Wednesday, November 24, 2010

"Health Check makes it easier for Ontarians to make healthy choices at Pizzaville"

That was the wording of the Heart and Stroke Foundation's Health Check program's proud press release headline on Monday.


I suppose now eating out at Pizzaville is a healthy, good for you, endorsed by the Heart and Stroke Foundation's own dietitians thing to do.

Never you mind that Health Checks on menus might in fact encourage people to eat out at restaurants more frequently. Never you mind that even health conscious, spurred by Health Check's involvement folks, once in Pizzaville may decide to order something else off the menu. Never you mind that there are no Health Check appetizers, desserts, or kids' meals at Pizzaville. Never you mind that research has shown that simply having healthier options on a menu inspires less healthy choices. Never you mind that most people don't hit restaurants alone and their not as health conscious friends, spouses or children will likely order some other nutritionally god-awful fare. It's all good, right?

So what could Health Check's dietitians possibly be thinking?

Basically their argument is that people are eating out anyhow so why not help them make healthier choices?

In fact in her blog post titled (I kid you not), "Making a difference one Pizza at a time", Health Check dietitian Samara Foisy spells this out quite explicitly. She points out that,

"Canadians eat out. A lot. About one of every ten meals we eat comes from a restaurant. According to Stats Can one in four Canadians consume an item from a fast food restaurant daily. And what are we choosing? About 40% of the time either a sandwich, hamburger, hot dog or pizza."
So rather than have the Heart and Stroke Foundation actually try to discourage such frequent meals out Samara wants, "to be practical",
"If I can help people make healthy eating choices when they are eating out, then I have definitely made a difference. By working with restaurants to get some healthier items on their menus and identifying these healthier items for customers I have the opportunity to help a lot of people. And as a dietitian, this is an opportunity I don’t want to miss."
By this logic I'd expect that knowing that lots of folks still drink and drive should have MADD celebrating the creation of a MADD sponsored 2% alcohol brew, or find the Canadian Lung Association knowing that there are still a great many teen smokers proudly stamping their seal of approval on a package of half length cigarettes.

Ultimately while I think it's great that Pizzaville is trying to offer less bad for you fare, I find it horrifying that going to Pizzaville for dinner is effectively being encouraged by the Heart and Stroke Foundation.

Ok, so you folks certainly know where I stand on this, but I'm curious what the dietitians and non-health professionals reading my blog think.

Is the Heart and Stroke Foundation an enormous, hypocritical, nutritional sellout by enabling Canadians to justify eating out at restaurants and in so doing further normalize regular meals out (one of the major contributors to growing rates of obesity and chronic disease in Canada) , or are they in fact rising to an opportunistic challenge?

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  1. You perspective is interesting, particularly the comparison with drinking and smoking. The reality is, people do eat out a lot and make unhealthy choices for faster options at home and out. It is a long road to change old habits...having a healthier option along the way may help some. We always encourage our members to make the "healthiest choice available". I don't eat fast food at all anymore but that took a few years and a lot of changes. I think the big issue is these options are HEALTHIER than other options but not necessary a HEALTHY choice. Love your blog.

  2. You know I'm going to agree with you on this 100%. It's similar to just dumbing things down.

    "Well, if people arent going to eat healthy, lets get them to eat not SOOO unhealthy."

    While I think it can be kind of understood, the fact of the matter as a culture we are diving in to a pool of lard we arent going to be able to swim out of.

    I'm not sure about how your health car works in Canada, heck I'm not even sure how it works in the U.S. right now, but obesity is such a heavy weight on our health care system, and all we are doing is feeding it more.

    Then we have morons that go on CNN talking about the twinkie diet saying that for the most part it doesnt matter what you eat, just not too much of it, and saying that it's ridiculous to think people will eat fruits and veggies. I'd love to get your take on that guy Yoni.

    But I'm with you. Screw the pandering. Tell it like it is. If you're going to eat something bad, lets not pretend like it's good!

  3. oops... *health care not car :)

  4. I agree with you that Health Check and similar campaigns should be based on science. If the science does not support the view that Health Check benefits the public health, it should be discontinued. That said, I am not personally familiar with what evidence is out there on this. The study you discussed in which the presence of healthier choices on a menu caused people to choose *less* healthy options was fascinating -- and disheartening.

    I don't know what the answer is, because certainly one would not want to discourage restaurants from offering healthier items.

    Anyway, great blog.

  5. We have a saying around here at work: Never attribute to malevolence or bad intentions things that are more easily explained by ignorance and incompetence. Maybe the Heart and Stroke Foundation is staffed by the ignorant and incompetent!

  6. Just to let you know, I'm running in the Thanksgiving Day race tomorrow in Cincinnati. One of the sponsors is McDonalds, and they give out headbands. I was going to go with a Underarmour one, but i think I'll do the McDonalds one upside down! If I do, i'll send you the pic lol

  7. You wouldn't have made a very good lawyer Dr. Freedhoff! That last question was what they call "leading the witness" :-) But I completely agree with you. The HSF is a Foundation and needs funds to support its operation. I'm sure a good deal of those funds come from its corporate sponsors. What they should encourage is making menu board or printed menu calories mandatory. I try to maintain a healthy weight. I've been on Weight Watchers 2 years now and have regained 15 of the 40 pounds but work continuously to get back down to a healthy BMI. However, any time I eat out (only once a month) it is like pulling teeth to get calorie information to make healthy choices. Next time you're at Boston Pizza, a Health Check stalwart, ask for a calorie guide. Take a picture of the look the waitress gives you.

  8. Given that one of the primary reasons(but certainly not the only reason)why people/families decide to eat out is for convenience, why doesn't the HSF spend more time promoting healthy quick and easy to make lunch and dinner recipes??

  9. Dr. Freedhoff, I'm curious, how would you rate the H&S Health Check Nutritional Criteria?

  10. Anonymous8:23 pm

    My issue is that these labels give people the wrong idea. People view the Health Check label as "heatlhy" when it's really just a little bit less detrimental to your health. Marginally. A dietitian backing that is doing a disservice to her clients, the public and our profession.

    I'm frustrated, and even sometimes ashamed, of some of the affiliations in our profession. Dietitians of Canada is funded by big food business, and hand out chocolate bars at conferences.

    At the end of the day, yes, people are going to eat out and eat junk sometimes, and as I dietitian I ACCEPT that, but I will never ENCOURAGE it.

  11. After just reading the China Study, as a dietitan, I feel like I need to take a whole new perspective on my philosophy about nutrition.
    It is sick how Americans and I guess Canadians too are being fooled by large corporations who are just money hungry, trying to appeal to those looking to lose a few pounds.
    The "healthier" options are usually very limited on restaurant menus and people DO stray away from them.
    I don't know what the answer is, but I guess it is my job to educate people about the importance of REAL, WHOLE foods, that you cook for yourself and how valuable it is to eat as a family from your home.
    ug. So much work to do...