Monday, May 31, 2010

Frankenfood: Meat vending machine edition

You know, much as I bad mouth meat and its deleterious effects on health, long time readers of my blog will also know I adore eating it.

That said, my first reaction when hearing about this meat vending machine was an unqualified, "Ew".

I can't really explain my reaction though - the machines are being installed in the storefronts of classy looking Spanish butcheries, not Walmarts, presumably they're refrigerated, and from the looks of them they sell a variety of different cuts and options.

Perhaps it's just my aversion to vending machines casting aspersions on the contents.

Enjoy your barbecues off work Americans and if you forgot to buy burgers before the stores closed perhaps there's a meat vending machine nearby you can access.

[Via Springwise with hat tip to Lorne]

Saturday, May 29, 2010

Saturday Stories

Corpulent explains a recent study that suggests "obesity is truly disgusting"

Dr. Arya Sharma explains how we should be focused on the doing, not the weighing.

Lindy West pens perhaps the funniest movie review ever written (crude language warning).

Melanie Warner on why the Food Industry's pledge to reduce calories likely won't reduce waistlines.

Lastly here's a fabulous video where Malcolm Gladwell debates Mark Kingwell about the differences between knowing and doing (hat tip to Adriana).

Friday, May 28, 2010

I enjoy British humour.

Enough said.

Have a great weekend!

[Hat tip to Rob, BMI's fitness director]

Thursday, May 27, 2010

The most important questions you can ask yourself when you're down.

Have you ever thought about the fact that our brains tend to interpret our lives through internal questioning?

Unfortunately for many, our internal inquisitors are both monotonous and merciless, asking the same few questions over and over again, and then ripping us a new one with our own critical answers.

Questions like,

"What's wrong with me?"

"Why can't I just do this?"

"What's my problem?"
Those are the questions that tend to accompany slips off the wagon. And it doesn't really matter which wagon it is. Whether you're working on your weight, your relationship, your job, life isn't a straight line and neither are our efforts and some weeks frankly we all suck.

I see those times as opportunities. I see those questions as spotlights. They're opportunities to turn things around. They're spotlights to shine on new questions.

The questions?
"What can I do right now that I can be proud of?"


"What can I do right now that will help a little bit?"
If you're working on your health maybe you'll choose to make a home cooked, calorie controlled dinner, or write in a food diary, or go shopping for healthier staples, or pack your lunch for tomorrow, or take a 20 minute walk. If you're working on your relationship maybe you'll call someone up and tell them you love them, or buy somebody some flowers, or make the apology you've been procrastinating making. If you're working on your job maybe you'll finish some menial task that's been nagging at you, clean out your inbox, or stay late to finish an assignment.

Bottom line, the situation's the same, all that's changed are the questions you ask yourself to help interpret things. One set of questions is destructive and rear thinking. The other, constructive and forward thinking.

What can you do right now that you could be proud of?

What can you do right now that will help a little bit?

Wednesday, May 26, 2010

Weight loss plateaus be damned!

Does this sound familiar? You think you're doing everything right but the scale just isn't moving.

You've "plateaued".

Of course physiologically, plateaus don't exist. If you eat fewer calories than you burn you ought to be losing, and if you're not, perhaps the scale's measuring constipation, water retention or clothing.

So if you're not losing, and it's not just a trick of the scale, either you're burning fewer calories than you think, eating more than you think, or some combination therein.

Certainly as the body loses weight it adapts and metabolism may well slow which means you might be burning less than when you'd started, which means that you might not be plateauing - perhaps you've just reached a new equilibrium, a new floor.

Ultimately though, there are really only two questions you need to ask yourself.

1. Could you eat any less and still enjoy your life?
2. Could you exercise any more and still enjoy your life?

If the answers are "No", there's nothing left for you to do. If the answers are, "Yes", well then by all means tighten things up.

Do remember though, if you can't happily eat any less and you can't happily exercise any more then guess what, you're probably not going to.

Ultimately it doesn't matter if it's a plateau or a floor. The scale doesn't tell you how you're doing, you do. And if you can't happily do any better, you're doing great - scales and plateaus be damned.

Tuesday, May 25, 2010

Can a camera replace your food diary?

It works for Javier Garcia, a 28 year old neuroscientist who was recently profiled in the New York Times for photographing every single thing he's eaten over the course of the past 5 years.

Apparently there's a whole lot of folks like Javier out there, so many that I'm starting to receive blind PR pitches from iPhone developers who are creating apps for photographing food diarizing.

One such app is called Thin-cam and basically the premise is that you're less likely to forget what you've eaten if you've photographed it.

The PR pitch came with their handy dandy 10 reasons why it's a good idea and why it's superior to more traditional forms of food diaries (ie. counting calories).

So let me explain succinctly why it's not.

Pretend that times are tough and that you're trying to keep a careful household budget and you've decided that instead of tracking the costs of your purchases you're just going to take pictures of them.

Sound like a good plan?

Javier started his practice after losing 80lbs as a means to try to help himself keep it off. In that sense I can see potential value in that he may well be able to ensure he's not straying from the choices that helping him lose the weight.

Ultimately though, using a photographic food diary may help someone who's not keeping track at all and it may also helpfully augment traditional food diarizing, but it certainly won't supplant actually tracking the currency of weight, calories, in helping you balance your caloric books.

Spend the few seconds to write the foods down as you eat them (and at home ensure you've included measurements) - probably won't take much more time than pulling out your camera, framing your shot and taking it and it'll give you much more information.

Monday, May 24, 2010

Sorry Oprah, apparently only white women can work it off.

I admit my confirmation bias has exercise being a very minor contributor to a person's overall weight - at least in terms of a direct effect.

There's no doubt that exercise plays a major role in weight management, but I feel that it's primary role is to support a healthy living attitude. Anyone who's ever trained hard for anything knows it's a great deal easier to think about healthy eating and healthy habits when you actually feel health than when you don't, and exercise certainly confers a sense of health.

Of course not everyone shares my views and there are many folks who think I'm dead wrong and that exercise is the bomb for weight. Some of these folks have been pointing for a few days to a study published last month in the Journal of Epidemiology and Community Health as proof of their assertion.

The study looked at 12,227 men and women between the ages of 20-64 between the years 1999 and 2006 and compared their weights to their degree of leisure time physical activity.

The results?

Not exactly a slam dunk. They found what they called a "crude graded inverse
dose‑response relationship
" between leisure time physical activity in women, but not men. Oh, and not all women, only white women.

Crude indeed.

So really, if anything, the study demonstrated that exercise correlated with decreased rates of obesity in white women and absolutely nobody else.

Of course even with white women, correlation does not imply causation.

Amazingly the authors didn't bother to control for the major variable of weight - diet.

Could it simply be that the white women who exercised the most also ate the best?

Sure sounds possible to me.

Could it simply be that lighter white women enjoyed exercise more simply because they were lighter and that the heavier a woman was, the less they enjoyed leisure time exercise and therefore the less they did of it?


And what happened with men? Or with black and Hispanic women? If exercise truly impacted on weight certainly you'd expect to see across the board significance, yet here, it's just white women.

Sorry Oprah.

Ultimately this study adds absolutely nothing to either side of the argument of exercise's role in weight management and its publication serves only to appease the confirmation biases of those folks who are exercise's true believers and to further shake my faith in peer review.

No doubt exercise is great for your health, no doubt exercise is crucial in maintaining weight loss, lots and lots of doubt that exercise alone in real world experiments does much to help lower or maintain weight, and this study doesn't do anything to dispel any of it.

Seo, D., & Li, K. (2010). Leisure-time physical activity dose-response effects on obesity among US adults: results from the 1999-2006 National Health and Nutrition Examination Survey Journal of Epidemiology & Community Health, 64 (5), 426-431 DOI: 10.1136/jech.2009.089680

Saturday, May 22, 2010

Saturday Stories

Cariobrief's take on how Nintendo bought the American Heart Association.

The BBC's report on how parents should be more worried about childhood inactivity than murder (and while I understand the comparison, I'd love to see the source of their 1 in 3 kids who are inactive will develop serious health problems as a consequence statistic).

Science Based Medicine weighs in on whether or not cell phone use causes brain cancer.

If you only read one article about soda taxes, make it this one from the New York Times (though I find it laughable the columnist points to the American Heart Association as a source of credibility given their sell out to Nintendo and their atrocious Heart Check program)

Dr. David Katz explains why the latest study that suggests red meat might not be so bad for us, might not be such a good study.

Friday, May 21, 2010

Google's new phone - free with ads

The Onion News Network rarely disappoints.

While today's Funny Friday video on the Google phone starts out slow, it's worth sticking with it until it delivers.

Have a great weekend!

New Google Phone Service Whispers Targeted Ads Directly Into Users' Ears

Thursday, May 20, 2010

Badvertising: KD Smart thinks you're KD Stupid!


Kraft's got that in spades for trying to pass off Kraft Dinner as healthy by grinding in a smidgen of cauliflower.

And so how much cauliflower is in a serving of Kraft Dinner Smart?

Well I did my own quick analysis.

I based it off the fact that Kraft Dinner Smart contains 10% of the %DV of Vitamin C whereas Kraft Dinner Original has zero.

One ounce of cauliflower contains 22% of the %DV of Vitamin C so by my calculations that'd mean that per serving of Kraft Dinner Smart you're getting a grand total of 12.6 grams or just under half an ounce of cauliflower.

Now the ad says I'll get half a serving of vegetables per serving of Kraft Dinner Smart. The thing is, a "serving" of cauliflower would be 1/2 a cup of cauliflower and therefore I ought to have 1/4 cup per serving.

My calculations peg 1/4 cup of cauliflower as providing 19.25% of the %DV of Vitamin C. Therefore it'd be more accurate to suggest that you'd get 1/4 of a serving of vegetables per serving of Kraft Dinner Smart - two whole tablespoons worth.

So what miraculous product comes from the combination of white flour and two whole tablespoons of cauliflower?

Well if you compare nutrition facts panels (which is tricky because the Kraft Dinner Smart says a serving is 50g while the KD Original says it's 56g) you'll find that Kraft Dinner Smart has:

12% more saturated fat
9% more sodium
12% more sugar
4% less protein

You'll also find that you're getting ripped off in that Kraft Dinner Smart, which I'd be willing to wager is markedly more expensive than Kraft Dinner Original, has 33% less KD per box.

So if you think it's KD Smart to pay more for a refined flour product with markedly more saturated fat, sodium and sugar than its already nutritionally atrocious counterpart but is made with two whole tablespoons of cauliflower per serving, then Kraft's done their job by using deceptive badvertising to render you KD Stupid.

Wednesday, May 19, 2010

How many minutes a day should you exercise?

I don't think there's a one size fits all answer.

Last week the Canadian Society for Exercise Physiology (CSEP) and ParticipACTION released their new recommendations that saw their minimum recommended amounts of exercise drop to 60 minutes a day for children and 90-150 minutes a week for adults.

I was critical of their press release. I felt that by providing specific numbers and omitting calls to action to change the environment it perpetuated the notion that sloth is a disease of the individual, and by extension for many, that so too is weight and that the solution is increased personal responsibility. To me it seemed akin to the NRDC and Greenpeace putting out a press release about cleaning up the oil in the gulf of Mexico without a call to action for oil rig regulation reform and a call to actually plug the leak.

A friend and colleague emailed me to tell me that they felt I had been too harsh and that my post misconstrued the press release because I focused on the fact that the minimums had dropped while ultimately the report strongly encourages people to do more than the minimums. They also felt that having evidence-based guidelines for exercise was a good thing and mentioned that they felt evidence-based guidelines were something I ought to support given my call for evidence to be applied to Canada's dietary guidelines.

That led to an interesting email exchange (we're still friends) and given they read into my post intentions that weren't there, I figure it's best to flesh them out here.

So let me start by saying that I do not believe that society has recently been afflicted with an epidemic of laziness. People haven't changed, the world has, and to steal a line from Dr. David Katz, it used to be that calories were scarce and physical activity was unavoidable while today physical activity is scarce and calories are unavoidable.

Consequently I feel that press releases that simply focus on how many minutes a day everyone supposedly ought to be exercising fail to address the root cause of exercise deficiencies - the world we live in.

Cheap cars, suburbia, non-walkable neighbourhoods, irrational fears of child abductions, always on electronic tethers to work, constant chauffeuring of kids to activities, the Internet, video game consoles, hundreds of television channels, big box malls, etc. If we want people to take responsibility for exercising, I think we need to ensure we do our very best to empower them to do so and that means changing the world.

Elementary school children aren't lazy, they're just faced with a different environment than we were when we were kids and consequently their weights have risen. While my take on the literature is that the rise is more due to intake increases rather than output decreases, when it comes to exercise people always tend to focus on the "when we were kids we used to play outside" argument. Yes we used to play outside, but the alternative then was staying home with our parents and playing with them, talking to them, or doing chores, whereas now more attractive alternatives abound. Kids, like adults, are consumers of both time and pleasure. If there's a behaviour that's more fun, they're likely to choose it and many find playing video games, surfing the net, instant messaging, and iPhones, to be more entertaining than a ride around the block, a game of cops and robbers or hopscotch in the driveway.

I also disagreed that a fair comparison can be drawn between the utility of evidence-based exercise recommendations and evidence-based dietary recommendations. I disagreed there because the simple fact of the matter is that more exercise is good, any exercise is good and all exercise is good. Whether it's formal gym based exercise, playing with your kids, gardening in your yard or shoveling snow in the winter, simply put, it all counts, it's all good for you and doing more is better. The same certainly can't be said for food and consequently having more specific guidelines with food is much more of a necessity.

My friend felt that my assertion that the personal responsibility focus should simply be on getting people to exercise more rather than providing them with a specific number to shoot for was flawed and perhaps overly simplistic.

My thinking's pretty straightforward. It stems from SMART goal setting, which suggests that while goals should certainly be specific, goals should also be both realistic and attainable. What's realistic and attainable for one person may not be for another and frankly telling sedentary children or adults that they need to at a minimum exercise for 60 minutes a day isn't likely either.

More importantly though, I wonder if we'd be better off simply encouraging people to exercise more because that's more likely to have an actual impact than specific minute based minimum targets.

People should be encouraged to find small bouts of lifestyle based or more formalized exercises, with the recommendation being that every 5-10 minutes count.

Certainly the literature would suggest that multiple short bouts of exercise have many of the same health benefits as you'd get from more discrete large bouts of exercise, but perhaps more importantly research might suggest that people encouraged to find short bouts of exercise in fact do more exercise overall than folks trying to find those big blocks of time.

One such study, conducted in 1995 by John Jakicic and colleagues found that women encouraged to find multiple 10 minute bouts of exercise, exercised more frequently and with greater total duration than women who were trying to carve out 40 minute blocks of time for exercise.

Undeniably more is better, but why paralyze people with huge chunks of minimum more?

One argument my friend made, and it's a theoretical one, does fairly refute my post from a few days ago. They wondered whether or not CSEP and ParticipACTION would have been permitted to make specific governmental calls to action in their press release. They wondered whether or not the involvement of the Public Health Agency of Canada would have precluded any criticism of governmental inaction. I don't know the answer to those questions and indeed it's possible that they were muzzled and while if true it might help to explain the omission, it doesn't help change my most basic concern.

Press releases are by their nature picked up by the press. The press by its nature is busy and with rare exceptions doesn’t spend tremendous amounts of time researching back stories to succinctly worded press releases. While ParticipACTION may be involved with the Active Health Kids Report Card that does indeed include governmental calls to action as part of its 80 pages of commentary, the average reporter isn't going to dig that up to include it in their coverage of this story.

Consequently absent the call to action to government in the press release on exercise, what the CSEP/ParticipACTION press release does, along with provide recommendations as to how many minimum minutes of exercise are necessary, is continue to perpetuate the myth, a dangerous one at that, that individuals themselves are the problem, and not their environment. And while I don't for a moment believe that CSEP or ParticipACTION set out purposely to do so, press releases and calls to action which embolden the flawed notions that inactivity and weight are diseases of the individual have the unintended consequence of hamstringing efforts for the dramatic environmental reforms we so desperately need by taking attention off of the cause and focusing it only on the consequences.

So my answer to the question of how many minutes a day should you exercise? As many minutes as you can enjoy, and every single one of them count.

Murphy, M., Blair, S., & Murtagh, E. (2009). Accumulated versus Continuous Exercise for Health Benefit Sports Medicine, 39 (1), 29-43 DOI: 10.2165/00007256-200939010-00003

Jakicic JM, Wing RR, Butler BA, & Robertson RJ (1995). Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 19 (12), 893-901 PMID: 8963358

Tuesday, May 18, 2010

Canadian stimulus package funding gigantic ribfest?!

Yup. That's a picture of last year's festivities and according to a report in the Globe and Mail, "Canada's Largest Ribfest" is set to receive federal funding for being a "marquee tourist event".

The ribfest, slated for September 3-6th in Burlington, boasts that last year 175,000 people consumed 150,000lbs of ribs.

Indeed, that does sound like a marquee tourist event, but really, should the government be promoting it?

Having attended a few ribfests in my time I can tell you, they're not events that focus on moderation and the average rack of smoky barbecued ribs will contain in the neighbourhood of 1,000 calories and 4,000mg of sodium. Add some sides to that and most ribfesters will consume a day's worth of calories and likely 4 days worth of sodium in a single meal.

Remember too it's now abnormal in Canada to have a healthy body weight. Childhood obesity rates have tripled in the past 30 years. Healthcare expenditures are skyrocketing and dire predictions of the end of socialized medicine come more and more frequently.

While I think events like ribfests can be a lot of fun, I do find myself scratching my head to learn that the government thinks selling horribly unhealthy food is something they should be doing with my tax dollars.

I'd complain, but no one would listen.

[Hat tip to Peter from Vancouver's Humane Society]

Monday, May 17, 2010

Why is the Running Room promoting chocolate milk?

A few of my readers forwarded me an email they received from the Running Room this week. They received the email because at some point they had signed up for clinics or races at the Running Room.

The email's subject line was, "Recharge with Milk" and it contained the graphic up above which in turn is not linked to a Running Room website, but rather to the Dairy Farmer's of Canada's site extolling the virtues of chocolate milk.

Research has shown that eating foods inclusive of both carbohydrates and protein post heavy workout may in fact help with recovery, but it's important to focus on that word heavy.

A stroll is not a heavy workout. A short jog or run is not a heavy workout. A heavy workout is an extended or intense bout of exercise.

Chocolate milk is certainly not a magical post workout choice, it's just a post workout choice inclusive of carbs and protein.

Chocolate milk, for those of you who don't read my blog regularly, has drop per drop double the calories and double the sugar of Coca Cola. It's a liquid chocolate bar.

The Running Room does not sell chocolate milk in its stores.

The Running Room is a trusted resource for Canadian runners and walkers and is often the location of choice for beginners who may never have run or walked for exercise. This general mailing, out to everyone who's signed up for anything at the Running Room, is an abuse of the public's trust because consuming chocolate milk post stroll, walk, light jog or short run is going to do more harm than good for the average beginner.

The container in the advertisement is a 500mL container of 1% chocolate milk. It contains 15.5 teaspoons of sugar, 400mg of sodium and 360 calories, 40 calories shy of what you'd get from a litre of Coca Cola.

Chugging a litre of Coca Cola post walk, jog or run doesn't strike me as the best caloric plan. If you're concerned about weight, as many walkers and runners are, you'd best be sure to only drink that chocolate milk if you've walked more than 70-80 minutes or run more than 30.

If you're walking or running to lose weight, best to pass altogether and stick with water for re-hydration.

I wonder how much the Running Room got paid by the Dairy Farmers of Canada to effectively sell them their email directory and in so doing, sell out.

[Hat tip to blog reader and soon to be mom Jesse who was first out of the blocks with this unfortunate campaign]

Saturday, May 15, 2010

Saturday Stories

Larry Husten from Cardiobrief asks why is there a red dress on diet Coke cans?

The Neuromarketing blog covers the fact that men's brains seem to be wired differently than women's when it comes to fMRI driven body image studies.

Scott Stinson from the National Post opines about stupid studies that state the obvious.

Friday, May 14, 2010

Hockey night in the newborn unit

Hockey fans are an interesting bunch.

Just ask the rioters in Montreal.

Enjoy Verizon's take on hockey fans for this week's Funny Friday.

Have a great weekend!

[Hat tip to BMI's fitness director Rob]

Thursday, May 13, 2010

Canadian health authorities recommend we exercise less?!

Yesterday the Canadian Society for Exercise Physiology and the social awareness experiment called ParticipACTION recommended that Canadians exercise less.

What do I mean?

Well old guidelines advised Canadian kids to aim for 90 minutes of daily exercise and adults 30-60 minutes.

The new ones?

Kids are now supposed to aim for 60 minutes a day and adults 21 minutes a day if the exercise isn't particularly vigorous and 13 minutes if it is (they're recommending 90-150 minutes per week depending on intensity).

I guess their thinking is that perhaps the facepalm ridiculous recommendations of 90 minutes a day for kids and 60 minutes a day for adults was too daunting and that by actually recommending we aim for less, people will be less paralyzed with the knowledge they'll never hit the targets and actually do more.

Personally I think both the old and the new sets of recommendations are backwards.

What CSEP and ParticipACTION should be calling for are changes to the environment we live in, rather than calling for changes in individuals.

Off the top of my head they should be calling for:

- Tax exemptions for gym memberships, sporting equipment and organized sports.
- Industry encouragement to provide multiple 10-15 minute fitness breaks for employees.
- Corporate tax breaks dependent on the percentage of employees with proof of gym memberships or for corporation's whose health plans include fitness dollars.
- Increase in recess time and a greater focus on play in schools.
- Modification of parking lots to encourage parking further away with better lighting, creative line painting and signage.
- Renovation of government stairwells with better lighting, paint, art and music along with signage steering people to the stairs in building such as hospitals, libraries, art galleries and museums.
- Bike lanes anywhere and everywhere possible.
- Improving the country's hiking trails and mounting public awareness campaigns as to their existences.

Do CSEP and PartipACTION truly believe that by simply telling Canadians how many minutes a day they ought to exercise they're actually going to get Canadians out doing it? Given that there has never been a public health intervention where a simple call to action to exercise has been successful in inspiring people to do more exercise, including the 30 years of ParticipACTION between 1970 and 2000 when obesity rates in children tripled and exercise dropped off, if they do believe it they're quite simply delusional.

Our environment, our fast paced lifestyles, our perpetual kid carpooling, our electronic smart phone tethers, our always on Internet - these things are not going away and if we weren't finding the time to exercise before, telling us we have to do less certainly isn't likely to help us exercise more.

We need to physically change our environment to make physical activity unavoidable. All setting our exercise bar lower does is gives us all a lower target not to hit.

We need to enable action, not just call for it.

Wednesday, May 12, 2010

Pepsi Refresh adapts Big Tobacco marketing playbook for the 21st century.

Have you heard about Pepsi Refresh? If not, I promise you will, probably from your friends.

Pepsi Refresh is Pepsi's latest brilliant marketing campaign.

The premise is simple. Each month for a year consumers will be asked to submit and vote for Pepsi funded grants ranging from $5,000 to $250,000 in one of six areas: Health, arts and culture, food and shelter, the planet, neighborhoods and education. 1,000 applications are accepted monthly and applicants use their own social networks to rally for votes. Each month Pepsi will fund up to 32 projects and they estimate that over the course of the year they'll give out in the neighborhood of $20 million to "refresh everything".

So what's in it for Pepsi?

Public sentiment and trust. Effectively this is a one year legitimacy campaign with the aim of creating deep and meaningful positive connections with consumers in some of the very areas that Pepsi has run into difficulty - health (obesity), food and shelter (junk food), the planet (factories, waste and plastic), and education (obesity).

Ultimately Pepsi Refresh is an extremely cost effective public relations and framing tool geared to position Pepsi as part of the solution and not as part of the problem, a play perhaps learned from the experiences of Big Tobacco.

In Brownell and Warner's fantastic paper, "The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food?" they lay out the playbook of Big Tobacco in their handling of the news that smoking was really, really bad for you.

In their opinion the writing of the playbook began on January 4th, 1954 when the industry published, "A Frank Statement to Cigarette Smokers" and had it published in 448 newspapers with the personal signatures of the top Big Tobacco executives adorning the statements,

"We accept an interest in people’s health as a basic responsibility, paramount to every other consideration in our business."


"We always have and always will cooperate closely with those whose task it is to safeguard the public’s health"
Flash forward to 2010 and here's Pepsi doing the very same thing but this time with the harnessed power of social networking.

Brownell and Warner describe Big Tobacco's statement as,
"a charade, the first step in a concerted, half-century-long campaign to mislead Americans about the catastrophic effects of smoking and to avoid public policy that might damage sales"
and that their reasons for launching it in retrospect were as plain as day,
"The industry wanted desperately to prevent, or at least delay, shifts in public opinion that would permit a barrage of legislative, regulatory, and legal actions that would erode sales and profits."
And what are Pepsi's concerns?

Schools are banning the sales of their products, governments are considering soda and junk food taxes, banning advertisements targeting children, and creating more transparent food labeling laws, while the public is growing more and more concerned about the impact of obesity on their future and that of their loved ones.

Pepsi is taking the Big Tobacco playbook and giving it some 21st century polish. And it's not just their Pepsi Refresh project.

In February Pepsi teamed up with Yale University's Faculty of Medicine to open a research laboratory to fund the development of, "healthier food and beverage products" as well establish a fellowship to Yale's MD/PhD program to fund work on nutritional research. This led Michele Simon, public health lawyer and author of Appetite for Profit (the book and the blog) to quip about returning her Yale law degree.

The Wall Street Journal explained Michele's concerns,
"When a business gets its name worked into the academic fabric of a school, it is buying something more than a place to slap a corporate insignia. There is the implication that the firm is a partner in the intellectual enterprise."
Pepsi wants you to believe that they're part of the team trying to find the solution, not the team fueling the problem.

Never mind that they're spending $30 million rebranding Gatorade to snag teenage athletes, never mind the $5 million they spent in 2009 lobbying the American government to help stymie progressive food marketing, or the $6.7 million they spent in 2009 lobbying the government to support their stances on school nutrition, or the nearly $7 million they spent in 2009 lobbying against soda taxes - they're the good guys, just look at what they're doing with Pepsi Refresh.

More depressing still? I've had high school friends and blogging buddies, including physicians and researchers, send me links on Facebook and Twitter encouraging me to vote for the Pepsi Refresh projects they felt worthwhile.

If they can't see through this Big Tobacco'esque smoke screen, who will?

Ultimately Pepsi Refresh is meant to refresh Pepsi's image. If Pepsi can sway the court of public opinion to think they're the good guys, that gives them clout politically. How? Politicians, expect perhaps New York's politicians, tend not to push issues where they don't have public support. Much tougher to garner public support for practices that might impact negatively on Pepsi when what the public remembers is that Pepsi offered to fund little Timmy's classroom computers, or a $250,000 program to help combat childhood obesity. With 1,000 different grant applications a month that means there are 1,000s of folks each month all harnessing the power of their own personal social networks to spread the word that Pepsi's a wonderful company.

Brilliant. The stuff of I'm sure many future case studies in advertising textbooks.

I know that the Big Food apologists out there will argue that it's sour grapes that makes me be so negative. Why not take money from Pepsi to do good? What harm is there?

My answer?

How many years did Big Tobacco manage to continue to pull the wool over people's eyes and minimize the negative impact of their products? How many deaths are attributable to their stall tactics?

Obesity is now the number one preventable cause of death and my hope would have been that at the very least those who should know better would feel it just as anathema to stump for Pepsi funding community altruism as they would feel stumping for Philip Morris.

I don't think junk food can, or should be banned, but that doesn't mean that people should feel comfortable getting into bed with Big Food. Philip Morris is still allowed to sell cigarettes, but at least no one in their right mind would touch them with a ten foot pole for research fellowships, University chairs, hospital wings, health conference sponsorships or funding their children's school's computer room. I can only hope that one day the same will be true of the purveyors of junk food.

Deals with the devil always have consequences.

BROWNELL, K., & WARNER, K. (2009). The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food? Milbank Quarterly, 87 (1), 259-294 DOI: 10.1111/j.1468-0009.2009.00555.x

Tuesday, May 11, 2010

Rapid weight loss is the best way to keep it off?

You'd sure think so if you'd just been reading headlines.

You see a study came out last week in the International Journal of Behavioural Medicine that looked at the impact the initial rate of weight loss had on long term success in 262 women over the course of an 18 month weight management program.

The study is a mess. Before I get to the results, let's go over some methodological issues.

Firstly the study represents a secondary data analysis of a different randomized controlled trial. That pretty much always means trouble because it means that the trial wasn't in fact originally designed to properly answer the study question.

Secondly when analyzed, the racial makeup of the fast, medium and slow groups were markedly different with the slow group being primarily made up of visible minorities and the fast group Caucasians, and while the authors describe using ethnicity as a covariate in further data analysis, I wonder how that's possible given there were only 65 non Caucasians enrolled in the study with a grand total of 6 ending up in the fast group.

Results wise the authors conclude that it is the speed of loss that determines longterm success. Yet the authors also report that the fast and medium speed losers had better session attendance, better food diaries, consumed fewer calories and took more steps than those in the slow group. Wouldn't this then suggest that longterm success is dependent on adherence to one's treatment plan? Is that news?

Even the authors realize their study added nothing to the literature. In their words,

"This study used a correlational design and thus cannot directly assess causality. This post-hoc separation of groups according to initial rate of weight loss did not account for underlying physiology or behaviors that may have self selected participants into each group and determined longterm outcomes."
Translation? Even the authors realize that you can't make any conclusions about the results because there are a multitude of factors that may in fact provide better causal explanations.

But my biggest beef with the study is their use of the words FAST, MEDIUM and SLOW.


Because when people think about rapid weight loss, they think many pounds a week. They think about things like the very-low-calorie-diets (VLCDs) the authors themselves refer to in their discussion. They think of losses easily running into the 3-5lb/week range.


FAST was the term used to describe folks where an arbitrary post-hoc analysis not designed to look at cause revealed losses averaging more than 1.5lbs a week. MODERATE was for losses averaging between 0.5-1.5lbs per week and SLOW for those averaging less than 0.5lbs per week.

Not exactly dramatic between group differences and not exactly what most would think of when they heard the term, "FAST".

Why does that piss me off so much? Because when the media grabbed hold of it headlines, blogs and tweets all sounded off about how rapid weight loss is a great idea, the best way to lose weight, and yet there is a wealth of studies suggesting that rapid weight loss may in fact be a bad plan, that VLCDs are a really bad plan, and that there may be additional health risks to overly rapid weight loss.

Reporters and bloggers - while I recognize it's not your job to be experts, I would expect that at the very least your job is to read the article you're writing about and even a casual read would inform anyone that this study is not in fact talking about rapid or fast weight loss and moreover isn't a study that anyone can draw real conclusions from.

Peer reviewers - really? A post hoc analysis that certainly can't be relied upon for any real conclusions? Did you even read it?

Authors - Fast, medium, slow? Sure, a sexy title, but whether you meant to or not, all you've succeeded in doing here is use an admittedly useless study to promote unhealthy dieting practices.

Publish or perish, never mind the consequences.


Nackers, L., Ross, K., & Perri, M. (2010). The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race? International Journal of Behavioral Medicine DOI: 10.1007/s12529-010-9092-y

Monday, May 10, 2010

Supermarket endorses Meatless Mondays - Beef Information Centre busts a spleen

So it started harmlessly enough. Sobey's (a grocery chain) printed its Spring issue of Inspired Magazine which featured an article on how to "be green".

Among their three suggestions was, "Try going meatless once a week" with reference to the Meatless Monday's movement. They also suggested that eating less meat overall could help to lower your intake of cholesterol and saturated fat.

That ticked off Laura Bodell.

You see Laura's the co-owner of Bella Spur Innovative Media Inc., an Edmonton based company that caters to the beef industry. Laura read the article in Sobey's Inspired magazine and according to coverage in trade magazine Western Producer, decided to launch a letter writing campaign on Facebook because, "My clients’ livelihood is based on the popularity of beef."

Now while I can't find any such campaign on Facebook, the Beef Information Centre, the marketing snout of the beef industry, did get wind of this outrageous outrage and jumped into action. Ron Glaser, their Executive Director of Communications sent a comical letter to Belinda Youngs, Sobey's Chief Marketing Officer.

The letter lays out beef's defense.

Wait for it.

Beef's good for you because, hmmm.

Wait for it.

Beef's good for you because regardless of the incredible variety of cuts and types of fresh and processed beef there exist 8 cuts that qualify for the Heart and Stroke Foundation's Health Check!

It's also good for you because it's included in Canada's Food Guide and contains, guess what, nutrients!

Ron then goes on to talk about how cattle are raised on lands that couldn't be forests and that the methane produced by cow flatulence depends on feed quality and that Canadian feed quality is top notch.

I guess that means also top notch is our cow flatulence, and reading the letter I couldn't help but be surprised that Ron didn't try to make the argument that Canadian cow farts actually smell like roses.

Viva Meatless Monday!

[For the other side of the beef/environment argument head over to Meatless Monday's site where you can find all sorts of information that I'm sure Ron Glaser would find fault with.]

[Hat tip to Meatless Monday aficionado Peter Fricker from the Vancouver Humane Society]

Saturday, May 08, 2010

Saturday Stories

Ten things not to say to someone with cancer - a brilliant post by a young woman whose fight with breast cancer ended recently. Thanks to Angela Mulholland from CTV for steering me to Leanne Coppen's blog, Living with Breast Cancer.

Registered dietitian Sybil Hebert takes the Dietitians of Canada to task for their corporate Big Food sponsorships. I'd read this one quickly! I bet it's already set off war drums over at Dietitians of Canada. Important to note, this is a real dilemma with no easy solution. Who else is going to fund Dietitians of Canada other than the food industry? And yet, if the food industry steers the ship, who's going to trust the voice of the captain?

Dr. Arya Sharma comments on parenting styles and adolescent obesity risk.

The newly doctored Peter Janiszewski from Obesity Panacea covers research asking how much salt is in your fast food?

Friday, May 07, 2010

Look at me, look at me, look at me!

Today's Funny Friday is Beth Fulton's fantastic interpretation of Todd Alcott's poem, "Television".

I feel so cultured.

Have a great weekend!

Television is a drug. from Beth Fulton on Vimeo.

Thursday, May 06, 2010

Who matters more to newspapers - readers or advertisers?

That's the question I asked myself when I saw the ad one of my patients cut out of last week's National Post.

The ad was placed by MacMillan Orchards to sell their maple syrup and the copy reads,

"Recent studies have disclosed the remarkable health benefits of dark maple syrup.

They include higher quantities of antioxidants, manganese and zinc and immune boosters.

It also has anti-inflammatory qualities and increases good cholesterol.
They must be really, really recent studies because searching Medline from 1950 through to the 3rd week of April 2010 I can't come up with a single study, well designed, peer reviewed, or otherwise, that describes the effects of maple syrup ingestion on systemic inflammation or on cholesterol.

So it would seem that MacMillan Orchards, the folks trying to sell you their maple syrup, are quite comfortable lying to you to do so. They're happy to just make stuff up to try to entice you to believe that eating maple syrup, basically just liquid sugar, will help reduce systemic inflammation and increase your good cholesterol.

According to the National Posts' parent company Canwest, their core values are to,
"Serve the customer
Strive for quality and excellence
Win, but fairly with integrity and honesty
Empower citizens with knowledge
Give back to the community
Not sure how printing outright lies geared to dupe readers into making misinformed choices represents those values.

Shame on MacMillan Orchards, and shame on the National Post. Both should know better.

Wednesday, May 05, 2010

Badvertising Bagel Bites

"Which would you rather give your kids?"
Is there a door number 3?

Why would I want to give my kids horrific, heavily processed, lowest common denominator nutrition, food garbage?

I love this ad though and truly admire their chutzpah.

The ad's premise is simple. Totino's pizza rolls have lots of scary sounding ingredients in their cheese so you should feed your kids Bagel Bites instead.

I decided to look up Bagel Bites' ingredient list and found out that while its cheese only has 4 ingredients the rest of this frankenfood has 37!,
"Bleached Wheat Flour, Water, Mozzarella Cheese (Milk, Cultures, Salt, Enzymes)Tomato Puree (Tomato Paste, Water)Pepperoni (Pork, Beef, Salt, Spices, Water, Dextrose, Seasonings [Oleoresin of Paprika, Natural Spice Extractives, BHA, BHT, Citric Acid]Lactic Acid Starter Culture, Sodium Nitrate)2% or Less of: High Fructose Corn Syrup, Modified Cornstarch, Salt, Soybean Oil, Yeast, Whey Protein Concentrate (Milk)Nonfat Milk, Flavor Enhancer (Potassium Chloride, Ammonium Chloride, Yeast Extract, Maltodextrin [Corn]Lactic Acid, Citric Acid, Calcium Lactate, Natural Flavor)Methylcellulose, Citric Acid, Red Pepper, Natural Flavor, Dough Conditioner (Ascorbic Acid)Enzymes.

Oh, and guess what. Bagel Bites have 21% more sodium and 250% more sugar than Totino's Pizza Rolls.

Of course making an argument that Bagel Bites are better to give your kids than Totinos or vice-versa is like making the argument that it'd be better to get kicked in the nuts than get punched in the nuts.

Don't buy your kids either!

Make them actual food.

Tuesday, May 04, 2010

Badvertising: Lunchables Turkey & Cheddar Sub

"it doesn't get better than this"
Way to set the bar low Oscar Meyer.

Here we've got a tiny little sandwich that contains 8 teaspoons of sugar and 600mg or half of your child's daily maximal recommended amount of sodium.

Gravity might not stand a chance, but neither do your children if you've given up to the point of feeding them Lunchables on a daily basis rather than taking a whole 5-10 minutes out of your day to make your children, your most precious possessions, lunches that are actually nutritious

Monday, May 03, 2010

Sign of the times - pharmacies provide free diabetic medications

Ever hear of a "loss leader"?

A loss leader is an item a store sells at a loss to draw people into the store. The premise is that by leading them into the store, the loss will be more than made up by spending elsewhere.

Milk's a pretty common loss leader for pharmacies where it's often sold cheaper than in supermarkets. Of course most everything else in pharmacies is marked up through the roof, but still, that milk is cheap and so often that's where I'll go to get it.

Milk's a good loss leader because most households buy it, it has an expiry date so people won't stockpile it, and you can place it in the back corner of the store so people need to walk through other aisles to find it and in so doing be more likely to grab other, higher priced items.

Items that would make bad loss leaders? Things not enough people want or need as it simply wouldn't draw in enough business to recoup the losses.

So what does that say about Meijer's latest plan to give away free prescription diabetes medications?

Yup, Meijer's, with 191 stores across 5 American States has announced that Metformin, the most commonly prescribed diabetic medication, a drug that retails there for between $14 and $42 monthly, will be dispensed freely to those with prescriptions.

The medical community there is thrilled, and so too I'm sure are uninsured patients.

Me? I don't find it as thrilling. Sure it's wonderful that low income folks will no longer have an issue affording their medication but what does it say about the state of the nation that diabetes medications can be successful loss leaders, and not just at discounted prices but at 100% markdowns?

It says that type 2 diabetes, weight-related diabetes, is now so prevalent that actually giving away the medication for free is a cost effective strategy for improving store sales.

Given the exponential rise in the risk of obesity with rising weight, diabetes rates are set to soar with some predictions suggesting rates are set to more than double by 2050.

That's a lot of free Metformin.

Saturday, May 01, 2010

Saturday Stories

Michael Ruhlman calls bullshit on you being too busy to cook.

Physician Bruce Dan blogs about his fight with acute myelocytic leukemia. Keep on slugging Bruce!

The New York Post has the best headline of the week in, Putting the "Die" in Diet in a story about how a nutritional supplement maker almost killed himself by taking his own supplements.