Dietitians Explain Why Canada's Food Guide Is Not For Those With Eating Disorders

Estimated reading time: 6 minutes

[Image: Round plate with egg, noodles, oranges, and vegetables on a turquoise and grey background.]

[Image: Round plate with egg, noodles, oranges, and vegetables on a turquoise and grey background.]

Recently, Health Canada released the new version of Canada’s Food Guide (CFG). With over a decade since the old guide was published, Canadians finally got updated nutrition recommendations. The new Food Guide brings many changes, such as eliminating portions, emphasizing the importance of savouring our foods, being curious about our hunger and fullness cues, and eating with others when possible.

While these are steps in the right direction in terms of population health, it’s important to recognize that Canada’s Food Guide is not appropriate for many, including those healing from disordered eating or eating disorders. Canadian Registered Dietitians have teamed up to explain why, in the context of eating disorders, this tool might be more harmful than helpful.

There is no one way to eat… or achieve health

There are as many ways to eat as there are people. Canada’s Food Guide is designed to guide policy making, support the development of menus, and provide Canadians with general eating guidelines. Vincci Tsui, RD explains, “Canada's Food Guide is a public health document meant to promote a healthy eating pattern among the general population, not as an individual meal plan.”

It’s important for Canadians to realize the guide is only that: A GUIDE. It ultimately needs to be individualized based on culture, food preferences, health issues, etc.

Tsui says, “The dietary guidelines which form the basis of Canada's Food Guide state 'Individuals with specific dietary requirements...may need additional guidance or specialized advice from a dietitian.' This includes people with eating disorders, as it would any medical concern."

Further, the Food Guide may unintentionally suggest that following the guide is the path to health and wellness.

“Any Guide that steers towards “healthy foods and exercise” insinuates that these two determinants are the only two vehicles to health. While the Guide made an effort to include important messages around mindfulness, I am concerned about its contribution to “healthism” and “foodism”.”, explains Shawna Melbourn, RD, CEDRD-S, Certified Intuitive Eating Counselor.

It can fuel food rules

Many people with disordered eating struggle to let go of food rules. While the messages in the Food Guide are well meaning, they can easily reinforce rigid food rules.

“The new Canada's Food Guide's focus on plant-based eating and whole foods may create the implication that foods which have been minimized (sugars, fats, dairy and meat) are harmful. Clients with eating disorders are especially vulnerable to this dichotomizing messaging. The inclusion of these foods is part of normal eating, as they provide flavour, enjoyment, and abundant nutrients essential for eating disorder recovery and everyday health.”, explains Elke Sengmueller, RD.

Jillian Walsh, RD adds, “I am most disappointed with the scale of food items which appear on the main focal point, the meal plate. The piece of bread is smaller than the slice of apple depicted while the egg appears to be 1/4 of its whole. While I’m sure the intention was not to promote miniature portions of grains and protein foods as normal, I worry that this is the message being heard by many.“

Making vegetarian choices can be risky

If the planet’s health and animal welfare are part of your values, there is definitely merit to reducing your intake of animal-based foods. However, for those vulnerable to eating disorders, this kind of dietary change can be a slippery slope.

Kori Kostka, RD says, “The new food guide has a strong emphasis on vegetarian eating styles which may worsen “healthism”, “orthorexia” and other eating disorders. It’s important when using these tools to be aware of their limitations to vulnerable populations.”

If you tend to be “all or nothing” when it comes to food, it may be helpful to discuss with a Registered Dietitian with experience in eating disorders before choosing a vegetarian eating style. They can work with you to explore your motivations and see if this the right choice for you.

Energy dense foods and drinks are important

When healing from eating disorders, energy dense foods and drinks are important. They provide energy, nourishment, and help normalize all foods.

Kathy MacKay, MSc, RD explains, “A study conducted on people with anorexia showed an association between a higher intake of energy dense food and reduced risk of eating disorder relapse (Schebendach, Mayer, Devlin, Attia, & Walsh, 2012) . Further, including fear foods on a regular and consistent basis (fears often are foods labelled “unhealthy”), helps train the brain that these foods are in fact safe. As such, pizza, candy, chips, desserts, etc are part of healthy eating for people recovering from eating disorders.”

Fat. Is. Important.

While the new Food Guide emphasizes including protein and grains (source of carbs) on our plate, it forgets an essential nutrient: fat.

Suzanne Dietrich, RD shares, “The new Canada’s Food Guide misses the boat one of the most vital macronutrients for all populations - Fat. At varying life stages we need anywhere from 1/5-2/5 of our total energy from fat. Dietary fat give us energy, supports cell growth, aids in the absorption of fat-soluble vitamins and hormone regulation to name a few roles. Fat adds flavour and contributes to satiation and satisfaction. As a Dietitian who works with individuals with disordered eating and eating disorders this new guide will make it very hard for me to share the vital role that fat plays in our body.”

Mindful eating is misrepresented…

Mindful eating is a great tool for the general population. However, in the new Food Guide, it is presented as “being mindful of our eating habits” as opposed to “bringing mindfulness into our eating experience”. While these may sounds similar, there is in fact a big difference.

Miranda Burgess, RD MPH explains, “When talking about mindful eating, CFG asks the question "how much food and drink did you have?" This question may lead some people to gauge their eating using some external measure related to the amount of food or drink consumed. When in fact in mindful intuitive eating, we encourage people to focus on learning about and following their internal cues of hunger, fullness, and satiety.”

Mindful eating also goes beyond examining our hunger and fullness cues.

“If we consider the essence of mindful eating, it encourages being present and non-judgmental towards our eating habits. The focus is not only on hunger and fullness. The current food guide guidance can be misused as a way to police our food choices and portions.", says Grace Wong MSc CEDRD.

… and may not always be helpful for those with eating disorders

While mindful eating is a wonderful approach, some elements may not be helpful during certain stages of healing from eating disorders.

“One study showed mindful eating for those with anorexia nervosa and bulimia nervosa increases premeal distress (Marek, Ben-Porath, Federici, Wisniewski, & Warren, 2013). Further, hunger and fullness signals are often not accurate for people living with eating disorders. Mechanical eating, where individuals eat a set amount of food at set times regardless of hunger and fullness, is used in most specialized eating disorder treatment programs in Ontario.” explains Kathy MacKay, MSc, RD.

However, certain aspects of mindful eating, such as compassion and non-judgment towards our eating, are always applicable, and introspective awareness may be a helpful tool in later stages of recovery.

The Bottom Line

The new Canada’s Food Guide is an important public health document. It can be a place to start for those interested in making changes to their eating. However, it needs to be individualized to each person’s unique circumstances. It is not meant to be a list of food rules one must follow to achieve health. Further, for those with medical conditions, including eating disorders, it is not an appropriate tool. We need to increase access to Registered Dietitians experienced in eating disorder care in order for vulnerable individuals to get personalized support.

What are your thoughts on the new Canada’s Food Guide? I would love to hear from you!

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