the Public Interest (CSPI) is a consumer health advocacy organization specializing in nutrition and food safety with offices in Ottawa and Washington, D.C. CSPI's Ottawa advocacy efforts are supported by more than 100,000 subscribers to the Canadian edition of Nutrition Action Healthletter. CSPI does not accept industry or government funding. Nutrition Action Healthletter does not carry advertisements.

Suite 2701, CTTC Bldg. 1125 Colonel By Drive

Ottawa, Ontario K1S 5R1 Tel.: 613-244-7337

www.cspinet.org/canada

Table of Contents

Open Letter to Federal, Provincial and Territorial Ministers Executive Summary I. Introduction – The human and economic toll of diet-related diseases, including

childhood obesity...........................................................................................................................1 II. The need to standardize and improve nutrition criteria for school foods ......................................3 III. Investing in nutritious food............................................................................................................5 IV. Overview of provincial nutrition criteria for school foods............................................................9 V. How provincial nutrition criteria were rated ...............................................................................15 VI. Weaknesses of provincial nutrition criteria .................................................................................16 VII. Conclusions and recommendations .............................................................................................24

Charts:

1. US federal government and Canadian federal, provincial and territorial government financial investments in school meals, 2005-06.......................................................................................6

2. Report card on school nutrition standards (summary).............................................................13 3. How provincial school nutrition criteria stack up against IOM core nutrient

standards (detailed)..................................................................................................................17 Appendices:

1. Key findings from publicly available provincial school nutrition surveys .............................26 2. List of provincial nutrition criteria for school foods ...............................................................28 3. Excerpt from the US Institute of Medicine’s “Nutrition Standards for

Foods in Schools”....................................................................................................................31 4. Excerpt from Canada’s Food Guide (2007) relevant to institutional food service for school-

aged children ...........................................................................................................................33 5. Provincial/territorial government and Breakfast for Learning investments in

school food programs ..............................................................................................................34 6. Legal analysis: Putting to Rest Constitutional Excuses for Inaction on School

Foods .......................................................................................................................................35

Open Letter October 3, 2007

Federal, Provincial and Territorial Ministers of Health and Provincial and Territorial Ministers of Education and Child Protection

Dear Ministers: As you know, diet-related diseases, including cancer, heart disease, stroke, and diabetes,

represent a major public health threat, with many of their causes well-known. Many Canadians, including children, consume too few fruits, vegetables, and whole grains and too many foods high in saturated fat, trans fat, salt, and added sugars. As a report commissioned by Health Canada noted, “poor nutrition is a key preventable risk factor for the major chronic diseases that take a huge toll in morbidity, disability and premature death in Canada.” Fortunately, means are available to prevent those diseases.

Obesity is a major risk factor in the development of many diet-related diseases and

increases in childhood obesity portend higher rates of those diseases. The House of Commons Standing Committee on Health found that childhood obesity is attributable in large part to increases in portion sizes and in the intake of foods and beverages high in fats and sugars. The Committee fears that, if this trend is not reversed, today’s generation of children may be the first in a long time to live shorter, sicker lives than their parents. Economic ramifications, including additional strains on publicly funded medicare, could be enormous.

Schools can be effective venues to encourage healthy eating. However, our review of

provincial school food policies, as detailed in our new report, Are Schools Making the Grade?, reveals that they are governed by inadequate nutrition criteria and recent school food surveys demonstrate that many foods offered in schools are high in saturated fat, trans fat, salt, and sugar.

In 2005, under the Integrated Pan-Canadian Healthy Living Strategy, health ministers

committed to develop school nutrition standards as part of comprehensive school health efforts. Most have done so, but, unfortunately, all of those nutrition standards currently in place fall short of the US Institute of Medicine (IOM) school nutrition standards issued in 2007. Current provincial nutrition programs also offer inadequate incentives for students to consume more fruits, vegetables, and whole grains, as recommended in the 2007 edition of Canada’s Food Guide

To improve school foods, we urge you to take the following actions:

1. Develop and support the implementation of comprehensive Pan-Canadian school nutrition policies that contain nutrition standards for all foods distributed in school and reflect Canada's Food Guide (2007) as well as the US Institute of Medicine’s Nutrition Standards for Foods in Schools (2007).

2. Support the establishment of a pan-Canadian school meals program that is based on

health-protecting nutrition standards and encourages healthy eating habits. 3. Conduct regular surveillance of school food policies and guidelines, food offerings,

and student consumption measured against benchmarks. While we are cognizant of inter-jurisdictional political sensitivities, Canada's children are

entitled to nutritious fare at school regardless of where they live. We urge you to implement these recommendations to ensure that all children can learn in a

healthy school nutrition environment. These measures will help children improve their diets and learn to eat better as adults, thereby ensuring the health of future generations and reducing the high incidence—and price—of diet-related disease.

Sincerely,

Bill Jeffery, LL.B. National Coordinator

Aileen Leo Senior Policy Advisor

2 of 2

Executive Summary

Diet-related disease is a serious public health problem in Canada. Many Canadians, including children, consume too many calories, too much saturated and trans fats, salt, and added sugar, and not enough fruits, vegetables, whole grains, and legumes. Every year, diet-related diseases, including heart disease, stroke, diabetes, and certain cancers, prematurely end the lives of tens of thousands of Canadians and cost the economy billions of dollars in healthcare expenses and lost productivity.

The epidemic of childhood obesity is especially worrisome. According to the 2007

House of Commons Standing Committee on Health, Canada has one of the highest rates of childhood obesity in the world. Obesity-related health problems are now occurring at a much earlier age and continue to progress into adulthood.

The health and economic implications of these trends are alarming. In fact, today’s

generation of children may be the first in some time to have shorter life expectancies and poorer health outcomes than their parents. If left unchecked, diet-related diseases are likely to fetter access to health services and strain the capacity to finance publicly funded medicare.

Schools are ideal fora in which to begin reversing this trend and to encourage children to

choose healthier foods, such as fruits, vegetables, and whole grains, as recommended in Canada’s Food Guide (2007). However, we have found that a disturbing number of school food choices are high in saturated and trans fat, salt, and sugar, perhaps because cafeterias focus more on optimizing product sales than students’ health. This report card examines the adequacy of nutrition criteria for school foods as set out by each province (called policies, standards or guidelines depending on the jurisdiction).

Because there are virtually no current, publicly available data about what is actually

being served in schools since these nutrition standards came into effect—and, more importantly, what and how much children are actually eating—we were not able to evaluate the nutritional merit of the school food environment directly. However, anecdotal evidence indicates that adherence to these standards in those schools where they are intended to apply is the exception rather than the rule. Furthermore, depending on the province, nutrition criteria may apply broadly to all foods distributed in any manner for students K-12 (e.g., New Brunswick), or only to foods distributed through vending machines in elementary schools and volunteer-organized meal programs (e.g., Ontario). The narrow scope of some criteria, the inadequacy of enforcement measures in most jurisdictions, as well as the paucity of government fiscal support for healthy eating in schools must be fixed as governments revisit their nutrition criteria to respond to the recently revised Canada’s Food Guide (2007) and important guidance from the U.S. Institute of Medicine’s Nutrition Standards for School Foods (2007).

In 2005, under the Integrated Pan-Canadian Healthy Living Strategy, health ministers

committed to develop school nutrition standards and healthy eating programs. Nutrition criteria for school foods are now in place in eight out of ten provinces. Alberta's draft guidelines are currently undergoing consultation, and the government of Quebec has announced that its new

criteria will apply as of 2008. The Yukon, the Northwest Territories and Nunavut have no school nutrition criteria.

Some provincial criteria include measures that could, if followed, help enhance the diets

of Canadian children. Overall, however, Canadian school food criteria are a patchwork quilt of flimsy, inconsistent standards. They suffer from several shortcomings, including: • Weak nutrition standards that permit the sale of nutrient-poor foods—New Brunswick, for

example, allows the sale of high-fat and high-salt items such as ice cream and pizza twice a week. Prince Edward Island allows the sale of high-fat and high-salt foods such as cheese pizza and pretzels two to three times a week. Alberta's draft criteria allow the sale of dozens of foods high in fat, sodium, and sugar, such as potato chips, soft drinks, chocolate bars, candy, ice cream, cakes, cookies, deep fried foods, donuts, pastries, and whipped cream, on a weekly basis. And Newfoundland and Labrador allows the sale of ice cream, chicken wings, fried meats, pretzels, and other junk foods on a daily basis so long as such foods comprise less than 50% of food offerings at school.

• Failure to set explicit limits on saturated and trans fats, salt, and sugar content—In

Saskatchewan and several other provinces, school nutrition criteria merely suggest which general types of foods can be sold, but provide almost no nutrient criteria to aid such determinations. Specific nutrient criteria in other provinces, such New Brunswick, Prince Edward Island, Quebec and Ontario concerning fats, salt, sugars, and calories/portion sizes exist only on a piecemeal basis or not at all.

• Wide variations in school food nutrition criteria among provinces—These include

approaches to limiting substandard food choices as well as whether criteria apply to all or only part of the food offerings available within schools.

• Failure to develop school nutrition policies—The northern territories have not yet issued any

school nutrition standards. • Lack of published information concerning schools’ compliance with provincial nutrient

criteria—Given the lack of publicly available information concerning school compliance, it is very difficult to determine the extent to which provincial nutrient criteria for schools are actually being followed.

In addition, all provincial nutrition criteria fall short of the new US Institute of Medicine

(IOM) school nutrition standards issued in April 2007. The IOM standards primarily set upper limits for unhealthy amounts of nutrients in foods sold on school premises outside of federally subsidized meals. We compared existing provincial school nutrition criteria to the IOM standards; Canada’s Food Guide (2007) as well as a report from the US National Alliance for Nutrition and Physical Activity were also used as interpretive aids to assess the provincial rules on serving size and/or calorie limits. Each province was assigned a letter grade ranging from “A” to “F.” The following table outlines how provincial nutrition criteria rated. No province received an “A” since none has a policy entirely consistent with those standards. Only one province, Alberta, received a “B”—and it is important to point out that the school food

guidelines for this province are only in draft form and will not be confirmed until later this year. The three northern territories received “No Standards” because these jurisdictions have not issued nutrition policies.

SCHOOL NUTRITION POLICY REPORT CARD Province/Territory Grade British Columbia D Alberta (*draft guidelines) *B Saskatchewan F Manitoba D Ontario F Quebec D New Brunswick D Nova Scotia C Prince Edward Island F Newfoundland and Labrador C Nunavut No Standards Northwest Territories No Standards Yukon No Standards

These results indicate the pressing need to improve school nutrition criteria across

Canada to ensure that children have access to healthy and nutritious food while in school no matter in which province they live. To improve Canadian standards for foods sold in schools, we recommend that all governments:

1. Develop and support the implementation of comprehensive school nutrition policies that include nutrition standards for all foods distributed in school and reflect Canada's Food Guide (2007) and the US Institute of Medicine’s Nutrition Standards for Foods in Schools (2007).

2. Support the establishment of a pan-Canadian school meals program that is based on health-

protecting nutrition standards and encourages healthy eating habits.*

3. Conduct regular surveillance of school food policies and guidelines, food offerings, and student consumption and compare to benchmarks.

* Ideally, this program should also support local agriculture, and contribute to a sustainable environment, but those aspects of such a program are beyond the scope of this paper.

Financial support of school meals by the federal government is necessary to help ensure that students consume healthy nutritious fare, as recommended in Canada's Food Guide (2007). Presently, there is no pan-Canadian publicly subsidized school meal program and provincially-funded programs are small and piecemeal. While education in Canada is primarily a provincial responsibility, responsibility for health protection, nutrition, food safety, and consumer protection has long been assumed by both levels of government.

In light of federal inaction, the responsibility for funding school food programs has fallen

on provincial governments and the non-profit sector. But together, average support per student is just $5.95 per year. In contrast, US school feeding programs, which are primarily paid for by that nation’s federal government, provide approximately CAD$212 per child, almost 38 times more than Canadian governments spend. The time has come for the federal government to step up and take responsibility for establishing a nutritionally sound, standards-based, subsidized school meal program that ensures access to healthy foods for all school children and restricts access to unhealthy foods.

Development and enforcement of nutrition standards for school foods and initiation of a federally subsidized school meal program will help children improve their diets and learn to eat better as adults. It will also help protect the health of future generations and reduce the high human toll and economic costs of diet-related disease.

1

I. Introduction – The human and economic toll of diet-related diseases, including childhood obesity

Diet-related diseases have emerged as serious public health problems in Canada. Many Canadians — including children — consume too many calories, too much saturated and trans fat, salt, and added sugar and not enough vegetables, fruit, whole grains, and legumes.1

Every year, diet-related illnesses such as cardiovascular disease, diabetes, and certain forms of cancers prematurely end the lives of tens of thousands of Canadians2 and rob the Canadian economy of $6.6 billion due to healthcare costs and lost productivity.3 As a report commissioned by Health Canada has noted, “poor nutrition is a key preventable risk factor for the major chronic diseases that take a huge toll in morbidity, disability and premature death in Canada.”4 Rising obesity rates and other health problems have the potential to exacerbate waiting times for treatment and strain our capacity to finance publicly funded medicare. In fact, a recent report to Congress of the US Medicare Advisory Commission noted that the share of spending attributable to obese enrollees increased from about 9% in 1987 to about 25% in 2002, a substantially larger increase than was seen in the obesity rate for the medicare population. (In the US, medicare enrollees are mainly senior citizens.)5

The epidemic of childhood obesity is especially worrisome. According to the April 2007 report on this issue by the Standing Committee on Health of the House of Commons:

Canada has one of the highest rates of childhood obesity in the developed world, ranking fifth out of 34 OECD countries. Recent data reveals [sic] that 26% of young Canadians aged 2 to 17 years are overweight or obese. Even more

1 Physical activity also plays an important role in health promotion, but a detailed discussion of its importance is beyond the scope of this report. 2 See PT Katzmarzyk, et al. “The Economic Burden of Physical Inactivity in Canada,” CMAJ, 2000; 163(11): 1438, http://www.cmaj.ca/cgi/reprint/163/11/1435, last accessed September 23, 2007. Katzmarzyk estimated both the number of annual deaths at 21,340 and the healthcare costs attributable to physical inactivity at $2.1 billion annually; this estimate is likely conservative now given the rising rate of obesity. The Centre for Science in the Public Interest is not aware of any published estimates of the death toll from diet-related illness in Canada, however, by extrapolating from estimates such as Katzmarzyk on annual deaths from inactivity-related illnesses and Health Canada's estimate for the economic burden of diet-related disease, we estimate it to be roughly 25,400 deaths per year. 3 See Diane Gorman, Assistant Deputy Minister of Health. Speech at the stakeholder meeting on the review of Canada's Food Guide to Healthy Eating in Ottawa, January 20, 2004, p. 3. 4 Diane McAmmond and Associates. Food and Nutrition Surveillance in Canada: An Environmental Scan. (Prepared for Health Canada), March 2000, p. 9, http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/surveill/environmental_scan_e.pdf, last accessed September 23, 2007. 5 Medicare Payment Advisory Commission, Report to the Congress: Promoting Greater Efficiency in Medicare, June 2007, p. 9, http://www.medpac.gov/documents/Jun07_EntireReport.pdf, last accessed September 23, 2007.

2

distressing is the evidence that about 55% of First Nations children on reserve and 41% of Aboriginal children living off reserve are either overweight or obese.6

The 2006 Canadian Clinical Practice Guidelines on the management and prevention of obesity notes that “obesity-related health problems are now occurring at a much earlier age and continue to progress into adulthood.”7 For example, the Canadian Diabetes Association has observed that a decade ago, type 2 diabetes was an adults-only disease. “Today, childhood obesity, unhealthy eating habits and inactivity are leading to more and more children, as young as nine years of age, being diagnosed with type 2 diabetes.”8 Other conditions associated with obesity include hypertension, dyslipidemia, coronary artery disease, stroke, osteoarthritis, some forms of cancer,9 orthopedic problems as well as negative self-esteem, withdrawal from interaction with peers, depression, anxiety, and feelings of rejection.10 Indeed, the Standing Committee on Health concluded that today's children may be the first generation for some time to have poorer health outcomes and a shorter life expectancy than their parents.11

The Committee went on to note that this rise in caloric intake by Canadian children and youth is attributable to:

increased portions, increased intake of fatty and processed foods as well as greater consumption of sugary drinks. The link between obesity and the increased consumption of sweetened drinks is particularly disturbing. It has been estimated that sugary drinks may be responsible for as much as one pound per month weight gain in adolescents.12

Recent surveys of the eating habits of Canadian children and youth confirm excessive consumption of nutrient-poor foods. For example, the Statistics Canada’s 2004 Canadian

6 Standing Committee on Health, House of Commons (Canada). Healthy Weights for Healthy Kids: Report of the Standing Committee on Health, March 2007, p. 1, http://cmte.parl.gc.ca/Content/HOC/committee/391/hesa/reports/rp2795145/hesarp07/hesarp07-e.pdf, last accessed September 23, 2007. 7 David C.W. Lau et al. “2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children” [summary], Canadian Medical Association Journal, April 10, 2007; 176 (8), p. S1, http://www.cmaj.ca/cgi/reprint/176/8/S1, last accessed September 23, 2007. 8 Canadian Diabetes Association. “Type 2 Diabetes In Kids: A Crisis In Progress?” News Release, October 16, 2003, http://www.diabetes.ca/section_main/NewsReleases.asp?ID=79, last accessed September 23, 2007. 9 Lau et al., p. S1. 10 See also for example Richard J. Deckelbaum, Christine L. Williams. “Childhood Obesity: The Health Issue,” Obesity Research, November 4, 2001, 9(S4), p. 239S-243S, http://www.obesityresearch.org/cgi/reprint/9/suppl_4/S239, last accessed September 23, 2007. 11 Healthy Weights for Healthy Kids: Report of the Standing Committee on Health, op.cit. 12 Ibid, p. 4.

3

Community Health Survey found that, on average, 33% of 14-18 year-olds reported that they had consumed prepared fast-food the previous day compared with 25% of overall respondents.13

Similarly, in 2007, Breakfast for Learning, a national non-profit organization that

supports child nutrition programs in Canada, found that: • Only 50% of children surveyed consume the minimum number of daily servings of

vegetables and fruit. • Only 25% meet the new Canada’s Food Guide (2007) recommendations for grain

products. • 28% eat french fries two or more times per week.14

These figures indicate a trend toward disturbing dietary patterns that must be reversed.

II. The need to standardize and improve nutrition criteria for school foods

Schools are, by far, the most effective public venues for introducing healthy eating initiatives to improve children's health. Most Canadian children aged 4-18 spend more of their waking hours at school than any other single place—for many kids, even more time than at home, at least during week-days. The centrality of schools in children’s everyday lives makes schools attractive and efficient sites for health promotion programs, including efforts to improve diet. As the Heart and Stroke Foundation of Canada has noted,

schools are an ideal setting to establish and promote healthy eating amongst children and youth. Schools have an important influence on what children and youth eat. The school environment influences healthy eating in children and youth through the foods that are available, nutrition policies, school nutrition and the health curricula, and teacher and peer-modelling.15

Similarly, the World Health Organization points out that “schools have been identified as

13 Statistics Canada (Didier Garriguet). Nutrition: Findings from the Canadian Community Health Survey – Overview of Canadians' Eating Habits, p.8, http://www.statcan.ca/english/research/82-620-MIE/82-620-MIE2006002.pdf, last accessed September 23, 2007. Statistics Canada surveyed more than 35,000 people concerning what they had eaten during the previous 24-hour period. 14 Breakfast for Learning. Canada's Kids Still Don't Make the Grade http://breakfastforlearning.ca/english/resources/index_ReportCard2007.html, last accessed September 23, 2007. The BFL Report Card surveys 500 households by telephone with children aged 6 - 12 and adolescents aged 13 - 18 concerning their eating habits. 15 Heart and Stroke Foundation of Canada, “Schools and Nutrition,” Position Statement, http://ww2.heartandstroke.ca/images/english/Nutrition_in_SchoolsPS(06)-English.pdf, last accessed September 23, 2007. See also: Institute of Medicine and National Academies. Preventing Childhood Obesity–Health in the Balance, The National Academies Press, Washington. D.C., 2005; and Kubik, M.Y., Lylie, L.A., Story M. “School-wide food practices are associated with body mass index in middle school students,” Arch Pediatric Adolescent Med, 2005 (159) p. 1111-1114.

4

one of the fundamental settings for health promotion and establishing healthy eating and lifestyle patterns,”16 noting the beneficial effects of healthy nutrition on improved learning ability, academic performance, attendance, behaviour, and child-teacher relationships.17

However, schools can also have major adverse effects on children’s health if the food available in cafeterias, vending machines, tuck shops, and at special events and fundraisers is dictated by appealing to children’s palates or cost-cutting measures.18 School food environments thus present both a threat and an opportunity to improve children’s health. While public schools face fiscal pressures due to chronic under-funding by governments,19 selling nutrient-poor foods to children and undermining children's health should not be the answer to the fiscal challenges these institutions face.20

The US Institute of Medicine (IOM) has recognized the importance of improving school

food nutrition standards. (Scientific advice from the IOM is often used as the basis for Canadian government policy.) In April 2007, the IOM proposed model nutrition standards for foods sold outside the US National School Lunch Program entitled Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth21 (see Appendix 3). Such items are typically sold in vending machines and snack bars and as à la carte items in cafeterias in American schools.

16 World Health Organization. Food and nutrition policy for schools: A tool for the development of school nutrition programmes in the European Region, 2006, p. 8, http://www.euro.who.int/Document/E89501.pdf, last accessed September 23, 2007. 17 Ibid, p. 6. 18 In the words of John Alm, CEO of Coca-Cola until 2005, “the school system is where you build brand loyalty.” Leith, S. “A lesson for Coke: Atlanta-based CCE takes on critics, defends soft-drink sales in schools,” Atlanta Journal-Constitution, April 6, 2003. 19 See: Canadian Teachers’ Federation Canadian Centre for Policy Alternatives, Fédération des syndicats de l'enseignement. Commercialism in Canadian Schools: Who's Calling the Shots? 2006, http://www.ctf-fce.ca/commercialism_in_school/en/FullReport.pdf, last accessed September 23, 2007. 20 While underfunding forces many schools to rely upon junk food sales as a form of revenue, this is particularly the case for schools in low-income areas. As such, policy development to eliminate junk food in schools should be undertaken in such a way to ensure that poor schools do not suffer punitive effects when junk food sales are eliminated. 21 See The National Academies Press, Washington, D.C., http://books.nap.edu/execsumm_pdf/11899.pdf, last accessed September 23, 2007. Such items are known as "competitive foods" since they compete with National School Lunch Program choices.

5

If implemented, the IOM standards would ensure that such foods meet limits on calories, sodium, saturated and trans fats, and sugars, and would include water, 100% juice, low-fat dairy products, whole grains, fruit, and vegetables. Caffeine-free diet soft drinks would be available only in high schools and only after the school day has ended; sports drinks could only be available, at the coach’s discretion, to students engaged in programs that include more than an hour of vigorous physical activity.

Several states in the US have already finalized new nutrition standards for foods sold at

schools. Mandatory regulations established by the states of California22 and Kentucky23 incorporate some of the most health-promoting criteria for foods sold in US schools.

III. Investing in Nutritious Food

Any examination of provincial school food standards must also note the complete absence of a federally subsided school meal program and meager provincial subsidies. In contrast, the US has had a federally subsidized school meal program since 1946.24 Last year in the US, federal government support for this program surpassed US $10 billion, or approximately CAD $212.26 per student.25 However, despite the obvious need, there is no comprehensive, national publicly subsidized school meal program; the federal government contributes nothing to help ensure proper nutrition for Canadian children while in school and there is little parity or coordination among provincial and territorial programs.

Most provincial and territorial governments and the non-profit sector do make some

efforts to feed our children. But together, their combined annual funding per student (i.e., elementary and secondary school enrollees) ranges from a low provincially of $0.31 in Alberta (where public funding is non-existent) 26 to $23.77 in British Columbia (where the provincial

22 See California Department of Education. “Restrictions on Food and Beverage Sales Outside of the School Meal Program in the State of California,” Management Bulletin 06-110: Restrictions on Food and Beverage Sales Outside of the School Meal Program, http://www.cde.ca.gov/ls/nu/sn/mb06110.asp, last accessed September 23, 2007. 23 See Kentucky Board of Education. “Minimum Nutritional Standards for Foods and Beverages Available on Public School Campuses During the School Day in Kentucky.” Board Notes: Board Approves 702 KAR 6:090, Minimal Nutritional Standards for Foods and Beverages Available on Public School Campuses During the School Day, 13(4), August 3-4, 2005, http://education.ky.gov/users/spalmer/Board%20Notes%20August%202005.pdf, last accessed September 23, 2007. 24 See United States Department of Agriculture. “School Meals, USDA Food and Nutrition Service,” http://www.fns.usda.gov/cnd/, last accessed September 23, 2007. 25 See United States Department of Agriculture. Federal Costs of School Food Programs, http://www.fns.usda.gov/pd/cncosts.htm. Costs for 2006 of US$10,249 million were multiplied by the Canadian exchange rate of $1.0252 (September 4, 2007), for a total of US$10,507 million, then divided by 49.5 million, the total number of children enrolled in elementary and high school in the US in 2003; see "School Enrollment Surpasses 1970 Baby-Boom Crest, Census Bureau Reports," Press Release, US Census Bureau News, June 1, 2005, http://www.census.gov/Press-Release/www/releases/archives/education/005157.html, last accessed September 23, 2007. 26 See Assessment of Provincial/Territorial Government Support for School Food Programs (as at May 2006),

6

government spent $14 million in 2005-06). The average provincial/territorial subsidy per student in 2005-06 was just $5.95. If non-profit support is subtracted, this leaves just $5.54 per student in public funding to support school meal programs across Canada – 38 times less than US federal government funding per student (see Appendix 5).

Chart 1:

US federal government and Canadian federal, provincial and territorial government financial investments in school meals, 2005-06 (Canadian $ per student)

0 50 100 150 200 250

BC [23.48]

AB [0]

SK [8.52]

MB [0.54]

ON [4.00]

QC [1.62]

NS [6.88]

NB [10.67]

PEI [8.93]

NL [6.29]

YK [7.69]

NWT [0]

NU [0]

CAN FED AVG [0]

P/T AVG [5.54]

US FED AVG [212.26

British Columbia has recognized the importance of subsidies to ensuring that children eat

healthy and nutritious food: the province’s fruit and vegetable snack program is a promising example of public dollars providing nutrient-rich foods to ensure a healthy school food environment. The program provides one serving of vegetables or fruit twice per week to children at participating schools. A recent expansion will enable up to 50 schools across the

Breakfast for Learning, http://breakfastforlearning.ca/english/images/provincial_territorial_gov-supp_may_2006.pdf, last accessed September 23, 2007.

7

province to join the program, and by 2010 the province hopes to make the program available to all schools.27

Several options for school feeding programs (scope and level of investment required) are

outlined within the Children’s Health and Nutrition Initiative (CHNI), supported by a broad base of diverse stakeholders. The initiative calls for a nutritious breakfast, snack, or lunch to be available to any Canadian child under age 19 through nutritious food programs. Under the proposal, universal access regardless of circumstance is recognized as a critically important way to ensure that all children receive nutritious food in a non-stigmatizing way. This is particularly important to the school-aged children among the 1.2 million children who live in poverty, according to Campaign 2000. Many of those kids rely on food banks and often go to school hungry with a compromised opportunity to learn. In the words of one child quoted within the Campaign's 2006 Report Card on Child and Family Poverty in Canada, poverty is “pretending that you forgot your lunch.” Rates of child poverty are especially acute among people with disabilities, racialized communities, aboriginal and First Nations people, and single parent (usually female-headed) households.28

The CHNI also calls on the federal government to invest in expanding pre-existing programs

and stimulate efforts where independent programs do not yet exist. The initiative also urges the federal government to develop program standards for healthy foods, with an emphasis on nutrition education, cooking and growing skills, and inclusion of locally and sustainably sourced foods. Long-term monitoring and evaluation of standards and implementation are regarded as essential to the success of a school feeding program.

CHNI has estimated the annual investment required to provide all children aged 4-18 years

(6.1 million) with breakfast for 190 days of operation to be $1.76 billion, about $1.50 per child daily, a cost that could be shared among federal provincial and municipal governments (e.g, the City of Toronto now contributes $2.8 million to its city program), and parents, where possible.29 Ultimately, the goal of a school nourishment program should be to provide one-third of the recommended intake of nutritious foods as recommended by federal dietary advice, including Canada’s Food Guide (2007).

Sound nutrition standards and subsidies for nutritious school meals should work together to

ensure the healthy choice is the easy choice for students. Pricing is also critically important to 27 See “Expansion of School Fruit and Vegetable Snack Program” and “Over 70 Fridges in B.C. Schools,” Backgrounder, Ministry of Tourism, Sport and the Arts, Government of British Columbia, January 22, 2007, http://www2.news.gov.bc.ca/news_releases_2005-2009/2007TSA0005-000034-Attachment1.htm, last accessed September 23, 2007. 28 See Campaign 2000. 2006 Report Card on Child and Family Poverty in Canada. This estimate was derived using data from Statistics Canada and the Canadian Economic Observer, http://www.campaign2000.ca/rc/rc06/06_C2000NationalReportCard.pdf Last accessed September 23, 2007. 29 See Total Cost of Providing Breakfast to School Aged Children in Canada for the Entire School Year, http://breakfastforlearning.ca/english/prog_events/pdfs/Federal%20Grant%20Analysis%202.pdf.

8

ensuring a healthy diet for school children. As noted by the Ontario Society of Nutrition Professionals in Public Health in its 2004 report on the school nutrition environment in that province:

Healthy foods such as salads, sandwiches, and muffins,30 are more expensive than french fries, hamburgers, and cookies. Students say they are choosing freshly baked chocolate chip cookies for breakfast from the cafeteria because they are cheap (three cookies can be purchased for the price of one muffin).31 Similarly, as noted by Ostry et al. in their 2007 review of food sales, availability, and the

extent of nutrition policy implementation in British Columbia schools, “price can have an impact as well, as healthier options often cost more than ‛junk’ foods. When faced with price reductions on healthy foods such as fresh fruit or baby carrots, students tend to choose these options over traditional high-fat snack foods.”32

Despite the familiar rejoinder that education is an exclusive provincial responsibility,

school foods are not the exclusive domain of provincial ministers of education. While the provinces have broad (but not exhaustive) powers to manage the affairs of schools, the federal government has long had broad, undisputed authority to regulate the food supply throughout Canada. Also, Supreme Court jurisprudence makes it clear that both levels of government have broad concurrent authority over health protection, nutrition, food safety, child protection, and consumer protection that courts would be reluctant to limit. And the federal government has virtually unlimited legal authority to establish nutrition standards by exercising its spending power through conditional grants (see Appendix 6); assertions by the federal government that it has no authority to act should be regarded with skepticism. Federal government subsidies for school food programs that ensure Canada's children receive at least a third of their daily intake (during the school week) of whole grains, vegetables, and fruits as recommended by Canada's Food Guide (see Appendix 4) could help reach vital population health objectives.

30 Note: The healthfulness of muffins varies depending on their content of saturated fat, sodium, and whole grains. 31 Ontario Society of Nutrition Professionals in Public Health. Creating a Healthy School Nutrition Environment, March 2004, p. 18, http://www.osnpph.on.ca/pdfs/call_to_action.pdf, last accessed September 23, 2007. 32 K. Rideout, R. Levy-Milne, C. Martin, A.S. Ostry. “Food Sales, Food Availability, and the Extent of Nutrition Policy Implementation in Schools in British Columbia,” Canadian Journal of Public Health, 98(4), July/August 2007, p. 249, http://www.cpha.ca/en/cjph/articles/ABS098N04.aspx#1007 (abstract), last accessed September 23, 2007. S. French. Pricing Effects on Food Choices," J. Nutr., 133, March 2003, 841S-843S, http://jn.nutrition.org/cgi/reprint/133/3/841S.

9

IV. Overview of provincial nutrient criteria for school foods

Many dedicated health and education professionals work in schools, municipal public

health units, government departments, and other public institutions to enhance nutritional opportunities for children at school. Similarly, committed non-profit organizations, such as Breakfast for Learning, support the delivery of child nourishment programs to feed thousands of Canadian children.33,34

However, we must ask whether school nutrition criteria—in jurisdictions where they

exist—are adequate to protect children’s health. Unfortunately, the answer appears to be no. Surveys of school food service in several provinces and one national survey conducted from 2000 through 2006 reveal that a disturbing amount of foods high in fat, salt, and sugar are available for sale to students.35,36,37,38,39 (See Appendix 1.) For example:

• A 2005 survey by the British Columbia ministries of education and health noted that

“the most common foods available in cafeterias were pastries/cookies.”40 Ostry's review of school foods in that province concluded that “‛junk’ foods were widely available in elementary, middle and secondary schools through a variety of outlets.”41

33 See: Joint Consortium for School Health Secretariat. An Environmental Scan of Activities Related to Schools and Nutrition, 2006 (updated by the Canadian Association for School Health February 2007), http://www.safehealthyschools.org/NutritionandSchools.pdf, last accessed September 23, 2007. Child nourishment programs exist in all provinces and territories, often in partnership with Breakfast for Learning, which is the only national non-profit organization exclusively dedicated to supporting child nutrition programs in Canada; see in particular. pp. 16-18, 26. 34 See, for example, the Breakfast for Learning website, http://www.breakfastforlearning.ca/, last accessed September 23, 2007. 35 Coalition for School Nutrition. Key Findings, Survey of Food and Nutrition Policies and Services in Newfoundland Labrador, 2000, http://www.nlta.nf.ca/HTML_Files/coalition/findings.html, last accessed September 23, 2007. 36 Ministry of Education and Ministry of Health, Government of British Columbia. School Food Sales and Policies Provincial Report, 2005, http://www.bced.gov.bc.ca/health/sales_report.pdf, last accessed September 23, 2007. 37 Dr. Shawna Berenbaum. Nutrition in Saskatchewan Schools: Policy, Practice and Needs, April 2004, http://ww1.heartandstroke.sk.ca/Images/English/SK-Nutrition-Report-April-2004.pdf, last accessed September 23, 2007. (Prepared for the Heart and Stroke Foundation of Saskatchewan.) 38 Ontario Society of Nutrition Professionals in Public Health. Creating a Healthy School Nutrition Environment, March 2004, http://www.osnpph.on.ca/pdfs/call_to_action.pdf, last accessed September 23, 2007. 39 Department of Health, Government of Manitoba. Manitoba School Nutrition Survey, 2006, http://www.gov.mb.ca/healthyschools/foodinschools/documents/survey.pdf, last accessed September 23, 2007. 40 School Food Sales and Policies Provincial Report, 2005, p. 5. 41 “Food Sales, Food Availability, and the Extent of Nutrition Policy Implementation in Schools in British Columbia,” op.cit.

10

• A 2004 review prepared for the Heart and Stroke Foundation of Saskatchewan found that “vending machines typically serve pop, chips/chocolate bars, candy and juice.”42

• A 2006 review by the Manitoba Department of Health noted that 49% of the schools surveyed sold products from restaurants (31% from local pizza restaurants and 18% from fast food chains).43

• A 2004 survey of school foods in Ontario found that food offered for “special food days” include hot dogs, potato or nacho chips, pop, cookies, milk (chocolate and white), fast food restaurant items (e.g., burgers, cheeseburgers, french fries, ice cream bars, fried chicken, sub sandwiches), chili, pasta, chocolate bars, Rice Krispies Squares, water, and ice cream/sherbet.44

• A 2000 review of foods available in schools in Newfoundland for the Coalition for School Nutrition found that “in those schools with canteens, the most commonly sold foods are ice cream and potato chips.”45

While most of these surveys were completed before many school nutrition criteria were

introduced, The Globe and Mail still concluded in January 2007, after conducting its own national survey of school boards in early 2006, that most Canadian schools are “nutritional wastelands.”46

Reliance by publicly funded schools on profits from commercial food sales to fund

programs and activities—a phenomenon noted in The Globe and Mail survey as well as some provincial surveys—is plainly contributing to the problem. A 2004 survey of schools by the Canadian Teachers’ Federation, the Canadian Centre for Policy Alternatives, and la Fédération des syndicats de l'enseignement found that 16% of all schools reported a marketing arrangement with Coke, 11% had a similar arrangement with Pepsi, and 6% participated in Pizza Hut’s “Book It!,” a program that provides for educational materials while encouraging pizza consumption.47,48 According to the survey, the average amount of money raised from food and non-food-related 42 Nutrition in Saskatchewan Schools: Policy, Practice and Needs, p. 4. 43 Department of Health, Government of Manitoba. Manitoba School Nutrition Survey, p. 9. 44 Creating a Healthy School Nutrition Environment, p. 18. 45 Survey of Food and Nutrition Policies and Services in Newfoundland Labrador. 46 Caroline Alphonso. “Nutritious fare is tough sell in schools,” The Globe and Mail, January 20, 2007, p. A7. The survey assessing a variety of factors influencing health was sent to 139 school boards across Canada at the end of the 2005-06 academic year. Seventy-four boards responded. 47 See Commercialism in Canadian Schools: Who's Calling the Shots? op.cit. 48 Note that in the 2005 Integrated Pan-Canadian Healthy Living Strategy, health ministers undertook to develop school nutrition standards “as part of comprehensive school health efforts.” While this was a step in the right direction, this strategy was released before the 2007 IOM school food standards, and therefore provincial nutrition standards need to be updated. Secretariat for the Intersectoral Healthy Living Network, F/P/T Healthy Living Task Group, F/P/T Advisory Committee on Population Health and Health Security. Integrated Healthy Living Strategy, October 22-23, 2005, p. 36, http://www.phac-aspc.gc.ca/hl-vs-strat/pdf/hls_e.pdf, last accessed September 23, 2007. Reliance on the sales of foods of low nutritional value to fund school activities is inconsistent with that mandate.

11

sources was approximately $16,000 per English-speaking school and $13,500 per French-speaking school (though some schools raised hundreds of thousands of dollars), and school staff and students reportedly played a much bigger role in fundraising decisions than provincial governments or school boards.

Since 2005, school nutrition criteria (see Appendix 2)49 have been established in every

province except Alberta (where they were released in draft form in July 2007 and are undergoing consultation until October 31, 2007) and Quebec (where they will come into force in 2008). However, the Yukon,50 the Northwest Territories,51 and Nunavut52—jurisdictions with the greatest need and the highest federal presence—have no school nutrition criteria.

This report assesses provincial nutrition criteria for fats, sodium, added sugars, and

calories/serving sizes for food offerings within schools by measuring those criteria against the benchmarks set by the US Institute of Medicine’s report: Nutrition Standards for Foods in Schools. Provincial governments set out nutrition criteria in documents variously called guidelines, standards or policies; it is often unclear whether these are truly binding requirements for schools, or simply roadmaps offered to educators that volunteer to address the issue.

All provincial school nutrition criteria are based, to some extent, on the Canada's Food

Guide (1992)53 food groups: grains, vegetables and fruit, milk and milk products, and meat and alternatives or, in the case Quebec and Alberta, the food groups in the 2007 edition of the Guide.54 However, since most of these policies were developed, the Guide was revised; a new edition with school-age-appropriate dietary advice was released earlier this year. The IOM

49 Guidelines in Ontario, New Brunswick, and Prince Edward Island were released prior to the Healthy Living Strategy. Some provincial policies, e.g., Nova Scotia’s, are to be phased in over time. 50 The Yukon Ministry of Education does have a policy (#1023) concerning the school sale of home-prepared foods to the public; see: http://www.education.gov.yk.ca/policy/policy_prepared_foods.pdf, last accessed September 23, 2007. Other activities such as “Drop the Pop” encourages Grades K-12 to make healthier drink choices and “Healthy Eating Resources for Yukon Schools” is designed to help children grades K through 8 build and maintain healthy habits with diabetes prevention in mind. But currently no nutrition guidelines exist for food and beverages sold and/or served within Yukon schools. See An Environmental Scan of Activities Related to Schools and Nutrition, op.cit, pp 5, 15, 21. 51 School nutrition guidelines are being developed by regional school boards within the Northwest Territories. In preparation for this, a school nutrition survey was developed for the fall of 2006 and coordinated by the NWT Departments of Health and Social Services and Education, Culture and Employment. The NWT also participates in the “Drop the Pop” campaign. See An Environmental Scan of Activities Related to Schools and Nutrition, pp 4, 15. 52 Like Yukon and the NWT, Nunavut also participates in “Drop the Pop” but has yet to develop school nutrition guidelines. See An Environmental Scan of Activities Related to Schools and Nutrition, p. 15. 53 Canada's Food Guide was revised earlier in 2007. As such, with the exception of Alberta's draft guidelines and Quebec's new standards, provincial nutrition policies, standards, and guidelines are based on the previous iteration of the Guide (1992). 54 Some provinces such as British Columbia include additional food groupings such as nuts and seeds, mixed entrées, soups, candies and chocolates, energy bars, beverages (milk-based, juice-based, and other kinds), and condiments and add-ins.

12

released new specific guidelines for school foods in 2007 as well. These developments beg a reconsideration of existing provincial school food criteria that were developed prior to the publication of these key benchmarks.55

Efforts shown in some provincial policies to promote better nutrition education in the

curriculum are laudable, but these must be supported by applying sensible nutrition standards to foods actually distributed on school grounds. The true measure of schools’ commitment to nutrition is what they are actually feeding students. Because there is so little evidence about food consumption at school—and even that evidence is discouraging—monitoring the actual menus and consumption at school is a vital part of government’s political commitment to ensuring school food service providers apply what public health authorities and nutrition educators recommend.

With the exception of Ontario and Quebec’s guidelines, all provinces group food

offerings within schools according to their perceived health benefit. The healthiest foods are grouped under “maximum nutrition” or “choose most” (to be served the most often, e.g., daily). Foods that may have some health benefits, but are higher in fat, sodium, or sugar are grouped under categories such as “moderate nutrition” or “choose sometimes” (definitions of which vary widely). Nutrient-poor foods high in fat, sodium, or sugar are grouped under “minimal nutrition” or “choose least” (definitions of which also vary widely). By contrast, under the IOM approach, it is rarely justifiable for schools to sell health-eroding foods to children.

Some aspects of provincial school nutrition criteria could—if followed and enforced—

help improve the diets of Canadian children and youth in school. For example:

• In 2004, Ontario called on school boards to “restrict the sale of all food and beverage items in elementary school vending machines to those that are healthy and nutritious.”56

• Quebec's recently announced guidelines aim to remove some of the worst junk food from schools, such as soft drinks and french fries, by 2008.

• By 2008, British Columbia aims for foods in the “not recommended” and “least recommended” categories to be eliminated from school offerings (January for elementary schools and September for middle and high schools).57

• New Brunswick’s policy claims to ensure that only foods of moderate and maximum nutrition be sold in elementary schools cafeterias, vending machines, etc. As of September 2007, this stipulation also applies to middle and secondary schools.58

55 Alberta's draft guidelines and Quebec's guidelines were released after the release of the new Food Guide in January 2007 and the IOM standards in April 2007. 56 See Policy/Program Memorandum No. 135, Healthy Foods and Beverages in Elementary School Vending Machines, Ministry of Education, Government of Ontario, October 20, 2004, http://www.edu.gov.on.ca/extra/eng/ppm/135.html, last accessed September 23, 2007. 57 See “BC sets national standard in promoting student health,” Press Release, Ministry of Education, and Ministry of Tourism, Sport and the Arts, Government of British Columbia September 4, 2007, http://www2.news.gov.bc.ca/news_releases_2005-2009/2007EDU0113-001078.htm, last accessed September 23, 2007.

13

• Nova Scotia requires school boards to report progress on implementation.59

Some provinces appear to have made noteworthy progress toward ridding schools of unhealthy food choices. For example, in Nova Scotia, preliminary indications are that soda pop, chips,60 frozen novelties, and other minimally nutritious foods have been removed from schools.61 In addition, the province has hired nine new public health nutritionists.62

However, despite some particular strengths of certain provincial school nutrition criteria, such criteria in Canada—where they exist—comprise a patchwork quilt of often weak, inconsistent guidelines. To compare provincial school nutrition criteria to one another, as well as to appropriate benchmarks for healthy school eating, this report assigns a grade to each provincial program. We graded provincial nutrition criteria for school foods as follows:

Chart 2:

School Nutrition Policy Report Card (Summary)

Province/Territory Grade British Columbia D Alberta (draft guidelines) B Saskatchewan F Manitoba D Ontario F Quebec D New Brunswick D Nova Scotia C Prince Edward Island F Newfoundland and Labrador C Nunavut No Standards Northwest Territories No Standards Yukon No Standards

Explanation of Letter Grades Letter Grade: Numeric Score: Percentile Score: A 16 - 20/20 80 - 100% B 14 - 15.5/20 79 - 70% C 12 - 13.5/20 60 - 69% D 10 - 11.5/20 50 - 59% F 0 - 9.5/20 0 - 49%

58 Personal communication with Department of Education, Policy and Planning Division staff, September 11, 2007. 59 Personal communication with Department of Health Promotion and Protection staff, May 3, 2007. 60 “Nutritious fare is tough sell in schools,” op.cit. The Globe and Mail surveyed a handful of school boards in that province. 61 Personal communication with Department of Health Promotion and Protection staff, May 3, 2007. 62 Ibid.

14

The grading scheme for provincial school nutrition criteria measures what provincial government policies declare to be optimally nutritious foods (variously called “maximum nutritional value,” “choose most,” etc) against the benchmarks established by the standards for calories, fats, sodium, and sugars set out in the April 2007 IOM Report.

In addition to the IOM report, the following sources were also used as interpretative aides

to evaluate the adequacy of provincial criteria that use serving sizes as proxies for calorie limits:

• Standards for calories as recommended by the US National Alliance for Nutrition and Activity63 (NANA); and

• Standards for portion sizes as recommended in the 2007 edition of Canada’s Food Guide.

The April 2007 IOM school food standards are designed to apply to individual foods and

entrées. However, existing Canadian provincial school nutrition criteria focus almost exclusively on individual foods; 64 only three provinces, Saskatchewan, Ontario, and Quebec even contemplate complete meals in their guidelines.65

Nutrition standards established by the US Department of Agriculture (USDA) for school

meals are particularly out-of-date in regards to limits on sodium, trans fats, and added sugars.66

63 The IOM standards include calories thresholds [200] for single foods and à la carte entrées [400], but do not include calorie ranges for full meals. Calories ranges recommended by the National Alliance for Nutrition and Activity could be used to set calorie limits for meals. They are: breakfast, grades K-5: 350-550; grades 6-8: 400-550; grades 9-12: 500-700; lunch, grades K-5: 460-730; grades 6-8: 530-730; grades 9-12: 660-920. See NANA letter to Secretary of Agriculture Mike Johanns, January 24, 2005, at: http://www.cspinet.org/nutritionpolicy/nanaDGA_schoolmeals.pdf , last accessed September 23, 2007. Accordingly, calorie ranges recommended by the National Alliance for Nutrition and Activity are used to judge calorie thresholds for meals where provincial criteria are set-out for meals since a meal may include an entrée, a drink, a dessert, etc. Calorie ranges, where applicable, are noted within Chart 3. 64 The IOM’s nutrition criteria could theoretically be applied to such food-specific standards. For instance, IOM limits for fat and added sugars are prescribed as a percentage of total calories, so these could be applied to meals. Similarly, IOM limits for sodium are designed to apply to both single foods as well as à la carte entrée items; so, these standards could, theoretically, be used to evaluate whole meals by examining each food element of the meal, e.g., the drink, side-dish, and entrée. 65 Saskatchewan's policy states that “A meal should contain at least 1 serving from each of the 4 food groups of Canada's Food Guide to Healthy Eating [grains; vegetables and fruit; milk products; meat and alternatives].” Ontario's policy states that “A meal (i.e., breakfast and lunch) should contain at least one serving from a minimum of three out of the four food groups of Canada’s Food Guide with at least one serving from the Vegetables and Fruit food group and at least one serving from the Milk Products food group.” However, there are no stipulations within any provincial policy beyond this (no nutrient criteria, limits, or thresholds) for school meals. Quebec's guidelines require that meals be composed of the four food groups of Canada's Food Guide (2007).

66 While the results are “weak and mixed,” current USDA guidelines for school nutrition programs appear to improve some dietary outcomes, e.g., lower calories, lower prevalence of vitamin C deficiency, but worsen other dietary outcomes, e.g., higher fat and saturated fat intakes, low vitamin E and A and iron. See Jayanta Bhattacharya, Janet Currie, and Steven J. Haider. Evaluating the Impact of School Nutrition Programs (Final Report), Economic Research Service, USDA, July 2004, p. 20,

15

The USDA has acknowledged that its meal standards will be revised over the next several years to better comport with the 2005 US Dietary Guidelines for Americans.67

V. How provincial nutrition criteria were rated

In comparing the provincial polices to the April 2007 school nutrition standards recommended by the IOM for fats, sodium, added sugars, and calories,68 the highest a province could score is five points per nutrient, for a total of 20 points. Demerit points were assigned according to the degree to which the criteria were inconsistent with the IOM standards. For example, if a province sets no limits whatsoever for sodium, it received “0” out of five points. If a province has weak sodium limits, then it received a low score depending how much higher the sodium limits are than the IOM standard or how many types of high-sodium foods are exempted from the limit. And if a province has good criteria across all food groups for sodium, then it received a score closer to five.

One demerit point for each nutrient standard was assigned to provincial criteria that

categorize food choices according to “maximum,” “moderate,” and “minimal” nutrition or any similar categorization. (All except Ontario and Quebec present their criteria in this way.) That practice significantly undermines the stricter criteria for “maximum nutrition” foods by allowing foods of low nutritional value to be sold to children a portion of the time or as a percent of choices. British Columbia, New Brunswick, and Newfoundland and Labrador criteria were penalized somewhat less for this practice since these jurisdictions have either eliminated the “minimally nutritious” food category (NB), will soon eliminate this category (BC, along with “not recommended foods”), or only ever permitted “maximum nutrition” and “moderate nutrition” foods within their criteria (NL). (It should be noted here that foods called “moderately nutritious” within several jurisdictions are in fact nutrient-poor; see below.)

These ratings are limited in that they do not address the adequacy of provincial policies to

promote the consumption of whole grains, vegetables and fruit, and other healthy foods. Instead, the IOM standards are designed to act as a barrier to distributing nutrient-poor foods in school. Keeping junk foods away from children in school is important but, as noted earlier, ensuring that students consume healthy food can best be achieved by government subsidies for

http://www.ers.usda.gov/publications/efan04008/efan04008.pdf, last accessed September 23, 2007. A more recent USDA study found that children who consume mainly National School Lunch Program food report “a higher intake of most nutrients, milk, fruits, and vegetables and lower intakes of sweetened beverages and candy than students who consumed mainly non-NSLP food, including à la carte items, food from vending machines, and food from home.” However, “students in the ‛mainly NLSP’ group also consumed more sodium, fat, and saturated fat . . . and calorie intake was also higher for this group, although it was only 80 percent of the NSLP requirement for calories served at lunch.” See Karen Cullen, Kathy Watson, and Issa Zakeri. Middle School Student Lunch Consumption: Impact of National School Lunch Program Meal and Competitive Foods, June 2007, http://www.ers.usda.gov/Publications/CCR30/, last accessed September 23, 2007. 67 USDA. “Johanns discusses USDA nutrition goals during National Nutrition Month.” News Release, March 26, 2007, http://www.fns.usda.gov/cga/PressReleases/2007/PR-0075.htm, last accessed September 23, 2007. 68 As noted above, the NANA suggested ranges for calories for meals, and the portion sizes recommended under the 2007 version of Canada’s Food Guide were also used as interpretive aids.

16

truly nutritious fare like vegetables, fruits, whole grains This aspect of school nutrition is not included in the grading scheme, however, considering the extremely low level of provincial government subsidies across the board, all provinces would fare very poorly if the adequacy of school food funding for healthy food comprised a significant part of the report card evaluation.

The following table on pages 17-18 indicates an overall grade for each province’s school

nutrition criteria. No province received an “A” since no policy is entirely consistent with the IOM standards. Only one province (Alberta) received a “B”; two provinces (Nova Scotia and Newfoundland and Labrador) received a “C”; four provinces (British Columbia, Manitoba, Quebec and New Brunswick) received a “D”; and three provinces (Saskatchewan, Ontario, and Prince Edward Island) received an “F.” The three northern territories received “No Standards” since they have not issued policies.

Some provincial school nutrition criteria include measures that could—if followed—help

enhance the diets of Canadian children. But with some exceptions, provincial criteria also suffer from a number of serious weaknesses. These results speak to the pressing need to examine and enhance school nutrition criteria across Canada to ensure that Canadian children, wherever they live, have access to healthy and nutritious food while in school.

VI. Weaknesses of provincial nutrition criteria Specific flaws within provincial school nutrition policies include:

• Weak policies that permit the frequent sale of nutrient-poor foods

Our grades for provincial school food criteria are based on a comparison of the nutritional values of foods that are to be served most under those programs (known as “maximum nutrition foods,” “choose most,” or a similar name) with the April 2007 IOM core nutrient standards concerning calories, fats, sodium, and sugars. However, all provinces except Ontario and Quebec group foods into “maximum nutrition,” “moderate nutrition,” and “minimal nutrition” categories (or similar categories).

For example, while British Columbia's guidelines require that “choose least” foods

comprise less than 10% of available choices (i.e., not 10% of sales volumes), there is no mechanism to ensure that students would not simply choose these 10% of possibilities more often than the more healthy choices comprising 90% of possible choices. Limiting to 10% the number of “minimally nutritious” menu items available on any given school day is certainly no guarantee that such foods will comprise 10% of a child’s diet at school.

17

Chart 3: How Provincial School Nutrition Standards

Stack Up Against IOM Core Nutrient Standards

INSTITUTE OF MEDICINE STANDARD

FAT • Total fat: ≤ 35% of total calories • Saturated fat: <10% of total calories • Trans fat: ≤ 0.5g per serving • Milk: ≤1% milk fat (MF)

SODIUM • ≤ 200 mg/serving • ≤ 480 mg/entrée

SUGARS (Excl. sugar from fruit and dairy.)

• Total sugar ≤ 35% of total calories • Yogurt: ≤ 30g/8 oz. • Milk: ≤ 22g/8 oz. • Elementary: water w/o flavouring,

additives or carbonation • High school: uncaffeinated, unfortified

beverages with < 5 calories/serving.

CALORIES/ SERVING SIZES

• ≤200 calories, single foods

• ≤400 calories, à la carte entrée items

• Juice: ≤4 oz. for elementary/middle school and ≤ 8 oz. for high school

BRITISH COLUMBIA: 11/20 GRADE: D Sale of “choose sometimes,” “choose least” and “not recommended” foods with weak controls (e.g., “minimally nutritious” food as ≤ 10% of choices) undermines stricter criteria. This weakness is mitigated by the planned elimination of “choose least” and “not recommended” foods by 2008. This policy is very complicated and, even with strong nutrition criteria, difficulties interpreting the policy would likely impede compliance.

2 out of 5 Points: • Weak or no fat limits in most food

groups, e.g., 14.9 g for grains, vegetables and fruit; 12 g of saturated fat in mixed entrees and 5 g in grains; 14.9g of total fat in soups, 15 g in milk and allows 2%, 3.25% milk and up to 20 g in other dairy, e.g., cheese; up to 12g fat per 60g serving for meats and alternatives; and high-fat condiments permitted in the "choose most" category.

3 out of 5 Points: • Good sodium limits for

other beverages (50 mg), vegetables and fruit (150 mg), nuts and seeds (200 mg), energy bars (200 mg), and milk-based beverages (200 mg).

• Higher sodium limits for milk-based foods (300 mg), meat (375 mg), mixed entrees (750 mg); high-sodium condiments in the "choose most" category.

3.5 out of 5 Points: • Strong, but sometimes confusing (and

perhaps lax) sugar limits for grains (up to 16 g if fruit is the 1st or 2nd ingredient); “Choose Most” sugar criteria may be more lenient on sugar in foods with less fruit (i.e, 28g per serving); no artificial sweeteners.

• Strong sugar limits for milk-based foods (20 g/175 mL) and beverages (20g/250 mL); no artificial sweeteners.

• Allows up to 8g sugars/250 mL of non-fruit, non-milk beverages if fortified with calcium; no added sugars if calcium < 20% of DV.

• Sugars may not be even the 2nd ingredient and no artificial sweeteners for vegetables and fruit.

• Sugars are neither the 1st nor 2nd ingredient for nuts and seeds; no artificial sweeteners.

• Sugar-free gum and mints allowed

2.5 out of 5 Points: • Sets explicit, though

high, calorie limits for most food groups, e.g., 300 for energy bars, 400 for milk-based foods, grains, nuts and seed mixes or bars, 600 for milk-based beverages, and 1,000 for mixed entrees.

• Some reference to serving sizes, e.g., 175mL for milk-based foods, 250 mL for milk-based beverages.

ALBERTA (DRAFT):×14.5/20 GRADE: B Sale of “choose sometimes” and “choose least often” foods with weak controls undermines stricter criteria; e.g., dozens of foods listed under “minimally nutritious” foods (allowed weekly) are high in fat, sodium and sugar. To its credit, the draft policy aims to apply to all schools, childcare facilities, recreation centres, etc.

3.5 out of 5 Points: • Good criteria for saturated fat (no more

than 2g), trans fat (0g), and total fat (no more than 35% of total calories from fat). (However, some suggested foods may not meet these criteria—e.g., some cheeses—and send conflicting signals to food service operators.

• Weak fat limits for some milk products (e.g., 2% milk).

3.5 out of 5 Points: • Good criteria for

sodium for single foods (no more than 200 mg/packaged portion), but no distinction between single foods and entrées.

• But some suggested foods may not meet this threshold (e.g., mixed dishes, cheese) and send conflicting signals to food service operators.

4 out of 5 Points: • Good criteria for sugar (no more than

35% of total calories from sugar).

3.5 out of 5 Points: • Serving sizes as per

Canada's Food Guide (2007)

• Reference amount serving sizes as per nutrition labelling regulations also listed.

• No calorie ranges listed.

SASKATCHEWAN:Ŧ:

5.5/20 GRADE: F Sale of “serve sometimes” and “serve least often” foods with weak controls undermines stricter criteria.

1.5 out of 5 Points: • Little clear guidance on fats for most

foods (although lean ground meat is recommended) under meats and alternatives; weak fat limits for milk products where explicit criteria is provided (e.g., permits 2% milk); and no limits for sat/trans fat.

0.5 out of 5 Points: • No limits for sodium

beyond a vague overall directive to "limit salt."

3.5 out of 5 Points: • Strong limits on sugar for cereal (8

g/serving) and fruit (unsweetened only). • Soft drinks (regular and diet), slushies,

sports drinks, fruit flavoured crystal drinks, candy and chocolate and other sugary foods are under the "serve least" category of foods, to be served no more than twice in a four-week period.

• No explicit sugar limits for milk prods.

0 out of 5 Points: • No calories or serving

sizes listed.

MANITOBA: 10.5/20 GRADE: D Sale of “serve sometimes” and “serve rarely” foods with weak controls undermines stricter criteria for “serve most” foods.

2 out of 5 Points: • No explicit limits for saturated or trans

fat for any foods (limits are for total fat); mention is limited to choosing grain products without trans fat; weak fat limits for some milk products (e.g., allows 2% milk), but better limits for other products, e.g., cheese (20% MF or approx. 10 g fat per 50 g serving).

• Modest guidance for meats and alternatives (lean or extra lean choices)

2 out of 5 Points: • Broad limits for

sodium in all food groups (less than 480 per serving), which is too high per serving of single foods, e.g., 1 slice of bread, 1 half-cup of vegetable juice.

3.5 out of 5 Points: • No sugar limits for vegetables and fruit. • Strong sugar limits for grains (12 g) and

milk products (20 g). • Discourages consumption of energy

drinks and soft drinks.

3 out of 5 Points: • Serving sizes as per

Canada's Food Guide (1992).


× Note: Alberta's draft guidelines, released in July 2007, will undergo online stakeholder consultation until October 31, 2007. Ŧ Note: a number of different versions of the Saskatchewan guidelines are in circulation. The version used for this review is the four-page document that appears on the Saskatchewan Learning website (see Appendix 2).

18

PROVINCE FAT

SODIUM SUGARS CALORIES/

SERVING SIZES

ONTARIO: 9/20 GRADE: F The Ontario government’s nutrition criteria cover only food services provided by community volunteers and vending machines. Accordingly, 1 demerit is assigned for each nutrient criterion since the narrow application of these standards leave significant portions of the school nutrition environment without any nutrition standards.

2 out of 5 Points: • Strong fat and/or saturated/trans

fat limits for most grains and “other” foods.

• Limited guidance on fats for vegetables, fruits, meat and alternatives; weak limits on fats for some milk and alternatives (e.g., allows 2% milk) but better limits for others (e.g., 20% MF for cheese).

2 out of 5 Points: • Limited guidance on sodium

for grains and none for milk products and alternatives.

• Broad limits on sodium for vegetables, meat and alternatives (480 mg), which is too high per serving of single foods.

• Some typically high-sodium foods are not recommended, such as hotdogs, sausages, bacon, and deep fried foods.

2 out of 5 Points: • No sugar limits on milk products, or

alternatives, or any vending machine foods and limited guidance for grains (low-sugar cereals)

• Canned and dried fruit provided by volunteers must not contain added sugar.

• Some high-sugar foods are not permitted in community feeding programs (e.g., soft-drinks, ice-cream, cookies, candy).




QUEBEC: 10/20 GRADE: D While Quebec’s post-IOM effort to rid schools of some of the least nutritious foods (especially soft drinks and french fries) is praiseworthy, its failure to specify nutrition criteria deprives schools of important guidance and could lead to nutrient-poor substitutes getting a foothold.

3 out of 5 Points: • Guidance to avoid products

containing saturated or hydrogenated fat, offer meat with lower fat content, eliminate fried foods, avoid desserts and snacks with high fat content, and use cooking methods involving very little or no fat.

• But no specific limits for total fat, saturated fat or trans fat.

0 out of 5 Points: • Salt is hardly mentioned and

no limits for sodium are proposed.

3 out of 5 Points: • Emphasis on unsweetened fruit juices,

avoiding desserts and snacks with high sugar content.

• Aims to eliminate carbonated soft drinks high in sugar or sugar substitutes, any drinks with added sugar, and products with sugar or an equivalent as the first ingredient.

• But no specific limits for sugar.

4 out of 5 Points: • Recommendations are

based on Canada's Food Guide (2007), which includes serving sizes, though these are not listed in the guidelines.


NEW BRUNSWICK: 10.5/20 GRADE: D Sale of “moderate nutrition” and “minimum nutrition” with weak controls undermines stricter criteria for “maximum nutrition” foods. This weakness is mitigated by elimination of “minimally nutritious” foods by 2007.

2 out of 5 Points: • Minimal or no guidance on fats

and no limits for saturated or trans fats for grains, vegetables, and fruit; weak fat limits for some milk products (e.g., allowing 2%) and none for others (e.g., hard cheese).

2 out of 5 Points: • Few or no sodium limits for

grains, milk, meat, and alternatives (only for nuts/seeds); incomplete criteria for vegetables and fruits.

3 out of 5 Points: • No sugar limits for milk and

alternatives and no explicit sugar limits for vegetables and fruit (except unsweetened cereals, fruit, and juice).

• Many sugary products are listed as not recommended.


Canada's Food Guide (1992) listed within the handbook that accompanies the policy.


NOVA SCOTIA: 12/20 GRADE: C Sale of “moderate nutrition” and “minimum nutrition” with weak controls undermines stricter criteria for “maximum nutrition” foods.

3.5 out of 5 Points: • Strong limits on total, saturated

and trans fat per serving, i.e., 3g of total fat and 2g of sat/trans fat combined for grains, vegetables and fruit; 5g total fat and 4g sat/trans fat combined for milk and alternatives; and 5g total fat and 3g sat/ trans fat combined for meats and alternatives.

• But allows 2% milk.

2 out of 5 Points: • Broad limits for sodium in

all food groups (less than 480 per serving), which are too high per serving of single foods, e.g., 125mL for 1 half cup of vegetables, etc., and high limits for entrées (960mg).

3.5 out of 5 Points: • Good limits for sugar in vegetables

and fruit (no added sugars) and milk and alternatives (lower fat and flavoured milk should contain ≤28g total sugar per 250 mL).

• No artificial sweeteners for grains, milk and alternatives, but no sugar limits specified for grains.


Canada's Food Guide (1992), though these are not listed in the policy.


PRINCE EDWARD ISLAND: 4.5/20 GRADE: F Sale of “serve sometimes” and “serve least often” with weak controls undermines stricter criteria for “serve most often” foods.

1.5 out of 5 Points: • Incomplete fat criteria for grains

and milk products. • Weak fat limits for milk and

alternatives, e.g., allowing 2% milk and cheese without fat limits.

• No limits specified for saturated/trans fat.

0.5 out of 5 Points: • While the policy states that

foods sold or made available at school will be "low in salt," there are no explicit sodium limits in any food group except seeds and nuts under meats and alternatives.

2.5 out of 5 Points: • No sugar limits for milk and

alternatives. • Unsweetened or low-sugar cereal

within the "choose most" category of foods.

• Candy, chocolate, pop, sports drinks sweetened fruit drinks, within "serve least often" category (1-2 times per month).

0 out of 5 Points: • No calories or serving

sizes listed.

NEWFOUNDLAND AND LABRADOR: 12/20 GRADE: C Sale of “serve moderately” foods with weak controls undermines stricter criteria for “serve most” foods. (Nutrient-poor "moderately nutritious" foods may comprise less than 50% of foods daily.)

2.5 out of 5 Points: • Strong fat limits for grains (3 g). • Very little guidance regarding

fat for vegetables and fruit (except minimize deep-fried french fries); weak fat limits for some milk and alternatives (e.g., allowing 2% milk) but better for others (e.g., 20% MF cheese); no limits specified for trans fat or saturated fats.

2 out of 5 Points: • Broad limit of 480 mg of

sodium for all foods in “serve most” category, which is too high per serving of single foods, e.g., 2 cheese slices, etc.; a salt shaker icon to identify potentially high-salt foods (and if they may be “served most”) may be confusing; it does not appear beside foods (e.g., bread, cheese) often high in sodium.

4 out of 5 Points: • Good sugar limits for milk and

alternatives (e.g., 14 g or less per 175 mL of yogurt, unsweetened milk).

• Good sugar limits for cereals (6g/standard serving size)

• Only unsweetened fruit, juice and fruit bars, etc. are permitted.




19

The Government of British Columbia recently pledged to eliminate both “not recommended” and “choose least” foods by 2008 and revised its nutrient criteria within the “choose most” and “choose sometimes” categories. While these revisions have introduced some improvements to the guidelines such as some lower sodium limits, the fat limit was actually increased from 5 g to 14.9 g for “choose most” vegetables, and from 10 g to 14.9 g for grains. “Choose most” foods still include mixed entrées with up to 750 mg of sodium, which deliver double the amount of sodium per serving recommended under the new IOM school nutrition standards and deliver one-third of the maximum daily intake of sodium even for an adult.69

Recently released Statistics Canada data on sodium consumption show that Canadian

children, on average, ingest approximately twice the recommended amount of sodium (largely from processed and commercially prepared foods).70 Lax sodium limits in school food policies in BC and most other provinces are especially troubling because “in the cultures like North America, the lifetime risk among adults of becoming hypertensive is 90% and evidence indicates that reducing sodium intake (and increasing potassium intake) may blunt the age-related rise in blood pressure.”71

Similarly, Newfoundland and Labrador requires only that 50% of food offerings on a

daily basis in this province’s schools comes from the “serve most” category of foods, but there is no guarantee that children will choose these items more often than the “serve moderately” items higher in salt, fat, and sugar, e.g., pretzels, ice cream, bacon, chicken wings, and other unhealthy choices.72

69 According to the IOM, the maximum daily intake for sodium for children aged 4-8 is 1,900 mg, aged 9-13 is 2,200 mg, and aged 14-18 is 2,300 mg. 70 For children aged 4-8, the Upper Limit for sodium is 1,900 mg, but children, on average, ingest 2,677 mg of sodium per day. Older children and youth have even higher consumption levels. See Statistics Canada. Sodium consumption at all ages. April 10, 2007, http://www.statcan.ca/english/freepub/82-003-XIE/2006004/articles/sodium/sodiumconsumption_e.pdf, Last accessed September 23, 2007. 71 See: US Institute of Medicine, Dietary Reference Intakes for Water, Potassium, Sodium, Chloride and Sulfate, Washington, DC: IOM, 2005, p. 354. 72 Some items have some restrictions. For example, french fries or hash browns can only be served once a week and both cannot be served during the same week.

20

These foods are considered “moderately nutritious” under some provincial standards.

In New Brunswick, this province’s policy aims to eliminate minimally nutritious foods

by September 2007, but permits so-called “moderately nutritious” foods to be served thereafter. According to the New Brunswick government, “moderately nutritious” foods include items high in salt (e.g., canned noodle or rice soups, baked ham, and salted nuts and seeds), foods high in sugar (e.g., pre-sweetened whole-grain cereals, and fruit compote with sugar added), foods high in saturated fat (e.g., ice cream), and combination foods high in both salt and fat (e.g., cheese pizza). Under New Brunswick’s policy, these and other low-nutrition foods can be served twice a week to students in school. Given that several unhealthy food options are available for sale in any given week, this could undermine restrictions on the availability of individual foods; conceivably students could consume nothing but unhealthy foods for the entire week by eating each unhealthy food offered only once or twice a week. Compounding this problem is the fact that there are few unambiguous nutrient limits for any of the foods listed under Appendix A of the New Brunswick food criteria, except for some milk products.

Similarly, even though the Nova Scotia policy claims to have eliminated some foods of

minimal nutritional value, this province’s policy still allows schools to offer whole milk (3.25% milk fat) and high-fat cheeses. Single servings of such foods supply 25% and 50%, respectively, of the recommended daily limits for saturated fat even for an adult’s 2,000 calorie diet. And, at just under 960 mg per serving, the upper limit for sodium for mixed entrées allows individual foods to contain almost half the daily maximum intake of sodium, even for an adult.

While Alberta’s draft guidelines have good criteria for fats, sodium, and added sugars

under the “choose most often” group of foods, the “choose least often” group of foods includes dozens of options high in fat, sodium, and added sugar, including potato chips, soft drinks, chocolate bars, candy, ice cream, cakes, cookies, deep fried foods, donuts, pastries, and whipped cream.

Some provincial guidelines are ambiguous concerning how frequently low-nutrition foods can be served.

However, one part of Alberta’s guidelines indicates that those foods should be limited to “one to two servings a week,” while another states that “these foods [plural, emphasis added]

21

could be consumed once a week.” The draft guidelines are, like other provincial standards, ambiguous concerning exactly how frequently these so-called “choose least often” foods can be served. Given the sheer number of such foods listed in the policy, it is conceivable that students could consume many foods high in fat, sodium, and added sugar at school even if schools served each nutrient-poor food only once per week.

Public policy should ensure that all school food offerings are healthy and not rely on the

nutritional savvy and good judgment of minors to pick the health-enhancing choice over the health-eroding one. Nutrition criteria must be relatively strict across the board and, if non-nutritious treats are permitted, one such food should be available only on a very limited basis (e.g., once a month or less) and offered alongside healthy fare.

• Lack of specific guidance to food service and vending machine operators concerning nutrient limits for permitted foods

Although most provincial school nutrition criteria provide lists of foods under the

categories of maximum, moderate, and minimally nutritious foods, several provide very little precise nutrition criteria to aid food service operators in determining which foods are sufficiently nutritious to feed to children. For example, in Saskatchewan’s nutrition criteria, the only explicit nutrient limits concern fibre and sugar for cereals, milk fat for some dairy products, and levels of real fruit or vegetable content in juices and fruit leather or bars. Similarly, the province’s of Saskatchewan, Quebec, New Brunswick and Prince Edward Island set few, poor, or no criteria for key nutrients such as sodium.

• Wide variations and inconsistencies among provincial food policies

While food groupings are roughly similar across provinces—likely due to the influence of Canada’s Food Guide (1992)—the placement of various foods within specific food categories is subject to considerable variation across jurisdictions. For example, in Manitoba, fortified soy and rice beverages are placed under the “serve most often” category for milk products, however, in British Columbia, some flavored soy drinks are placed under the “choose sometimes” category. And in Newfoundland and Labrador, pepperoni sticks are listed under the “serve moderately” category for meats and alternatives, while in Manitoba this food item is listed under the “serve rarely.”

There is also a lack of consistency in the approach to limiting substandard food choices.

For example, British Columbia defines food availability by percentages of available choices (i.e., 50% or more for “choose most” foods, 40-50% for “choose sometimes” foods, and less than 10% for “choose least foods”; this will change to 50% for “choose most” foods and up to 50% “choose moderately” foods by 2008). The Newfoundland and Labrador policy also stipulates that more than 50% of food offered on a daily basis must come from its “serve most” category of foods. But most provincial policies that define food availability do so in temporal terms, i.e., maximum nutritional value (serve most often), moderate nutritional value (serve sometimes,

22

which can vary between a few times a week to a few times per month), or minimal nutritional (serve rarely, meaning a few times a month or else not defined at all).

These practices contrast with the single set of nutrition standards recommended by the

IOM. While it is important to ensure that provincial policies meet local and regional needs, there is no indication that discrepancies in provincial nutrition criteria for school foods reflect geographically varying dietary needs or food supplies. Indeed, in the region of Canada with the most unique nutrition and food system challenges—the northern territories—there are no school food nutrition standards whatsoever.

The most serious variation among provincial school nutrition criteria is whether such

criteria apply to all foods offered within schools, and the two most disappointingly narrow examples involve policies in Ontario and Manitoba.

In Ontario, aside from the province's vending machine policy (which only applies to

elementary schools) provincial school nutrition criteria as outlined within the document Student Nutrition Program: Nutrition Guidelines only apply to community volunteer-driven school feeding programs, but, conspicuously, not foods for sale in Ontario schools.73 This is an enormous loophole that essentially means foods sold in school cafeterias, canteens, tucks shops, etc. are not even claimed to be held to any nutrition standards.

In Manitoba, the School Nutrition Handbook provides detailed nutrient criteria to assist

schools in the development of their own policies. However, the only requirement is that all schools must develop a policy by the end of the 2007/2008 school year; there is no requirement that schools follow any of the Handbook’s nutrient limits for fats, sodium, added sugars, calories, and serving sizes.74 That said, considering there is very little published data about the actual nutritional merit of foods sold in schools throughout Canada, it is possible that even provincial government standards purporting to apply relatively strict nutrition criteria to all foods are, in reality, largely ignored by schools—especially without additional funding for implementation (see recommendation #3).

Inconsistencies among provincial nutrition criteria for school foods perhaps reflect the

difficulties in formulating such standards prior to the publication of the April 2007 IOM nutrition standards for school foods. These inconsistencies further underscore the importance of revisiting these criteria. There should be a greater degree of consistency among provincial policies to ensure that Canadian school children are provided healthy and nutritious foods regardless of where they live.

73 Personal communication with staff within both the Department of Education and the Ministry of Children and Youth Services, September 7, 10, and 11. 74 Personal communication with Department of Education staff, September 11, 2007.

23

• Complete absence of school food standards in Canada's north

Canada's three northern territories have yet to adopt any nutrition criteria for schools.

The lack of standards for those jurisdictions consigns children who reside there to the luck of the draw.

Given the significantly higher rate of diet-related illness among Aboriginal people and

the high cost of food in the north, stringent nutritional standards and adequate public funding are urgently needed to ensure that children have access to nutritious and affordable food. The primacy of the federal government’s role in healthcare and public health in the territories and in First Nations communities underscores the need for federal leadership.

• Lack of publicly available information concerning compliance Given the relative newness of provincial school nutrition policies, it is not surprising that

no formal evaluations have been completed (or at least published) for some of them. However, given the alarming rise in the rate of childhood obesity in Canada and the capacity of our public schools to establish and promote healthy eating among Canada's young people, public accountability for adherence to provincial standards is critical. There is no point in having school nutrition policies—even weak ones—if schools are not following them, and there is no way to know if schools are following them unless provincial governments conduct surveys on a regular basis (e.g., once a year) with meaningful benchmarks. Such evaluations should include: assessing compliance with explicit school nutrition standards; the extent to which school food offerings meet science-based nutrient standards (e.g., those set out in the 2007 IOM standards) and help ensure children consume the minimum number of servings of healthy foods like whole grains, fruits, and vegetables (as set out in the 2007 update of Canada's Food Guide); barriers inhibiting schools from meeting such objectives; and enabling factors that have helped schools meet such standards.

VII. Conclusion and Recommendations Canada is experiencing an epidemic of childhood obesity and a crushing burden of diet-

related diseases across the life-span, which already exact a high price in health and economic costs that will rise for years to come unless health, education, and food policy-makers act now. Schools are ideal venues to help ensure future generations get a healthy start in life. While some provincial nutrition standards for foods sold at schools are useful first steps in helping to improve school foods, these standards fall far short of the April 2007 IOM recommendations for school foods, and federal and provincial governments devote precious little financial resources to subsidize the consumption of nutritious foods like fruits and vegetables.

To improve Canadian standards for foods sold in schools, we recommend that all

governments and school authorities:

24

1. Develop and support the implementation of comprehensive school nutrition policies that contain nutrition standards for all foods distributed in school and reflect Canada's Food Guide (2007) as well as the US Institute of Medicine’s Nutrition Standards for Foods in Schools (2007).

2. Support the establishment of a pan-Canadian school meals program that is based on

health-protecting nutrition standards and encourages healthy eating habits.75

3. Conduct regular surveillance of school food policies and guidelines, food offerings, and student consumption measured against benchmarks. The health of Canada's children is too important to fall sway to jurisdictional

parochialism. While responsibility for education has historically been primarily assumed by provincial governments, the legislative and financial responsibility for nutrition, food safety, health, public health, consumer protection, and child protection has long been exercised in various ways by local, provincial and federal governments. School nutrition, which should support our children's health, should be no different.

While we are cognizant of inter-jurisdictional political sensitivities, Canada's children

and youth are entitled to expect a decent standard of nutritious fare at school regardless of where they live. The current patchwork (and, in some places, threadbare) quilt of nutrition standards and the minuscule level of public subsidies for nutritious foods fall far short of that mark. Governments must act quickly to ensure that schools make a positive contribution to the nutritional well-being of children.

75 See note 1.

25

Appendices

26

Appendix 1: Key Findings from Publicly Available Provincial School Nutrition Surveys

Province Author and Title of

Report Key Findings

BC Ministry of Education and Ministry of Health, Government of British Columbia. School Food Sales and Policies Provincial Report. 2005. http://www.bced.gov.bc.ca/health/sales_report.pdf, last accessed September 23, 2007.

• Coated granola bars, pastries/cookies, and uncoated granola bars accounted for the bulk of items available for sale in school stores in British Columbia. Few school stores offered “more healthy” beverage choices such as water, milk, and 100 percent fruit drinks. (p. 4)

• The most common foods available in cafeterias were pastries/cookies. Given that snack machines are also located in middle and secondary schools, the concentration of “less healthy” food choices was very high in these schools. (p. 5)

• The proportion of “more healthy” choices available in beverage machines was low (ranging from 26 to 34%) in elementary, middle, and secondary schools. (p. 8)

SK Dr. Shawna Berenbaum. Nutrition in Saskatchewan Schools: Policy, Practice and Needs. 2004. http://ww1.heartandstroke.sk.ca/Images/English/SK-Nutrition-Report-April-2004.pdf, last accessed September 23, 2007. (Prepared for the Heart and Stroke Foundation of Saskatchewan.)

• Vending machines typically serve pop, chips/chocolate bars, candy and juice. (p. 4)

• Canteens most often serve chips/chocolate bars, candy, pop, milk, baked goods and ice cream items. (p. 4)

• Cafeterias typically serve hamburgers, hot dogs, French fries, baked goods, juice, milk and pop. (p. 4)

MB Department of Health, Government of Manitoba. Manitoba School Nutrition Survey. 2006. http://www.gov.mb.ca/healthyschools/foodinschools/documents/survey.pdf Last accessed September 23, 2007.

• The top ten foods sold in school cafeterias were chocolate milk, sandwiches/wraps, cookies, pizza, french fries, soft drinks, soup, 100% fruit juice, water and white milk. The top ten foods sold in canteens and tuck shops were chocolate milk, candy, pizza, chips, hot dogs, chocolate bars, soft drinks, and ice-cream, 100 fruit juice and water. (p. 9)

• 49% of the schools surveyed sold products from restaurants: 31% from local pizza restaurants and 18% from fast food chains. (p. 9)

• Very few schools sold fresh fruit or nuts in their canteens and tuck shops. (p. 8)

• By far the most popular items sold in snack vending machines were fried snacks (chips, cheesies, crackers) and chocolate or yogurt-coated granola/breakfast/sports bars and nuts bars. (p. 13)

27

ON Ontario Society of Nutrition Professionals in Public Health. Creating a Healthy School Nutrition Environment. March 2004. http://www.osnpph.on.ca/pdfs/call_to_action.pdf, last accessed September 23, 2007.

• Other food offered for “special food” days includes hot dogs, potato or nacho chips, pop, cookies, milk (chocolate and white), fast food restaurant items (e.g., hamburgers, cheeseburgers, french fries, ice cream bars, fried chicken, sub sandwiches), chili, pasta, chocolate bars, Rice Krispies Squares, water, and ice-cream/sherbet. (p. 18)

• There are limited amounts of healthy foods prepared each day, and these items are often more expensive than less healthy choices. As a result, students turn to fast food options. (p. 18)

• Healthy foods such as salads, sandwiches, and muffins are more expensive than french fries, hamburgers and cookies. (p. 18)

• Many schools hold “special food days” and have contracts with fast food restaurants to provide lunches for students. Foods from these vendors are usually high in fat and calories. (p. 19)

• Per capita consumption of milk is 30% lower in schools that sell pop and fruit drinks than in schools that sell milk only. (p. 19)

• Beverage companies that become involved with individual schools or school boards generally offer incentives for selling products from their vending machines. (p. 19)

NL Coalition for School Nutrition. Survey of Food and Nutrition Policies and Services in Newfoundland Labrador. 2000. http://www.nlta.nf.ca/HTML_Files/coalition/findings.html, last accessed September 23, 2007.

• Hamburgers, chicken nuggets and french fries are on the cafeteria menu more often than salads, fruits and yogurt.

• In those schools with canteens, the most commonly sold foods are ice-cream and potato chips.

• Soft drinks and sport drinks are overwhelmingly the choices offered to students in vending machines. 100% fruit juices are in less than half the machines. Potato chips and chocolate bars occupy more compartments than cheese and crackers.

• The consumption of greasy food increases if students are permitted to use outside suppliers. Pizza and hamburgers are the favourite orders.

• Only 46% of food offerings in cafeterias, 53% in canteens, and just 27% in vending machines were considered to be nutritious.

28

Appendix 2: List of provincial nutrition criteria for school foods76

• British Columbia:

o Ministry of Health and Ministry of Education, Government of British Columbia. Guidelines for Food and Beverage Sales in B.C. Schools. November 22, 2005. http://www.bced.gov.bc.ca/health/guidelines_sales.pdf Last accessed September 23, 2007.

“The guidelines apply to foods and beverages sold to students in all school locations, including vending machines, school stores and cafeterias, and at fundraisers and other special events.” (p.2). See also: Ministries of Health and Education. FAQs for Schools: Guidelines for Food and Beverage Sales in B.C Schools, 2005, http://www.bced.gov.bc.ca/health/faq_for_schools.pdf, last accessed September 23, 2007.

• Alberta:

o Alberta Health and Wellness. Alberta Nutrition Guidelines for Children and Youth – Draft for Discussion. July 2007. http://www.healthyalberta.com/Documents/20417_Nutri_Guidelines-web.pdf, last accessed September 23, 2007.

“The goal of the Alberta Nutrition Guidelines for Children and Youth is to equip facilities and organizations with the tools they need to provide children and youth with healthy food choices in childcare settings, schools, in recreation centres, at special events, and in the community at large.” (p.1)

• Saskatchewan:

o Department of Learning. Government of Saskatchewan. Nutrition Guidelines for Schools. September 2005. http://www.sasked.gov.sk.ca/branches/pol_eval/community_ed/docs/foodlists.pdf, last accessed September 23, 2007.

“The following food lists were developed for use in Saskatchewan Community Schools that offer regular snack and/or meal service.” (p. 1)

• Manitoba:

o Government of Manitoba. Manitoba School Nutrition Handbook: Getting Started with Guidelines and Policies. October 17, 2006. http://www.gov.mb.ca/healthyschools/foodinschools/documents/handbook.pdf, last accessed September 23, 2007.

76 Whether the majority of these policies are binding on school food and foodservice suppliers and if there are any consequences of non-compliance is unclear.

29

“These guidelines apply to foods that may be sold in, or provided by, schools in Manitoba.” (p. 7)

• Ontario:

o Ministry of Children and Youth Services. Government of Ontario. Student Nutrition Program: Nutrition Guidelines. June 2005. http://www.children.gov.on.ca/NR/CS/BestStart/En-NutritionGuidelines.doc, last accessed September 23, 2007.

“These guidelines are intended to assist student nutrition program providers in selecting nutritious foods for breakfasts, lunches and snacks in order to promote healthy eating habits among children and youth across the province.” (p. 1)

o Ministry of Education. Policy/Program Memorandum No. 135, Healthy Foods and

Beverages in Elementary School Vending Machines. October 20, 2004. http://www.edu.gov.on.ca/extra/eng/ppm/135.html, last accessed September 23, 2007.

“The purpose of this memorandum is to set out clear, recommended standards for school boards, in response to requests for direction, regarding the sale of foods and beverages through vending machines in elementary schools.” (Introduction)

• Quebec o Ministére de l'Éducation, Loisir et Sport. Pour un virage santé à l'école. September

2007. http://www.mels.gouv.qc.ca/sections/virageSante/pdf/virageSante.pdf, last accessed September 23, 2007.

“Les orientations présentées interpellent les milieux scolaires, les fournisseurs de services alimentaires, les services de traiteur et de cafétéria. Chaque orientation en matière de saine alimentaire comprend un certain nombre de composantes considérées comme étant prioritaires par le MELS. Elles touchent non seulement la qualité des menus, mais également les aliments offerts dans les machines distributrices, dans les comptoirs alimentaires, etc.” (p. 18)

• Nova Scotia:

o Ministries of Education and Health Promotion. Food and Beverage Standards for Nova Scotia Public Schools. September 2006. http://www.ednet.ns.ca/healthy_eating/pdf/22454_ver2_lo_res.pdf, last accessed September 23, 2007.

“The Food and Beverage Standards for Nova Scotia Public Schools . . . provide nutrition criteria, suggestions, and detailed lists of healthy options that can help inform decisions about the food and beverages served and sold during the school day.” (p. 1)

30

• New Brunswick: o Department of Education, Government of New Brunswick. Healthier Foods and

Nutrition in Public Schools. October 11, 2005. http://www.gnb.ca/0000/pol/e/711A.pdf last accessed September 23, 2007.

“This policy establishes the minimum requirements for healthy foods in New Brunswick's public schools by setting standards for healthy food awareness, food options available in schools and the sale of foods in and through the public school system.” (p. 1)

• Prince Edward Island:

o Eastern School District. Policy Statement: School Nutrition. January 12, 2005. http://www.gov.pe.ca/photos/original/eastern_policy.pdf, last accessed September 23, 2007.

o Western School Board of P.E.I. Elementary and Consolidated School Nutrition Policy. June 8, 2005. http://www.gov.pe.ca/photos/original/western_policy.pdf, last accessed September 23, 2007.

o Commission scolaire de langue française.

These policies, which apply to elementary schools (grades 1 - 6) and consolidated schools (grades 1 - 8), are almost identical; see Backgrounder: PEI School Nutrition Policies, November 25, 2004, http://www.edu.pe.ca/esd/pdf/nutritionbackgrounder.PDF, last accessed September 23, 2007.

“The initial phase of the policy is for schools without cafeterias, which is for the most part elementary and consolidated schools, as well as the six schools in the French board. The next phase will address intermediate and high schools.” (p. 1)

• Newfoundland and Labrador:

o Department of Education, Department of Health and Community Services, Government of Newfoundland and Labrador. School Food Guidelines. June 16, 2006. http://www.ed.gov.nl.ca/edu/k12/pdf/school_food_guide_.pdf, last accessed September 23, 2007.

“The system is a complete, detailed set of food guidelines for every serving situation in your school, from cafeteria menus to vending machine snacks and more.” (p. 2)

31

Appendix 3:

Excerpt from the US Institute of Medicine’s Nutrition Standards for Foods in Schools:

Standards for Nutritive Food Components77 Note: these standards are for “competitive foods” obtained from a variety of sources, e.g., à la carte service in school cafeterias, stores, snack bars, and vending machines.

Foods and Beverages That Meet Tier 1 and Tier 2 Standards Foods Beverages

Tier 1 for All Students Tier 1 foods are fruit, vegetables, whole grains, and related combination products* and nonfat and low-fat dairy that are limited to 200 calories or less per portion as packaged and: • No more than 35% of total calories from fat. • Less than 10% of total calories from saturated fats. • Trans fat-free (≤0.5 g per serving). • 35% or less of calories from total sugars, except for yogurt

with no more than 30 g of total sugars, per 8-oz. portion as packaged.

• Sodium content of 200 mg or less per portion as packaged. • À la carte entrée items meet fat and sugar limits as listed

above and:** o Are National School Lunch Program (NSLP) menu

items. o Have a sodium content of 480 mg or less.

*Combination products must contain a total of one or more servings as packaged of fruit, vegetables, or whole grain products per portion. **200-calorie limit does not apply; items cannot exceed calorie content of comparable NSLP entrée items.

Tier 1 beverages are: • Water without flavouring,

additives, or carbonation. • Low-fat* and nonfat milk:

o Lactose-free and soy beverages are included.

o Flavoured milk with no more than 22g of total sugars per 8-oz. serving.

• 100% fruit juice in 4-oz. portion as packaged for elementary/middle school and 8oz. (two portions) for high school.

• Caffeine-free, with the exception of naturally occurring caffeine substances.

*1% milk fat.

Tier 2 for High School Students After School Tier 2 snack foods are those that do not exceed 200 calories per portion as packaged and: • No more than 35% of total calories from fat. • Less than 10% of total calories from saturated fats. • Trans fat-free (≤0.5g per portion). • 35% or less of calories from total sugars. • Sodium content of 200 mg or less per portion as packaged.

Tier 2 beverages are: • Nonnutritive-sweetened, non-

caffeinated, non-fortified beverages with less than 5 calories per portion as packaged.

77 See The National Academies Press. Washington, D.C.. April 2007. http://books.nap.edu/execsumm_pdf/11899.pdf, last accessed September 23, 2007.

32

Standards 8-13 for the School Day and After-School Setting (Note: Standards 1 through 7 are summarized in the IOM chart, replicated above.)

Standard 8: Plain, potable water is available throughout the school day at no cost to students. Standard 9: Sports drinks are not available in the school setting except when provided by the school for student athletes participating in sports programs involving vigorous activity of more than 1 hour’s duration. Standard 10: Foods and beverages are not used as rewards or discipline for academic performance or behaviour. Standard 11: Minimize marketing of Tier 2 snacks, foods, and beverages in the high school setting by:

• Locating Tier 2 food and beverage distribution in low student traffic areas; and • Ensuring that the exterior of vending machines does not depict commercial products

or logos or suggest that consumption of vended items conveys a health or social benefit.

Standard 12: Tier 1 snack items are allowed after school for student activities for elementary and middle school. Tier 1 and Tier 2 snacks are allowed after school for high school. Standard 13: For on-campus fund-raising activities during the school day, Tier 1 foods and beverages are allowed for elementary and middle school; Tier 1 and 2 foods are beverages are allowed for high schools. For evening and community activities that include adults, Tier 1 and 2 foods and beverages are encouraged.

33

Appendix 4:

Excerpt from Canada’s Food Guide (2007) relevant to institutional food service for school-aged children

Recommended Number of Food Guide Servings

Per Day Age in Years

4-8 9-13 14-18

Sex Girls and Boys

Females Males

Vegetables and Fruit

5 6 7 8 • Eat at least one dark green and one orange vegetable per day. - Go for dark green vegetables such as broccoli, romaine lettuce and

spinach. - Go for orange vegetables such as carrots, sweet potatoes and winter

squash. • Choose vegetables and fruit prepared with little or no added fat, sugar

or salt. - Enjoy vegetables steamed, baked or stir-fried instead of deep-fried.

• Have vegetables and fruit more often than juice. Grain Products 4 6 6 7 • Make at least half of your grain products whole grain each day.

- Eat a variety of whole grains such as barley, brown rice, oats, quinoa and wild rice.

- Enjoy whole grain breads, oatmeal or whole wheat pasta. • Choose grain products that are lower in fat, sugar or salt.

- Compare the Nutrition Facts on labels to make wise choices. - Enjoy the true taste of grain products. When adding sauces or spreads,

use small amounts. Milk and

Alternatives 2 3-4 3-4 3-4 • Drink skim, 1%, or 2% milk each day.

- Have 500 mL (2 cups) of milk every day for adequate vitamin D. - Drink fortified soy beverages if you do not drink milk.

• Select lower fat milk alternatives. - Compare the Nutrition Facts table on yogurts or cheeses to make wise

choices. Meat and

Alternatives 1 1-2 2 3 • Have meat alternatives such as beans, lentils and tofu often.

• Eat at least two Food Guide servings of fish each week. (See www.healthcanada.gc.ca for advice re limiting exposure to mercury from certain types of fish.) - Choose fish such as char, herring, mackerel, salmon, sardines and trout.

• Select lean meat and alternatives prepared with little or no added fat or salt. - Trim the visible fat from meats. Remove the skin on poultry. - Use cooking methods such as roasting, baking or poaching that require

little or no added fat. - If you eat luncheon meats, sausages or prepackaged meats, choose those

lower in salt (sodium) and fat. Oils and Fats • Include a small amount - 30

to 45 mL (2 - 3 Tbsp) - of unsaturated fat each day. This includes oil used for cooking, salad dressings, margarine and mayonnaise.

• Use vegetable oils such as canola, olive and soybean.

• Choose soft margarines that are low in saturated and trans fats. Limit butter, hard margarine, lard and shortening.

Counting Food Guide servings in a meal, an example: Vegetable and beef stir-fry with rice, a glass of milk and an apple for dessert. • 250 mL (1 cup) mixed broccoli, carrot and

red sweet pepper = 2 Vegetable and Fruit Food Guide servings

• 75 g (2.5 oz.) lean beef = 1 Meat and Alternatives Food Guide serving

• 250 mL (1 cup) brown rice = 2 Grain Products Food Guide servings

• 5 mL (1 tsp) canola oil = part of your Oils and Fats intake for the day

• 250 mL (1 cup) 1% milk = 1 Milk and Alternatives Food Guide serving

• 1 apple = 1 Vegetable and Fruit Food Guide serving

Children: Young children have small appetites and need calories for growth and development.

• Serve nutritious meals and snacks each day.

• Do not restrict nutritious foods because of their fat content. Offer a variety of foods from the four food groups.

Water • Drink

water regularly.

• Drink more water in hot weather or when you are very active.

Eating well • Limit foods and beverages

high in calories, fat, sugar or salt (sodium) such as cakes and pastries, chocolate and candies, cookies and granola bars, doughnuts and muffins, ice cream and frozen desserts, french fries, potato chips, nachos and other salty snacks, alcohol, fruit flavoured drinks, soft drinks, sports and energy drinks, and sweetened hot or cold drinks.

34

Appendix 5:

Provincial/Territorial Government and Breakfast for Learning Investments in School Food Programs, 2005/2006

(Source: Breakfast for Learning with enrolments figures from Statistics Canada)

Province/Territory Total Elementary/ Secondary Enrolment

Public ($) Breakfast for Learning ($)

$ per child (public+ BFL)

$ per child (pub only)

British Columbia 596,174 $14,000,000 $170,000 $23.77 $23.48 Alberta 550,983 $0 $173,000 $0.31 $0 Saskatchewan 176,069 $1,500,000 $121,000 $9.21 $8.52 Manitoba 184,352 $100,000 $118,000 $1.18 $0.54 Ontario 2,123,904 $8,500,000 $803,000 $4.38 $4.00 Quebec 1,233,053 $2,000,000 $160,000 $1.75 $1.62 New Brunswick 117,145 $1,250,000 $115,000 $11.65 $10.67 Nova Scotia 145,396 $1,000,000 $144,000 $7.87 $6.88 Prince Edward Island 22,393 $200,000 $57,000 $11.48 $8.93 Newfoundland and Labrador

79,503 $500,000 $72,000 $7.19 $6.29

Nunavut 9,354 $0 $70,000 $7.48 $0 Northwest Territories 9,607 $0 $81,000 $8.43 $0 Yukon 5,459 $42,000 $77,000 $21.80 $7.69 CANADA 5,253,392 $29,092,000 $2,161,000 $5.95 $5.54

35

Appendix 6: Putting to Rest Constitutional Excuses for Inaction on School Foods

by Bill Jeffery, LLB,

Centre for Science in the Public Interest a. Concurrency in federal-provincial divisions of powers

Parents who entrust the care of their children to school authorities some 200 days each

year should expect no less than health-promoting school food environments. Decision-makers at both levels of government should—and are constitutionally authorized to—work toward that objective by establishing nutrition standards that both (a) keep foods high in salt, sugar, saturated fat, and trans fat out of schools, and (b) help encourage children to consume significant amounts of the vegetables, fruit, whole grains and other foods that Canada’s Food Guide (2007) recommends, e.g., by in-school price subsidies for nutritionally “balanced meals.”

There is a substantial degree of concurrency in Canadian federal and provincial

constitutional authority generally, even with respect to topics assigned “exclusively” to federal or provincial governments by the Constitution Act, 1867. Far from being the exclusive domain of provincial education ministers, this concurrent authority is even more evident in the case of powers to establish rules and programs governing school foods. Accordingly, nutrition standards could be established by either level of government (or by local governments, themselves creatures of provincial legislatures) if dilatory tactics by any government obstructs the adoption of policy improvements.

In planning legislative or regulatory initiatives, governments must anticipate whether the

proposed law would survive the constitutional scrutiny of a court. In determining whether any law has been properly enacted by the responsible level of government, a court would first make the unavoidably subjective assessment of what is the dominant or most important characteristic of the law (i.e., its so-called “pith and substance”). However, unlike judicial scrutiny of a law’s compliance with the Charter of Rights and Freedoms, 1982, there is a “presumption of constitutionality” in division of powers analysis such that “in choosing between competing, plausible characterizations of a law, the court should normally choose that one that would support the validity of the law.”78 [italics added]

However, even a law whose “pith and substance” falls squarely under a subject assigned to

one level of government (in the Constitution Act, 1867) may “incidentally affect” subject matters assigned to the other level of government, provided the intruding provisions are “rationally and functionally connected” to the main head of power. This permits a flexible standard to give the enacting body some leeway in selecting legislative techniques.79 Accordingly, for example, a federal school food law that seeks to ensure proper nutrition of young people outside of class 78 P.W. Hogg, Constitutional Law of Canada, (Toronto: Thompson, Carswell: Loose-leaf) at 15-20.2 to 15-21. 79 See Hogg, supra, at 15-36 to 15-37.

36

time (at best, incidentally affecting provincial authority over education80) could not likely be said to fetter provincial authority over teaching, learning, or other central aspects of education; indeed, the federal government has a long unchallenged history of managing all aspects of schools, including instruction, on military bases and Indian reserves, incident to constitutionally prescribed federal heads of power concerning defense and aboriginal people. That said, as the length of the school day necessitates nourishment be provided there,81 a provincial government would also have little difficulty justifying its own efforts to regulate food provided at school.

Also, a law may have two equally important aspects, each belonging to a head of power

assigned to a different level of government (i.e., the “double aspect” doctrine),82 such as pertaining to food (an area with ample federal legislative presence) or education (a mainstay of provincial authority). According to Hogg, federal government authority over aspects of public health, including the regulation of food, is clear.83 Indeed, regulations promulgated under the Food and Drugs Act already include requirements for the disclosure of nutrition information on food labels. And, the Food and Drug Regulations already prescribes hundreds of compositional standards specifying minimum and maximum amounts of ingredients permitted in processed staple foods (a) that are for general consumption (e.g., fruit jam, preserved vegetables and meat, cheese, ice-cream and other dairy products, and various bread and other bakery products); (b) that may be sold only to adults (e.g., alcoholic beverages); (c) that are usually only consumed by adults (e.g., coffee and tea); or (d) that are marketed expressly for consumption by young children (e.g., infant formula). Accordingly, specifying federal compositional standards for foods is a central feature of existing federal food regulations, and specifying compositional requirements for foods sold to certain age groups is also consistent with current regulations. So, establishing rules governing the compositional requirements of foods sold, for instance, to children aged 5-18 is likely authorized under the regulation-making powers conferred on the 80 Section 93 of the Constitution Act, 1867 confers on provinces exclusive authority to make “Laws in relation to Education.” 81 As such, regulating the quality of school food would likely satisfy the general test that the law have, at least, a “rational functional connection” to the exercise of the respective constitutional head of power (e.g., Papp v. Papp [1970] 1 O.R. 331 (Ont. C.A.) and also applied by the Supreme Court of Canada in R. v. Zelensky, [1978] 2 S.C.R. 940 and Multiple Access Ltd. v. McCutcheon, [1982] 2 S.C.R. 161). 82 The “double-aspect” doctrine is set out by the Supreme Court of Canada in Multiple Access Ltd. v. McCutcheon, [1982] 2 S.C.R. 161, and Rio Hotel v. N.B. [1987] 2 S.C.R. 59, 65. 83 Hogg, supra, at 18-7 to 18-11. The regulation of health-related aspects of food flows from the federal jurisdiction over criminal law (e.g., R. v. Wetmore, [1983] 2 S.C.R. 284) which included the authority to ban the sale of dangerous foods, and, presumably, to take lesser measures to otherwise limit marketing of such products (see LaForest J. writing for the majority in RJR-MacDonald v. Canada [1995] 3 S.C.R. 199). According to Hogg, despite Justice Estey’s obiter dicta and narrow contrary ruling in the Supreme Court’s Labatt decision, the compositional standards (so-called “identity standards”) for foods specified in the Food and Drug Regulations are likely authorized under federal criminal law powers. Furthermore, in light of recent Supreme Court jurisprudence, the regulation of food in Canada, because it is so often nationally manufactured, branded, distributed, and sold may also be supported by the federal “trade and commerce” powers set out in section 91(2) of the Constitution Act, 1867 (e.g., General Motors of Canada Ltd. v. City National Leasing, [1989] S.C.R. 641). Chief Justice Dickson ruled that the entire “Combines Investigation Act [as it was then called] is valid under the federal trade and commerce power, in particular, [under the] ‘second branch’” of that power, the power “over ‘general’ trade and commerce.” Id. at 642–43.

37

federal government by the Food and Drugs Act. However, the federal government’s responsibilities to maintain the safety and quality of the

food supply is also complementary to provincial governments' extensive authority over public health.84 So, if there were parallel federal and provincial regulations respecting school foods--for instance, as regulations pursuant to the federal Food and Drugs Act85 and the Ontario Health Promotion and Protection Act86--courts would probably be inclined to find both operative, barring a significant encroachment on the constitutional authority of the other level of government. Notably, general food safety standards in both of these laws already apply to food sold in schools.

Currently, all foods sold in schools are also already subject to federal authority in relation to

consumer protection standards established in the Competition Act. Likewise, the commercial sale of food in schools is subject to provincial consumer protection laws restricting, for instance, misleading, deceptive and/or unconscionable marketing practices (e.g., in the Ontario Consumer Protection Act). According to the Supreme Court of Canada in Irwin Toy,87 the Québec Consumer Protection Act88 derives its authority from subsections 92(13) and 92(16) of the

84 Canadian Federation of Agriculture v. A.G. (Quebec), [1951] A.C. 179 (P.C.) (“The Margarine Reference”) and Labatt Breweries v. A.G. (Canada), [1980] 1 S.C.R. 1914. 85 Sub-section 30(b) of the Food and Drugs Act authorizes the Governor in Council (i.e., a Cabinet committee) to make regulations

“(b) respecting: (i) the labelling and packaging and the offering, exposing and advertising for sale of food… (ii) the sale or the conditions of sale of any food…and (iii) the use of any substance as an ingredient in any food…to prevent the purchaser or consumer thereof from being deceived or misled in respect of the design, construction, performance, intended use, quantity, character, value, composition, merit or safety thereof, or to prevent injury to the health of the purchaser or consumer;

(c) prescribing standards of composition, strength, potency, purity, quality or other property of any article of food…

(e) respecting the method of manufacture, preparation, preserving, packing, storing and testing of any food, drug, cosmetic or device in the interest of, or for the prevention of injury to, the health of the purchaser or consumer;…”

86 While the existing two school nutrition guidelines (which are not formal regulations) in the Province of Ontario were developed by the Ministry of Children and Youth Services, and the Ministry of Education, the Ontario Health Promotion and Protection Act administered by the Minister of Health and Long-Term Care, authorizes the Lieutenant Governor of Ontario to promulgate regulations:

“(b) governing the construction, equipment, facilities (including sanitary facilities), operation and maintenance of food premises, and prescribing standards and requirements in respect thereof; (c) regulating, restricting or prohibiting the manufacturing, processing, preparation, storage, handling,

display, transportation, sale or offering for sale of any food on or in food premises and the distribution of food from food premises, and prescribing standards and requirements in respect thereof;…

(j) regulating, restricting or prohibiting the construction, alteration, repair, location, operation, maintenance and use of food vending machines;…”

87 [1989] 1 S.C.R. 927. 88 R.S.Q., c. P-40.1.

38

Constitution Act, 1867.89 Similarly, the Supreme Court of Canada held that the entire federal Competition Act, which, in part, regulates commercial advertising,90 was properly enacted pursuant to federal authority to regulate trade and commerce specified in subsection 91(2) of the Constitution Act, 1867.91

Likewise, while the responsibility for the welfare of children is generally thought to fall to

provincial governments,92 the federal government has considerable experience establishing policies to safeguard the interests of children in various settings, including policies and community programs related to the federal Young Offenders Act (and its precursors) and the custody and maintenance of children pursuant to the federal Divorce Act.

b. The effect of a conflict between competing federal and provincial school food

standards Even if there were expressly competing or over-lapping federal and provincial school

nutrition regulations, the constitutional law doctrine of “paramountcy” stipulates that a federal law will prevail, but only to the extent of an “operational conflict” with a provincial law. However, there is no such conflict when a person (e.g., a school food service provider) can comply with both laws by adhering to the stricter one.93 A provincial law that is supplementary or duplicative of a federal law would not be inconsistent with the federal law, by virtue of that fact alone.”94 In the case of an express conflict (i.e., where complying with one requires violating another), federal law trumps the provincial law, but only to the extent of the conflict.95 Accordingly, even if parallel federal and provincial nutrition standards were in place, only standards that expressly contradicted each other would be affected and, in the case of two non-conflicting standards, the stricter rule would apply. So, for instance, a provincial law requiring that a minimum of five vegetables be served per week, and a maximum of one serving of chocolate milk, in the face of parallel federal rules specifying double those amounts, would lead to a legal requirement for 10 vegetables and one serving of chocolate milk, weekly. Alternatively, federal and provincial rules that created an express conflict by establishing those

89 Constitution Act, 1867, 30 & 31 Vict., c. 3 (Eng.). Section 92(13) confers provincial authority over property and civil rights, and section 92(16) confers authority on provinces over “[g]enerally all [m]atters of a local or private [n]ature.” The Court’s decision was unanimous on this point. Irwin Toy, [1989] 1 S.C.R. at 944, 953, 958, 1005. 90 E.g., Competition Act, R.S.C. 1985, c. C.-34, subsections 52(1), 74.01. 91 General Motors of Canada Ltd. v. City National Leasing, [1989] 1 S.C.R. 641, 694. 92 E.g., Re Adoption Act [1938] S.C.R. 398 and Re BC Family Relations Act [1982] 1 S.C.R. 62. 93 See Irwin Toy, 1 S.C.R. at 963–64 (quoting Multiple Access Ltd. v. McCutcheon, [1982] 2 S.C.R. 161, 191). 94 Hogg, supra, at 16-15. See also Garland v. Enbridge Gas Distribution Inc., [2004] 1 S.C.R. 629, 654, and Multiple Access Ltd. [1982] 2 S.C.R.,161. 95 The test for paramountcy originated in the Ontario Court of Appeal in Papp v. Papp, [1976] 1 O.R. 331 (Ont. C.A.), and was later applied by the Supreme Court of Canada in Multiple Access Ltd. v. McCutcheon, [1982] 2 S.C.R. 161, and R. v. Zelensky, [1978] 2 S.C.R. 940.

39

weekly legal limits as contradictory absolute numbers of weekly servings (instead of minima and maxima) might lead to the paramountcy of federal rules (i.e., 10 servings of vegetables and two servings of chocolate milk, weekly).

c. Federal and Provincial Spending Powers There are virtually no limits on the extent to which federal and provincial governments may

exercise their spending powers to financially support programs that fall under the exclusive jurisdiction of the other level of government. The long accepted principle of “implicit equalization” in federal-contribution programs is actually embodied in section 36 of the Constitution Act, 1982, which affirms the rights of Canadians to “reasonably comparable levels of public services at reasonably comparable levels of taxation.” Furthermore, the Supreme Court of Canada unanimously affirmed Parliament’s power to authorize grants to provinces for use in fields within exclusive provincial jurisdiction and the authority to impose conditions on the recipient provinces.96 According to Professor Peter W. Hogg, a former justice of the Ontario Court of Appeal and leading constitutional law expert:

“This broad interpretation of the federal spending power…despite occasional objections to federal intrusions on provincial autonomy…is the basis of the federal-provincial financial arrangements of the last 30 years…It is supported by caselaw and most commentators.”97 Its persistence, according to Hogg, relates in part to the reality that “humanitarian and

egalitarian ideals which emphasized governmental responsibility for the provision of minimum standards of income, health, education and welfare to all Canadians could only be fulfilled by action at the national level.”98 In recent years, the breadth of this power has been curtailed only by a political prerequisite for prior federal-provincial consultation, establishing the existence of a broad national consensus in favour of the program, and creating a mechanism for provincial “opting out” (though, historically, the opting out provision has generally amounted only to a transfer of administrative responsibilities to the affected province).99

So, for instance, while section 92(2) of the Constitution Act, 1867 vests in provinces

exclusive jurisdiction over the management of hospitals, the federal government has long assumed an important role in setting national standards for hospital and medical care programs (e.g., through the Canada Health Act) largely by exercising its spending powers through conditional contributions to these programs. According to Hogg, more than 100 provincial undertakings have been created by federal transfers to provinces since the Second World War, involving, but not limited to, social assistance, healthcare, post-secondary education, and

96 Re Canada Assistance Plan, [1991] 2 S.C.R. 525. 97 Hogg, supra at 6-19. 98 Hogg, supra at 6-21. 99 Hogg, supra at 6-12, 6-15 and 6-22.

40

transportation.100 In this context, federal government efforts to, for instance, subsidize nutritious meals in schools would be consistent with constitutional law and a long history of federal-provincial relations.

d. Federal and provincial governments have the constitutional authority and the moral and political responsibility to act, either alone or in concert.

As with many Canadian public issues, rhetoric about constitutional jurisdiction and active

inter-jurisdictional disputes can stymie government responses and provide opportunities for governments to shirk responsibility for political inaction. Likewise, provincial protests against federal meddling can sometimes be used in craven attempts to leverage transfers of federal cash and tax points to provincial government coffers for other purposes. Of course, it is desirable to pursue cooperation between federal and provincial government authorities on matters of common interest. However, as this report demonstrates provincial government efforts to establish school nutrition policies and programs have fallen far short of two new key benchmarks: Canada’s Food Guide (2007) and the US Institute of Medicine’s Nutrition Standards for Food in Schools: Leading the Way Toward Healthier Youth (2007). Likewise, the federal government’s lack of meaningful participation in school food standard-setting and funding begs redress. Improving government nutrition standards and establishing sensible nourishment programs are important measures that could be initiated by any level of government in the absence of federal-provincial political will to act in concert.

100 Hogg, supra at 6-11.

41


SCHOOL NUTRITION POLICIES ACROSS CANADA

For further information, contact: Suite 2701, CTTC Bldg. 1125 Colonel By Drive,

Ottawa, Ontario K1S 5R1 Tel.: 613-244-7337

www.cspinet.org/canada