Is Fat the New Tobacco? The Canadian Weight Crisis.

There has been a general recognition that the fitness of Canadians has declined over time, yet we have never had a clear sense of the magnitude of this decline. As widely reported last week, we do now and the news is disturbing. Let me explain the results of the study here in more detail.

Due to cost and time, most population surveys tend to rely on self-report to collect data about health factors such as weight, body mass index and fitness. This may give a less accurate picture of population health. For example, reviews suggest people under-report weight and over-report height. In the first time in more than twenty years, a comprehensive and objective assessment of the fitness of Canadians has been conducted. The recent 2007-2009 Canadian Health Measures Survey by Statistics Canada administered over 3000 comprehensive health interviews in the home, and had participants complete body composition measurements and fitness tests in a mobile examination centre across Canada.

The survey's key findings, after the jump...


Comparisons were made with data drawn from the 1981 Canada Fitness Survey (CFS). Between the two surveys, muscular strength and flexibility decreased, while mean values for body composition measures such as BMI and waist circumference increased.

To illustrate this finding, the study authors highlight that a current, average 20 to 39-year-old man and woman is overweight and has the same body composition profile as those who were aged 40 years or older in 1981. The percentage of Canadians aged 40 to 69 years categorized as "fair" or "needing improvement" according to their body composition more than doubled. Among males aged 20 to 39 years, the increase was fourfold, and more troubling, among younger females, sevenfold. Overall, these findings clearly suggest, in the words of one of the study authors, Dr Mark Tremblay, that Canadians are becoming heavier, fatter, rounder, weaker and less flexible than previous generations.

Is fat the new tobacco? Yes, particularly if we think of this question in terms of the relative prevalence of a serious health risk in the population. Smoking rates have declined over the last twenty years but the numbers of obese and overweight have increased. While we must not lose sight of the need to maintain efforts in tobacco control, it is also clear that lessons need to be learned from that experience and applied to stemming the drastic decline in fitness and associated increases in body composition.

There is no one magic solution. Rather, a combination of strategies may interact to cause a shift in the social acceptability of over-eating or being physically inactive – which in turn might improve body composition. Information strategies to promote healthy eating and physical activity; greater access to community-based physical activity and nutrition programs; legislation to regulate food marketing or how communities are built; economic interventions to reduce the cost of fresh fruit and vegetables; in addition to medical interventions and management, are all required. To be successful, all of these types of strategies need to be combined into comprehensive programs to simultaneously address as many influences on food intake and physical activity as possible.

This will not be easy, but the tobacco control experience suggests that it can be done. Looking ahead twenty years, we must hope that this Statistics Canada report was the stimulus for national commitment to such action.

Key Messages

* Fitness levels have declined among Canadians over the last twenty years while body composition has increased.
* Comprehensive strategies are urgently required that target the many influences on food intake and physical activity.