Tuesday, March 31, 2009

Repost: Do you have Scale Addiction?

[Sorry for the repost - 6 hours yesterday of flight delays and over 100 emails in my inbox and I decided a repost would save me some extra stress]

It's certainly not a condition written about in medical textbooks.

I'm talking about scale addiction. An affliction that causes the sufferer, usually someone in the midst of a weight loss effort, to step on the scale multiple times a day whereupon if the scale does not go down or goes up, they suffer mild to severe mental anguish.

I've met many folks who are scale addicts.

They tell me that rationally they understand that getting on the scale multiple times a day won't make a difference, but that they just can't help themselves.

For those folks I usually offer to babysit their scales in my office or I recommend that they turn them over, take out the batteries or put tape on the solar strip.

The thing is scales are truly frustrating devices because they don't simply measure caloric intake vs. caloric expenditure. They measure clothing, water retention, constipation and time of day differences.

Folks who do weigh frequently will know that weight fluctuates both day by day and within a day.

So for scale addicts out there, here are two things you need to know.

Firstly, there's 3,500 calories in a pound, and while bodies are not mathematical instruments whereby if you do or don't eat 3,500 calories you'll see a pound change on the scale, bodies do obey the laws of thermodynamics and if you step on a scale on a Wednesday and it's 3 pounds heavier than Tuesday, unless you consumed at least 10,500 calories more than you burned, the scale is weighing something other than true weight.

Secondly, your weight doesn't matter. What do I mean by that? To put it simply, what moves the number on the scale is not the act of standing on the scale, it's what you're doing and choosing during the times you're not standing on the scale. It's your lifestyle and your choices that change your weight. You need to determine how you're doing by how you're doing. What have your dietary choices been like? How's your fitness? Are you being thoughtful? Are you organized and consistent?

Scales can be helpful to illustrate trends, but weight fluctuation, both inter and intra day fluctuations are normal.

At the end of the day, it's your life that can change the scale, not the other way around.

My recommendations? During a weight loss effort weigh yourself once a week, stark naked Wednesday morning before breakfast. During a weight maintenance effort weigh yourself daily and get to learn your body's weight fluctuations and more importantly, use the scale to nip any weight regain in the bud.

Break the habit, stop the weighing.

(P.S. Those aren't my feet, just a scary picture from the internet)

Monday, March 30, 2009

Pretty much nobody checks fast food calories.

One of the arguments that Big Food puts forward against mandatory calorie labeling is that many restaurants already have in-store brochures or online listings of calories.

Ever wonder how many people look at them?

Well wonder no more as a study published in the American Journal of Public Health set out to answer that very question.

The study was pretty straight forward. Researchers observed 4,311 people buying food at McDonald's, Burger King, Au Bon Pain and Starbucks to see how many of them looked at those respective restaurants' in-store (but not on menu) nutritional information. In order to be counted all you would have had to do is, walked up to a nutritional information poster and turned their head toward it, picked up a pamphlet, or touched the screen of the computer in Au Bon Pain that displays nutritional information.

So out of 4,311 people want to guess how many checked?


6 out of 4,311 people - 0.1%.

Guess the argument that so long as it's in-store it doesn't need to be on-menu's out the window.

Friday, March 27, 2009

"I just twoted all over the place"

Some of you may have noticed that on my sidebar there's a section that states that, "I Twitter".

Today for Funny Friday I bring you a short clip that will help explain exactly what that means.

If you already Twitter, prepare to be amused.

If you don't already Twitter....look at me, look at me....

Have a great weekend!

[Via Addicted to MedBlogs]

Thursday, March 26, 2009

Why Isn't Canada Banning Canned Soft Drinks?

Hypocrisy on the Hill continues.

In April of last year the Canadian government banned the sale of bisphenol-A containing baby bottles.

Their rationale was despite agreeing that the levels were below those which scientists generally worry about BPA,

"due to the uncertainty raised in some studies relating to the potential effects of low levels of bisphenol A, the Government of Canada is taking action to enhance the protection of infants and young children."
My blog post at the time pointed out the unbelievable hypocrisy of a government that banned BPA with admitted "uncertainty" as to its risk yet was quite comfortable giving trans-fats a two year free pass despite the head of the government's own task force in 2007 labeling trans-fats,
"a "toxic" killer that need to be removed from the food chain as soon as possible"
Well the hypocrisy continues as a few weeks ago a report from Health Canada came out that found BPA in 69 of the 72 cans of pop they tested - a sample that was representative of 84% of the market share of soft drinks sold in the country.

Of course there's not been so much as a governmental peep about banning them. Shouldn't they? Nursing mothers drink canned pop. So do pregnant women and unfortunately so too do far too many children. If indeed they felt taking action on the baby bottles was in order, why isn't it in order here?

The answer of course is simple.

Banning canned drinks (or trans fat) would be decidedly bad for Canadian industry, whereas banning BPA containing baby bottles only affects a small market share and certainly gives warm fuzzies to the electorate.

Just goes to show you - Health Canada's is as much (or more) a political and industry pandering body than one that serves the public's or science's best interests.

Wednesday, March 25, 2009

Eat Red Meat - Die?

That's what a new study from the Archives of Internal Medicine suggests is more likely to happen to you if you eat lots of red meat.

The researchers followed more than a half million adults aged 50 to 71 who completed food-frequency questionnaires for a decade during which some 48,000 men and 23,000 women died.

The study controlled for confounding variables including: Weight, smoking, physical activity, education, age, marital status, family history of cancer, race, total energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption and menopausal hormone replacement therapy.

So after controlling for everything what did they find?

"There was an overall increased risk of total, cancer, and CVD mortality, as well as all other deaths in both men and women in the highest compared with the lowest quintile of red meat intake in the fully adjusted model."

"There was an overall increased risk of total, cancer, and CVD mortality, as well as all other deaths in both men (Table 2) and women (Table 3) in the highest compared with the lowest quintile of processed meat intake"

"When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women"

People who at the most red and processed meat had higher rates of total deaths, cancer deaths and cardiovascular deaths while white meat seemed to confer some protection.

The authors conclude that these results further bolster the call to reduce red and processed meat consumption.

According to an article written by Sharon Kirkey from Canwest the Canadian Cancer Society has already responded by reportedly lowering their recommendations for red meat consumption to 500grams weekly.

Constrast that rapid response with that of the Heart and Stroke Foundation whose spokesperson's quote suggests she didn't even bother reading the study saying,
"But the biggest meat eaters in the study were also more likely to be "out of shape and overweight."
despite the fact that the study adjusted for the obvious confounders of weight and fitness.

And yes of course the Heart and Stroke Foundation's Health Check misinformation program still happily sells their seal of approval to red meat and Canada's Food Guide still allows for women to consume 1,050grams weekly and men 1,575grams weekly - facts that I'm sure the Beef Industry press releases and letters to the editor are bound to mention in the coming days.

Tuesday, March 24, 2009

CBC Marketplace Bashes Health Check (Again)

I know most of my readers know that I'm far from fond of the Heart and Stroke Foundation's misinformation program "Health Check", and in my discussions with allied health professionals involved in nutrition and chronic disease prevention I can tell you my sentiments are widely shared.

CBC Marketplace, Canada's award winning investigative consumer affairs show has also rightly targeted Health Check as being deceptive and a program that may well be misleading consumers into buying less healthy choices. Last year they did a feature on Health Check (where I made a few brief appearances) and last Friday they hit them again in their "Busted" segment.

This time they were looking at the sodium content in restaurant foods such as the ones I've made fun of in the past at Boston Pizza.

To be honest at this point I really can't fathom what's going on inside the heads of the Health Check folks. Their program is maligned by anyone who bothers to take the time to really look at it (even Chatelaine magazine bashed it), the food industry itself has proposed a more rigorous front-of-package labeling program, and I have to imagine the controversy has affected donations. Why they persist in hanging onto it is beyond me. Isn't it time to hang up the gloves? Either completely revamp the program (or better yet, license Nuval) or just let it go. It's not helping Canadians and it's hurting the increasingly fragile integrity of the Heart and Stroke Foundation.

The segment's brief (5 mins) but well worth a look.

Check it out for yourselves by clicking here.

Monday, March 23, 2009

Eat red meat - go blind?

Probably not.

Much as you might think that I only like to criticize red meat (for things like increasing the risk of cancers and death and such), here's a study that doesn't worry me too much.

It was published in the American Journal of Epidemiology and it details a cohort study of 6,734 people aged between 58 and 69 and compared their incidence of age related macular degeneration (ARMD - a condition that can lead to central blindness) versus their consumption of red meat and chicken.

The findings?

People who ate more red meat were more likely to develop ARMD.

So why am I not concerned?

Because the group at risk was the group that reported red meat consumption greater than 10 times weekly.

10 times a week?

Who eats red meat 10 times a week?

You think maybe the folks who eat red meat at least 10 times weekly might in fact have some rather unique lifestyles that in turn may be responsible for the finding?

Cause and effect are tough things to suss out of a cohort study.

Friday, March 20, 2009

Breaking News! The Holy Grail of Deep Fryers Found!

This is a deadly serious post.

I, like most, enjoy French fries. I even "buried" two deep fryers in my pre-med days of bachelorhood.

Now of course I know French fries are not good for me (potatoes not so good either), but that said, sometimes they're worth the risk though usually my "fries" take the form of home-made, oven baked fries.

The days of fake fries may soon be over! Soon I may be back to "real" fries.


Apparently T-fal has figured out how to make a deep fryer that fries 2.2lbs of potatoes using only one measly tablespoon of oil!

T-fal folks, if you're reading and want to send me a machine to try out (they're not yet available for purchase in Ontario) I won't complain and will happily review.

Bliss doesn't come cheap however.

$350 and apparently ready for market late this year.

X-Rated Turtle vs. Hiking Boot

I debated about posting this clip.

Then I decided that for Funny Friday everyone ought to hear the sound a turtle makes when he's getting busy.

I guess he forgot to put a sock on the frat room doorknob.

The internet is one strange place.

Have a great weekend!

Thursday, March 19, 2009

Newsflash - Weight's not good for your health!

Published this week in the Lancet.

A meta-analysis summarizing 57 studies on the effects of BMI on mortality.

900,000 subjects in total and they excluded deaths in the first 5 years to eliminate the bias of death from subjects already dying (and consequently in many cases often quite skinny due to the wasting associated with many chronic illnesses).

The results?

All-cause mortality was lowest among those with BMIs in from 22.5 to 25.

Above a BMI of 25, every 5-unit increase in BMI translated to a:

  • 30% increased risk for all-cause mortality;
  • 40% higher risk for death from heart disease or stroke;
  • 60% to 120% increase in renal, hepatic, or diabetic mortality;
  • 10% increased risk for cancer-related deaths.

  • I wonder how folks who make their livings as contrarians to the risks of weight are going to spin this one?

    Wednesday, March 18, 2009

    Badvertising: Slenderizing Juice

    "4 slenderizing vitamins and minerals"
    So what are these 4 miracle vitamins and minerals?

    Chromium, vitamin C, L-carnitine and something called "Super-citrimax" (an extract of garcinia cambogia.

    So here's what I know.

    None of those ingredients have been shown to be significantly beneficial to weight loss but all have been significantly beneficial in selling misleading products like this one.

    Tuesday, March 17, 2009

    Watch the world's best ever rendition of Danny Boy

    I know it's not Friday but today's video is certainly funny.

    I've been saving this one since I found it surfing youtube with my daughters over 6 months ago.

    There's no doubt in my mind it's the world's best rendition of Danny Boy.

    (And this one's definitely worth a click through to the blog for my email subscribers (just click the title and it'll take you there)).

    Have a great St. Patrick's Day and remember, green beer has the same number of calories as regular!

    Monday, March 16, 2009

    Busted: President's Choice Blue Menu On Track Plus Protein Cereal

    As some of you may know, my wonderful wife is pregnant with our third child and for some reason she's been much hungrier this time around. Consequently she's been focusing on eating frequently and including protein with every meal and snack.

    A few weeks ago she came home with a bunch of high protein cereals. The one she was most excited about was the President's Choice Blue Menu On Track Plus Protein. She was excited because its nutrition facts panel reported that she'd get 13 grams of protein and 210 calories in 1.25 cups of the stuff. That excited her because it was a lot of protein and more importantly compared with the other high protein cereals, it was a large volume of cereal.

    It actually sounded too good to be true.

    Well, like most things that sound too good to be true, it's not.

    My wife decided to weigh the cereal as its nutrition facts panel reported that the 1.25 cups of cereal ought to weigh 54grams.

    When she weighed it, 54grams filled up 0.75 of a cup.

    That means that when measured by volume President's Choice Blue Menu On Track Plus Protein provides 40% more calories than reported on its label.

    That means if you decided to have the box's recommended 1.25 cup serving every day for breakfast in a year you'd consume 30,000 more calories than you bargained for.

    Given that the cereal is being marketed to folks as assisting in "maintaining a health body weight" and keeping them, "On Track" that's an incredibly off-track deception.

    Shame on you President's Choice.

    UPDATE 17/3/2009: Just heard back from President's Choice who report that indeed there was a labeling error that they are trying to remedy. They report 54grams being 7/8s of a cup and while not quite the 3/4 we measured, certainly close enough for me not to quibble.

    Friday, March 13, 2009

    Do you have what it takes to be a great marketer?

    Ok, so here's your dilemma.

    You're a marketing executive and you've been hired to market a device that women can use to pee standing up.

    What do you do?

    Today's Funny Friday is proof (for me at least) that I'm not creative enough to be a marketing executive.

    Have a great weekend!

    [Hat tip to my friend Naz]

    Thursday, March 12, 2009

    Follow up on Ayala's Herbal Water

    Long term readers may remember my post from almost a year ago about pediatrician Ayala's Laufer Cahana's herbal water.

    I was particularly irritated by Ayala's representation of her water as a potential healing tonic in her products' original press release given her clear understanding of evidence-based practice (as seen in her blog).

    Well, I just took a trip around Ayala's Herbal Water website and I've got this to say - other than that original press release she's done a bang up job of not in fact making ridiculous, non-evidence based claims.

    Ayala, while what I think clearly doesn't matter, I'm going to give you my thoughts anyways. Why not remove the September 18th, 2007 press releases? You've had plenty of great media and reviews since then and as noted, your subsequent press releases have never strayed into making nonsensical pseudo-medical claims. Clearly you care about your ethics and I think the Sepetember 18th press release besmirches the message you're currently trying to promote (and allows loudmouth bloggers like me to a year ago get all huffy).

    Kudos to you Ayala for abandoning the miracle-in-a-bottle path.

    Wednesday, March 11, 2009

    Want cheap prescription weight loss drugs? Buy a "natural" product.

    Some people swear by their "herbal" remedies.

    You know when I opened my offices I scoured the medical literature hoping I could convince myself that there was a herbal supplement that I could sell patients that would help them lose weight and help me pay salaries.

    Guess what?

    I don't sell any products.

    Oh, yours works? Maybe it's because its got prescription weight loss drugs mixed into the "natural" pills. At least that's what a recent FDA sting operation found out when they found prescription weight medications (including some not sold in the US) in 68 different "natural" products.

    Why put these into the "natural" products? Because the expensive part of coming up with medications isn't manufacturing them, it's the research and development behind them. Spend pennies a pill on making a herbal weight loss product work by putting in drugs that actually affect weight and now you've got a "herbal" product that people will keep buying.

    So what drugs did they use to taint the pills?

  • Sibutramine (can have fatal interactions with certain types of antidepressants)
  • Rimonabant (pulled from the weight loss market due to adverse effects of depression and suicidal ideation)
  • Phenolphthalein (a laxative no longer sold in Canada due to its potential contribution to getting cancer)
  • Phenytoin (an anti-seizure medication)
  • Bumetanide (a diuretic)
      If weight-loss in a bottle existed the world would be skinny.

    1. Tuesday, March 10, 2009

      From the "What were they thinking?" file

      Because there isn't enough temptation in your children's lives to eat cookies and chocolate here are more stupid kid games (like the ones I blogged about back here).

      I wonder who awarded the chocolate game the "Best Games Award 2008"?



      Monday, March 09, 2009

      Overweight? Your dietitian probably doesn't like you.

      At least not if the results from a recent study are in fact applicable to the profession as a whole.

      Dr. Rebecca Puhl, one of the Rudd Center's researchers (and bloggers I might add) published a study in the Journal of the American Dietetic Association whereby she polled 200 dietitian students about their attitudes towards the obese.

      Her findings were frightening.

      Only 2% of those training to be dietitians had positive (and she included "neutral" as positive) attitudes towards the obese with the remaining 98% being moderately biased against prospective heavier patients.

      Of course the same could be said of many health professionals (including doctors). Similar to the dietetic students in a comparable study medical students held almost universally negative beliefs while a study with practicing family physicians showed roughly 50 of them cultivating negative stereotypes.

      I'm sure real-life dietitians with real-world experience are likely far less judgemental than the wide-eyed students in Rebecca's study (hint - here's a ripe study for the picking for someone with resources).

      Clearly all health professionals have a long way to go at eliminating their own weight-related biases.

      Friday, March 06, 2009

      Altruistic Boy Scouts to Offer Free Breast Exams

      Ever wonder who thinks up this stuff for the Onion?

      Today's Funny Friday is their Today Now report on some clearly selfless boy scouts.

      (For extra giggles make sure to read this captions)

      Have a great weekend!

      Thursday, March 05, 2009

      Guess what? You're probably not fated to be fat.


      People like to blame genes.

      Now there's no doubt whatsoever that genes affect weight, but given the fact that genes haven't changed in the past 100 years and obesity rates have, it's tough to suggest that if you've got an unlucky deck you're fated to be fat.

      Recently there's been some work done on the FTO gene. Readers of my friend Dr. Arya Sharma's blog may have come across his post that detailed research published in the New England Journal of Medicine that suggested kids with a particular version of the FTO gene were more likely to choose higher fat (and hence higher calorie) foods.

      So are they fated to be fat? Is there nothing they can do?

      Of course not.

      In an article published yesterday in the PLoS Laura Johnson and colleagues looking at a sampling of 2,275 children found that those children with the higher calorie version of the FTO gene who consumed lower energy dense diets did not find themselves at an elevated risk of obesity.


      Regardless of your genes, if you're not eating more calories than you burn you're not likely to gain.

      This doesn't mean that life isn't more challenging for folks with genetic contributors to weight gain - it just hammers home the fact that like those towns I blogged about in France, without tremendous education and a focus on changing the actual environment, this problem's probably not going away.

      Remember too 100 years ago obesity was an incredible rarity - the world back then was truly a phenomenal behavioural weight loss program as it was a program that worked not on an individual level, but rather a societal one.

      As always talks about genetics and weight bring me back to Dr. George Bray's famous quote,

      "Genes load the gun, the environment pulls the trigger"

      Wednesday, March 04, 2009

      Reality Weight Loss Lies - Biggest Loser Edition

      So at the end of last week's show the exiled player was shown completing one of his dreams - running a marathon with his wife. It was an idyllic ending - running hand in hand past the finish line. The somber text following the shot, complete with Biggest Loser music in the background, read that Dane finished the 26 mile marathon with his wife in 3 hours and 53 minutes - a pace that if true would have had Dane placing 14th overall.

      Inspirational or impossible?

      Dane, though much slimmer than his starting Biggest Loser weight, weighed in on race day at 280lbs. A sub-four hour marathon for someone who's only been training for 6 months who weighs 280lbs to me sounded impossible.

      Imagine my lack of surprise when the truth actually hit the net. According to a report out of Runner's World magazine's blog, not only did Dane not complete the marathon in under 4 hours, he didn't actually complete it at all. Apparently when it became clear that he would be unable to complete the marathon in the 6 hour time limit of the Arizona Desert Classic Marathon a Biggest Loser show SUV picked Dane and his wife up and gave them a lift.

      Oh, and even with the lift they didn't finish in 3:53, they finished in 5:53:48.

      The Biggest Loser's production company Reveille LLC reportedly put out a press release detailing their "error" (I can't find the press release) suggesting there was a problem with the time readout. Certainly I can read 5:53 in the video below and you think that maybe, just maybe the camera guys knew how long it took and that Dane's run included an SUV ride?

      Looking at the Biggest Loser website I couldn't find anything that suggested they lied to their viewers, nor did I see mention of it last night.

      Dane, the guy whose incredible weight loss and commitment to changing his life I'm not knocking, isn't planning on giving back his finisher's medal because "in his mind" he finished the race.

      Now as you might imagine, I don't espouse the ridiculously non-sustainable approaches the Biggest Loser broadcasts as helpful, but that said I've always felt the show was useful for that last two minutes. That's the two minutes where the incredibly dramatic weight loss is juxtaposed with the incredibly dramatic lifestyle changes that contestant has made. I've often said, "the more weight you want to permanently lose, the more things in your lifestyle you'll have to permanently change". I guess I'll have to take some of those changes with a grain of salt too as clearly lying is something the show espouses.

      To watch a video of last week's last two minutes, click on below.

      [Hat tip to Twitter's @stepank ]

      Tuesday, March 03, 2009

      This is not the best response to childhood obesity

      Bigger clothes.

      That picture up above is of British school uniform supplier Nadeem Ahmed holding the size 44inch waist trousers he's been selling to kids as young as 13.

      In fact a recent report describes how some of Britain's largest retailers of childrens' clothing are joining together to fund a study into just how big Britain's children have gotten. They're going to use high-tech scanners to measure shapes and sizes with the aim to roll out better fitting clothing for ever-larger children.

      Yet you'll still find folks vehemently denying increasing rates of childhood obesity.

      I guess the clothing industry is in on this giant public health conspiracy.

      Monday, March 02, 2009

      Shocker - Calorie Burning Tea Doesn't Actually Burn Calories

      Long time readers of my blog may remember my post from 2007 where I made fun of the claims being made by the Coca Cola company in the marketing of their "calorie-burning" tea Enviga.

      Well guess what? On Friday Coca Cola agreed to pay $650,000 in penalties for their misleading Enviga advertisements and change them to include disclaimers that Illinous attorney general Lisa Madigan states will provide,

      "clear and conspicuous disclosure that the product does not produce weight loss without diet and exercise"
      I guess the,
      "perfect partnership of science and nature"
      doesn't actually break the laws of science and nature.

      Shocker that.