Remember that Calendar from the Heart and Stroke Foundation? The one that had recipes with butter, non-skimmed milk and regular soy sauce? Well, here's another example from that calendar of why you might think that the Heart and Stroke's dietitians aren't paying too much attention to their recommendations - December's Chewy Cinnamon Oat Cookies.
My wife made those cookies yesterday. Putting aside the fact that the Heart and Stroke Foundation seemingly prefers you eat almost a half cup of sugar rather than zero-calorie sweeteners (artificially sweetened juices can't apply for Health Checks) and recommended 3 tablespoons of canola oil rather than go half and half with something like apple sauce, and adds a tremendous amount of raisins and cranberries, those aren't the weird parts. The weird part is the fact that the recipe says it makes 48 cookies. It says that because it instructs you to use a teaspoon to dole out the dough.
Really? A teaspoon?
Recognizing that a teaspoon of dough wouldn't even yield a cookie the size of a Ritz cracker my wife decided to use a tablespoon. Doing that didn't make giant cookies, it made pretty normal sized cookies. Here's a picture:
So why do I care about the size of the cookies?
By allowing the recipe writer to use a teaspoon as a measure for a cookie the Heart and Stroke Foundation is helping to mislead chefs into thinking these are low calorie cookies, which they certainly are not. Make them out of a tablespoon and now each cookie will have 124 Calories - nearly double the calories of a President's Choice "The Decadent" Chocolate Chip Cookie.
Of course if their dietitians had asked that the sugar be replaced with a zero calorie sweetener and the canola oil with apple sauce and the raisins/cranberries cut in half which is what my wife decided to do, that would have cut the Calories by close to 40% - something you might have thought the Heart and Stroke Foundation would have wanted done given the contribution of obesity to heart disease and strokes and the contribution of calories to obesity (though I imagine cutting the canola oil out of the oilseed industry sponsored Calendar might be challenging).
Now I'm not advocating a life without cookies, but why is the Heart and Stroke Foundation making things tougher by publishing recipes with ridiculously small unrealistic portion sizes that grossly misrepresent and underestimate calories and why aren't they making any apparent effort at publishing recipes designed to trim down sugar and fat?
My guess?
No one ever bothered to even look at them.
[UPDATE - just received an email from my wife,
"Just made another batch of cookies: Splenda instead of white sugar, applesauce instead of oil, half the raisins/cranberries they called for, whole wheat flour instead of white, unpacked brown sugar instead of packed. Using the same scoop (tablespoon) and making 20 cookies again, got them down to 54 calories each. Not bad."So for you chefs out there - the cookies actually taste pretty good and at 54 calories each, not bad either.
Thanks honey]
Posts
Hi Dr.Freedhoff,
ReplyDeleteGreat post as usual. You mentionned artificial sweeteners, I wonder what you think of the safety of these. Sucralose is supposed to be the newer/safer alternative...how solid is the litterature on this. Do you directly recommend these to your patients?
I do recommend them to my patients.
ReplyDeleteThe evidence is solid that the risk is minimal if not non-existent. Every major meta-analysis ever done on artificial sweeteners have concluded that they are indeed safe.
Regardless, end of day, one thing's certainly clear - there's far more risk to calories than artificial sweeteners.
Have you ever taken a look at Splenda's Brown Sugar blend vs. regular brown sugar?
ReplyDeletePer 2 g (1/2 tsp.) brown sugar:
2 g carbohydrate
2 g sugars
7.3 calories
Per 2 g (1/2 tsp.) Splenda brown sugar blend:
2 g carbohydrate
2 g sugars
10 calories
People are using in place of sugar and getting the exact same amount of carbs and sugars, and more calories.
Hey Julie,
ReplyDeleteSplenda's brown sugar is made with actual brown sugar which is why the calories are the same.
My wife actually left the brown sugar in and replaced the white.
That said, for some reason I had been under the impression that Splenda's brown sugar still had half the calories of regular - thanks for the heads up that it doesn't.
Regards,
Yoni
To the person above worried about artificial sweeteners, perhaps stevia would be a better choice for you?
ReplyDeleteFor anyone arguing the saftey of this sweetener or the other, how can we say that stevia is better? Because it's natural? Is there really enough evidence of use of stevia in a "north american" type diet, in the quantities that we like to use sweeteners, to really say it is safe? It is not enough to say that it is "natural". Arsenic is natural too, but you wouldn't want to make cookies from it. Red meat is natural, but it is not recommended that our diet's focus on it as the main source of protein? I am not comfortable with using the word "natural" as a blanket statement that something is good for us. Having said that, I choose not to use any artificial sweeteners personally.
ReplyDeleteJulie - Splenda Brown Sugar Blend is required in HALF the quantity of regular brown sugar which is why the package says "1/2 the sugar". It is twice as sweet as regular brown sugar. 1 cup of brown sugar in a recipe only requires 1/2 cup Splenda Brown Sugar Blend (as per the package).
ReplyDeleteSo, in fact, people are getting less sugar (and carbs) when using this blend in place of regular brown sugar simply because they are using half the amount.
Dr. Freedhoff,
ReplyDeleteI'm wondering why you and your wife would choose an unnatural product over real food and why you would counsel your patients to do so as well. You indicate that "there's far more risk to calories than artificial sweetener" but why are you afraid of calories? Moreover, why would you replace canola oil with applesauce? What's wrong with canola oil?
It seems to me that avoiding foods, or replacing them with artificial substances, won't help with weight loss. To lose weight, you need to eat less and be more active.
Dr. Marion Nestle,a professor of nutrition at NYU points out that the increase in obesity parallels the increased in intake of sweeteners in her book 'What to Eat'. Although sweeteners don't make you overweight, it may fool you into thinking you're saving calories and, as a result, you may overeat. It doesn't take much food to make up for the calories you save.
You mentioned that "every meta-analysis ever done on artificial sweeteners have concluded that they are safe". Such a statement is highly questionable. In regards to sucralose (Splenda), there has been no long term human studies done- the product was only approved in 1998. The FDA relied on a few short-term tests when it reviewed the safety of Splenda for human consumption and these human tests were all conducted by the manufacturer of Splenda! Moreover, the majority of tests reviewed by the FDA to determine whether Splenda was safe for human consumption were conducted on animals, including rats and rabbits. The safety of other sweeteners like saccharine (sweet n' low) and acesulfame-k (in coca-cola zero) is questionable as well, as Dr Nestle points out in her book.
Regarding Stevia, it has not been approved in Canada, the US or Europe. That's why it's sold as a dietary supplement- its safety doesn't have to be regulated.
As a registered dietitian, I recommend exercise and natural foods (in appropriate amounts) to all patients seeking to lose weight- I thought you did as well.
Anonymous,
ReplyDeleteThanks for the thoughtful words.
Regarding calories, we know that they are certainly determinants of health. Too many lead to obesity and multiple medical co-morbidities. Too few and also we can see problems. I find it somewhat surprising that you as a registered dietitian, do not consider calories as a determinant of healthy eating.
Regarding "artificial" sweeteners, it's true that Splenda has not been around long enough for long term studies, though that doesn't change my statement that every meta-analysis done on artificial sweeteners has vindicated them. You're simply pointing out that as per Splenda, there's yet to be a meta-analysis.
Regarding the substitution of apple sauce for canola oil and artificial sweeteners for sugar and your reported lack of understanding of how that might help with weight management I'm at a loss as the concept of energy should not be foreign to anyone with an expertise in nutrition.
Lastly regarding natural. I'm not so anthropocentric as to believe that natural is synonymous with healthy. Consequently I don't fall into the trap of defining "natural" as being automatically "good". Whether nature made a chemical or whether we made a chemical, it really doesn't matter. Tobacco is natural, as are many mushrooms I'd rather not eat so having the moniker, "natural" does not in any way impress me and consequently I don't tie my patients hands with artificial artificial restrictions.
I'm sorry, but recommending artificial sweeteners like Splenda is just not okay with me. They're not real food. People should eat food made from real ingredients, not fake ones. Fake ingredients do not satisfy, and you just consume more of whatever food they're in.
ReplyDeletecan i ask the real dietitian a question? what about all the benefits of foods that we do not even know about? like all the studies that correlate some foods with decreased cancer risk and stuff? like, the one for brocoli came out when? 3 years ago? arent we safe to assume that replacing them with a diet coke and a multi-vitamin means that we will not benefit from them?
ReplyDeleteYikes! Seems like you have a little misplaced aggression mr. Freedhoff! As a registered dietitian I do consider calories a determinant of healthy eating and maintaining a healthy weight, hence the "eat less and be more active" I indicated as the way to lose weight. Perhaps you didn't read that part?
ReplyDeleteTrying to put my professionalism as a dietitian in question doesn't take away from the fact that you are counseling your patients to replace real foods with fake stuff and telling them to be afraid of foods like canola oil.
Rather, you should be counseling your patients to eat less calories, be more active and that real foods have no substitute- pills or chemicals cannot replace the benefits of eating a variety of foods. I'm surprised that as a GP, you were not taught that this is the basis of healthy eating. Actually, I'm not so surprised.
Regardless, this is not about how little a GP is taught about nutrition, but it's about recommending sweeteners rather that real foods. Studies on the effect of sweeteners on human health in ambiguous so you have 2 choices: not include them in your diet and rely on real foods to meet your caloric needs OR keep consuming them (and feeding them to your kids) and hope that they don't turn out to be harmful to your health.
I would recommend (and I practice) the former.
Anonymous, regarding your comment about replacing foods with diet coke and a multivitamin, you’re right: supplements are not a substitute for a healthy diet that includes a variety of foods. We actually don’t really know how fruits and veggies protect us from some cancers, heart disease and other illnesses. We know that they have vitamins, antioxidants, phytomchemicals, plant hormones and fibre but the benefits come from a combination of these elements working together.
The elements can't be put into a pill form and even if they could, they would be delivered in unnatural proportions.
The supplement industry is a multi-billion dollar one that works very hard to convince people that they are deficient in certain vitamins or minerals. However, most of us get enough food and meet our vitamin and mineral requirements.
Rather than taking a multivitamin and drinking a diet coke or replacing real sugar with a phony substance, eat less food, be more active and don’t be scared of real foods- eat a variety of them everyday!
The dietitian is right! You say you believe in evidence, but telling us to replace sugar with sweetener isn't right. I don't believe in limiting or avoiding foods such as sugar and healthy oils. Moreover, the evidence on artificial sweeterns is obviously inconclusive; as the dietitian pointed out: there are no long-term studies that have been done on humans.
ReplyDeleteI think the dietitian is the professional when it comes to nutrition and his/her comments make a lot of sense. Perhaps you could learn from a nutrition expert rather than be so defensive?
Gee whiz,
ReplyDeleteGo to one 3 year old's birthday party and come back to an anonymous and clearly passive aggressive dietitian who is most certainly unhappy with my views.
Thanks though for providing me with a topic for a future post - no sense in keeping this discussion to the small few who might be following these comments.
Stay tuned - hopefully I'll have a post for you to yell at me about some more within the next week or so.
i think the GP and the dietician and others should focus on how much evidence there is for the efficacy and the safety from animal studies and humans studies.
ReplyDeleteIf there arent any credible and long term studies in humans then how can we approve and recommend artificial sweetners to consumers? are only animal studies enoguh to warrant its use?
I am very late getting into this discussion. First, Kudos to Dr Freedhoff. I think it is important to challenge HSF and others that put out meaningless symbols such as the health check. The general public relies on the symbol thinking they are eating a healthier food which is clearly not the case. That was the point as I see it of the original post.
ReplyDeleteAs the comments become focused on sugar vs “artificial” sweeteners and alternatives there is clearly some misunderstanding by the RD. Sugar is natural but clearly not a great food choice. Neither is excessive use of canola or other oils. The blogs focus is on weight management but there are other issues to consider in my layman’s opinion.
I am a type 2 diabetic. CDA and ADA says there is no connection between sugar and diabetic control. My glucose meter says otherwise. In fact, all diabetics I communicate with say they see the connection to sugar use and increased blood glucose readings. The artificial sweeteners do not raise my blood glucose. That said, I will not use most artificial sweeteners based on health concerns raised about them. I do use spenda and stevia.
Stevia has been in use for over 2500 years and has been studied. The issue with stevia is more political than science based. The sugar industry managed to get it blocked as a competitor to their very lucrative market. If the FDA and Health Canada were really concerned about national health in both countries there would be more pressure to reduce the consumption of refined sugar, HFCS, highly processed grains, trans fats, saturated fats and the inflammatory foods that are contributing to the international health crisis.
Type 2 diabetes and a number of other chronic diseases that are directly linked to an unhealthy diet are increasing rapidly in diagnoses. Type 2 diabetes and several others have exploded. In 1950 less than 1% of the population was diagnosed as diabetic. According to reports I read we are currently at or near 9%. There are projections that if we do not change our dietary practices. Weight is only one of the issues in the health crisis but an important one. Arguing about natural vs artificial is meaningless. More important; What is working? What is not?
I am a layman with type 2 diabetes. At the same time, I learned how to control my diabetes with diet. When I was diagnosed my numbers were horrible. For the past 3 years I have been able to maintain non-diabetic lab numbers without the use of medications.
I will not hide behind an anonymous posting. I am Toma Grubb, webmaster for www.Diabetic-Diet-Secrets.com