Canadians like Tim Hortons -- but, alas, are we enjoying our Timbits and double doubles too much? Based on recent studies, the answer seems to be yes. When it comes to obesity, Canadians may be the next Americans.
Here's an irony of modern health care: while medicine has never been better, people across the Western world are, collectively, getting less healthy. According to one study published in The New England Journal of Medicine, despite super-sized health spending, American life expectancy may actually drop in the coming years.
Why? Obesity rates have exploded in the United States, with fully one in three adults now qualifying as medically obese; nearly two thirds qualify as obese or overweight.
But, alas, bad American trends often migrate across borders; the obesity epidemic is now seen in wealthier countries across the world. Canadians greeted the arrival of KFC's Double Down sandwich last fall with enthusiasm (and despite media reports that one provincial government sought to regulate the product). Canadians lined up to buy more than a million of the fatty sandwiches in a one-month market trial. It is just one of many bad dietary choices.
A full one in four adults in Canada is obese, roughly a doubling of the percentage of the population since 1980, according to a new report.
It turns out that the world is not flat, but slowly becoming fat. A recent OECD report documents the trend. Sixty-three per cent of the English population is overweight or obese, and Continental Europe has been loosening its metaphorical belt for years.
France -- often held up as the healthy diner's dream of fresh ingredients, slow dining, red wine and witty conversation -- is the home of much unhealthy eating. French women don't get fat in bestselling books, but they do in Paris. Forty-four per cent of the French will be medically overweight or obese by 2019, up from 39 per cent in 2009.
Italy? For all the talk of the Mediterrian diet, of the wonders of sunny Tuscany and its fresh tomatoes on the vine, Italians will be standing heavy on their scales, with about 45 per cent overweight or obese by 2019, according to OECD projections.
The future for Canada, for the record, looks, well, American -- as in fat. By the close of this decade, we'll see the percentage of overweight or obese climb from about half the population to nearly 60 per cent. Canadians still aren't quite American in their girth, but our fondness for Timbits takes a toll.
For policymakers, this poses a major challenge. Though thinner people may or may not live longer than their obese friends, this much is clear: health spending is higher with greater weight. That's not exactly a surprise: excess weight is taxing on joints and internal organs, and it's linked to a variety ailments, from diabetes to heart disease.
But, to date, Canadian policymakers have been passive. This past winter, provincial health ministers announced a joint effort to study the issue more -- an underwhelming response, if there ever was one.
The temptation, though, is for our politicians -- eager on the stump to embrace a solution -- to champion a bad idea. When it comes to obesity, many of our neighbours are doing just that. From California to Denmark, legislators are considering some type of tax, usually on sugary drinks. It's an idea that has gained popularity in academic circles. Just last month, a number of authors who published studies in Britain's The Lancet called on governments to tax junk foods.
The evidence for such a tax is, at best, questionable. The tax would have to be very high (say 25 per cent for a soda) and even then it's not clear that people would get healthier, so much as shift their intake. Less root beer could just mean more potato chips.
If Canada wants to avoid American-style obesity rates, we need to take some thoughtful steps.
First, we need to emphasize physical education in our schools. Children are spending too much time on the Internet, and not enough with their hockey sticks.
Second, agricultural subsidies and regulations should avoid using taxpayers money for unhealthy foods or to overprice healthy ones. Subsidies should promote health, and regulations (like on dairy pricing) shouldn't promote unhealthy foods.
And, ultimately, we should recognize the importance of incentives. In the British experiment Pounds for Pounds, people received compensation for losing weight. No surprise here: many did.
As we consider our public health-care system in the light of aging demographics and chronic illnesses, we'll need policies that emphasize health, not just health care. And that means that we must recognize our double-double problem.