What are Canada’s Dietary Guidelines?

Canada’s Dietary Guidelines set out Health Canada’s guidelines and considerations on healthy eating.

Guidance on nutrition during infancy, including breastfeeding, is available in the guidance document Nutrition for Healthy Term Infants.

Breastfeeding—exclusively for the first six months, and continued for up to two years or longer with appropriate complementary feeding—is important for the nutrition, immunologic protection, growth, and development of infants and toddlers.

The objectives of the guidelines are to promote healthy eating and overall nutritional well-being, and support improvements to the Canadian food environment.
The intended audience is health professionals and policy makers.
The guidelines are a resource for developing nutrition policies, programs, and educational resources for members of the Canadian population two years of age and older.
Individuals with specific dietary requirements, including those receiving care in a clinical setting, may need additional guidance or specialized advice from a dietitian.

Related tools and resources

Canada’s Healthy Eating Pattern ⁱ is a resource that builds on and complements the contents of this report.

The objective of the healthy eating pattern is to provide more specific guidance on the recommended amounts and types of foods as well as life stage guidance (such as recommendations for young children and seniors).
The intended audience is also health professionals and policy makers.
The healthy eating pattern can be used as an additional resource for developing procurement policies in institutions, such as long term care facilities and hospital settings.

The Healthy eating recommendations in Appendix A translate Canada’s Dietary Guidelines into simple, relevant, and evidence-informed messages. The recommendations form the basis of a mobile-responsive web application that is modern and easy to use. This web application houses tools and resources that will help Canadians apply the guidelines in their daily lives. Examples of tools and resources include:

An interactive tool ⁱⁱ that provides custom information for teens, adults, parents, and older adults in a variety of settings including at home, at work, at school, on the go, grocery shopping, and eating out.
Web resources, such as factsheets, videos and recipes, to help Canadians apply Canada’s Dietary Guidelines.

Overview of this report

This report is based on the best available scientific evidence. It contains healthy eating guidelines and considerations that are relevant and applicable to the Canadian context.

The report is presented in four sections:

Section 1 focuses on nutritious foods and beverages that are the foundation for healthy eating.

Section 2 describes the types of foods and beverages that can have a negative impact on health when consumed on a regular basis.

Section 3 highlights the importance of food skills as a practical way to support healthy eating.

Section 4 describes the importance of creating supportive environments for healthy eating.

The considerations provide complementary guidance on issues of public health importance, while recognizing the context within which Canadians live, learn, work, and play. This includes considering that the food supply—and people’s ability to access the food supply—varies across regions. Some considerations take into account Canada’s diversity, while others are based on Canadian health statistics and consumption data. Some considerations also reflect factors and conditions that influence food choices and eating behaviours, including the determinants of health.

A full list of the guidelines and considerations is in Appendix B.

How this report was developed

Health Canada developed a multi-step decision making process to establish these guidelines, which is described briefly in Appendix C.

Health Canada used the best available evidence to translate the science on food and health into healthy eating guidelines. This included evidence published between 2006 and 2018. ^1 2 To find out more about our evidence review, refer to the Food Nutrients and Health: Interim Evidence Update 2018.

Guidelines 1 and 2 were developed based on convincing findings from scientific reports that included extensive systematic reviews of the literature on the relationship between food and health. ¹ ² The reports are listed in Table 1. These convincing findings are supported by a well-established evidence base and are unlikely to change in the foreseeable future as new evidence emerges. Probable, possible and insufficient findings from all reports included in the evidence review ¹ ² were also considered during the policy development process. Health Canada primarily drew evidence for Guideline 3 from its analysis of findings on food skills, including interventions aimed at promoting and improving these skills.^3 4 5

The considerations as well as Section 4 of this report help support the implementation of the guidelines by health professionals and policy makers. They also reflect Health Canada’s population health approach to developing dietary guidance. This approach considers the broad range of factors and conditions that have a strong influence on health.

Throughout the development of this report, Health Canada’s scientists, as well as population health and nutrition experts, collaborated with other Government of Canada departments and agencies. Input was sought from academics, members of provincial and territorial governments, health professional regulatory bodies/organizations, health charities, and National Indigenous Organizations.

In addition, Health Canada considered the results of two rounds of public consultation on the revision of the Food Guide which were held in the fall of 2016 and summer of 2017. This helped to develop dietary guidance that is relevant and clear to the general Canadian population.

Further, Health Canada considered dietary guidelines from other countries to gain a broad perspective on the communication of guidelines, such as how they are developed, their content, and their use in education and health promotion. ⁶

The importance of dietary guidance

What we eat influences our health.

In Canada, dietary risks are one of the three leading risk factors for disease burden, as measured by death and disability combined. ⁷Tobacco use and high body mass index (BMI) are the other two. Chronic diseases impacted by diet—namely ischemic heart disease, stroke, colorectal cancer, diabetes, and breast cancer—are among the leading causes of premature death in Canada. ⁷ ⁸

Oral diseases, such as dental decay, share common nutrition-related risk factors with some of the leading chronic diseases in Canada such as diabetes and cardiovascular disease. ¹¹ Dental decay affects 57% of Canadian children aged 6 to 11 years and 96% of Canadian adults over their lifetime. ¹² Each year in Canada, children aged 1 to 5 are put under anesthesia to perform dental surgery operations to treat dental decay, with a disproportionate representation of Indigenous children. ¹³ ¹⁴ In 2015, total expenditures for dental services in Canada were estimated at $13.6 billion. ¹⁵

The burden of chronic disease in Canada varies across populations. Indigenous Peoples in Canada face a greater burden of chronic disease than the general population. For example, First Nations populations in Canada have disproportionally higher rates of diabetes. ⁹ ¹⁰ However, the rates vary across communities and between First Nations, Inuit, and Métis populations. In addition, Indigenous Peoples face barriers to adequately managing chronic disease.

In Canada, chronic diseases account for approximately one third of direct health care costs. ¹⁶ The Canadian population is aging, ¹⁷ faces high rates of obesity, ¹⁸ ¹⁹ and engages in sedentary lifestyle behaviours. ²⁰ ²¹ Thus the impact of chronic diseases is likely to continue to increase, unless we take action to address the many factors that influence what we eat.

The food environment influences what we eat.

The food environment influences our food and beverage choices. ²² For example, the foods and beverages available in homes, retail food outlets, and restaurants can have a big impact on what and how we eat and drink. Moreover, for Indigenous Peoples, food intakes can be negatively influenced by the limited availability of food acquired in traditional ways (such as hunting, fishing, trapping, and gathering), and the numerous barriers to traditional food access. ²³ ²⁴ ²⁵ ²⁶ ²⁷ ²⁸ ²⁹

In addition to what is available around us, we receive a constant stream of changing (and often conflicting) messages on healthy eating. Food marketing is evolving rapidly, and now includes channels such as social media. This complex and crowded information environment can make it hard for Canadians to make healthy eating choices.

Supporting healthy eating is a shared responsibility.

Canada’s Dietary Guidelines can make an important contribution to nutritional health. Health professionals and policy makers in all sectors and at all government levels can use these guidelines as a resource to support program and policy decisions. For example, policies that reflect these guidelines can improve the food environment in settings such as schools, workplaces, recreation centres, and health care facilities. ³⁰ ³¹ Creating supportive environments across settings can help increase the positive influence that dietary guidelines can have on individuals, families and communities. This is further described in Section 4.

Table 1: Scientific reports that included convincing findings^* from extensive systematic reviews of the literature on the relationship between food and health

Source	Report title
American College of Cardiology/American Heart Association 2013	Guideline on lifestyle management to reduce cardiovascular risk: a report of the ACC/AHA task force on practice guidelines
Canadian Cardiovascular Society 2016	Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult
Dietary Guidelines Advisory Committee 2015	Scientific report of the Dietary Guidelines Advisory Committee: advisory report to the Secretary of Health and Human Services and the Secretary of Agriculture
Dietary Guidelines Advisory Committee 2010	Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans
Food and Agriculture Organization of the United Nations 2010	Fats and fatty acids in human nutrition – report of an expert consultation
Health Canada 2016	Summary of Health Canada’s assessment of a health claim about vegetables and fruit and heart disease
Health Canada 2015	Summary of Health Canada’s assessment of a health claim about soy protein and cholesterol lowering
Health Canada 2014	Summary of Health Canada’s assessment of a health claim about ground whole flaxseed and blood cholesterol lowering
Health Canada 2012	Summary of Health Canada’s assessment of a health claim about barley products and blood cholesterol lowering
Health Canada 2012	Summary of Health Canada’s assessment of a health claim about the replacement of saturated fat with mono- and polyunsaturated fat and blood cholesterol lowering
Health Canada 2010	Summary of Health Canada’s assessment of a health claim about oat products and blood cholesterol lowering
International Agency for Research on Cancer 2018	IARC Monographs on the Evaluation of Carcinogenic Risks to Humans – Red Meat and Processed Meat
National Health and Medical Research Council 2011	A review of the evidence to address targeted questions to inform the revisions of the Australian Dietary Guidelines
Scientific Advisory Committee on Nutrition 2015	Carbohydrates and health report
World Cancer Research Fund International 2018	Continuous Update Project (CUP) report: breast cancer
World Cancer Research Fund International 2018	Continuous Update Project (CUP) report: colorectal cancer
World Cancer Research Fund International 2018	Continuous Update Project (CUP) report: oesophageal cancer
World Cancer Research Fund International 2018	Continuous Update Project (CUP) report: liver cancer
World Cancer Research Fund International 2018	Continuous Update Project (CUP) report: cancer of the mouth, pharynx, and larynx
World Cancer Research Fund International 2018	Continuous Update Project (CUP) report: energy balance and body fatness
World Health Organization 2017	Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis
World Health Organization 2016	Effects of saturated fatty acids on serum lipids and lipoproteins: a systematic review and regression analysis
World Health Organization 2016	Effect of trans-fatty acid intake on blood lipids and lipoproteins: a systematic review and meta-regression analysis
World Health Organization 2012	Guideline: sodium intake for adults and children
^*Convincing findings are findings graded ‘High’ by the American College of Cardiology/American Heart Association, the Canadian Cardiovascular Society, and the World Health Organization; findings graded ‘Strong’ by the Dietary Guidelines Advisory Committee; findings graded ‘Sufficient’ by Health Canada; findings graded ‘Group 1: Carcinogenic’ by the International Agency for Research on Cancer; findings graded ‘Adequate’ by the Scientific Advisory Committee on Nutrition; findings graded ‘Convincing’ by the Food and Agricultural Organization, and the World Cancer Research Fund/American Institute of Cancer Research; and findings graded ‘A’ by the National Health and Medical Research Council.

Notes

Note i: Expected publication in 2019 i
Note ii: Expected release in 2019 ii

References

Footnote 1: Health Canada. Evidence review for dietary guidance: technical report, 2015. Ottawa: Health Canada; 2016.1
Footnote 2: Health Canada. Food, Nutrients and Health: Interim Evidence Update 2018. Ottawa: Health Canada; 2019. 2
Footnote 3: Government of Canada. Improving cooking and preparation skills: a synthesis of the evidence to inform program and policy development [Internet]. Ottawa: Government of Canada; 2010 [cited 2018 Sep 14]. 3
Footnote 4: Government of Canada. A look at food skills in Canada [Internet]. Ottawa: Government of Canada; 2015 [cited 2018 Sep 14]. 4
Footnote 5: Government of Canada. Improving cooking and food preparation skills: a profile of promising practices in Canada and abroad [Internet]. Ottawa: Government of Canada; 2010 [cited 2018 Sep 14]. 5
Footnote 6: Food and Agriculture Organization of the United Nations [Internet]. Rome: Food and Agriculture Organization of the United Nations; 2018 [cited 2018 Sep 14]. Food-based dietary guidelines. 6
Footnote 7: Institute for Health Metrics and Evaluation [Internet]. Seattle: Institute for Health Metrics and Evaluation; 2018 [cited 2018 Nov 28]. Global burden of disease (GBD) profile: Canada. 7
Footnote 8: Global Burden of Disease 2013 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386(10010):2287-2323. 8
Footnote 9: Public Health Agency of Canada. Diabetes in Canada: Facts and figures from a public health perspective [Internet]. Ottawa: Public Health Agency of Canada; 2011 [cited 2018 Sep 14]. 9
Footnote 10: Indigenous Services Canada. Preventing and managing chronic diseases in First Nations communities: a guidance framework [Internet]. Ottawa: Indigenous Services Canada; 2018 [cited 2018 Sep 14]. 10
Footnote 11: Canadian Academy of Health Sciences. Improving access to oral health care for vulnerable people living in Canada [Internet]. Ottawa: Canadian Academy of Health Sciences; 2014 [cited 2018 Sep 14]. 11
Footnote 12: Health Canada. Report on the findings of the oral health component of the Canadian Health Measures Survey, 2007-2009 [Internet]. Ottawa: Health Canada; 2010 [cited 2018 Sep 14]. 12
Footnote 13: Canadian Institute for Health Information. Treatment of preventable dental cavities in preschoolers: a focus on day surgery under general anesthesia [Internet]. Ottawa: Canadian Institute for Health Information; 2013 [cited 2018 Sep 14]. 13
Footnote 14: First Nations Information Governance Centre. National report of the First Nations Regional Health Survey Phase 3: Volume One [Internet]. Ottawa: First Nations Information Governance Centre; 2018 [cited 2018 Sep 14]. 14
Footnote 15: Canadian Dental Association. The state of oral health in Canada [Internet]. Ottawa: Canadian Dental Association; 2017 [cited 2018 Sep 14]. 15
Footnote 16: Public Health Agency of Canada. How healthy are Canadians? A trend analysis of the health of Canadians from a healthy eating and chronic disease perspective [Internet]. Ottawa: Public Health Agency of Canada; 2016 [cited 2018 Sep 14]. 16
Footnote 17: Statistics Canada. Age and sex, and type of dwelling data: key results from the 2016 census [Internet]. Ottawa: Statistics Canada; 2017 [cited 2018 Sep 14]. 17
Footnote 18: Statistics Canada. Body composition of adults, 2012 to 2013 [Internet]. Ottawa: Statistics Canada; 2014 [cited 2018 Sep 14]. 18
Footnote 19: Rao DP, Kropac E, Do MT, Roberts KC, Jayaraman GC. Childhood overweight and obesity trends in Canada. Health Promot Chronic Dis Prev Can. 2016;36(9):194-198. 19
Footnote 20: Statistics Canada. Directly measured physical activity of children and youth, 2012 and 2013 [Internet]. Ottawa: Statistics Canada; 2015 [cited 2018 Sep 14]. 20
Footnote 21: Statistics Canada. Directly measured physical activity of adults, 2012 and 2013 [Internet]. Ottawa: Statistics Canada; 2015 [cited 2018 Sep 14]. 21
Footnote 22: Health Canada. Measuring the food environment in Canada [Internet]. Ottawa: Health Canada; 2013 [cited 2018 Sep 14]. 22
Footnote 23: Richmond CA, Ross NA. The determinants of First Nation and Inuit health: a critical population health approach. Health Place. 2009;15(2):403-411. 23
Footnote 24: Chan L, Receveur O, Sharp D, Schwartz H, Ing A, Tikhonov C. First Nations Food, Nutrition and Environment Study (FNFNES): results from British Columbia (2008/2009). Prince George: University of Northern British Columbia; 2011. 24
Footnote 25: Chan L, Receveur O, Sharp D, Schwartz H, Ing A, Fediuk KI. First Nations Food, Nutrition and Environment Study (FNFNES): results from Manitoba (2010). Prince George: University of Northern British Columbia; 2012. 25
Footnote 26: Chan L, Receveur O, Batal M, William D, Schwartz H, Ing A, et al. First Nations Food, Nutrition and Environment Study (FNFNES): results from Ontario (2011/2012). Ottawa: University of Ottawa; 2014. 26
Footnote 27: Chan L, Receveur O, Batal M, William D, Schwartz H, Ing A, et al. First Nations Food, Nutrition and Environment Study (FNFNES): results from Alberta (2013). Ottawa: University of Ottawa; 2016. 27
Footnote 28: Chan L, Receveur O, Batal M, William D, Schwartz H, Ing A, et al. First Nations Food, Nutrition and Environment Study (FNFNES): results from the Atlantic (2014). Ottawa: University of Ottawa; 2017. 28
Footnote 29: Chan L, Receveur O, Batal M, Sadik T, Schwartz H, Ing A, et al. First Nations Food, Nutrition and Environment Study (FNFNES): results from Saskatchewan (2015). Ottawa: University of Ottawa; 2018. 29
Footnote 30: Hawkes C, Smith, TG, Jewel J, Wardle J, Hammond RA, Friel S, et al. Smart food policies for obesity prevention. Lancet. 2015;385(9985):2410-2421. 30
Footnote 31: Raine KD, Atkey K, Olstad DL, Ferdinands AR, Beaulieu D, Buhler S, et al. Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations.Health Promot Chronic Dis Prev Can. 2018;38(1):6-17. 31

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Canada’s Dietary Guidelines