Chronic disease rates are on the rise in Canada, a trend that is expected to worsen over time. An aging population is not the only explanation, doctors tell The Epoch Times. They also see it as a sign and symptom of unhealthy lifestyles and an overburdened health-care system that focuses on acute care instead of prevention.
“In Canada and many other Western countries, we have very reactive health-care systems where there is very little emphasis on prevention,” said Dr. Saverio Stranges, a medical doctor and chair of the department of epidemiology and biostatistics at Western University in London, Ont.
“We have completely given up the idea to prevent disease from occurring in the first place,” he said, noting that this is why the growing prevalence of serious illness is affecting elderly and working-age Canadians alike.
Past president of the Ontario Medical Association Dr. Shawn Whatley, also a medical doctor, agrees.
While having an “acute care mindset” is great for someone with a broken bone or another type of injury, it doesn’t often help treat what Whatley calls “lifestyle illnesses.”
“With acute care, the goal is to help someone get back to normal, say walking properly after a broken ankle,” he said. “When you start talking about lifestyle issues, you’re not talking about getting back to normal—you need to create a new normal.”
For David J. Schleich, past president of the National University of Natural Medicine in Portland, Ore., that means having better education in place for the public and doctors alike.
“There’s a lack of education, not only of the medical professionals so they know what to do, but also of the people themselves in elementary and secondary schools,” said Schleich, who holds a PhD in medical history and health policy. “There’s zippity doo dah by way of curriculum that teaches people about the primacy of food choice and lifestyle.”
Dr. Brian Day, a practising orthopedic surgeon and past president of the Canadian Medical Association, said change would not be easy, however, because Canada has become a “victim of the success of medicine.”
“Preventative health care is not covered under the Canadian health system, so if you go for an annual physical without a complaint, that’s not covered. In Canada, it’s not considered essential,” he said.
Obesity-Related Illness
Nearly one in three Canadians are living with one of the 200 weight-related health conditions associated with obesity, according to an Obesity Canada report. Such conditions include diabetes and high blood pressure.
Failing to recognize obesity as “a chronic and progressive disease, combined with a lack of access to effective treatment and prevention strategies,” cost Canada more than $27 billion in 2023, the report said.
The best way to avoid obesity-related conditions and to improve health overall is by managing weight and living a healthy lifestyle, Stranges said. That, he said, begins with proper nutrition.
It is also about self-discipline, Day said.
Importance of Diet
Poor dietary patterns and reliance on processed foods is an ongoing issue for Canadians, Stranges said. The key to getting people to change their diet, he said, is education because people need to understand where they are going wrong and why it matters.Schleich said chronic illnesses are on the rise because food quality has been on the decline since the 1950s.
It’s an issue that has received much attention in the United States lately as well, with Robert F. Kennedy Jr. promising to fix the “broken food system and Make America Healthy Again” as President-elect Donald Trump’s pick for Secretary of Health and Human Services.
Schleich said while many of the products that use added sugars and high-fructose corn syrup on grocery store shelves are advertised as low-fat or low-calorie choices, that doesn’t mean they are healthy. Products like ready-to-serve cereal, crackers, chips, and pasta kits are what he calls “inflammatory foods.”
“One look at grocery stores, all those centre aisles are loaded with these attractive boxes of junk,” Schleich said. “It tastes amazingly good, but nutrition-wise, it’s terrible. It’s inflammatory.”
Inflammatory foods are those that are heavily processed or contain high levels of saturated fats, added sugars, high fructose corn syrup, or trans fats. Eating too much of these foods can lead to obesity, heart disease, diabetes, and cancer, he said.
Even those trying to eat healthy have to be careful, Schleich said, noting that an apple a day to keep the doctor away really depends upon the apple a person chooses. Some fruits and vegetables are heavily sprayed with pesticides. Meat also needs to be sourced carefully to avoid harmful substances, he said.
“You have meats that are loaded with all sorts of drugs and hormones and so on,” he said. “You have vegetables that are not organic, and have been sourced with the presence of various toxic pesticides … it’s so pervasive in the main food supply, people just eat them and their bodies are harmed over time.”
Schleich recommends buying organic and whole foods as much as possible and paying attention to the ingredients in products to ensure they aren’t heavily processed. For example, instead of reaching for a sugary cereal, he suggests steel-cut oats.
Despite a dwindling reliance on whole foods in favour of more heavily-processed meals and snacks, life expectancy has increased in Canada because of medication, Stranges said.
“People living longer lives does not necessarily mean that they live healthy lives,” he said. “Lifestyle factors, the way people eat are factors in that.”
Medication Reliance vs. Healthy Lifestyle
Over reliance on medications contributes to chronic conditions because it is often a band-aid solution for a more serious problem, Stranges said. The medications may treat the symptoms and may even make the patient feel better for a while, but they don’t always offer a cure.“It’s much easier to tell someone, take Ozempic for obesity, or take Metformin for prediabetes, instead of saying let’s try to be healthy, let’s work on your diet, let’s work on your physical activity,” he said.
The problem is that many family doctors are not trained in lifestyle medicine, Schleich said.
“They don’t know much about nutrition, frankly,” he said. “They think that prevention is earlier diagnosis, which means you can throw some pharmaceuticals at it, or some therapies at it sooner.”
Unfortunately, that model of medicine does little to help lifestyle illnesses, Whatley said.
“Lifestyle issues require a transformation of how we think,” he said. “Like, ‘Why do I eat a bag of Doritos and watch a movie every day?’ And that’s a much more difficult problem to fix than a broken ankle.”
He said while doctors depend on medication to manage chronic conditions, many patients are just as eager to be prescribed a pill for their problem.
“Some patients are very unsatisfied when you say, ‘you’ve got back pain in part because you’re 55 pounds overweight and you don’t exercise,” Whatley said, adding that many patients don’t have the time or energy to commit to a lifestyle overhaul.
“Telling them ‘it will get better, but it’s going to require maintenance for the next 30 to 40 years of your life,’ that is a very unsatisfying response for patients,” he said. “They would much rather hear there’s a new anti-inflammatory. It’s not going to solve everything, but it will take the edge off.”
Often that attitude is tied to the stressful schedules many middle class Canadians commit to in order to afford the house and vehicles they want while balancing work, family, and other commitments, Whatley said.
“Parents in two-income homes, they’re often working long hours, and when they get off work, they have to take their kids to after-school programs or sports,” he said. “They really don’t have any time to pay attention to their own bodies, so by the time they get to their mid-40s they’re slightly overweight, and they haven’t had time to exercise.”
That is how health problems begin with many working-age Canadians, Whatley said. And the ease of grabbing prepared meals that are high in salt and additives is a trade-off many of them make to stay on schedule.
Lack of Sleep and Sedentary Lifestyle
A huge part of good health is maintaining an active lifestyle and getting proper sleep, Stranges said.Sufficient sleep in particular is often ignored by people who are busy, but it is essential to overall well-being.
“I’ve been spending the last 20 years of my career working on the importance of sleep,” Stranges said. “Many people are experiencing sleep deprivation, disrupted sleep, and there is a huge body of evidence linking sleep problems with all kinds of chronic illnesses.”
Cancer, cognitive decline, musculoskeletal problems, depression, and anxiety are just a few, he said.
Being well-rested, particularly when it’s linked with proper nutrition, is a key to being more physically active, Stranges added.
Exercise does not have to be difficult or gruelling, however. Whatley said it’s best if people pick an activity they enjoy, as they’ll be more apt to stick with it.
“You can’t just say, ‘go for a walk’ or ‘get this many steps,’” he said, noting that the key is to get people moving. How people choose to do it is up to them, whether it’s walking, swimming, or joining a sports league.
Doctor Shortages and the Pandemic Effect
Canada’s health-care system itself could be seen as a contributing factor in the rise of chronic illness because a lack of doctors and escalating wait times to see specialists means many patients aren’t being diagnosed until there is a serious problem, the doctors said.“When I came to Canada in the 1970s, we were second or third in the world in the number of doctors on a per population basis,” Day said.
Many Canadians do not have a family doctor, which negatively impacts the health of the general population, Stranges said. The shortage also extends to specialists leading to long wait times for treatment.
Those wait times have been exacerbated by the COVID-19 pandemic when people were unable to see their family doctors or receive some types of medical screening, Stranges said.
“That eventually translates into additional numbers of chronic disease,” he said.
Fixing the Problem
The growing incidence of chronic illness cannot be blamed on one thing alone, the doctors said, and that means the solution will also be multi-faceted.Two of the biggest issues, Stranges said, is a lack of public and doctor education on healthy lifestyles as well as a lack of political will to make changes to a system that is struggling to keep up with growing the demand for care.
“Doctors would benefit from having a deeper knowledge of what health really is,” he said. “What occurs in medical schools is more about disease management.”
He added: “We need to educate our kids and the parents to eat better, to sleep well, to be more physically active, to have less time on screen or engaging in sedentary behaviours, and primary care providers need to play an important role in conveying those messages to the general public.”
Day said one way the government could help is by sending price signals for unhealthy food the same way it does with smoking and alcohol, and make nutritious food cheaper.
“The way cigarette smoking was addressed, maybe we have to do that with bad foods, make it so that you have a 500 percent tax on candies and chocolates and cookies,” he said.
Stranges also wants to see the government invest more into preventative medicine rather than focusing on medications.
“We need to change the culture in terms of addressing not just disease, but trying to improve the overall health of people,” he said.
