Tuesday, August 23, 2016

Ugh, McDonald's Hands Out Activity Tracker With Happy Meals

Though they only lasted a single day, it wasn't public cynicism over McDonald's latest scheme to excuse eating there that sunk them, it was skin rashes that ended their Happy Meal provision of fitness trackers.

But I bet they'll be back.

It's great business for the food industry to state directly (like Coca-Cola's Global Energy Balance briefly tried to) or indirectly that exercise excuses (or balances) a crappy diet.

Though exercise is the world's best drug, as I've noted, it's not a weight loss drug, and though exercise absolutely mitigates the risks of both weight and likely diet too, that McDonald's believes fitness trackers to be a Happy Meal draw is worrisome.

It's worrisome because McDonald's belief that kids and their parents would see the activity trackers as both incentive and permission to eat there suggests that society is well and fully bought into the notion that exercise trumps diet.

So too does the much lauded scheme floated a few months ago that foods fronts-of-packages be festooned with "activity equivalent labeling".

And this photo of an advertisement from a local community centre that I took just 2 days ago.
"HAVE YOUR CAKE AND EAT IT TOO! (We'll help you work it off!)"
Listen, for most of us (me included), life includes some junk food, but all this to say, I worry about the potential unintended consequences of continuing to dumb down exercise to calories burned as the one thing people today don't need are more reasons to believe that they deserve a break today.

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Saturday, August 20, 2016

Saturday Stories: Running Women, Putin, and Farts

Meghan Kita in Runners World explains that the problem isn't women running alone.

David Satter in National Review on how terrorism brought Putin to power.

Maggie Koerth-Baker in FiveThirtyEight answers the age old question of how big a fart is.

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Friday, August 19, 2016

Did You Miss The Greatest Interview of the Rio Olympics?

If you didn't see this chat with two fantastic Irish rowers then yes, yes you did miss Rio's greatest interview.

Today's Funny Friday video is here to fix that for you.

Have a great weekend!

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Thursday, August 18, 2016

We're Giving Away 5 Free Spots for Our Office's New Distance Program!

It's been over a dozen years since we opened our weight management office.

In that time we have worked with literally thousands of patients and while they were each unique and had their own sets of medical concerns and life challenges, they did share one thing in common - they all lived in or near to Ottawa.

In the beginning, that was a necessity. The technology to work with patients remotely simply didn't exist.

I'm thrilled to report that it does now.

For the past few months we've been working with a smartphone app that lets us reach our patients even when they're not sitting in front of us. The app allows us to create customizable and trackable goals that we can monitor remotely (and reach out if we see someone's struggling), and more importantly, the app provides two-way communication - both by way of quick text messages, but also by way of video conferencing, between patients and our office's professionals. While so far we've pretty much only been using the app with our Ottawa based patients, we're about to open our virtual doors and in so doing, use the app to work with anybody, anywhere.

We've designed a 12 week program that will be delivered by our office's registered dietitians to help people with their weight loss and behavioural change goals (and once formally launched, there'll be ongoing support options available once completed). During those 12 weeks people will have regular videoconferences with our RDs and work with them on creating personal goals that are designed to target each individual's specific needs, concerns, and barriers. They will also have access to our RDs by way of the app supported (and both PHIPA and HIPAA compliant) text messaging for quick questions and words of support.

While we will soon offer access to this program to everyone, right now we're looking for 5 volunteers to work through our new program with us and help us iron out the kinks in its delivery. In return for our best efforts to help you achieve your Best Weight, we’re looking for individuals who are comfortable giving us honest feedback on what’s helpful in our program and just as importantly what’s not.

Because the supporting program curriculum is still being developed (videos and articles that will accompany the 12 weeks and serve as offline resources) there is the requirement that those interested own and read my book The Diet Fix: Why Diets Fail and How to Make Yours Work as it will serve in the offline course curriculum's stead. As well, for the beta-testers only, we need to restrict the offer to those with iPhones as we’re still working out some of the issues with the Android operating system.

If you're interested in being considered as a beta-tester, please send us a letter telling us a bit about you and your history with weight loss (please limit the letter to no more than 400 words), and in 2 weeks we'll contact those who our RDs select. We're looking for divergent people and issues and consequently can't simply take the first 5 people who write. That said, if you do write in and you're not selected, we'll be sure to put your name in the queue for when our program formally launches and make sure you’re at the top of the list.

Please send your emails to distance@bmimedical.ca.

We're so excited to be rolling this out!

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Tuesday, August 16, 2016

Will Personalized Genetic Risk Knowledge Lead People to Change Their Diets?

Image Source: ThinnerGene
Certainly that's the notion behind the rise of the for-profit personalized medicine genetic testing industry. The thinking is that if people are made aware of their personalized genetic risks, and if those risks are modifiable by way of diet, that said knowledge will motivate people to affect dietary changes.

But does it?

That's the question a recently published randomized trial sought to answer. The study, The effect of the apolipoprotein E genotype on response to personalized dietary advice intervention: findings from the Food4Me randomized controlled trial, randomly assigned 1,466 participants to a 6 month trial of one of 4 interventions.

1. Standard non-personalized dietary and physical activity advice
2. Personalized advice based on dietary intake
3. Personalized advice based on dietary intake, physical activity, and standard blood biomarkers
4. Personalized advice based on dietary intake, physical activity, standard blood biomarkers, and genotyping

The genotyping was for apolipoprotein E (APOE) which in turn is thought to be a key regulator of cholesterol and lipids. It's also thought that differing APOE genotypes influence lipid responses to dietary fat and therefore given the known increased risk of certain APOE genotypes with coronary heart disease and on lipid responses to dietary fat, that risk carrying individuals if told about their genotypes, might be more likely to adopt gene-based personalized nutrition recommendations.

The study's findings aren't particularly heartening for personalized medicine as it pertains to individual behaviour change.

Personalized advice was found to be better than non-personalized advice, but there was no additional benefit to change found with those whose personalized advice warned them that their unique genetic makeups conferred greater risk.

There is a silver lining here though. Personalized advice based on an individual's dietary intake alone was just as likely to inspire change. So rather than spending your money on all sorts of tests, if you're worried about some diet related aspect of your health, go see an RD (but maybe not one who tries to sell you personalized genetic testing), and with the money you save on all that other testing, you can book a few follow ups and likely get an even bigger bang for your buck.

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Friday, August 12, 2016

Squirrels are Surprisingly Polite

At least judging from today's Funny Friday video they are.

Have a great weekend!

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Wednesday, August 10, 2016

Another Great Not Junk Food Fundraising Program!

Thanks to my friend and med school classmate Christine Gibson for sharing this with me.

It's called Raise a Patch and it's an Australian initiative that I adore. It's fundraising (school, sports team, whatever) by way of selling "veggie patches", herb pots, and flower gardens.

Healthy foods, beautiful flowers, and the joy of gardening? What's not to love. Hope this catches on globally.

(and if you're looking for more healthy fundraising inspiration, here's a compiled list of other Aussie programs)

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Monday, August 08, 2016

Anthocyanins And Flavonones Aren't Fruit!

For the most part, supplement sales and hype are built off of extrapolations. Extrapolations of animal studies to people, extrapolations of basic science to clinical utility, extrapolations of small studies to general conclusions.

And here's an example of another extrapolation - the extrapolation of presumed causality.

The study, Habitual intake of anthocyanins and flavanones and risk of cardiovascular disease in men, is amazing.

Not in that it's a great or conclusive study, but rather that despite the very clear first sentence,
"Although increased fruit intake reduces cardiovascular disease (CVD) risk, which fruits are most beneficial and what key constituents are responsible are unclear."
a sentence that spells out the fact that while we know fruit consumption is healthful, we genuinely don't know why, the article goes on to conclude, despite not in fact testing for it, that certain fruits' anthocyanins and flavonone content reduce heart disease risk in men.

How'd they come to that conclusion?

Well they estimated how much anthocyanins and flavonones were consumed as a function of how much anthocyanin and flavonone containing fruit was reported in food frequency questionnaires and then looked at cardiovascular disease risk as a function of same.

Of course fruit contains more than simply anthocynanins and flavonones, so to suggest those were the causal agents of the study's findings is purely a guess.

So putting aside why the American Journal of Clinical Nutrition published an article with a hugely misleading title and conclusion (and how it passed through peer review as is), why did the authors of this US Blueberry Highbush Council funded study (blueberries contain anthocyanins) focus on presumptive causal factors rather than the berries themselves?

Hard to say. Though it's certainly not impossible that the study's lead author's 2013 patent, meant to provide phytonutrients (including anthocyanins and flavonones) to nursing mothers might have had some influence (and is probably something that should have been included in the study's confict of interest statement).

Regardless, one things's certain. For folks selling anthocyanin and flavonone supplements, studies like this one are a gold mine.

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Saturday, August 06, 2016

Saturday Stories: Supplement Science, CIA Votes, and a Starving Venezuela

Alex Hutchinson in Runner's World with a case study of the slimy salesmanship of science by supplement sellers.

Former CIA director Michael J. Morrell in The New York Times on his endorsement of Hillary Clinton and why Trump would be a disaster as President.

Fabiola Zerpa in Bloomberg on the nightmarish realities of life in Venezuela - a 30 day hunt for food in a starving land.

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