The Sandbox Project Growing Healthy Bodies Working Group Discussion Document on the Ontario No Time to Wait: Healthy Kids Strategy

As I’m sure you are aware, the Ontario Government has recently released a report from their Healthy Kids Panel called No Time to Wait: The Healthy Kids Strategy. The purpose of this document is to identify and discuss the positive and negative attributes of the report with respect to The Sandbox Project Growing Healthy Bodies Working Group.

On the positive side, the report did attempt to decrease the emphasis on weight especially with respect to children and youth. From the report:

Health is about more than weight. In fact, a child who is a little overweight and who is fit and active is healthier than a child who is the “right” weight for his or her age and height but is more sedentary. Focusing too much on weight is stigmatizing and will not address many of the factors that will contribute to unhealthy weights

Also, the commissioning of the report and the formation of the Healthy Kids Panel shows the government’s commitment to investing in Healthy Active Kids. This important first step will hopefully be the first in a long line of investments in Ontario children.

Overall, the report made some good recommendations and observations on the determinants of health for children, factors affecting our communities, the environment and food choices. The recognition of mental health as a factor affecting a healthy start in life was a great asset that we are excited to see in the report. The report recommends that Ontario focus on three main areas that would make a significant difference in our children’s weight and health:

  1. Start all kids on the path to health
  2. Change the good environment
  3. Create healthy communities

While this report is a valuable resource that identifies the status of Ontario children’s health there are some issues that have been identified. Some of the areas for potential development regarding this report include:

  • The focus group interviews did not include industry representatives. Industry is present in some of the recommendations including the recommendation to use corporate sponsorship to fund programs. 
  • The report does not look towards other programs or organizations to implement the report’s recommendations or identify best practice programs currently underway in the province. 
  • The report is flawed methodologically and misleading in how it is presented.  The problems exaggerated.  We need to remember that even today; over 90% of kids are not obese. They also are misleading, the problem is not a higher weight that causes poor health outcomes, it is rather that environmental and genetic factors, in the context of a Canadian culture and lifestyle leads to poor health.  Higher weight is an associated issue, and it is an imperfect marker. 
  • The media has largely focused on obesity and the marketing of food to children under 12. There was a significant amount of the report that has not garnered media attention (for example poverty, mental health, healthy weight, parents, the environment, sleep, television, etc).  This is reflection of the emphasis of the report where a significant number of recommendations focus on marketing, while only making one recommendation on the issue of poverty or mental health.

While this report was a good first step, some issues have been identified regarding the assumptions the report is based upon and should be considered as the government moves forward and works towards making kids healthier. The following are some underlying assumptions and some general discussion comments:

Assumption 1:  Health education interventions do no harm and are effective in changing lifestyle behaviours.

  • The literature would suggest otherwise on both points.

Assumption 2:  Overweight is the same as obese in terms of associated health outcomes.

  • This is not the case.  Being overweight is not strongly associated with the same outcomes.
  • In fact, the overweight category is associated with the longest lifespan and should be renamed (the live the longest category).

Assumption 3:  We know how to make a fat person thin. The report discusses maternal weight and outcomes in children as if we can easily get a person to become thinner and that all it takes is “education”.

  • Reviews of the literature have repeatedly demonstrated that while achieving weight loss is possible, success is inevitably short lived.
  • Maintaining significant weight loss is impossible for the vast majority of people

Assumption 4:  This generation of children will live shorter lives.

  • However mortality rates are improving for cardiac disorders and cancer and although we are fatter, we continue to live longer.  Folks in the overweight category live the longest-how do they explain this?

Assumption 5:  We must act now.

  • This report assumes we know what to do and have strong evidence to direct us.  In fact this is not true.
  • The report also assumes that our interventions do no harm.  This is also not true.
  • Let’s remember that eating disorders in adolescent girls is twice as prevalent as obesity and some interventions can trigger eating disorders.  Having an eating disorder can increase risk of death by 2-10 times –not later in life (as with obesity as the report suggests), but in adolescence.

For reference purposes we have identified the issues identified in the report, the corresponding recommendations and some comments.

To view the table above, please click either image above, or click here to read the full document.

What the province needs are more recommendations that are detailed enough and consider how our society actually functions.  What sounds like a good idea may not turn out to be so great in its implementation or effect if there is no evidence that it works and no assurance that it does no harm.  It also has to be possible to implement in the context of how government is structured in this country and how parents and families actually live their day to day lives.  Otherwise we are wasting time and money that would be better served in other areas of health and social justice.

Again, the purpose of this document is to continue the conversation about the health of children and youth in Canada.  Let’s work together, continue this important conversation, invest in children and youth and make Canada the healthiest place in the world for children and youth to grow up.

Sample Coverage

Sample Responses


To read the discussion above in a PDF format, please click here.