Tuesday, May 24, 2011

Nova Scotia hospitals ban Tim Hortons! (Sorta)

For me, this is a bittersweet story.

Back in 2008 my colleague Rob Stevenson and I wrote an editorial for the Canadian Medical Association Journal calling for the reform of hospital cafeteria food.

It was met with a great deal of word of mouth support, but very little in the way of feet on the ground (except Quebec whose Health Minister Yves Bolduc quickly banned the use of deep fryers in hospitals).

Perhaps with the gentle encouragement of Rob (he's much nicer than me), Nova Scotia's Capital Health hospitals followed suit, and in September 2009, they also banned deep fryers.

With both of us being quite busy, I don't hear from Rob too often, but just last Friday he sent me a copy of a memo penned by Nova Scotia's Capital Health hospital's vice president of sustainability. The memo explained Capital Health's next move, one that will see Tim Horton's (a Canadian donut/coffee icon), forbidden from selling donuts and muffins that don't meet Capital Health's healthy food guidelines.

Capital Health nails the "why" argument with their explanation,

"One way Capital Health is working to improve the health of our community is by making healthier choices the easier ones in the food we sell to the staff, patients, families and visitors that use the restaurants in our facilities day in and day out."
Indeed! Hospitals should not be profiting off the sale of unhealthy foods and instead should serve as role models for their communities.

So what's going to be left on Tim Horton's Capital Health shelves?

Hard to say with certainty, but this line,
"baked goods such as doughnuts and those muffins that do not meet Capital Health’s healthy food guidelines will no longer be sold"
certainly suggests that some muffins will meet their guidelines.

Of course their guidelines will be based on Canada's Food Guide, and therein lies the rub.

According to a CTV article on this story, Capital Health hospital Tim Horton's will still be selling their low-fat berry muffin. Low-fat of course, is pretty much the focus of Canada's entire Food Guide.

Problem is, evidence-based nutrition would suggest that with rare exceptions, single nutrients are difficult to truly link to disease and that rather patterns of eating are more important. Using a guideline that falsely elevates the reduction of fat to the pinnacle of dietary discretion means that so long as a food's fat levels are low, the rest doesn't matter.

So let's look at Tim Horton's low-fat berry muffin.

Compared with a soon-to-be-banned chocolate donut it's made with the same highly refined carbohydrates, packs nearly 30% more calories, 150% more sodium, equivalent amounts of trans-fat, and a whopping 5 teaspoons more added sugar.

So at the end of the day, while this is a real, formative and praise-worthy step forward for Nova Scotia's Capital Health and hospital food reform, until we see our government step up with actual evidence-based dietary guidelines, these forward thinking efforts, may still ultimately end up being nutritionally backwards.

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  1. As far as I can tell, the only things that Tim Hortons sells that aren't unhealthy are coffee, tea and water. Everything else is either bad for you, or of questionable nutritional value. Maybe hospitals should open mini grocery stores and kitchenettes where people can make their own food!

  2. Anonymous8:33 am

    thanks for the heads up on the muffin, sugar, calories.

    I would have been fooled. I would have picked the muffin as a "healthy" muffin, after all it passed the hospital "healthy option" test.

  3. Anonymous9:33 am

    No surprise to me. I went to Hfx hospital on doctors referral for weight loss nutrition counselling. I was told to follow the Canada Food Guide, but eat a little less. I made no progress.
    (I did later lose weight on my own with a mostly salad+lean protein based approach)

  4. Anonymous10:32 am


    Truly disappointing. So much for my assumption that a low-fat muffin was healthier than a donut. At least the dietary fibre is higher, but the total cals are disgusting.

  5. Cynthia11:01 am

    Aaaaaarg. Where are the dieticians??????

  6. Anonymous12:49 pm

    "As far as I can tell, the only things that Tim Hortons sells that aren't unhealthy are coffee, tea and water"

    Considering the godawful creamy vaguely-caffeined milkshake that most people ask for (the double double), I'm not sure I'd even put coffee in that category marchwinds!

  7. Coffee too, is not health, according to some. It will affect insulin and blood glucose, via adrenalin. It is also a diuretic, and causes capillaries to constrict. After all, it was first promoted in Europe by the Catholic Church, who had a boat load of it to unload.

  8. I was recently stuck at the airport in Ottawa at supper time and tried my best to order something vaguely healthy at Tim Horton's. After checking the website anonymous posted here, I am gobsmacked, especially by the high sodium in the sandwich I chose. Well, the next time I'm stuck with no choice but Tim's, I'll be able to make a somewhat better choice.

  9. Let's be honest with ourselves. Most muffins are really just cupcakes in disguise. Further, even if they are somewhat healthy with some bran, they are usually too huge and high in calories (some are up to 800 calories each) that they are still not a healthy choice.

    Sometimes a real dessert is better than a bad food choice pretending to be better. For example, I choose the vanilla cone at McDonalds (150 calories) and ignore the burgers and fries entirely when the kids and I go there. Sometimes, now, they are doing the same.

    :-) Marion

  10. Anonymous12:17 pm

    You might want to follow up on this story. See what is really happening.

  11. Hospitals here seem to be disastrous places to try to get a healthy lunch. I usually bring my own. It's a struggle to find a bit of fresh fruit to snack on. The only place that has any often is the smoothie/juice place...that will only sell it in a 400 calorie+ smoothie.