Two weeks ago Canada revised their physical activity guidelines. Great new, right? Not so much considering they actually lowered their minimum daily requirements. And it’s got a few healthy folks spitting hellfire, like Dr. Ali Zentner, obesity expert on CBCs Village on a Diet.
The same day mainstream media announced Canada’s new activity guidelines (which failed to clearly state daily minimums were reduced in the revisions), I jumped into a conference call with three of the health pros who helped the town of Taylor, BC in reaching their goal of losing a ton of collective weight. (Check out my review of Village on a Diet.)
The call started early and I caught only a fraction of Dr. Ali Zentner’s passionate review of the new guidelines. She’s a physician specializing in obesity and cardiac risk management, and last Friday I had the pleasure of speaking with this vivacious spitfire about the subject.
(She confessed she was especially spirited during our interview with “vinegar in her belly” as she was on-call at the time, activating her “war mode.”)
Who’s Dr. Ali Zentner?
Before we get into the nitty-gritty of the new guidelines, I’d like to introduce you to Dr. Zentner. Besides her impressive medical credentials, there are few facts that make her special. She’s struggled with obesity all her life but when she hit med school, between stress, poor diet and long, irregular hours, she tipped the scales at nearly 330 pounds and became morbidly obese.
Since then, Ali has lost 180 pounds, runs marathons and triathlons, gave up her car in lieu of a bike in order to fit physical activity into her schedule and was recently an Olympic torchbearer! For fun, she’s a fictional novelist, “A Good Life” (described as, “Sex in the City meets ER“), contributes articles, is featured in others offering health advice and writes for her blog, Girlfriend’s Guide to Health.
The Issue with Canada’s New Activity Guidelines
While the Public Health Agency of Canada has taken down the old activity guidelines from their site (actually, they don’t have the new ones posted either, you must now go to the Canadian Society for Exercise Physiology for them), GlobalNews.ca mentioned them in their article:
Previous guidelines recommended children and youth work towards getting at least 90 minutes of physical activity a day. The daily target for adults was at least 60 minutes daily, while older adults were recommended to accumulate 30 to 60 minutes of moderate physical activity on most days.
As for the new activity guidelines:
…children and youth aged five to 17 get at least 60 minutes of moderate to vigorous intensity physical activity daily. This should include both vigorous-intensity activities and muscle and bone-strengthening activities at least three days a week.
Adults aged 18 to 64 and older adults 65 and up are recommended to get at least 150 minutes of moderate to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more.
The decrease in minimum daily activity is apparent for kids, but what’s even more disturbing is how they’ve chosen to word their recommendations for adults: 150 minutes per week which works out to be a mere 21.5 minutes per day!
There are some perks to these new guidelines, specifically, informing Canadians that there are different intensities of exercise and muscle-building activities needed to realize health benefits (where’s calisthenics, i.e. stretching?), as well as suggesting “more is better.”
Despite these positive changes, Dr. Ali Zentner is seething about the reductions.
“Since when did we lower the bar to let more people into the club?” Apparently these new guidelines reflect more on what most Canadians are currently doing rather than on science. Ali looks at large population studies, like those published from the American Heart Association, to guide her recommendations:
For most healthy people: For health benefits to the heart, lungs and circulation, perform any moderate-to-vigorous-intensity aerobic activity for at least 30 minutes on most days of the week at 50–85 percent of your maximum heart rate.
To safely exercise, you must slowly increase your heart rate to its maximum and then slowly decrease it to avoid shocking the body. Considering this, with 5-minutes each to warm up and cool down, we’re looking at an effective cardiovascular workout lasting at least 40 minutes per session.
Of course, the following sentence on the American Heart Association’s website concurs with the Canadian recommendations:
You can accumulate 30 minutes in 10 or 15 minute sessions. What’s important is to include physical activity as part of a regular routine.
“We’re dumbing down the argument,” says Ali, and the message Canada [and America] is sending to its citizens is, “Anything is better than nothing.” While that is technically true, Dr. Zentner is concerned that lowering standards is the wrong approach.
“It’s like the government saying, `You can pay your taxes whenever you feel like it.’,” Ali said while half-laughing with barely disguised disgust. “Canada should be encouraging its citizens to be their healthiest and best!”
How Should Canada Approach Healthy Living?
When we’re discussing health, a life and death issue, we can’t afford to worry about hurting people’s feelings, says Dr. Zentner. Being overweight, obese or a cardiac risk (which many skinny-fat people are), is due to lifestyle choices. Telling people this often triggers them to blame themselves for their current situation.
Meanwhile, the truth may hurt but it’s a necessary evil in order for people to wake up and strive to be better. To help Canadians overcome guilt and blame, health professionals can empower people with the right information, tools, attitude and encourage them to take personal responsibility through small changes.
Ali is a strong proponent for a proactive solution. When asked about taxing junk and fast food, suggested by some health professionals treating overweight and obesity, like Dr. Robert Pretlow in Overweight: What Kids Say (read my book review), she vehemently disagreed with a sugar tax. She said it didn’t work in the past, citing England’s sugar tax, and that it was ineffective to punish those who don’t know better or who aren’t ready for a change.
Instead, Dr. Zentner suggests we use a tax relief system for healthy living. For instance, Nova Scotia has provided a Healthy Living Tax Credit for youth to cover the costs of organized sports and activities since 2005, and was about to expand it to adults in 2008 until it was deferred due to reelections and provincial budgetary restraints. (source: thecoast.ca)
Unfortunately, I failed to locate a current evaluation of the impact of Nova Scotia’s healthy living tax credit on its youth. However, I did find an interesting paper published by the Library of Parliament on the subject suggesting multiple economic instruments Canada can use to promote healthy living. By the way, it concluded that more research was needed. Surprise!
Some of Dr. Zentner’s suggestions:
- Make it difficult for industries to bed with government policy-makers.
- Tougher laws on food marketing initiatives/packaging. For instance, Ali says the `heart healthy’ labelling on many foods are a joke.
- Better health standards with fast food outlets, like posting calorie counts on menus.
- Forbid juice and pop machines in schools.
- Include nutrition and calorie information in home economics.
- Tax exemptions on public transit and tax credits for home gym equipment.
- Include obesity training in med school so docs are better equipped for treating patients who struggle with weight issues.
As we wrapped up the interview, Ali had some words of wisdom for Canadian government officials and health professionals, “We all must take a long, hard look at what we’ve been doing and ask if we’re part of the problem. If you find you’re not part of the solution, then you need to change sides.”
As for all of us as Canadian citizens, including policy-makers and health pros alike, Dr. Zentner asks us to reevaluate what we’re doing in regards to healthy living and ask for more.
So do you agree with Ali that Canada’s reduced standards are hindering progress? Or do you think by including more effort (intensity) in our activities as the new guidelines suggest, we would be using our time more effectively thereby reducing the total physical activity time needed to achieve the same results?