Saturday, October 22, 2016

Saturday Stories: Illness Metaphors, Tramadol, and Solitude

Louise Kinross in The Walrus on how serious illness should never be framed as a battle, especially not for children.

Justin Scheck in The Wall Street Journal on the damage being done by Tramodol in the developing world.

Donald Hall in The New Yorker with his beautifully written first person account of solitude.

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Friday, October 21, 2016

I Never Knew You Could Eat Shoelaces Either

Today's Funny Friday involves Jimmy Kimmel, $14 shoes, and some people who really love Kanye.

Watching it I couldn't help but consider it in the context of this election. Blind faith is one powerful drug.

Have a great weekend!

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Wednesday, October 19, 2016

What Is It About Cows That Makes The Word "Heifer" An Insult?

On Monday I wrote about how no one seemed to notice or care about the use of the term "heifer" as an insult in a story that went viral on Facebook.

That led to a whole pile of hoopla which, putting aside some of the more unhinged outrage and misrepresentation, ultimately boiled down to: that the term might not have been meant as a weight related slur, and/or that the flight attendant on its receiving end wasn't fat, and/or that really, who cares, she was upset and so it was justified.

Despite the fact that I've never seen or heard the term heifer used for purposes other than fat shaming (see for example the usage I'm accustomed to here and here from past also gone viral stories), and that all the various urban dictionaries and definitions online state that heifer is a pejorative term for a woman with obesity, it's of course possible that in this circumstance it wasn't meant as a weight related insult but rather as a general slur, and that heifer has become a term that some use in place of "bitch".

Which in turn speaks to the point I was making which is that we're so accustomed and innured to weight related insults, jokes, and judgement, that derisive terms with clear relationships to appearance and weight have become entrenched and even defended as being acceptable parts of our general vocabulary and vernacular regardless of whether or not they're marginalizing to an undeniably and regularly discriminated against population.

And where exactly do people think the pejorative part of the term comes? Is there something else obvious and well known about cows, besides their size and seeming laziness, to serve the general public as the word heifer or cow's driver of scorn?

Heifer or cow, wielded as an insult, regardless of intent, furthers the gluttonous, stubborn, lazy, narrative of obesity, and so yes, I'm going to continue to call it out, and that me doing so apparently upsets people, speaks directly to why doing so is worthwhile.

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Monday, October 17, 2016

Black Doctor Recounts Blatant Racism, Spreads Blatant Weight Bias

By now you've probably already heard the story about Dr. Tamika Cross. She's a 4th year medical resident at the University of Texas Health Science Centre and she was on a flight when she tried to answer an overhead ask for an onboard physician to tend to an in-flight medical emergency. Instead of her help being welcomed, she was dismissed by some combination of racism and sexism as the flight crew would not believe that she, a black woman, was a physician.

She wrote up her undeniably awful experience on Facebook and the post went viral and at least at the time of me writing this, has been shared over 45,000 times, has received over 130,000 reactions, and has inspired the awesome #WhataDoctorLooksLike hashtag on Twitter.

The story was picked up by dozens of media outlets including The Washington Post, The New York Times, The Guardian, but missing in all of their coverage was the term Dr. Cross used to describe the flight attendant.

She called her a heifer.

Weight bias is a real social justice issue. Briefly, weight bias has proven medical and psychological consequences, it has been shown to reduce a person's earning potential, affect their hiring and advancement opportunities, and restricts their academic advancement (click the link if you don't believe me). Weight bias is also now the number one cause of schoolyard bullying.

Consider for a moment this same story but instead of stating,
"Then this heifer has the nerve to ask for my input on what to do next about 10 mins later",
Dr. Cross had said,
"Then this kike has the nerve to ask",
"this chink",
"this wop".
Would the story have had the same pickup? Or would the story have even been picked up at all?

I have yet to read a single piece about Dr. Cross' blatantly racist treatment mention her use of the term heifer which in turn speaks to just how normal and acceptable weight bias is. Moreover, that a person who was blatantly judged on the basis of her appearance, who notes in her own post that blatant discrimination on any grounds is "not right", calmly wields a derogatory appearance based slur as if it's no big deal, shows just how far society still has to go on this very real issue.

Racism and sexism are inexcusable. Weight bias should be too.

[For more on the realities of weight bias, please consider a tour around the Rudd Centre's Weight Bias and Stigma page]

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Saturday, October 15, 2016

Saturday Stories: Rape Silence, Chemical Weapons, and ICU Delirium

Lauren McKeon in Toronto Life on her 15 years of silence when it came to her 3 rapes.

The Associated Press with a terrifying story of how $3,000 buys a person a deadly chemical weapon that could kill thousands.

Usha Lee McFarling in Stat on ICU delirium (I've seen it, it's awful)

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Friday, October 14, 2016

Watch This To See If You're An "Entitled Testosterone Monster"

Today's Funny Friday, where Samantha Bee covers the Billy Bush Trump tapes and more, isn't safe for work or watching around young kids. And that's an amazing statement given it's a story, albeit by a late night comic host, about an actual presidential candidate. No doubt it's more horrifying than funny, but do watch it - she's awesome.

Have a great weekend.

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Thursday, October 13, 2016

If Health Canada Won't List Free Sugars, These Frustrated Researchers Will

Today's guest post comes from PhD candidate and RD Jodi Bernstein. The post covers her, and her supervisor Dr. Mary L'Abbe, the University of Toronto's Earle W. McHenry Professor and Chair Department of Nutritional Sciences', continued push for Health Canada to require free sugars to be included on Canada's nutrition fact panels.
The World Health Organization recommends that we limit free sugar intakes to a maximum 10% of calories a day. But there are many factors that hinder our ability to abide by these guidelines, far more than support it. First of all, it’s pretty difficult to picture what 10% of calories looks like. Sure I can tell you that for the average adult it’s about 50g or 12 teaspoons, but would that really help you all that much? Most of the free sugar we eat is coming from inside candies and sweets, cereal, beverages, and baked goods, so we can’t easily see how much free sugar is in the food. To abide by the World Health Organization’s recommendations, free sugar needs it to be included on the nutrition facts table.

The United States is planning to include the amount of added sugar (similar to free sugar) on their food label. But here in Canada, the latest proposal to change the nutrition label did not include free sugar on the label. In fact, we discussed the importance of including added sugar on Canada’s nutrition label in a previous blog post on Weighty Matters.

But in the meantime, we weren’t about to just sit around and wait. In light of this difficult predicament we took it upon ourselves to calculate the free sugar content of over 15,000 Canadian packaged foods and beverages, published it for open-access use, and found some interesting results along the way. Using the University of Toronto’s Food Label database, which has nutritional and ingredient information, we calculated the amount of free sugar in each product using a 6-step algorithm tailored for just this purpose. Here’s what we found:
  1. A lot of foods have free sugar in them. Sixty-five percent to be exact. That means its probably harder to find a packaged food that doesn’t contain free sugars, although the proportion was a lot lower in certain food groups like vegetables, nuts and seeds, dairy products and cereals and grains and highest in desserts, sugars and sweets, and bakery products.
  2. Free sugar accounts for 62% of total sugar. Although this was much higher for sweets, bakery products, desserts, and beverages and much lower for fruits and vegetables.
  3. There is a wide range of free sugar in a food category. This means two things: 1) when choosing a product, there may be a similar one that has less free sugar available; and 2) successful reformulation is possible. Having similar items, some with less free sugar, acts as proof showing that, yes, this food can be made with less free sugar and consumers will still buy it!
  4. There are 152 ways to say “free sugar” in the Ingredient List. It’s no wonder free sugar is considered a “hidden” source of calories. For instance, ‘table sugar’ was listed 40+ ways including all dehydrated, dried, granulated, concentrated, refined, coarse, evaporated, solid, powdered, and liquid variants of cane juice, sugar, and sucrose.
  5. 1/5 of total calories come from free sugar. Of course this ranged between food groups, with the highest at 70% of calories coming from free sugar in beverages. Consuming foods that have more than 10% of calories from free sugar increases the likelihood of exceeding dietary recommendations.
We are hopeful that these results will support of interventions and policies (including labelling free sugar on the nutrition label!) to limit excess free sugar consumption. The detailed information we provided in this study can be used as a benchmark to monitor changes in free sugar contents overtime, identify areas and targets to focus reformulation efforts, direct educational messages, and can be linked to national nutrition surveys to evaluate free sugar consumption and monitor associated health outcomes.

Jodi Bernstein is a Registered Dietitian and has a Master’s in Public Health, specializing in community nutrition. She is currently a PhD Candidate in the Department of Nutritional Sciences at the University of Toronto. Her thesis focuses on sugars in the Canadian food environment.

Most recently, Jodi has developed an algorithm to estimate the free sugars contents of Canadian food and beverages. Results have since been used to populate One Sweet App, a mobile app that allows users to track their free sugars intakes and compare this to guidelines from the World Health Organization.

Dr. Mary L’Abbé is the Earle W. McHenry Professor and Chair of the Department of Nutritional Sciences, Faculty of Medicine, at the University of Toronto, where she leads a research group on Food and Nutrition Policy for Population Health. Dr. L’Abbé is an expert in public health nutrition, nutrition policy, and food and nutrition regulations, with a long career in in mineral nutrition research. Her research examines the nutritional quality of the Canadian food supply, food intake patterns, and consumer research on food choices related to obesity and chronic disease.

Dr. L’Abbé a member of several committees of the WHO including the Nutrition Guidance Expert Advisory Group on Diet and Health and the Global Coordinating Mechanism for NCDs; the former which recently released the WHO Guidelines on Sugars. Dr. L’Abbé was co-chair of the Canadian Trans Fat Task Force, led the Trans Fat Monitoring Program and served as Chair and vice-Chair of the Canadian Sodium Working Group. Before joining the University of Toronto, Dr. L’Abbe was Director, Bureau of Nutritional Sciences at Health Canada. Dr. L’Abbé holds a PhD in nutrition from McGill University and has authored over 180 peer-reviewed scientific publications, book chapters and government reports.

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Tuesday, October 11, 2016

New Canadian Senate Bill Calls For a Ban on Marketing Food to Kids

It's shocking that we allow anything to be advertised to young children, but its doubly shocking we allow "food" to be advertised to them. I put the word food in scare quotes because frankly given what's generally advertised to children, calling it food is generous. Sure it's technically consumable, but it's far from healthy fare. Here in Canada, and the world around, the foods advertised to children (and adults too I might add) are unsurprisingly dominated by the food industry's profit drivers - ultra-processed foods laden with salt, sugar, and/or fat, because it's not the food industry's job to promote healthy eating, it's the food industry's job to profit.

The thing is, times have changed. Whereas when I watched the Kool Aid Man crash through walls during commercials running through Saturday morning cartoons, today's kids are watching far more sophisticated commercials running nearly 24/7 on multiple media platforms. Worse, the kids who are watching today's advertising are developing chronic, non-communicable, diet-related diseases that when I went to medical school were only found in adults.

And don't kid yourself into thinking that marketing doesn't matter. While there are some who like to suggest that kids are, or with brief teaching can be made, media literate and that presumably the food industry is simply wasting literally billions of dollars on marketing that's just window dressing, the evidence states otherwise. Children who see advertisements are more likely to prefer branded foods, especially those high in sugars and fats, and that those advertisements lead kids to eat more of them. , and more food in general (including foods not being advertised). And in a study published recently, researchers suggested that food marketing to kids may alter the psychological and neurobiologic mechanisms of children's food decisions leading the researchers to state,
"Food commercials may prompt children to consider their liking and wanting of specific food items, irrespective of the lack of any health benefits. This increased emphasis on taste may make it even more difficult for relevant caregivers to encourage healthy food choices."
So with all of that in mind I can't tell you how pleased I am that The Honourable Nancy Greene Raine has introduced a bill in Canada's Senate that if passed would prohibit marketing of all food and beverages to children under the age of 13.

There really aren't any arguments to support the food industry's current advertising practices. Capitulating to the food industry by supporting the current status quo isn't about freedom of speech. Freedom of speech shouldn't extend to preying on our most precious, and vulnerable population.

Please consider voicing your support by clicking here and signing up to encourage your MP to support this bill.

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Friday, October 07, 2016

Sometimes You Just Need a Little Silly to Start Your Day

And if that's you today, here's Joaquin Phoenix' forehead.

Just watch it.

Have a great weekend!

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