It's amazing what a public health NGO can do when it divorces itself from the food industry.
Canada's Heart and Stroke Foundation, just a few short years ago, was happily in bed with the food industry, selling it their "Health Check" front of package seal of approval and partnering with multiple fast food restaurants. But then last year, the Health Check program was shuttered and since then, the Heart and Stroke Foundation has forged a course that their prior partnerships would have undoubtedly prevented.
First they published the most rigorous sugar recommendations in North America.
Next they launched a campaign urging the government to restrict the commercial marketing of foods and beverages to children.
And most recently they proved that food industry money, while green, isn't the only money available as they've just announced their largest industry partnership in the Foundation's history - with the Canadian Pacific Railway.
Huge kudos to Canada's Heart and Stroke Foundation.
Selasa, 30 Juni 2015
Senin, 29 Juni 2015
Dairy Farmers of Canada Break The Law At Medical Conference
I took that photo up above at the recent Canadian Obesity Network conference's exhibit hall.
According to Health Canada and the Canadian Food Inspection Agency,
While dairy has a longstanding tradition of marketing a protein source with calcium as a uniquely magical elixir of strength and health, even I was surprised at how blatantly they ignored CFIA guidance in a room that among others might well have included conference attendee Dr. Hasan Hutchinson, the Director General of the Office of Nutrition Policy and Promotion within the Health Products and Food Branch of Health Canada.
Guess that means either the Dairy Farmers of Canada don't care about CFIA's guidelines, or that they're not worried about their enforcement, as the notion that they were unaware of the guidelines is simply not a possibility.
UPDATE, July 14th: The Dairy Farmers of Canada reached out to me, and citing 1987 Alberta case law, pointed out that in Canada, if the target of the message isn't the general public, they can make any claims they see fit. See more here.
According to Health Canada and the Canadian Food Inspection Agency,
"Nutrient function claims may not refer to the treatment, prevention or cure of a Schedule A disease; or claim to treat, mitigate, or prevent a disease, disorder or physical state; or claim to correct, restore or modify an organic function [3(1) and 3(2), FDA]. Such claims are considered to be drug claims (see Drugs vs. Foods)."And,
"Nutrient function claims are not made for a food per se; they may only be made respecting the energy value or nutrients in a food."And yet here we see, in a room full of influencers important enough for the Dairy Farmers to buy a booth, that Dairy Farmers of Canada have explicitly claimed that the consumption of "milk products" prevents colon cancer and type 2 diabetes, improves bone health, and confers healthy blood pressure.
While dairy has a longstanding tradition of marketing a protein source with calcium as a uniquely magical elixir of strength and health, even I was surprised at how blatantly they ignored CFIA guidance in a room that among others might well have included conference attendee Dr. Hasan Hutchinson, the Director General of the Office of Nutrition Policy and Promotion within the Health Products and Food Branch of Health Canada.
Guess that means either the Dairy Farmers of Canada don't care about CFIA's guidelines, or that they're not worried about their enforcement, as the notion that they were unaware of the guidelines is simply not a possibility.
UPDATE, July 14th: The Dairy Farmers of Canada reached out to me, and citing 1987 Alberta case law, pointed out that in Canada, if the target of the message isn't the general public, they can make any claims they see fit. See more here.
Sabtu, 27 Juni 2015
Saturday Stories: Vitamins, David Perlmutter, and Lithium
Cardiologist Chris Labos in MacLeans takes on the hard to swallow truth of vitamin pills.
Alan Levinovitz in The Science of Us covers the history, and it's an ugly one, of Grain Brain's Dr. David Perlmutter.
Jaime Low, an author who has had bipolar disorder for 20 years, in The New York Times Magazine, on how she doesn't believe in God, but she does believe in lithium.
Alan Levinovitz in The Science of Us covers the history, and it's an ugly one, of Grain Brain's Dr. David Perlmutter.
Jaime Low, an author who has had bipolar disorder for 20 years, in The New York Times Magazine, on how she doesn't believe in God, but she does believe in lithium.
Jumat, 26 Juni 2015
♫ "I'd Like to Buy the World a Drink That Doesn't Cause Disease" ♫
So, it's far sadder than it is funny, but CSPI's take on Coca-Cola's iconic "Hilltop Ad" (the one featured in the last episode of Madmen and with the song, "I'd like to teach the world to sing"), is definitely worth including as a Friday video.
Have a great weekend!
Have a great weekend!
Kamis, 25 Juni 2015
Eat Your Veggies and Proteins Before You Eat Your Carbs
Was Pink Floyd onto something? |
Those qualifiers out of the way, the study, published in this month's Diabetes Care, looked at the impact of order of food ingestion on post-meal glucose levels, in 11 adults with type 2 diabetes who were taking metformin. The subjects, after a 12 hour fast, were offered two meals spaced one week apart. The meals included carbs - ciabatta bread and orange juice, protein - skinless grilled chicken breast, and vegetables - lettuce and tomato salad with low-fat Italian vinaigrette and steamed broccoli with butter. What differed was when they ate the carbs. One week it was first, the next, last. Post-meal glucose levels were measured at 30, 60 and 120 minutes.
Though the study definitely left me scratching my head as to why the diabetic patients were given juice with their meals at all, results wise, when protein and veggies were consumed before a meal's carbs, post meal glucose and insulin levels were markedly lower!
And though indeed this is a very small study, given the incredible ease of the intervention, and with no obvious downside or hardship attached, it may well be worth considering the order of your meals' foods if diabetes or impaired glucose tolerance is a concern.
Rabu, 24 Juni 2015
Badvertising: Kellogg's New Frosted Flakes with Energy Clusters Cereal
Thanks to RD and friend Andy Bellatti for highlighting Kellogg's new, "Frosted Flakes with Energy Clusters" cereal. According to Andy, it's Kellogg's most sugary cereal!
No doubt the "energy clusters" name will sell far more product than would, Frosted Flakes with "Sugar Clusters", but given the cereal, at more than 4 teaspoons of added sugar per cup, contains more of the stuff cup per cup than Froot Loops and regular Frosted Flakes, no doubt it'd have been a far more honest descriptor.
Consider this further proof that the word "energy", is used by the food industry, as a health-washed euphemism for "sugar".
No doubt the "energy clusters" name will sell far more product than would, Frosted Flakes with "Sugar Clusters", but given the cereal, at more than 4 teaspoons of added sugar per cup, contains more of the stuff cup per cup than Froot Loops and regular Frosted Flakes, no doubt it'd have been a far more honest descriptor.
Consider this further proof that the word "energy", is used by the food industry, as a health-washed euphemism for "sugar".
Selasa, 23 Juni 2015
Use the 95:5 Rule To Forever Ignore All Further Healthy Living Advice
You've heard of the 80:20 rule. 80% of the time focus on your strict diet and exercise routine and 20% of the time, don't worry about it. And the 80%, it's usually filled with lots of difficult to follow and remember rules, and generally includes a fair bit of sacrifice and restriction.
Well I've got a different ratio to sell you on today. It's the 95:5 ratio, and if you follow it, you can ignore every new fad diet, every well-intentioned friendly lifestyle zealot, and every supplement huckster out there.
Here goes.
Focus 95% of your healthy living energies on:
Life's too short to worry about the minutia of healthful living and if you're looking for the best bang for your healthful living buck, look to the unsexy, but incredibly beneficial, 95%.
Well I've got a different ratio to sell you on today. It's the 95:5 ratio, and if you follow it, you can ignore every new fad diet, every well-intentioned friendly lifestyle zealot, and every supplement huckster out there.
Here goes.
Focus 95% of your healthy living energies on:
- Cooking your meals from fresh whole ingredients while minimizing restaurant meals and ultra-processed foods (and remember too "minimize" is a relative term and one that you can continually improve upon but need not start at awesome), and then eating those meals free from distractions and ideally with friends or family.
- Exercising as often and as much as you can enjoy, and ideally more days of the week than not, while still remembering if all you can find are short bursts, they're good too.
- Not smoking
- Cultivating good night sleeps (dark, cool and quiet rooms, no screens right before bed, set sleep times, no caffeine past noon, rare alcohol within 3 hours of bed time would be a good start)
- When indulging, asking first if it's worth it, and second what's the smallest amount you need to be happy?
- Drinking alcohol only in moderation (1 daily for women, 2 for men)
- Nurturing your friendships and relationships
Life's too short to worry about the minutia of healthful living and if you're looking for the best bang for your healthful living buck, look to the unsexy, but incredibly beneficial, 95%.
Senin, 22 Juni 2015
A Genuinely and Amazingly Effective Dr. Oz Cleanse
"Dr. Asshat" - Courtesy of Peter Cook (@DoodlePeter) |
- If the Dr. Oz show is on your television set, immediately change the channel or turn your TV off.
- Use your browser's web controls to specifically block all content emanating from the www.doctoroz.com URL (instructions for how to do so in Firefox, Chrome, Internet Explorer, Safari).
- Unfollow @DrOz on Twitter, Facebook, Instagram, Google+, and anywhere else his toxin oozes.
- Never buy or read Dr. Oz' The Good Life magazine, and if you happen to see it in a friend's home, a waiting room, or elsewhere, consider disappearing it.
- If a friend or relative starts talking to you about something they heard about on Dr. Oz, place your fingers in your ears and quack loudly until their lips stop moving. Repeat as necessary.
[This post was inspired by this recent toxic tweet]
In 3 days, you can cleanse your body of toxins and help reverse damage. Use this one-sheet to get started: http://t.co/u6lCgHXGkk— Dr. Mehmet Oz (@DrOz) June 18, 2015
Sabtu, 20 Juni 2015
Saturday Stories: Alcohol, Soda, and Death
German Lopez in Vox covers the alarming "new" drug that's killing Americans by the thousands.
The Mexican National Institute of Health's press release explaining how the Mexican soda tax has done precisely what it was designed to do - decrease Mexican soda consumption
Alexandra Butler in the New York Times with an essay on death and dying on your own terms.
The Mexican National Institute of Health's press release explaining how the Mexican soda tax has done precisely what it was designed to do - decrease Mexican soda consumption
Alexandra Butler in the New York Times with an essay on death and dying on your own terms.
Jumat, 19 Juni 2015
Never Ask a Goat Not To Eat Your Pants
That's the moral of today's Funny Friday video.
Have a great weekend!
Have a great weekend!
Kamis, 18 Juni 2015
Could Our Inactivity Epidemic Be Due to Exercise's Dismal Effect on Weight?
If people's primary reason for exercising is weight loss, and if exercise doesn't effect major changes to weight, could it follow that the reason so few of us regularly exercise is because we can't stop banging the exercise is the ticket to the weight loss express drum, and people quit when discouraged by their lack of loss?
Though there's not a great deal of research on this directly, preliminary work by ConscienHealth's Ted Kyle certainly supports the idea's possibility.
Again, we need to rebrand!
Though there's not a great deal of research on this directly, preliminary work by ConscienHealth's Ted Kyle certainly supports the idea's possibility.
Slide Courtesy of Ted Kyle |
Rabu, 17 Juni 2015
The False Dichotomy Between Food Calories and Food Quality
I come across it all the time. Angry folks who claim that when it comes to weight and/or health, calories don't matter at all and that what really matters is the quality or types of foods, or the folks who claim that the quality or types of foods don't matter at all, it just comes down to calories.
It's both of course.
The currency of weight is certainly calories, and while we all have our own unique internal fuel efficiencies when it comes to using or extracting energy from food or from our fat stores, we still need a surplus of calories to gain and a deficit to lose.
But foods matter too. Choice of food matters in terms of health, but also in terms of how many calories our body expends in digesting, and more importantly, upon satiety, which in turn has a marked impact upon how many calories, and which foods, we choose to eat.
So if you do come across a zealot from either camp that claims one or the other doesn't matter, feel free to ignore them.
It's both of course.
The currency of weight is certainly calories, and while we all have our own unique internal fuel efficiencies when it comes to using or extracting energy from food or from our fat stores, we still need a surplus of calories to gain and a deficit to lose.
But foods matter too. Choice of food matters in terms of health, but also in terms of how many calories our body expends in digesting, and more importantly, upon satiety, which in turn has a marked impact upon how many calories, and which foods, we choose to eat.
So if you do come across a zealot from either camp that claims one or the other doesn't matter, feel free to ignore them.
Selasa, 16 Juni 2015
Pro Athletes Who Sell Soda Are Business People, Not Role Models
Here's Canada's own superstar Christine Sinclair, considered to be one of the greatest female soccer players of all time, selling her name and credibility to the promotion of drinking Coca-Cola (while sitting on a couch playing video games).
The argument in her defence is that we don't fund women's sport sufficiently and consequently she has to take whatever she can get endorsement wise to survive.
I honestly have no idea whether or not that's true. I do know that Sinclair has multiple sponsors, that she's an in-demand public speaker, and this article intimates that her speaker's fee is likely well into the five-figure realm, but even if that weren't the case, her choice to be, in her words, "selling Coke", is undoubtedly still a choice, and likely a lucrative business decision.
Proof that who you take on as your sponsor is still your choice even when times are tight comes from skateboarder Sebo Walker. Walker lives in a van. When in a recent interview he was asked,
The argument in her defence is that we don't fund women's sport sufficiently and consequently she has to take whatever she can get endorsement wise to survive.
I honestly have no idea whether or not that's true. I do know that Sinclair has multiple sponsors, that she's an in-demand public speaker, and this article intimates that her speaker's fee is likely well into the five-figure realm, but even if that weren't the case, her choice to be, in her words, "selling Coke", is undoubtedly still a choice, and likely a lucrative business decision.
Proof that who you take on as your sponsor is still your choice even when times are tight comes from skateboarder Sebo Walker. Walker lives in a van. When in a recent interview he was asked,
"Would you ever draw lines with sponsorship choices? Would you ride for a cigarette company or energy drinks."his answer was pretty clear,
"Nah, I don’t think that I would do that honestly. Obviously there is the money factor, it seems like the dudes that jump on those are actually making a good amount of money and are chilling. But I’m never one to ever do something just because of money. It seems weird, like the worst kind of sellout I feel like. You have to promote something that you know is not gonna be healthy or good for kids. I had an opportunity to ride for Mountain Dew – they wanted to be on the AMforce team – where Paul Rodriguez picked me out of a couple of guys. I was like 15 or something. I just ended up having to tell the lady that I couldn’t do it."Walker also shared some thoughts on what being a role model meant to him,
"Well, it’s a pretty cool position to be in, especially if you’re pro. I mean it’s almost like, anything you do, the kids will want to do .... I feel like you just have that influence and it’s pretty powerful, so you can take advantage of that and promote good things like taking good care of your body or drinking water, eating healthy, things like that. Kids are really impressionable and it’s cool to be able to have them inspired by what you do."So I'm not here to criticize Sinclair's business acumen. Instead I'm just pointing out that if you're an elite athlete who commands the admiration and respect of adoring young fans, if you then choose to use that influence to sell them sugared soda, you're no longer someone who can be considered a good role model, instead you're just a business person.
Senin, 15 Juni 2015
Health Canada Giving Food Industry Nearly 7 YEARS to Adopt New Labels!
Whether or not you think Health Canada went far enough with their nutrition fact panel reforms (I don't), if you were wondering whose side Health Canada is on when it comes to nutrition - public health's or the food industry's - their labelling reform implementation plans are telling.
According to this piece by Trish Kozicka, the food industry will be given 5 years to implement the changes. 5 years? There's really no explanation for that kind of time frame beyond pandering to industry. Though industry pandering shouldn't come as a surprise. Much as Health Canada's stated mission is,
As to why the headline reads nearly 7 years and not 5?
Kozicka explains,
According to this piece by Trish Kozicka, the food industry will be given 5 years to implement the changes. 5 years? There's really no explanation for that kind of time frame beyond pandering to industry. Though industry pandering shouldn't come as a surprise. Much as Health Canada's stated mission is,
"to improve the lives of all of Canada 's people and to making this country's population among the healthiest in the world as measured by longevity, lifestyle and effective use of the public health care system",at the end of the day Health Canada is an arm of government. That means that along with Health Canada's stated mission, are its unstated and genuine obligations to consider politics and the interests of the largest single contributor of the manufacturing sector to Canada's GDP - the food industry - when rolling out change.
As to why the headline reads nearly 7 years and not 5?
Kozicka explains,
.@YoniFreedhoff & the 5 years may not kick in for a while. @HealthCanada has 18 months after 75-day consults to publish final changes in CG2
— Trish Kozicka (@TrishKozicka) June 13, 2015
Too bad health isn't Health Canada's only concern.
Sabtu, 13 Juni 2015
Saturday Stories: Urban Gardening, Ingress, and #DistractinglySexy
Anne Raver in the New York Times with a great piece on gardening on the 3rd floor in Manhattan.
Alan Henry in Lifehacker on Ingress - the real-world Google created augmented reality smartphone game that'll up your steps and community awareness.
SE Smith in XO Jane with a fabulous roundup of #DistractinglySexy women in science (a must click if you don't already know and love the hashtag).
Alan Henry in Lifehacker on Ingress - the real-world Google created augmented reality smartphone game that'll up your steps and community awareness.
SE Smith in XO Jane with a fabulous roundup of #DistractinglySexy women in science (a must click if you don't already know and love the hashtag).
Jumat, 12 Juni 2015
Strive in Life to be Dog Number 3
Watch today's Funny Friday video to understand the headline.
Have a great weekend!
Have a great weekend!
Kamis, 11 Juni 2015
The Post Game "Snack" Local Little League Coach Hands 9 Year Old Players
Thanks to a reader who would prefer to remain anonymous up above is a photo of what her 9 year old's little league coach gave the team at the end of their game last week. 238 totally non-sating calories packed with 5.3 teaspoons of sugar that also teach kids that exercise should be rewarded with food, and/or that teeny bits of exercise require "refuelling".
Given the sheer volume of email I get about this specific topic, it makes me wonder whether or not trying to tackle the ridiculous, but wholly normalized practice of providing kids who do the teeniest bit of sport with post-game "snacks" would be better approached by trying to ban the practice league-wide? Clearly our however well-intentioned status quo at best has health-washed junk food like granola bars and juice being handed out, and at worst, like up above, frank junk. And that's not to say I think junk should be banned from fields, but rather that we require parents who want their kids to have snacks to bring them with for their kids' own use, but end post game snacks' totally unnecessary and routinized provision to the entire team.
Pretty sure that if done, the kids will still have just as much fun, and if parents are desperate to be tasked to bring something, each week one can be responsible for bringing a bag of ice for a cooler full of water.
Given the sheer volume of email I get about this specific topic, it makes me wonder whether or not trying to tackle the ridiculous, but wholly normalized practice of providing kids who do the teeniest bit of sport with post-game "snacks" would be better approached by trying to ban the practice league-wide? Clearly our however well-intentioned status quo at best has health-washed junk food like granola bars and juice being handed out, and at worst, like up above, frank junk. And that's not to say I think junk should be banned from fields, but rather that we require parents who want their kids to have snacks to bring them with for their kids' own use, but end post game snacks' totally unnecessary and routinized provision to the entire team.
Pretty sure that if done, the kids will still have just as much fun, and if parents are desperate to be tasked to bring something, each week one can be responsible for bringing a bag of ice for a cooler full of water.
Rabu, 10 Juni 2015
My Testimony to Canada's Senate Regarding Obesity and Action
This afternoon I'll be speaking with Canada's Standing Senate Committee on Social Affairs, Science and Technology, who have been tasked with examining and reporting on the rising incidence of obesity in Canada and to provide recommendations as to what to do about it. My testimony, along with the question and answer period afterwards, will be webcast and starts at 4:15pm EST.
Good afternoon. My name is Yoni Freedhoff and I’m a physician, an Assistant Professor of Family Medicine at the University of Ottawa, and I have dedicated my professional career to the study and treatment of obesity. I'm very grateful for the invitation to speak with you today.
9 years ago I had the similar opportunity to speak with the House of Commons' Standing Committee on Health who were working on a report very much like the one you’ve been tasked to produce. Their 72 page report’s recommendations, though not necessarily describable as bold, did call for action. Now, nearly a decade later, while admirably we’re still talking about obesity in Canada, action has remained a rarity.
Some cling to the notion that obesity is a problem of personal responsibility, suggesting that somehow, over the course of the past 60 years, that not just Canada but the world as a whole, has suffered an epidemic loss of willpower. They suggest that consequent to the fact that on paper obesity can be prevented by the judicious use of forks and feet, that governments need not be involved in its prevention. Yet this flood of diet and weight related illness is poised to cripple Canada’s health care system, and to date, in responding to this flood, we’ve focused on education, on public health messaging campaigns, and on calls to action designed to spur conscious, individual change. Floods aren’t well treated by way of isolated, individual change, as swimming lessons, no matter how thoughtful, well-designed, or societally embraced, won’t stem rising tides, and even the strongest swimmers get tired. That doesn’t mean people shouldn’t learn how to swim or that we shouldn’t encourage them to do so, but when there’s a flood it’s a government’s responsibility to build levees, and when it comes to this flood, I’m not sure Canada’s bothered to fill even a single sandbag.
It’s important to recognize that no single sandbag can stop a flood. That fact is perhaps part of the problem as often that truth cripples action as it allows detractors to rightfully argue, “that sandbag won’t cure or prevent obesity”. And they’re absolutely correct in their criticism. Not only will single sandbags not stop floods, but also the nature of flooding is such that it is impossible to predict which of a levee’s sandbags will prove to be the most important ones. But that truth doesn’t mean we shouldn’t be filling sandbags.
There is no shortage of potential sandbags. The rise of obesity has been consequent to dozens, if not hundreds of changes we’ve made to our environment such that now, the default for the majority of the population is weight gain. People don’t choose to gain weight. Weight gain happens consequent to a world that requires each of us, if we want to eat healthfully, to actually go out of our way to do so. It’s a world where packages of ultra-processed foods laden with hyperpalatibility’s bet you can’t eat just one’s holy trinity of salt, sugar and fat are legally allowed to brag about the fact that they also happen to contain Vitamin D, or Omega-3s, or whole grains on the fronts of their packaging, where what our children are taught in schools that they shouldn’t be regularly eating is regularly provided to them in those same schools’ cafeterias and vending machines, where the food industry is allowed to market to children, where our Food Guide is non-evidence based and if followed, might well lead a person to gain weight, and where our nutrition fact panels are so confusing and unwieldy that our government has launched not one, but now two campaigns designed to help Canadians understand how to use them.
If we want to see change we need to re-engineer our Willy Wonkian food environment such that healthful becomes the default choice, and that hyperprocessed junk food needs to be actively sought out rather than not only actively avoid but also actively provided. Though there is no consensus as to which sandbags will have the greatest impact, or which should be filled first, the ones I believe would be both beneficial and within the purview of the federal government would include:
Good afternoon. My name is Yoni Freedhoff and I’m a physician, an Assistant Professor of Family Medicine at the University of Ottawa, and I have dedicated my professional career to the study and treatment of obesity. I'm very grateful for the invitation to speak with you today.
9 years ago I had the similar opportunity to speak with the House of Commons' Standing Committee on Health who were working on a report very much like the one you’ve been tasked to produce. Their 72 page report’s recommendations, though not necessarily describable as bold, did call for action. Now, nearly a decade later, while admirably we’re still talking about obesity in Canada, action has remained a rarity.
Some cling to the notion that obesity is a problem of personal responsibility, suggesting that somehow, over the course of the past 60 years, that not just Canada but the world as a whole, has suffered an epidemic loss of willpower. They suggest that consequent to the fact that on paper obesity can be prevented by the judicious use of forks and feet, that governments need not be involved in its prevention. Yet this flood of diet and weight related illness is poised to cripple Canada’s health care system, and to date, in responding to this flood, we’ve focused on education, on public health messaging campaigns, and on calls to action designed to spur conscious, individual change. Floods aren’t well treated by way of isolated, individual change, as swimming lessons, no matter how thoughtful, well-designed, or societally embraced, won’t stem rising tides, and even the strongest swimmers get tired. That doesn’t mean people shouldn’t learn how to swim or that we shouldn’t encourage them to do so, but when there’s a flood it’s a government’s responsibility to build levees, and when it comes to this flood, I’m not sure Canada’s bothered to fill even a single sandbag.
It’s important to recognize that no single sandbag can stop a flood. That fact is perhaps part of the problem as often that truth cripples action as it allows detractors to rightfully argue, “that sandbag won’t cure or prevent obesity”. And they’re absolutely correct in their criticism. Not only will single sandbags not stop floods, but also the nature of flooding is such that it is impossible to predict which of a levee’s sandbags will prove to be the most important ones. But that truth doesn’t mean we shouldn’t be filling sandbags.
There is no shortage of potential sandbags. The rise of obesity has been consequent to dozens, if not hundreds of changes we’ve made to our environment such that now, the default for the majority of the population is weight gain. People don’t choose to gain weight. Weight gain happens consequent to a world that requires each of us, if we want to eat healthfully, to actually go out of our way to do so. It’s a world where packages of ultra-processed foods laden with hyperpalatibility’s bet you can’t eat just one’s holy trinity of salt, sugar and fat are legally allowed to brag about the fact that they also happen to contain Vitamin D, or Omega-3s, or whole grains on the fronts of their packaging, where what our children are taught in schools that they shouldn’t be regularly eating is regularly provided to them in those same schools’ cafeterias and vending machines, where the food industry is allowed to market to children, where our Food Guide is non-evidence based and if followed, might well lead a person to gain weight, and where our nutrition fact panels are so confusing and unwieldy that our government has launched not one, but now two campaigns designed to help Canadians understand how to use them.
If we want to see change we need to re-engineer our Willy Wonkian food environment such that healthful becomes the default choice, and that hyperprocessed junk food needs to be actively sought out rather than not only actively avoid but also actively provided. Though there is no consensus as to which sandbags will have the greatest impact, or which should be filled first, the ones I believe would be both beneficial and within the purview of the federal government would include:
- Revising Canada’s Food Guide and mandating its regular reassessment
- Joining the rest of the G8 nations and establishing a national school food program that includes the integration of curriculum designed to teach children about nutrition, food and healthful cooking.
- Banning the marketing of all food to children.
- Mandating the provision of contextualized calories on menu boards of chain restaurants, coffee shops, movie theatres, etc.
- Effecting nutrition fact panel reform so as to utilize realistic and standardized serving sizes, decrease confusion and ambiguity, identify added sugars, and include whole package caloric information.
- Effecting front-of-package health claim reform so as to disallow the use of nutrient based health claims and promotions.
- Adopting a rigorous, engaging, and evidence-based national front of package nutrition guidance label (eg. The UK’s stoplight system and/or Nuval)
- Taxing sugar-sweetened beverages.
- Subsidizing fresh fruits and vegetables.
Selasa, 09 Juni 2015
A Large Swath of Nutrition Research is Based On Lies
A Sample Completed Memory Based Dietary Assessment (Not Mine) |
In a paper published today in Mayo Clinic Proceedings, Edward Archer and colleagues thoroughly review the futility of memory-based dietary assessments, and while I don't share Archer's overarching belief that the bulk of obesity is explicable on the basis of maternal obesity's impact on developing fetuses, or his contrarian viewpoint that diet is not a major risk factor for disease, his paper does an admirable job of destroying the notion that 24-hour dietary recalls and food frequency questionnaires (FFQs) are useful.
Before getting to the meat of the paper, back to Archer's assertion that diet is not a major risk factor for disease. To illustrate that point Archer notes,
"This hypothesis is supported by multiple lines of evidence, such as a 40% decline in the age-adjusted mortality rate from 1969 to 2010, a progressive decades long reduction in age-adjusted cardiovascular disease incidence and mortality, and a 1.5% per annum reduction in age adjusted mortality rates from all major cancers as well as significant reductions in lung cancer incidence in men and women between 2001 and 2010."Given that cigarette smoking has decreased dramatically in that same time period (see graph below),
and the fact that smoking is America's number one cause of death and lung cancer, and is a major cause of cardiovascular disease, that rather than point to smoking cessation as the improvements' probable cause, he instead suggests, absent of any pathophysiological explanation or hypothetical mechanism, that the standard American diet is responsible for the observed decrease in death and lung cancer, is plainly bizarre. All the more so when considering the impact the introduction of Westernized diets have been seen to have on non-communicable disease risks in populations the world over.
That aside (and truly, I wish it weren't part of the paper as it detracts from its impact), the paper's a worthwhile read. With an expansive review of the literature, Archer explains not only how far off the mark dietary recall is (up to 80% of some recall studies include dietary patterns that are "physiologically implausible"), but why, covering studies that explain how,
"24hr and food frequency questionnaires can be most accurately defined as mere attributions based on mental experiences that are strongly influenced by the respondents' idiosyncratic qualities (ie, education), previous memories and information, knowledge and beliefs, motives, goals, habitual behavior, and the social context in which the memories are encoded or reported."He also asserts that the design of memory based dietary assessments itself inspires false reporting and posits that,
"it is not a question of whether FFQs induce false reporting, but to what extent".Finally Archer discusses the criteria for scientific research and he suggests that memory based dietary assessments are,
"akin to creation science in that they fail to meet the basic requirements of scientific research"in that they are not independently observable or measurable (reporting you've eaten an apple, and how much of that apple you ate, isn't the same as having your apple eating independently observed and the amount of apple you consumed measured), they are easily and regularly falsified, they lack validity, and they are unreliable. This leads Archer to call the discipline of nutrition epidemiology "pseudoscience", stating that,
"when a person provides a dietary report, the data collected are not actual food or beverage consumption, but rather an error prone and highly edited anecdote regarding memories of food and beverage consumption"and hence,
"do not meet the basic requirements of the scientific method and, by definition, are pseudoscientific when presented as actual estimates of energy or nutrient consumption."Notwithstanding the non-evidence based ease with which Archer dismisses the potential impact of diet on health, this paper soundly illustrates the need for the rapid development and adoption of an objective means to track dietary choices - something the technologies of today are well suited to provide.
Senin, 08 Juni 2015
Sabtu, 06 Juni 2015
Saturday Stories: Steve Prefontaine, Dave Sackett, and Andrew Jennings
Mary Pilon in Grantland on the last run of Steve Prefontaine.
Iain Chalmers and Andrew Oxman at Cochrane pay tribute to the late and truly great Dave Sackett.
Michael Miller in The Washington Post on how Andrew Miller, a curmudgeonly old journalist, brought down FIFA.
And also the nameless. Please take the time to watch this spectacular visualization of both war and peace throughout history - it's time very well spent.
Iain Chalmers and Andrew Oxman at Cochrane pay tribute to the late and truly great Dave Sackett.
Michael Miller in The Washington Post on how Andrew Miller, a curmudgeonly old journalist, brought down FIFA.
And also the nameless. Please take the time to watch this spectacular visualization of both war and peace throughout history - it's time very well spent.
Jumat, 05 Juni 2015
Unconscious People Don't Want Tea
Thanks to Leah Dagenais for sending this week's Funny Friday video...though it's not actually funny in the usual Funny Friday way. No, this video's far sadder than it is funny. I wish the world wasn't the sort of place that made a video like this one worth sharing.
Have a great weekend.
Have a great weekend.
Kamis, 04 Juni 2015
Cookbook Review: Save with Jamie: Shop Smart, Cook Clever, Waste Less
Today's cookbook review comes from our office's stellar RD Rob Lazzinnaro, and for disclosure, Rob chose on his own volition to take Jamie's book out from the library and I asked him if he wouldn't mind writing a review.
Save with Jamie: Shop Smart, Cook Clever, Waste Less
Jamie Oliver is not only a talented chef but also one of the most outspoken ambassadors for home cooking, healthy eating and getting healthy food into schools. Recent example being his petition fighting for food education and his creation of the food revolution day and campaign. Jamie’s many television shows and campaigns around food in school and getting folks in the kitchen are inspirational, and his first cookbook back in 2000,The Naked Chef, even helped me to tackle new recipes outside of my comfort zone for the first time. More recently, with his good friend Gennaro Contaldo, he helped me rediscover some Italian classics that I had eaten frequently as a child. You can imagine my excitement when I ran across his book Save with Jamie, which was published a couple of years ago, while looking for cookbooks with budget in mind. All praise aside: I promise to do my best to review this cookbook as I do any other, without bias and guided by the four questions I ask in reviewing any cookbook.
1.Are nutrition facts included?
The calorie count per serving is indicated in clear view beside each recipe, as well the book has a five page rundown in the index of the fat, saturated fat, carbohydrates, and sugar for all of the book's recipes. I would have appreciated to see protein, fiber and sodium in the rundowns as they are key when choosing a well balanced recipe. *p.s. Jamie, if you need a consultant for your next book you know who to contact.
2. Are the recipes accessible and well balanced?
Absolutely! The general theme of the book is how to save by cooking in batch, cooking with cheaper proteins, using your freezer, and using every last bit of any food item. I give preference to recommending recipes that have a good balance of healthy protein, carbs/fiber, and fats which most of Jamie's dishes achieve. It is worth noting that some recipes may be too calorically dense to be eaten regularly, but all depending on your caloric requirements of course.
3. Is it free from nutrition myths and non-evidence based diet recommendations?
It is very important to me that any book providing nutritional recommendations beyond nutrient breakdowns try to do so through a nutrition professional. The author/chef may have good intentions but their advice needs to be guided by evidence. What I love about Jamie’s cookbooks and his general brand is that he focuses on what he does best which is creating delicious and accessible meals, the healthy aspect is that you cooked it yourself from scratch. He does not preach about certain diets or health fads; refreshing. The cookbook sticks to basic cost savings, stretching ingredients, using every last scrap, meal prep & storage, and delicious recipes.
4. Are the recipes engaging and delicious?
Absolutely! This is of course where Jamie’s cookbooks shine. All of the recipes have very beautiful and enticing photographs with easy to follow instructions. In Save with Jamie, he essentially pulls and then re creates classically delicious comfort dishes from around the world, which makes for one of his most culturally diverse cookbooks to date.
I highly recommended this cookbook as it is a stand out in Jamie’s Collection.
To buy your own copy, here is an Amazon Associates link from Canada (looks like the US stock is gone)
Save with Jamie: Shop Smart, Cook Clever, Waste Less
Jamie Oliver is not only a talented chef but also one of the most outspoken ambassadors for home cooking, healthy eating and getting healthy food into schools. Recent example being his petition fighting for food education and his creation of the food revolution day and campaign. Jamie’s many television shows and campaigns around food in school and getting folks in the kitchen are inspirational, and his first cookbook back in 2000,The Naked Chef, even helped me to tackle new recipes outside of my comfort zone for the first time. More recently, with his good friend Gennaro Contaldo, he helped me rediscover some Italian classics that I had eaten frequently as a child. You can imagine my excitement when I ran across his book Save with Jamie, which was published a couple of years ago, while looking for cookbooks with budget in mind. All praise aside: I promise to do my best to review this cookbook as I do any other, without bias and guided by the four questions I ask in reviewing any cookbook.
1.Are nutrition facts included?
The calorie count per serving is indicated in clear view beside each recipe, as well the book has a five page rundown in the index of the fat, saturated fat, carbohydrates, and sugar for all of the book's recipes. I would have appreciated to see protein, fiber and sodium in the rundowns as they are key when choosing a well balanced recipe. *p.s. Jamie, if you need a consultant for your next book you know who to contact.
2. Are the recipes accessible and well balanced?
Absolutely! The general theme of the book is how to save by cooking in batch, cooking with cheaper proteins, using your freezer, and using every last bit of any food item. I give preference to recommending recipes that have a good balance of healthy protein, carbs/fiber, and fats which most of Jamie's dishes achieve. It is worth noting that some recipes may be too calorically dense to be eaten regularly, but all depending on your caloric requirements of course.
3. Is it free from nutrition myths and non-evidence based diet recommendations?
It is very important to me that any book providing nutritional recommendations beyond nutrient breakdowns try to do so through a nutrition professional. The author/chef may have good intentions but their advice needs to be guided by evidence. What I love about Jamie’s cookbooks and his general brand is that he focuses on what he does best which is creating delicious and accessible meals, the healthy aspect is that you cooked it yourself from scratch. He does not preach about certain diets or health fads; refreshing. The cookbook sticks to basic cost savings, stretching ingredients, using every last scrap, meal prep & storage, and delicious recipes.
4. Are the recipes engaging and delicious?
Absolutely! This is of course where Jamie’s cookbooks shine. All of the recipes have very beautiful and enticing photographs with easy to follow instructions. In Save with Jamie, he essentially pulls and then re creates classically delicious comfort dishes from around the world, which makes for one of his most culturally diverse cookbooks to date.
I highly recommended this cookbook as it is a stand out in Jamie’s Collection.
To buy your own copy, here is an Amazon Associates link from Canada (looks like the US stock is gone)
Rabu, 03 Juni 2015
A Question You Might Want Ask Yourself More Often
"What would I tell my best friend?"
Working for the past 12 years to help people affect lifestyle changes, I'm still regularly amazed by how hard on themselves people are.
We all fall down. Considering whether or not your personal internal castigation is fair or not is important to the long-term likelihood of your success as if you regularly, unfairly, kick yourself when you're down, you're less likely to ever bother getting back up.
If you find the question confusing, or its implementation challenging, the next time you get down on yourself for some sort of lack of follow through imagine the counsel you would provide to your best friend or closest loved one if they found themselves in your exact situation.
My guess is that you'd be terrific at actively encouraging your loved one to look for the positive, and in so doing, increase your loved one's likelihood of getting back up.
You deserve to treat yourself with just as much love and respect as you treat those to who you are closest.
Are you treating yourself fairly?
Working for the past 12 years to help people affect lifestyle changes, I'm still regularly amazed by how hard on themselves people are.
We all fall down. Considering whether or not your personal internal castigation is fair or not is important to the long-term likelihood of your success as if you regularly, unfairly, kick yourself when you're down, you're less likely to ever bother getting back up.
If you find the question confusing, or its implementation challenging, the next time you get down on yourself for some sort of lack of follow through imagine the counsel you would provide to your best friend or closest loved one if they found themselves in your exact situation.
My guess is that you'd be terrific at actively encouraging your loved one to look for the positive, and in so doing, increase your loved one's likelihood of getting back up.
You deserve to treat yourself with just as much love and respect as you treat those to who you are closest.
Are you treating yourself fairly?
Selasa, 02 Juni 2015
Relentless Environmental Junk Food Tide Drowns Obesity Conference Menu
They tried. I know they tried. I know they tried because our office's RD Rob Lazzinnaro was on the food committee for the recent Canadian Obesity Network's (CON) Summit.
Not only did the food committee work with the hotel to ensure the mains were healthful, they also had some simple instructions. No liquid calories, and no junk food.
So what happened?
Well, on the first day right next to the sign from CON about eliminating liquid calories was a bowl of cinnamon churros.
Juice, and not just juice but ridiculously leanwashed sugar bombs by Odwalla were present at most workshops. And along with lunch on at least one of the days came a bag of Doritos.
A few weeks later and Rob was now battling the provision of muffins at a public health event meant to promote healthful eating for kids. The muffins suddenly appeared on the already agreed upon menu when a food service provider offered to provide them free of charge. For most intents and purposes commercial muffins are more fairly describable as cupcakes, and certainly their provision at this even would continue to perpetuate the notion that somehow cupcakes without icing are healthful choices. What was striking wasn't simply that one of the health professionals organizing the event gave the muffins an "ok", but that when Rob brought up his concerns, he was faced with indifference from his colleague.
Society's normal is junk food. It's the default. It's a tide. It's difficult to stop the tide. But we'll keep trying.
Not only did the food committee work with the hotel to ensure the mains were healthful, they also had some simple instructions. No liquid calories, and no junk food.
So what happened?
Well, on the first day right next to the sign from CON about eliminating liquid calories was a bowl of cinnamon churros.
Thrilled the @CanObesityNet not providing liquid calories at #COS15. Maybe next year we can tackle the churros? pic.twitter.com/EH8uyqf4xV
— Yoni Freedhoff, MD (@YoniFreedhoff) April 28, 2015
Juice, and not just juice but ridiculously leanwashed sugar bombs by Odwalla were present at most workshops. And along with lunch on at least one of the days came a bag of Doritos.
@YoniFreedhoff was only gone for a few hours when the muffins and doritos came out at #COS15 ;) pic.twitter.com/V2TlK6IOyo
— Ashley Hurley RD (@AshleyHurleyRD) May 1, 2015
Having helped to organize a conference myself a few years ago, we experienced the same phenomenon. We had very explicit instructions around soft drinks and juice, and yet, despite those explicit instructions, in 2 of the 3 venues for our travelling road show, out the soft drinks and juice came. A few weeks later and Rob was now battling the provision of muffins at a public health event meant to promote healthful eating for kids. The muffins suddenly appeared on the already agreed upon menu when a food service provider offered to provide them free of charge. For most intents and purposes commercial muffins are more fairly describable as cupcakes, and certainly their provision at this even would continue to perpetuate the notion that somehow cupcakes without icing are healthful choices. What was striking wasn't simply that one of the health professionals organizing the event gave the muffins an "ok", but that when Rob brought up his concerns, he was faced with indifference from his colleague.
Society's normal is junk food. It's the default. It's a tide. It's difficult to stop the tide. But we'll keep trying.
Senin, 01 Juni 2015
If You Perceive Exercise to Be a Misery, You Might Eat More When Done
"Because I exercised"
3 words that sink weight loss efforts and lead to the consumption of many a yummy treat.
Who out there hasn't felt like they deserved some dietary loving following a righteous sweat session, and a simple study out of Germany published last year concluded that you're even more likely to eat back your exercise if your gym equipment tells you that your exercise was in the "fat burning zone". But there was this weird catch.
The study randomly assigned participants to ride on bike trainers where half rode with a sign in front of them highlighting their ride was part of an experiment to develop training software for the "fat burning zone", while the other half, doing the same amount and intensity of riding, rode with a sign in front of them highlighting their part in an experiment to develop training software for "endurance".
At the end of their rides all riders were offered pretzels and water.
The "fat burning zone" riders, and here's the weird catch, varied in their response to the signage.
Riders who reported high levels of fatigue and distress ate more pretzels in the "fat burning zone" treatment than riders reporting fatigue and distress in the "endurance" treatment UNLESS they reported having enjoyed their exercise whereupon riders who reported enjoying their exercise, ate fewer pretzels in the so-called "fat burning zone" than "endurance".
Now putting aside the fact that "fat burning zones" are BS that should simply be ignored, and that exercise is for health, not weight, for me this study reinforced the importance of finding an exercise that you enjoy, because if exercise is perceived by you to be a misery, it would follow you'll be more likely to feel like you earned a reward "because you exercised" - a hypothesis that this paper suggests has merit.
3 words that sink weight loss efforts and lead to the consumption of many a yummy treat.
Who out there hasn't felt like they deserved some dietary loving following a righteous sweat session, and a simple study out of Germany published last year concluded that you're even more likely to eat back your exercise if your gym equipment tells you that your exercise was in the "fat burning zone". But there was this weird catch.
The study randomly assigned participants to ride on bike trainers where half rode with a sign in front of them highlighting their ride was part of an experiment to develop training software for the "fat burning zone", while the other half, doing the same amount and intensity of riding, rode with a sign in front of them highlighting their part in an experiment to develop training software for "endurance".
At the end of their rides all riders were offered pretzels and water.
The "fat burning zone" riders, and here's the weird catch, varied in their response to the signage.
Riders who reported high levels of fatigue and distress ate more pretzels in the "fat burning zone" treatment than riders reporting fatigue and distress in the "endurance" treatment UNLESS they reported having enjoyed their exercise whereupon riders who reported enjoying their exercise, ate fewer pretzels in the so-called "fat burning zone" than "endurance".
Now putting aside the fact that "fat burning zones" are BS that should simply be ignored, and that exercise is for health, not weight, for me this study reinforced the importance of finding an exercise that you enjoy, because if exercise is perceived by you to be a misery, it would follow you'll be more likely to feel like you earned a reward "because you exercised" - a hypothesis that this paper suggests has merit.
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