The newly revised Canada’s Food Guide (the Guide) was released on January 22, 2019. Dietitians of Canada’s CEO, Nathalie Savoie commended Health Canada on the meticulous revision process and describes the 2019 Canada’s Food Guide as relevant, modern and evidence based.
This newest version of Canada’s Food Guide encourages healthy eating habits, and includes an education poster that summarizes the guide’s main principles. The poster shows a plateful of food, divided neatly into sections. One half of the plate is filled with vegetables and fruits, one quarter is whole grain food and one quarter shows assorted protein foods.
The new guide is easy to understand with messaging that states:
- Eat a variety of healthy food each day
- Have plenty of fruits and vegetables
- Eat protein foods
- Choose whole grain foods
- Make water your drink of choice
The focus of the Guide has changed over the years. In 1942 the first Canada’s Food Rules were focused more on the prevention of malnutrition, and suggested foods that would be available to most Canadians. The focus and recommendations have changed, with more recent guides being quite specific and prescriptive, indicating the number and sizes of portions from each food group that should be eaten.
The latest guide is a dynamic tool that directs people to whole foods and does not recommend specific serving sizes. It emphasizes proportions instead of portions. It does shift the focus from meat to plant based protein sources and discourages eating processed or prepared foods and beverages on a regular basis to avoid consuming too much added sugar, sodium and saturated fat. As well, the guide includes advice on how to eat. This includes how we purchase and prepare foods. There has been a shift over the past years towards eating more meals away from home, spending less time cooking, and eating too many processed, packaged foods. For the first time, the Guide is advising people to be mindful of eating habits, to cook more often, to enjoy food, eat meals with others and to use food labels.
The new Dietary guidelines acknowledge the additional guidance needed by individuals with specific dietary requirements, including those receiving care in a clinical setting, and steering these individuals to get specialized advice from a Registered Dietitian.
How the new Guide can be used for menu planning
Menu planning in long-term care (LTC) is an ongoing challenge. There is little doubt that what we eat influences our health and we need to consider this evidence in planning LTC menus both for residents with special needs and for the LTC population at large. Canada’s Food Guide continues to provide guidelines to develop healthy menus. In LTC, these guideline need to be considered in conjunction with what residents are able and willing to eat. Conversations with residents, as well as audits, resident council meetings, meal time surveys and taste testing all provide information that allows planners to work towards providing foods that residents can manage and enjoy. This balance is most important in the LTC setting because quality of life is considered a primary goal for residents and this may in some instances not consistently correspond with optimal eating. Guidelines to support changes to the menu planning process are beneficial at a home or institution level and there may be benefit in developing industry wide standards and /or updating provincial regulations.
How will the Guide’s recommendations affect LTC menus?
- Nutritious foods are the foundation for healthy eating
Vegetables, fruits, whole grains and protein foods should be consumed regularly
Currently LTC menus include serving sizes and number of servings based on the 2007 Canada’s Food Guide requirements for a male, 51 plus years of age. This includes seven servings of vegetables and fruits, seven servings of grain products, three servings of meat and alternates and three servings of milk and alternatives. Current mealtime patterns in LTC are similar to the new Guide’s recommended plate, but the variety of choices offered could be improved.
Protein foods include legumes, nuts, seeds, tofu, fortified soy beverage, fish, shellfish, eggs, poultry, lean red meat, lower fat milk or yogurt and cheeses lower in fat and sodium
Current LTC menus offer these choices. The proportion of meat vs plant based protein choices offered will be a topic for discussion with residents going forward.
Foods that contain mostly unsaturated fat should replace foods that contain mostly saturated fat
As part of the menu development process, the nutrition profile of all food items and recipes should be assessed to determine appropriateness to include on a LTC menu. This would include at a minimum, a review of fats and oils used in food preparation and service. The recommended limit is less than 10 per cent of total energy intake from saturated fat.
Water should be the beverage of choice
Water is currently offered at meal times and between meals. Milk and juice are also offered in most LTC homes.
- Processed or prepared foods and beverages that contribute to excess sodium, (free) sugars or saturated fat undermine healthy eating and should not be consumed regularly
As part of the menu development process, the nutrition profile of all food items and recipes should be assessed to determine appropriateness to include on a LTC menu. This would include a review of the menu and how it complies with recommended limits of:
- Sodium – less than 2300 mg per day
- Free sugars – less than 10% of total energy intake
- Saturated Fat – less than 10% of total energy intake
- Food Skills are needed to navigate the complex food environment and support healthy eating
While food skills are not necessarily required by LTC residents, it is important to note that LTC residents for the most part do eat with others at meals and it is important that staff work to make this as meaningful an experience as possible for each resident. In addition, cultural food practices should be celebrated in LTC homes as it can benefit many residents.
The objectives of the guidelines are to promote healthy eating and overall nutritional well-being and to support improvements to the Canadian food environment. Remember, it is the overall pattern of our diet that matters when it comes to health. The new Canada’s Food Guide will be used as a resource for menu planning and food procurement that will result in positive changes for LTC residents.
Health Canada is planning to release more on Canada’s Food Guide later in the year. Stay tuned for more information as it becomes available.
Dale Mayerson, B Sc, RD, CDE, and Karen Thompson, B A Sc, RD are Registered Dietitians with extensive experience in Long-term care. They are co-authors of “Menu Planning in Long Term Care and Retirement Homes: A Comprehensive Guide” and have participated for many years on the Ontario Long Term Care Action Group, an advocacy group of Dietitians in Canada.