Saturday, July 31, 2010

Saturday Stories


A wonderful interview with Marion Nestle on how Big Food hijacked nutrition.

Colby Vorland on conflicts of interest and the American Dietetic Association.

The New York Times on whether or not science should be a prerequisite for medical school.

Steven Novella of Neurologica explains why you might want to stop taking your calcium supplement!

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Friday, July 30, 2010

Babies like watermelons!

Sadly my baby's probably too big to recreate this Funny Friday's now viral YouTube video.

Have a great weekend!



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Thursday, July 29, 2010

Breaking News: Canada's Sodium Working Group's Recommendations


It's not often I'm thrilled with something the government's had a hand in but today I'm thrilled with the recommendations that have come from Canada's Sodium Working Group.

CSPI posts the highlight reel which includes:

  • Reducing the Nutrition Facts table’s “daily value” for sodium from 2,400 mg to 1,500 mg, mandate standardized serving sizes as the basis for reporting nutrition information, and retrofit labels to facilitate improved consumer understanding after the US Institute of Medicine’s report on front-of-pack food labelling is published in 2011

  • Mandate prominent placement of sodium and calorie information at chain restaurants serving standardized fare;

  • Ensure regulatory standards for products using protected names like cheese and pickles to permit the use of low-sodium salt substitutes;

  • Include sensible sodium limits in government food-service policies and procurement contracts (e.g., for schools, hospitals, and the military);

  • Retrofit advice in Canada’s Food Guide on caloric intake and sodium.

    But please folks, don't hold your breath until these get done. Not to be a killjoy but I can't help but think of the wonderful recommendations that came out of Canada's 2006 Trans-fat Task Force which have yet to be acted upon.

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  • England's health officials continue to prove they're among the dumbest in the world.


    Hat tip to my friend and colleague Arya Sharma for his tweet which pointed me to the latest from across the pond.

    Apparently Anne Milton (pictured up above) the British parliamentary under-secretary of state for health, has called upon GPs to start calling their patients "fat" so as to "inspire" them to take, "personal responsibility" for their weight.

    Of course the notion that obesity is a disease of the individual, of "personal responsibility" and not a disease of a toxic, obesogenic environment is one near and dear to the food industry's so-called heart.

    As I've reported this week on my blog, the messages the food industry want shouted from the rooftops include:

    - There's no such thing as a bad food.
    - Obesity is caused by inactivity and treated through exercise.
    - It's about "balancing" energy in vs. energy out.
    - It's about taking "personal responsibility".

    And lately British health officials have been singing all four.

    I know I have some British readers and wondering if you folks might know - is there a transparent means whereby money spent by the food industry lobby on your politicians can be tracked? Given what's come out of the mouths of your officials these past 2 years, I'd be willing to wager tens of millions of pounds are involved.

    To add to Anne's crystal clear clarion call of stupidity, here's a quick recap of what were once only the wet dreams of British food marketers yet now are their daily realities:

    Jan. 2009 - England's government launches 3 year "Change4Life", food industry funded and government overseen program replete with useless messages of the, "Eat less, exercise more" camp with emphasis on the "exercise more".

    June 2010 - England's Health Minister Andrew Lansley slams Jamie Oliver inspired school lunches campaign that led to the removal of processed garbage from middle schools.

    July 2010 - England's Health Minister Andrew Lansley spews the food industry party lines of, "there's no such thing as a bad food", to the Faculty of Public Health in London while informing them of the British government's divestment of any involvement in Change4Life. He then tells them he's turning over direct control of Change4Life to the food industry and in return for their continued funding he's promised not to regulate them.

    July 2010 - England strips their Food Standards Agency (FSA) of their food labeling responsibilities because they had been pressing for the adoption of front-of-package traffic light labeling. Now that labeling's been formally returned to the hands of industry's best friend Andrew Lansley, guess what? No traffic lights.

    All I can say is good thing they've no longer got an exclusively socialized medical system over there for so long as the likes of Anne Milton and Andrew Lansley are at their health system's helm, that system's in big trouble.

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    Wednesday, July 28, 2010

    Can extremely low fat diets lead to obscene conflicts of interest? (Dean Ornish edition)


    That's certainly the question I'd love to ask Dr. Dean Ornish.

    Who's he?

    Well he's perhaps the most famous low-fat diet guru of all time and the founder and President of the non-profit Preventive Medicine Research Institute in Sausalito, California.

    His career has been exceedingly illustrious. Ornish is a best-selling author, a world-class researcher, an award-winning physician and he was voted "one of the most interesting people of 1996" by People magazine, one of the "TIME 100" in integrative medicine, one of LIFE magazine's "fifty most influential members of their generation" and one of Forbes magazine's "seven most powerful teachers in the world."

    Pretty lofty stuff.

    So what does one of the most powerful teachers in the world and one of the most influential members of their generation want to teach you?

    Usually it's how to eat an almost insanely low-fat diet but not when he's working for the Mars chocolate, confectionery and beverage conglomerate. When he's working for Mars he wants to help feed you Big Food's party line that,

    Feeling good is all about balance. It’s important to balance work life with time spent with loved ones, it’s important to find a balance between what we eat and how much we exercise
    He also wants to feed you the other Big Food party line that there's no such thing as a "bad food", something I blogged about a ways back.

    Now I don't disagree entirely with Ornish in that a sustainable lifestyle does need to include such things as chocolate bars, but I'm not about to start selling them for Mars Inc.

    Not so with Dr. Ornish. His message, that joy is a powerful medicine, when grabbed hold of by Mars' marketers gets spun into this message taken directly from their website,
    "At Mars, our products provide opportunities for people across the world to practice pleasure in balance every day. Mars chocolate products should be enjoyed in moderation as part of a healthy and well-balanced lifestyle – and bring people small moments of joy in the process. In fact, our vision is to make more moments of joy in more places, bringing more smiles into the world. We’re in the business of making people feel good, and that means being a part of a balanced and healthy lifestyle that supports your physical and emotional well-being. .

    We love being a part of many different kinds of chocolate moments.

    • A child sharing a treat with a friend.
    • Parents enjoying a quiet moment together at the end of a busy day.
    • A small celebration after a successful meeting.
    • Sweet memories from holidays, parties and gatherings.

    More Moments. More Places. More Smiles."

    Not less chocolate - more.

    More chocolate in more places.

    How many joyful chocolate moments is Ornish helping to sell? Again, according to the Mars website,
    "At Mars, we're responsible for more than 500 million chocolate moments each day! And our vision is to make more moments of joy in more places - bringing more smiles into the world."
    And now Dr. Dean Ornish, one of our generation and world's most influential teachers, lends (sells) his powerful voice to that vision, a vision that can be summarized as.
    More, not less; there is no such thing as a "bad food"; and really all you need is a balanced active lifestyle.
    Shameful is too soft a word to describe Dr. Ornish's cozy conflict of interest with Mars.

    That said I probably shouldn't be surprised. After all, before Dean Ornish was using his world class influence and teaching abilities to sell chocolate bars, he was using it to sell Big Macs.

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    Tuesday, July 27, 2010

    "Exercise is Medicine" (and a great smokescreen for Big Food)


    Further to my post from yesterday regarding the innocence by association test for conflicts of interest comes "Exercise is Medicine".

    Exercise is Medicine is a laudable organization whose aims are,

    "To make physical activity and exercise a standard part of a disease prevention and treatment medical paradigm in the United States.

    and,

    "For physical activity to be considered by all health care providers as a vital sign in every patient visit, and that patients are effectively counseled and referred as to their physical activity and health needs, thus leading to overall improvement in the public's health and long-term reduction in health care cost."
    It has great buy-in too with a massive list of supporters that include the who's who in health promotion.

    So why am I knocking it?

    It's not so much that I'm knocking it, more I'm questioning its role, as Big Food conspiracist that I am, I see a dual role for Exercise is Medicine.

    On the one hand its role is to encourage exercise for health - a true, valuable and important endeavour.

    But on the other hand, its other role is to serve its founding sponsor Coca-Cola, in the promotion of the assertion that the best means to deal with our current obesity epidemic is to ensure that people exercise. Or to put it another way, that sugary soda's not a bad thing so long as you live an active lifestyle.

    The "obesity can be treated effectively through exercise alone" message, crucial to the purveyors of high calorie foods everywhere, is indeed spread by Exercise is Medicine,
    "This is just the beginning. Hopefully, the insurance and medical communities will soon realize that the most effective way to treat and prevent a wide variety of obesity-related conditions is through exercise."

    - Press release from Exercise is Medicine founding partner Anytime Fitness, June 28th, 2010

    "As a whole, people are significantly less active today, even compared to just 20 years ago. When we look at the data that shows how diseases like obesity and diabetes are rapidly increasing, there's an obvious correlation to the decline in physical activity.

    Even though everyone has heard it before, something as simple as taking the steps instead of an elevator can make a big difference. It's too easy to consume a massive amount of calories and sit at a desk all day - both of which have negative consequences to our health. We need to remember to take breaks during the day to take a ten minute walk. Any bit of activity is better than being sedentary."


    - Press release for Exercise is Medicine quoting Sandra Billinger, PT, PhD, FAHA, research assistant professor in the KU Physical Therapy and Rehabilitation Science department, June 9th, 2010

    "Dr. Sallis poses this question to health-care providers: "What if there was one prescription that could prevent and treat dozens of diseases, such as diabetes, hypertension and obesity? Would you prescribe it to your patients? Certainly."

    Well, there is one prescription available to you that will do just that. It's called exercise."


    - Dr. Robert Sarlis, past President of the American College of Sports Medicine (a founding partner of Exercise is Medicine) to Charleston's Sunday Gazette-Mail, March 7th, 2010

    "The International Health, Racquet & Sportsclub Association (IHRSA) announced today their partnership with the Institute of Lifestyle Medicine (ILM); a division of Harvard Medical School's Department of Physical Medicine and Rehabilitation and of Spaulding Rehabilitation Hospital. IHRSA and ILM join together to fight the global obesity epidemic by working to improve physician knowledge of the science and benefits of physical activity, and to increase the practice of physician-prescribed exercise."

    - Press release from Active Doctors, an organization whose President is part of Exercise is Medicine's Task Force, May 19th, 2009

    "In an effort to decrease the prevalence of childhood obesity and promote physical activity to children, the American College of Sports Medicine (ACSM) has announced a partnership with the Youth Fitness Coalition (YFC). This partnership will feature ACSM's Exercise is Medicine(TM) initiative, designed to encourage America's patients to incorporate physical activity and exercise into their daily routine, and YFC's signature program, Project ACES (All Children Exercise Simultaneously)."

    - Press release from the American College of Sports Medicine, March 10th, 2009
    The message that obesity can be prevented or treated with exercise is an important one to the food industry as it shifts the blame for obesity from the consumption of their calorific products to a decline in fitness, a link which at best is described as debatable and at worst, inconsequential. It also fuels Big Food's ability to preach about what Coca-Cola refers to as, "an active, balanced lifestyle", McDonald's a, "balanced, active lifestyle" and "it's what i eat and what i do ... i'm lovin' it" campaign, Pepsi a, "balanced lifestyle", Unilever a, "balanced diet and lifestyle", Mars a "well-balanced lifestyle", and Nestlé' a, "balanced lifestyle".

    That the message is being spread by Exercise is Medicine and sometimes directly and other times by extension by the exceedingly reputable organizations included in Exercise is Medicine 397 signatory partners helps embolden the purveyors of calorific foods to make statements like Pepsi CEO's Indra Nooyi's,
    "If all consumers exercised, did what they had to do, the problem of obesity wouldn't exist."
    And Coca-Cola's President Sandy Douglas',
    "And we're for active lifestyles, with more than 6 billion Diet Coke packages helping the National Heart, Lung and Blood Institute remind women about the importance of staying active and maintaining a healthy weight, and our support of physical activity initiatives like Exercise Is Medicine."
    Ultimately, while exercise is indeed medicine, Exercise is Medicine again illustrates the risks and inherent conflicts of interest consequent to Big Food partnerships, and I would argue these risks and conflicts shouldn't come as a big surprise.

    Why?

    Because Big Food doesn't care about your health; they don't care about your well-being; and they don't care if you exercise. All Big Food cares about is whether or not you'll buy their products, and certainly every single dollar they spend on programs such as Exercise is Medicine are earmarked to further that goal. A goal Coca-Cola's certainly meeting as last week they reported North American sales volume growth for the first time in two years which led Coca-Cola CEO Muhtar Kent to proclaim,
    "We firmly believe that North America will be a growth market of great opportunity for the next 10 years and beyond"
    So while the notion of Big Food capitalizing on their investments in programs such as Exercise is Medicine to fuel sales isn't in and of itself surprising, what is surprising to me is the fact that well intentioned individuals, along with top-notch medical and public health organizations, don't seem to realize it, or simply don't care.

    [For some further reading on what I think about "balanced, active lifestyles", please have a read of the article I co-authored this year, Running Away with the Facts on Food and Fitness, published in the journal Public Health Nutrition]

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    Monday, July 26, 2010

    Expanding the Definition of Conflict of Interest - Big Food Edition


    This month the Annals of Family Medicine published a point/counterpoint discussion of last year's awful decision by the American Academy of Family Physicians (AAFP) to partner up with Coca-Cola.

    Howard Brody, arguing that the AAFP's deal was clearly a conflict of interest, explains that by definition a conflict of interest,

    "arises when individuals or organizations enter into a set of arrangements which under usual circumstances would lead to the reasonable presumption that they will be tempted to put aside their primary interests in favor of a secondary set of interests."

    and that,

    "It is true that where a conflict of interest exists, no actual unethical behavior has necessarily arisen."
    Meaning that simply having the opportunity for a conflict of interest is in and of itself a conflict, and certainly having Coca Cola fund and/or write educational materials on beverage consumption for the AAFP in return for $600,000 sure smells like a conflict of interest waiting to happen.

    Howard then does a fine job of describing the most common arguments against perceived conflicts which include:

    Premature accusations
    : How can you accuse the AAFP of having a conflict? You haven't even seen the educational materials yet!

    The other party's not evil: There's no conflict - just because Coca-Cola contributes to obesity doesn't make their parent company evil.

    It'd be wrong not to engage
    : Conflict or not, it'd be wrong not to enter into a partnership with Coca-Cola because we'd be missing out on an opportunity to influence their behaviour for the good.

    Counterpoint was delivered by Lori Heim, current President of the AAFP (I interviewed her about the Coca-Cola partnership when it went down).

    Basically Lori's argument boils down to Howard's premature accusations piece as she notes,
    "Integral to this discussion is the transparency of the interaction, the rules governing the interaction, and the outcome of the agreement. Examined only in a philosophical vacuum, issues of conflict of interest and the underlying ethics governing behavior become an ideological straitjacket."
    She then goes on to talk about the AAFP's great core values, the scourge of obesity in society and finally how great the educational materials are on the AAFP site and cites two statements that explicitly call for a reduction in sugar sweetened beverages.

    You know, I agree with Lori - you can't examine the partnership in a philosophical vacuum, nor a practical one. What do I mean? Well while the duelling Annals pieces were an interesting read, I think they're rather beside the point as I'd argue there's a further litmus test for a conflict of interest, one that a philosophical or practical vacuum would ignore. I'm calling it the, "innocence by association" test.

    Here's the basic premise: If your partnership with a corporation, regardless of the details or outcomes of that partnership, provides that corporation with the ability to use your partnership as a means to defend products, practices or positions that in turn are contrary to your or your organization's primary obligations, then partnership with said corporation should rightly be described as a conflict of interest.

    In this case, if Coca Cola can or does use their partnership with the AAFP, an organization whose obligations lie with the betterment and protection of public health, to defend products, practices or positions which in turn are harmful to public health, then AAFP's partnership with Coca-Cola should be considered a conflict of interest.

    So can or do they?

    Let's ask Sandy Douglas, President of Coca-Cola North America.

    Here's Sandy on April 6th 2010 in the Atlanta Journal-Constitution citing Coca-Cola's partnership with AAFP as part of his case for why soda taxes aren't necessary or appropriate,
    "We're for education, through support for organizations such as the American Academy of Family Physicians, which is providing consumers science-based information about sweeteners."
    Want to see another similar type example?

    Here's Coca-Cola Canada's Amy Laski defending Coca-Cola's sponsorship of the 2010 Winter Olympics (sorry the article itself isn't linkable),
    "We formed a red ribbon panel of experts from organizations such as the Heart and Stroke Foundation and the Canadian Diabetes Association to nominate torchbearers for Coca-Cola who committed to leading more active lifestyles and encouraging others to do the same."
    Maybe I'm just a simple man, but to me it seems pretty black and white. If you enter into a partnership with an organization whose products are anathema to you or your organization's aims it's a conflict of interest. The fact that the AAFP doesn't admit to that in the case of Coca-Cola is shameful and disingenuous and frankly I'd have preferred it if they simply came out and admitted the truth - yes, it's a terrifically unsavory conflict of interest, but hey, we needed the money.

    Brody, H. (2010). Professional Medical Organizations and Commercial Conflicts of Interest: Ethical Issues The Annals of Family Medicine, 8 (4), 354-358 DOI: 10.1370/afm.1140

    Heim, L. (2010). Identifying and Addressing Potential Conflict of Interest: A Professional Medical Organization's Code of Ethics The Annals of Family Medicine, 8 (4), 359-361 DOI: 10.1370/afm.1146

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    Saturday, July 24, 2010

    Saturday Stories


    Bad Science's Ben Goldace on how he was slandered by an incompetent millionaire.

    A touching love story from Auschwitz.

    Good, Bad, and Bogus explains why small studies aren't all that exciting.

    Dan Gardner talks politics, privacy and governmental hypocrisy.

    The dumbfoundingly eloquent Dr. David Katz doesn't disappoint with his take on the next generation of weight loss drugs.

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    Friday, July 23, 2010

    Stormtroopers invade the NYC subway.

    How badly do I wish I was part of this Funny Friday's video making?

    Once a Star Wars nerd, always a Star Wars nerd.

    Have a great weekend!



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    Thursday, July 22, 2010

    Health Halos and Kellogg's new FiberPlus Antioxidants Cereals

    Brian Wansink coined the term, "Health Halo" when he was studying consumer behaviours when faced with healthier sounding front of package statements and restaurants perceived as healthier.

    Words like, "low fat", "low carb", while not formal health claims in terms of function, still have strong influence on consumer perception, ingestion and likely purchase.

    I couldn't help but think of Dr. Wansink's work yesterday when I read an article in the Big Food e-tradezine Food Navigator. The article detailed Kellogg's new cereal brand that they claim, "makes no health claims".

    One of my favourite blogs, Fooducate, covered this cereal a few days ago, but when I saw that, "makes no health claims" piece, I had to weigh in myself.

    The cereals, will be part of Kellogg's new FiberPlus Antioxidants Cereals and their launch comes right on the heels of the Federal Trade Commission's slap for Kellogg's suggesting their cereals improved, "Immunity".

    Want to take a guess at how many ingredients there are in their Kellogg's FiberPlus Antioxidants Berry Yogurt Crunch? I guarantee you'll be wrong.

    82!

    Here they are in all their splendor with the 12 different sugar sources highlighted for good measure.

    WHOLE GRAIN WHEAT, SUGAR, RICE, CHICORY ROOT FIBER, MIXED BERRY FLAVORED CLUSTERS (ROLLED OATS, SUGAR, OAT FIBER, CORN BRAN, CORN SYRUP, WHEAT STARCH, HONEY, YELLOW CORN FLOUR, CORN CEREAL, CANOLA OIL, NATURAL AND ARTIFICIAL FLAVORS, FRUCTOOLIGOSACCHARIDES, MODIFIED CORN STARCH, SOYBEAN OIL, SALT, CARAMEL COLOR, MALT EXTRACT, STRAWBERRY POWDER, CITRIC ACID, GLYCERIN, BHT [PRESERVATIVE], RED #40, BLUE #2, CELLULOSE GUM, GREEN #3, BLUE #1, RED #40 LAKE, BLUE #2 LAKE), MODIFIED WHEAT STARCH, SOLUBLE CORN FIBER, MALT FLAVORING, SALT, ROLLED OATS, FRACTIONATED PALM KERNEL OIL, INULIN, OAT FIBER, NONFAT DRY MILK, CORN BRAN, MODIFIED CORN STARCH, GLYCERIN, WHEAT STARCH, CORN SYRUP, HONEY, APPLE PUREE CONCENTRATE, YELLOW CORN FLOUR, STRAWBERRIES, BLUEBERRIES, VITAMIN A PALMITATE, NATURAL AND ARTIFICIAL FLAVORS, KIWI JUICE CONCENTRATE, WHEY, MONOGLYCERIDES, SOY LECITHIN, CORN STARCH, NONFAT YOGURT POWDER (HEAT TREATED AFTER CULTURING), CANOLA OIL, INVERT SUGAR, STRAWBERRY JUICE CONCENTRATE, ASCORBIC ACID (VITAMIN C), CINNAMON, FRUCTOOLIGOSACCHARIDES, RED RASPBERRY JUICE CONCENTRATE, GUAR GUM, BLUEBERRY JUICE CONCENTRATE, NIACINAMIDE, MALT EXTRACT, CARAMEL COLOR, CITRIC ACID, VITAMIN D, ALPHA TOCOPHEROL ACETATE (VITAMIN E), BHT (PRESERVATIVE), PYRIDOXINE HYDROCHLORIDE (VITAMIN B6), RIBOFLAVIN (VITAMIN B2), THIAMIN HYDROCHLORIDE (VITAMIN B1), BETA CAROTENE (SOURCE OF VITAMIN A), FOLIC ACID, VITAMIN B12.
    So what does 82 ingredients including not 1, not 2, not 3, not 4, not 5, but 6 different artificial colours (including one that now has to have a warning label slapped on it in the EU) buy you nutritionally?

    170 calories per cup dry (not wonderful for a cereal)
    200mg of sodium (meh)
    10g of fibre (holy crap - no pun intended)
    12g of sugar (3 teaspoons worth)
    And a smattering of vitamins including some "antioxidants"

    Kellogg's of course isn't stupid. They're simply expecting consumers who don't take the time to think about what they're eating and read food labels to be saying, "you had me at antioxidants" when they walk down the cereal aisle.

    Sure, there's no formal health claim, but that doesn't change the fact that this Frankencereal is banking on the words "FiberPlus" and "Antioxidants" to serve a health halos whose job it is to dupe you into thinking that what's in the box is good for you, which it probably is.....if you're a shareholder.

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    Wednesday, July 21, 2010

    A rose may be a rose but perhaps a calorie's not a calorie


    File this one under cool data!

    Simple study published in Food and Nutrition Research to look at the differences between whole foods and processed foods and the calories the body utilizes to metabolize them (something called diet induced thermogenesis and also known as the thermic effect of food).

    18 subjects were enrolled in a cross-over study (meaning they each ate both test meals) whereby the thermic effect of food was measured following the ingestion of two different cheese sandwiches.

    One cheese sandwich was made with cheddar cheese and a multi-grain bread containing whole sunflower seeds and whole-grain kernels, while the other cheese sandwich was made with white bread and processed cheese.

    Both sandwiches contained the same number of calories.

    The results?

    While subjects reported that the whole food sandwich was tastier, both sandwiches conferred equal levels of satiety, and in a not completely surprising, but ultimately fascinating result, eating the whole food sandwich led to roughly double the thermic effect of food than the processed sandwich and that effect lasted nearly an hour longer than the processed meals.

    Why wasn't this surprising?

    Whole grains take longer to digest due to the protective fibrous sheath that processing removes. We also would expect the whole grain sandwich to have more protein and fat (which it did) which in turn delays the speed with which the body is able to break down its accompanying carbohydrates.

    Calorically what does this mean?

    It takes more energy to release the nutrients of the whole food sandwich with the differences between meals resulting in a 9.7% increase in the net energy gain of the processed food meal.

    Translation?

    Eat processed crap and you're effectively consuming 10% more calories than you would be were you eating healthier whole food alternatives.

    Now this is a small study and certainly it's too soon to extrapolate this across the board, but were it to be true for all processed foods, given their viral spread across the developed world these past 30 years, and given that a 10% net energy gain is huge, this might be another great reason to ditch the Wonder bread and Velveeta.

    Barr, S., & Wright, J. (2010). Postprandial energy expenditure in whole-food and processed-food meals: implications for daily energy expenditure Food & Nutrition Research, 53 DOI: 10.3402/fnr.v54i0.5144

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    Tuesday, July 20, 2010

    Burger King - Stricter Nutritional Criteria than Health Check!


    Last week Burger King Canada announced new nutritional criteria for their advertised kids' meals. I'll come back to that word, "advertised" in a bit, but wanted to look at what Burger King thinks their healthier kids' meals should contain:

    1. No more than 560 calories
    2. No more than 600mg of sodium
    3. Less than 30 percent of the calories from fat
    4. Less than 10 percent of calories from saturated fat
    5. No added trans fat
    6. No more than 10 percent of calories from added sugars

    Doesn't sound particularly healthy to me. 560 calories is still more than a child should consume in a single meal. 600mg of sodium is half a day's worth. The calories from fat and saturated fat stuff I don't care too much about. No trans fats - seems like a no brainer. I was pleased however to see the no more than 10% of calories from added sugars as that's the World Health Organization's recommendation.

    So basically it's a bit of healthier window dressing but certainly nothing brag worthy.

    Nothing brag worthy unless of course you're comparing Burger King's new guidelines with those of the Heart and Stroke Foundation's awful misinformation program Health Check.

    What does Health Check have to say about restaurant kids' meals?

    1. No caloric limits
    2. Allows up to 720mg of sodium
    3. Similar limit on total fat
    4. Similar limit on saturated fat
    5. Allows 5% of fat to be artery clogging trans-fat (and here I thought zero trans fat was a "no-brainer")
    6. No limit on added sugar

    Man, if I was the marketing director of Burger King's brand I'd be all over this as for those keeping score, compared with Burger King's, Health Check's kids' meals allow for unlimited calories, ignore added sugar, allow for a whopping amount of trans-fat and allow for 20% more sodium.

    So should we be cheering for Burger King? I'm not. Ultimately this is just smoke and mirrors as their new dramatically stricter than Health Check but still weak nutritional criteria only apply to their "advertised" kids meals and likely is just another ploy to appease parents and try to steer governments away from considering regulations.

    Interesting too that a day after the announcement the media was all over it and rightly pointed out the hollowness of Burger King's pledge. What a shame the media doesn't hold Health Check and the Heart and Stroke Foundation up to the same degree of scrutiny.

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    Monday, July 19, 2010

    Not everything's caused by obesity: Brain and memory function edition


    Good lord.

    I know people like to blame obesity for everything. Every disease, every problem - everything.

    You know what I'm blaming on it today? Authors' and peer reviewers' attitudes about their studies and results.

    Last Tuesday I was asked by CTV to read a study that was pending publication in the Journal of the American Geriatrics Society so that I could comment on it for the national news. The study looked at 8,745 women between the ages of 65-79 free of dementia and evaluated their weight and waist to hip ratios in relation to their scores on the 3MSE, a modified mini-mental state examination validated to give an overview of cognitive function.

    So I read the study.

    Want to know what I found out?

    That after controlling for age and education the test scores of folks whose BMI's were <25 were 95.2 while those whose BMIs were >40 were 94.1. I also discovered that the authors failed to provide the p value (the number whereby you'd see what the likelihood simple chance would lead to the result) for that comparison but they did provide a p value for the larger difference when age and education weren't controlled for and guess what, that p value, the one that looked at an even larger variance in test scores, wasn't even close to significant (at 0.10 there was a 10% likelihood the result occurred solely due to chance).

    Another odd result? Women with abdominal weight distributions (apples) scored better than those with truncal distributions (pears) suggesting that unlike pretty much everything else weight related, abdominal obesity was protective against this supposed negative impact on cognition.

    So basically in a best case scenario the authors could conclude that obesity may lead people to score a single percentage point lower on a test of global cognition but they'll point out at least that the difference in scores could easily have occurred due to chance. Worst case? They'll make it sound important so that they could get published.

    My take? I took it to read that obesity doesn't lead to any statistically significant differences in a test of global cognition and that consequently it would seem that obesity and cognition aren't too tightly linked - a result that perhaps is bolstered by the fact that abdominal obesity appeared to be beneficial (though I should note, it may simply be due to the fact the researchers didn't measure waist circumference properly as rather than use a consistent bony landmark they used the floating umbilicus).

    So what did the authors conclude?

    "Higher BMI was associated with poorer cognitive function in women with smaller WHR....Further research is needed to clarify the mechanism for this interaction".
    What I wrote back to CTV was the following,
    "It would have to be an unbelievably slow news day for this to make the rotation."
    And yet it was all over the news.

    Sigh.

    The media? I can forgive them, they're just trying to sell stories.

    The authors? I can almost forgive them too as certainly negative publication bias might have precluded this piece and it's a publish or perish world.

    The peer reviewers? I got nothin'.

    Kerwin, D., Zhang, Y., Kotchen, J., Espeland, M., Van Horn, L., McTigue, K., Robinson, J., Powell, L., Kooperberg, C., Coker, L., & Hoffmann, R. (2010). The Cross-Sectional Relationship Between Body Mass Index, Waist-Hip Ratio, and Cognitive Performance in Postmenopausal Women Enrolled in the Women's Health Initiative Journal of the American Geriatrics Society DOI: 10.1111/j.1532-5415.2010.02969.x

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    Saturday, July 17, 2010

    Saturday Stories


    The shocking, sugary truth behind the recent massive recall of Froot Loops and kin.

    Kim Hebert from Skeptic North takes on Canada AM's health coverage.

    CSPI wonders why Americans are subsidizing the purchase of sugary soda?

    Pharmacist Scott Gavura rips apart Health Canada's decision to rubber stamp hundreds of unapproved natural "health products".

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    Friday, July 16, 2010

    How to rock a karaoke bar!

    Simple, be a rock star to begin with.

    Today's Funny Friday video is entertaining, funny and oddly heartwarming as it covers Jewel, in a disguise, singing Jewel songs at a karaoke bar and for reasons I can't seem to really pin down, I'd rate this one a must watch.

    Have a great weekend!



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    Thursday, July 15, 2010

    Why the world needs Calories 101


    Small wonder the world struggles with obesity.

    The world is obscenely calorific. Calories are everywhere. Restaurant salads can have over 1,000. Kids' meals even more and with our supersized foodscape, almost nothing is safe.

    So let's shift gears and talk money.

    Let's pretend you got dropped into an exotic foreign country and while there were price tags on everything, you didn't know the exchange rate. Sure you might know that more was more expensive, but could you really be sure you weren't overspending?

    Or how about if you got hired for a job but weren't told your salary. How would you budget your monthly expenditures?

    Now back to calories.

    In a survey conducted by the International Food Information Council Foundation (a Big Food funded organization), only 12% of those surveyed knew how many calories they burned a day.

    What that means of course is that Americans (and probably it's a finding that's true the world over) don't have a clue how many calories they need in a daytime, and so even though calories are posted on nutritional facts panels and in some jurisdictions even on menu boards, how are they going to do any good?

    These results should serve to alert allied health professionals and public health officials that in the absence of an anchoring statement regarding how many calories a person needs, initiatives like mandatory menu labeling will fall deaf on ignorant ears.

    What we really need are public health officials to provide us with a Calories 101 campaign (like the one in the photo up above from New York's forward thinking, "Read 'Em Before You Eat 'Em" campaign) because if people don't know how many they've got to spend in a day, how can they possibly be expected to navigate our increasingly obesogenic food environment?

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    Wednesday, July 14, 2010

    Canada's only national food radio show? CBC's the Main Ingredient.


    Recently I had the pleasure of being interviewed by Khalil Akhtar for the CBC's new weekly food show The Main Ingredient.

    I was asked to chat about Canada's Food Guide and its contributions to obesity.

    Having listened to the show's first 3 episodes I can certainly vouch for its entertainment and interest value and would encourage you to have a listen.

    All of the shows are hosted online at the CBC's The Main Ingredient homepage and the episode I'm in can be found here (I come on at roughly the 9:14 mark).

    Kudos to the CBC for recognizing that not only is food delicious, it's fascinating.

    The Main Ingredient airs on CBC Radio One Mondays at 11:30 a.m. (3:30 p.m. NT) and Fridays at 7:30 p.m. (8 p.m. NT) and on Sirius satellite radio channel 137 Mondays 4:30 p.m., Thursdays 1 p.m., Fridays 3 a.m. and Saturdays at 6:30 p.m. (all times ET).

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    Tuesday, July 13, 2010

    Chewable Lipitor candy for kids?


    Thanks to blog reader Craig for forwarding me a report on the EU's approval of a new chewable tablet of Lipitor (the cholesterol lowering medication) geared for use in kids ages 10 and up.

    And according to a study published yesterday in the Journal Pediatrics, the market's probably bigger than once thought. The lead researcher of the study, one where over 20,000 kids' cholesterol levels were screened, was quoted by the Wall Street Journal as stating that current pediatric cholesterol screening guidelines would have missed 36% of kids with, "seriously high LDL".

    Sigh.

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    Monday, July 12, 2010

    England - the stupidest country in the world (when it comes to obesity)?


    Wow.

    Wow, wow wow.

    How's this for the dumbest thing you've ever heard a country do to help combat obesity - England has just turned over the reins for it's already crappy Change4Life program (I've blogged about it before) to the food industry and in return for Big Food's help the government's already promised not to mess with them anymore when it comes to things like labeling, taxes or other nutritional regulations or reforms.

    I have no words and as regular readers know, it's tough to render me speechless.

    Wow.

    As Marion Nestle put it on her blog,

    "Moral: Expect no public health messages about eating less, or further restrictions on health claims from this campaign."
    [Here's The Observer's scathing editorial about the decision.]

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    Sunday, July 11, 2010

    Carl's Jr.'s bid to out-gross KFC's Double Down


    First found by the folks over at Food Beast (that's their picture too - thanks Food Beast!) may I introduce to you the Foot Long Cheeseburger.

    While there are no numbers on it yet, if we take a look at Carl's Jr.'s bacon cheeseburger's calories and multiply by 3 it may well run you in the neighbourhood of 2,460 calories and 5,070mg of sodium.

    For those who like comparisons that'd be eating the caloric and sodium equivalent of roughly 5 KFC Double Downs.

    Cost per calorie? Well we can't use the $4 cost because that doesn't include bacon but $7 apparently does so that'd be 3.5 calories per penny.

    Head over to Food Beast to read their review and check out their pics.

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    Saturday, July 10, 2010

    Saturday Stories


    Ezra Levant takes on Michael Ignatieff's speech on human rights where he states Canada can learn lessons from China, positive ones, on justice.

    Peter from PhD Nomads and Obesity Panacea muses on friendships lost and what's important in life.

    Never take dietary advice from Baba Ramdev!

    Journalist Gaia Vince explains how Seed Magazine (the Scienceblog overlords), aren't strangers to questionable editorial decisions and then Emily Anthes quickly backs her up.

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    Friday, July 09, 2010

    Apple provides Apple apostles with friends

    Do you know an Apple apostle?

    The Onion News Network does and that's what today's Funny Friday clip is all about.

    Have a great weekend!


    New Apple Friend Bar Gives Customers Someone To Talk At About Mac Products

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    Thursday, July 08, 2010

    PepsiCo. tries to buy credibility by buying ScienceBlogs

    Wow.

    For evidence based bloggers like me the news that ScienceBlogs has just published a new nutrition blog, Food Frontiers was shocking news. It was shocking because it's not being written by some hand-selected blogger, it's being written by Pepsi Cola.

    So why does that matter?

    Because PepsiCo.'s job isn't to push science or evidence based nutrition, Pepsi's job is to push calories and products that increase shareholder's value with no concern for the public good (unless the public good happens to sell products).

    The irony on the blog itself is sugary sweet as well given that Pepsi's products have dramatically increased the burden of disease over the course of the past half century and yet their new ScienceBlog is reporting they're there to,

    "Discuss the science behind the food industry’s role in addressing global public health challenges"
    PepsiCo. of course isn't stupid. Their job is to make themselves look like the good guys and partnerships with folks like ScienceBlogs allow them to whitewash their sugary laundry in a way that simple press releases cannot.

    Of course it's not just me who's upset - have a peek at some of ScienceBlog's own bloggers who are chomping at their own bits:

    Orac from Respectful Insolence - Blindsided by my corporate overlords and PepsiCo

    Peter Lipson from White Coat Underground - Rethinking blog networks and ethics

    Grrlscience from Living the Scientist Life (with a URL that includes how she really feels) - Pepsi Ethics

    Alex Wild from Myrmecos - Enjoy a nice cold Pepsi today.

    Mark C. Chu-Carroll from Good Math, Bad Math - Seed, Conflicts of Interest and Sleaze.

    Jason G. Goldman from The Thoughtful Animal - A Pepsi Blog? Initial Thoughts.

    Janet D. Stemwedel from Adventures in Ethics and Science - Welcome to Inescapable Conflict of Interest

    Abel Pharmboy from Terra Sigillata - PepsiCo Food Frontiers blog did not have to be a #sbFAIL

    Martin Rundkvist from Aardvarcheology - An Egoistic Perspective on the Pepsiblog Debacle

    John Wilbanks from Common Knowledge - Of Pepsi and ScienceBlogs...

    John Dupuis from Confessions of a Science Librarian - A Teachable Moment

    Joshua Rosenau from Thoughts from Kansas - More on Pepsi

    And so far Sharon from Causobon's Book, James Hrynyshyn from Class: M, Rebecca Skloot from Cuture Dish, Erik Klemetti from Eruptions Mark Chu-Carroll from Good Math, Bad Math, Chris Rowan and Anne Jefferson from Highly Allochtonous, Brian Switek from Laelaps, Mike from Mike the Mad Biologist, Alex Wild at Myrmecos, David Dobbs at Neuron Culture, Scicurious at Neurotopia, Eric Michael Johnson from The Primate Diaries, Dave Bacon from The Quantum Pontiff, Blake Stacey from Science after Sunclipse, and Maryn McKenna from Superbug, have either gone on hiatus or quit in disgust.

    That's 33% of all current ScienceBloggers either pissed off or gone due Seed's strange decision to start selling blogs.

    Interestingly here's what Seed Media Group has to say about how ScienceBlogs goes about choosing their bloggers,
    "We have selected our 80+ bloggers based on their originality, insight, talent, and dedication and how we think they would contribute to the discussion at ScienceBlogs."
    And yet for Food Frontiers there's no particular voice they've chosen as according to the Food Frontiers sidebar,
    "All editorial content is written by PepsiCo's scientists or scientists invited by PepsiCo and/or ScienceBlogs"
    My advice to Seed Media - if you're not going to dump Food Frontiers, at the very least change your ScienceBlogs About Us page to reflect the fact that you'll also sell anyone a blog if the price is right because if you didn't haul in a huge wad of dough for this asinine move then you're crazier than I imagine and given who you've just sold out to, I think you're pretty freakin' crazy.

    [Update 10:32AM - The word on Twitter is that ScienceBlogs will be dumping Food Frontiers though I haven't seen anything official anywhere

    Update 11:01AM - Official word]

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    Wednesday, July 07, 2010

    Heart and Stroke Jump Rope for Pizza


    Ever hear of the Heart and Stroke Jump Rope for Heart program? Basically school children across Canada skip rope to fundraise for the Heart and Stroke Foundation.

    According to the Heart and Stroke Jump Rope for Heart parents' page the program is important because,

    "The biggest threat today is childhood obesity, with 26% of Canada's children (2 - 17 year olds) being overweight or obese - over 1.6 million!

    JUMP FOR A HEALTHIER TOMORROW

    At the Heart and Stroke Foundation, we're working hard to stop this trend through programs like Jump Rope for Heart.
    "
    One of my reader's elementary school kids participated in this year's Jump Rope for Heart and you wanna guess what they and all their friends received for jumping rope for a few minutes? They each received a coupon for a free kid's meal at Boston Pizza, a Heart and Stroke Foundation mega-sponsor.

    I've blogged about the unholy partnership between Boston Pizza and the Heart and Stroke Foundation before with regards to their Valentine's Day heart shaped pizzas and the Health Check restaurant program, but this really takes it to a new level of abominable.

    Why?

    Before I get into some numbers, bare in mind that the recommended maximal number of calories per kid's meal is 400 and that a child's recommended daily total sodium intake is 1200mg, and that childhood obesity is the primary driver behind the Heart and Stroke Jump for Heart program.

    Now, doing the math on the Heart and Stroke Jump for Heart coupon kid's'meals, the average meal (and full disclosure here, I admittedly didn't include the "Baked Salmon" main or the "Steamed Vegetables" side because what kid in their right mind would order them when eating out at Boston Pizza) contains 742 calories and 1,197mg of sodium - 2 meals worth of calories and a full day's worth of sodium.

    But that's just the average. If your kid eats the Boston Pizza grilled chicken sandwich with mayo, a side of fries, a juice and a "Monster Cookie", they'll consume a Heart and Stroke Foundation sponsored 1,293 calories and 2,220mg of sodium along with 10 teaspoons of sugar for good measure.

    So there's a few great lessons for these impressionable kids - unhealthy food is a fabulous reward for good deeds and that a few minutes of light exercise earns a highly processed, high calorie, high sodium and high sugar meal.

    Oh but parents, don't worry. According to the Jump Rope for Heart website,
    "When your child participates, they learn the importance of physical activity, healthy eating and social responsibility."
    Because what's healthier than your child eating a full day's worth of calories and two days worth of sodium in one meal at Boston Pizza, and what's more socially responsible than a for-health, non-profit organization like the Heart and Stroke Foundation encouraging families to eat out at restaurants to help combat the scourge of childhood obesity?

    Fire. Them. All.

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    Tuesday, July 06, 2010

    Built environments impact on obesity through food, not fitness.


    Chalk up another causal win to food in the battle of what's responsible for our current obesity epidemic - this time in the arena of built environment.

    Built environment is the term given to the neighbourhood you live in. It has to do with things like walkability, parks, bike paths, sidewalks and all the various and sundry that city planners can do to try to shape your use of where you live.

    Built environment is also a hot button issue at obesity conferences with researchers trying to find ways to get people moving more through smarter urban planning.

    My belief is that casually moving more doesn't matter too much with regards to obesity. There's simply no amount of sidewalks or bike paths or beautiful parks that you could put in a neighbourhood to help with the issue of obesity because obesity is primarily about energy intake, not energy output, and really no amount of leisurely strolling is going to negate our horrendously calorific food environment.

    But built environment does matter. What matters about the built environment though is food and how close you are to it, and what type it is.

    In a study published this month in the Journal of Planning Education and Research Samina Raja et al looked at the influence of built and food environments on 172 women's BMIs in Erie County New York between 1999-2004.

    What did they find?

    1. The more restaurants within walking distance the higher the BMI (p=0.037).

    2. The closer you live to a healthful food destination (supermarket), the lower the BMI (p=0.025).

    3. Walkability didn't make one whit of difference.

    Interestingly the authors listed the fact that they didn't know the types of restaurants as a limitation and suggested that there might be healthier ones. I'd argue, with exceedingly rare exceptions, restaurant food, regardless of whether it's sit down, stand up, casual, or fancy, has non-intuitively, astronomically large numbers of calories.

    Ultimately what matters isn't the sidewalks, it's where they take you.

    Raja, S., Li Yin, ., Roemmich, J., Changxing Ma, ., Epstein, L., Yadav, P., & Ticoalu, A. (2010). Food Environment, Built Environment, and Women's BMI: Evidence from Erie County, New York Journal of Planning Education and Research, 29 (4), 444-460 DOI: 10.1177/0739456X10367804

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    Monday, July 05, 2010

    How do you know you're on a "good" diet?


    Simple. You like it.

    What do I mean?

    Tolerating a diet's not good enough. If you're only tolerating your new lifestyle you're certainly not likely to keep living it.

    Food wise - you can't be regularly battling hunger, it can't be making you feel unwell and your life has to be "normal" meaning you should be able to include food for comfort, food for celebration, with no forbidden foods.

    Fitness wise - you can't be running out of time, running out of energy, hurting yourself or hating it.

    Ultimately you're aiming for a lifestyle where you can't happily eat any less and you can't happily exercise any more.

    Sure we can all improve our lifestyles but to use an extreme example, do you really think you can be a tee-totaling vegan, shut-in, marathon runner forever?

    If you can't happily eat less, you're not going to eat less. If you can't happily exercise more, you're not going to exercise more.

    Your goal should be your personal best recognizing that the best lifestyle you can enjoy and the best lifestyle that you can tolerate are two very different things.

    Is there any other aspect of your life about which you're striving to be "ideal"?

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    Saturday, July 03, 2010

    Saturday Stories


    Torontoist discusses their experience on the ground with the moronoic protestors at Toronto's G20.

    The New York Times does a great job covering the controversy surrounding Dr. Zamboni's new-fangled treatment for MS and here's a report on a study that refutes Zamboni's initial findings.

    Harvard toxicologist Julie Goodman tells moms to keep using BPA containing products.

    Pharmalot has an interesting piece on the limits of conflicts of interest in scientific publishing. I think ultimately the question can be thought of as is confirmation bias a conflict of interest? Since we all have them, I guess we're all conflicted.

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    Friday, July 02, 2010

    I want a piece of Bubbie's strudel!

    Today's Funny Friday is another gem from Old Jews Telling Jokes.

    Have a great weekend!



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    Thursday, July 01, 2010

    Honest ad executive calls for kids' advertising ban


    His name is Alex Bogusky and he's the "Chief Creative Insurgent" (aka the boss) of MDC Partners who according to Wikipedia are the 10th largest advertising agency in the world (and who have one of the coolest websites I've ever seen). Consequently he certainly knows more than you or I do about the ins, outs, evils and lies of advertising and since his clients have included the likes of Burger King, Domino's and Coca Cola to name just a few, he also probably knows more about how Big Food markets than we do.

    So what has Alex recently called for on his blog? An advertising award given to the consumer brand that

    "takes into consideration all the potential effects of their marketing and have built a plan that carefully avoids abusing the power of advertising"
    He's calling it the Cannes Crystal Grand Prix Lion.

    More specifically he's calling for a ban on advertising to children as he believes that cognitively they're simply unable to see the world in shades of gray and hence are defenseless,
    "As we all know from experience, children are not small grownups. Their brains are fundamentally different, the big difference being that right hemisphere brain development doesn’t really kick in until the age of twelve. This is important because without the right hemisphere involved, all decisions and concepts are very black and white....And this leaves them fundamentally and developmentally unequipped to deal with advertising in the way an adult can."
    The picture he paints of a post-children advertising ban is indeed rosy. He sees improved eating as Moms and Dads won't be caving into the pressure to buy their kids the crap their televisions tell them they want and by extension he sees improved parent-child relationships and increased childhood self-esteem. He sees increased incentives for kids to get involved in free thinking play as television networks built off the backs of children's nag power/advertising dollars crumble and kid TV becomes less lucrative to air. He sees companies being forced to make healthier kids' foods as now it'll be left to Mom and Dad to determine what should enter their homes and he sees those companies feeling better about themselves.

    Alex once turned down Burger King's kids' marketing campaign and hopes that somewhere out there a major Big Food player's public relations team is going to decide that it'd be well worth it to call for and support a ban on advertising to kids. He figures that North America's ready to applaud just such a move and that applause would serve that insightful firm as all the marketing it needs.

    Head over to Alex' blog and be sure to read his whole piece.

    Kudos to Alex Bogusky!

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