Wednesday, November 30, 2011

Has Your Doctor Ever Taken a Lifestyle History?


Whether you're worried about your weight or not, how you live your life - how you eat and how you play - will markedly impact on your health and well being. In fact it'll impact on your health far more than any drug your physician could ever prescribe.

So why is it that most people have never had their physicians discuss healthy living with them?

Sure, a doc may ask you whether or not you exercise, and might even inquire into your sleep, but do they delve further?

My belief, though unproven, isn't that doctors aren't interested, and it's not that they're unaware of the benefits of healthy living, but rather that they're simply not taught to consider lifestyle in their clinical history taking, nor how to champion healthy living effectively.

So what are the top 10 things I would want physicians to explore with you at a bare minimum?

In no particular order:
  1. How many meals do you eat out (including cafeterias), order in or take out (including prepared supermarket counter foods) per week?
  2. Do you feel comfortable cooking?
  3. How many meals a week do you cook yourself by means of the actual transformation of raw ingredients?
  4. How many glasses of milk, juice, sugared soda and/or alcohol do you drink a day?
  5. What do you put in your coffee or tea, and how many do you drink a day?
  6. What's your typical pattern of daily eating (ie do you miss meals or snacks and what do you typically have for breakfast/snacks/etc.?)?
  7. (If married and/or with children) How many meals a week do you eat together as a family?
  8. What was your favourite sport or activity as a kid and why aren't you doing it today?
  9. How many minutes of simple walking might you be able to add to your day without it being a hardship, and when would it be (ensuring goal here is Specific, Measurable, Attainable, Realistic and Timely)?
  10. (If a parent of still at home children) Are you living the life, food, fitness and health wise, that you want your child to be living, and if not, what do you think you might improve?
While I realize this list is by no means exhaustive (for instance it doesn't touch on other hugely important issues like relationship health, job stress and satisfaction, parental struggles, sandwich generation issues, etc.) and may only scratch the surface of healthy living, it would certainly help a physician to get a sense of how their patients are managing their two most important determinants of health, and provide a myriad of opportunities to try to help collaboratively trouble shoot common barriers to healthy lifestyles.

Unfortunately, while we physicians are all taught to examine the micro level minutia of each and every physical system in our annual review of systems, I strongly and firmly believe that as far as health benefits go, it'd be far more valuable to our patients to review the macro level of how they're are actually living their lives.

Of course asking those questions up above will also necessitate having answers...and sadly, therein lies the problem.

Medical schools and residency programs may do wonderful jobs at preparing us on how to treat illness with pharmacotherapy, but sadly the vast majority do a respectively terrible job at preparing us how to help patients manage, as Yale's David Katz puts it, "medical destiny's master levers" - forks and feet.

Here's hoping that one day, the day will come where forks and feet get the medical respect they so clearly and desperately deserve.

Bookmark and Share

Tuesday, November 29, 2011

You can stack your deck, but you can't get a new one!


Long time readers will know, I'm a slow runner.

I was thrilled a few weeks ago to break a 5 minute km pace on a 4km run (roughly a 7.5mph pace, nothing particularly brag worthy), and I had to really kill myself to do it, and the distance sure wasn't all that long.

Then I came across this video that highlighted an absolutely brilliant advertisement from ASICS.

Their challenge? Race against Olympic caliber marathoner Ryan Hall for just 60ft and see if you can keep up.

Ryan's best marathon time? 2:04:58. That translates to a pace of nearly 12.6mph for 26.2 miles!

Craziness.

And enlightening.

There are only a few Ryan Hall's in the world. Don't try to be one of them. Instead, as I've been yammering on about for some time, set your goal to do your best and never be discouraged if it's not as good as someone else's. Sure So-And-So might be losing weight faster than you, but really, why does it matter?

We've all got a deck of cards in life. We can stack them, but we can't swap them out.

Stack your deck as best you can, but don't ever be discouraged if your deck isn't as stacked as someone else - that's just real life.

If you want to see Ryan Hall run, and the brilliant ASICS ad, watch the video below (email subscribers, head to the blog to watch).



Bookmark and Share

Monday, November 28, 2011

Are you Feeding your Children Properly?


And here I'm not talking about nutrition, I'm talking about how you actually feed them. What are your practices surrounding food? Do you have regular meal times? Do you use coercion to try to inspire vegetable consumption? Do you reward with treats?

Parental feeding practices have been the subject of a great deal of research, and this month, the American Journal of Clinical Nutrition published a handy summary of it all.

Here are the top 10 take home messages:
  1. Pressuring kids to eat fruits and vegetables and markedly limiting their access to sweets and fatty snacks, along with using food as a reward are all strongly linked with dis-inhibited children's eating patterns.
  2. The more inconsistent parents are with either eating schedules or serving healthy vs. unhealthy foods, the greater the negative impact of the parenting styles listed in the first point above.
  3. Having at least one parent at the family meal is associated with better consumption of fruit and vegetables, and a lower risk of skipping breakfast.
  4. Adopting a knee jerk pattern of dietary restriction with an overweight child may drive that child to be more, not less, likely to overeat.
  5. The availability and exposure to foods at home most certainly affects children's long term food selections and preferences.
  6. The earlier and more broadly a child is exposed to different foods, the healthier that child's eventual adult diet.
  7. The more fruits and vegetables available at home the more fruits and vegetables your kids will consume.
  8. The more fruit juice and breakfast bars available at home the less actual fruits and vegetables your kids will consume
  9. The greater the frequency of meals in front of the television and/or the lesser the frequency of family meals, and/or the greater the use of food as a reward, the higher your kids' intake of sugar sweetened beverages.
And number 10?

I'll quote directly from the paper, as it pretty much sums up everything else up:
"Children like what they know and eat what they like."
So to make sure your children know healthy, here are some straight forward prescriptions for healthy home eating:
  • Encourage a wide and varied healthy diet introducing new foods frequently and early.
  • Don't pressure your children to eat (one bite rules are fine), or withhold dessert unless they eat their veggies.
  • Don't reward them with food.
  • Disband the clean your plate club.
  • Keep plenty of fruits and vegetables handy, accessible, visible, washed and prepared and literally smile at your kids when they eat them.
  • Sit at the table and eat with your kids.
  • Don't skip meals.
  • Dramatically minimize meals out and takeout.
  • Ensure that as many meals as possible a week involve the transformation of raw ingredients (not mixing boxes).
  • Involve your kids in cooking.
Or put even more simply?

Live the lives you want your children to live.

Bookmark and Share

Saturday, November 26, 2011

Saturday Stories - WWII, Astrophysics and Smoking Marathoners


If you think life's tough, take a peek at this collection of photos published in the Atlantic detailing WWII's Eastern front.

Astrophysicist Neil de Grasse Tyson visits Reddit and spends some time answering questions. Mind blowing.

Travis on Obesity Panacea discusses how one might think that cigarettes help distance runners.



Bookmark and Share

Friday, November 25, 2011

Grossest. Card Trick. Ever.

Wow.

The world is a strange place.

Don't believe me? Check out this week's Funny Friday video which is without a doubt the vilest card trick imaginable. Don't watch (I mean it), if easily offended, or if you have a full stomach.

Think David Blaine mixed in with 8 year old boy humour.

Don't say I didn't warn you.

Have a great weekend!

(email subscribers, you'll have to head to the blog to watch)



Bookmark and Share

Thursday, November 24, 2011

Brian Wansink contributes to milk's undeserved weight Health Halo


First up, let me tell you that I absolutely adore Brain Wansink's research. I think his work is important, and cool to boot. I also think he's a phenomenal speaker and a true force for good in understanding our current food environment.

Which is why I'm so perplexed by Brian's involvement with the "Got Milk" campaign.

Milk isn't magical. It's a liquid protein source with calcium, and while there may be fair debate out there to be had regarding various benefits and risks to milk, certainly to date, the data on milk and weight, excluding the data from the researcher who has a patent on milk being beneficial to weight claims, are far from conclusive and are rather spectacularly unimpressive.

How unimpressive? Here's the USDA's Nutrition Evidence Library on the evidence based relationship between milk and weight,
"Strong evidence demonstrates that intake of milk and milk products provide no unique role in weight control."
Now back to Brian.

Brian's brilliant work on Health Halos details the impact that perceptions of healthfulness through marketing have on consumption patterns, whereby when people believe something's healthful, they're liable to consume more of it than perhaps is nutritionally deserved, which in turn might be helping to fuel problems like obesity.

In his Milk Moustache ad, Brian perpetuates the notion that somehow drinking milk will help with weight management,
"When I'm looking to quench my thirst without increasing my girth, I reach for a tall cool glass of low-fat milk."
And here I'm at a loss, as not only am I certain Brian more than anyone understands the impact of marketing and Health Halos, I'm also confident he's familiar with the evidence base on milk and weight.

If you want to quench your thirst without increasing your girth, drink calorie-free water, and if you choose to drink milk, please don't for one moment think that doing so is somehow going to magically exclude milk's calories from your daily totals or in some other way help you lose weight, because regardless of what one of my personal heroes might be telling you with his Health Halo'd ad, it won't.

Bookmark and Share

Wednesday, November 23, 2011

What is your Toothbrush Level of Exercise?


Do you enjoy brushing your teeth?

I mean really enjoy it? Do you relish the time that you take to do it, or are you brushing because you value the outcome (clean teeth, non-scary breath) enough to happily put in the 4-6 minutes a day it takes?

I'm guessing it's the latter.

I've met many folks who reportedly can't stand exercise....and I can't help but wonder if they're simply trying to brush their teeth for hours.

What I mean to say is that if you've got it in your head that unless you do "X" minutes per day of exercise it's not worth doing, that'd be akin to thinking that unless you brush your teeth 30 minutes at a shot it's not worth brushing.

My eight word exercise manifesto is straightforward, and given all of the data piling up on the risks of sitting and the benefits of small bouts of exercise, I'm willing to go out on a limb and suggest it's probably even supported by evidence.

The eight words?
Some is Good. More is Better. Everything Counts.
So rather than focus on big blocks of time, if you're an exercise avoider, why not take a few minutes and figure out your "Toothbrush Level".

What's that?

Well you know exercise has tremendous health benefits. So what amount of exercise do you think you'd be able to regardless of likeability, add to your day?

5 mins? 10 mins?

And then, as with tooth brushing, figure out when you're going to do it.

Maybe it'll simply be parking 5 minutes away from work so that you get 5 minutes of walking on either end of your work day. Maybe it'll be a brief 10 minute weights or calisthenics program when you wake up.  Whatever you decide, do figure out when you're going to do it, because simply aiming at a nebulous "more" isn't likely to help.

Next, set up a reminder system. Smart phones, outlook reminders, text messaging services (like oh, don't forget)- use them, because here you'll be trying to remember to do something you're not accustomed to doing, and reminders count. How many times do you think your parents reminded you to brush your teeth before you simply started doing it automatically?

I know more is better, but truly, everything counts, and who knows, as your fitness improves and you grow accustomed to intentional daily exercise, perhaps your toothbrush level will grow too.

Now go brush your teeth!

Bookmark and Share

Tuesday, November 22, 2011

Does your Bench need a Bedside?


So I was figuratively leafing through this week's table of contents from the American Journal of Clinical Nutrition, and a study caught my eye.

It was entitled, "Satiety-relevant sensory qualities enhance the satiating effects of mixed carbohydrate-protein preloads", which matters to me as the title would suggest that there were modifiable qualities to food that would help enhance fullness.

When I clicked over to read the article, here's what I found they studied - the impact of a juice with or without whey protein powder consumed 30mins before lunch on total lunch calories consumed.

The results?

If you drink a high calorie, high protein drink 30mins before lunch, you'll consume less lunch.

So is this helpful clinically?

This study doesn't say. And to be fair, perhaps it's simply a preliminary study and further studies will address what I'm about to suggest is important.

What matters to me isn't lunch calories. What matters to me are total daily calories. What matters to me are perceptions of hunger, especially at night. What matters to me are cravings and compulsions the whole day through.

The thing is, hunger and cravings are funny things. What a person eats in the daytime will most assuredly impact on their hunger and/or cravings, especially at night, and so really, any study on daytime dietary manipulation truly needs to look at the day's entirety in order to actually provide clinical relevance.

Now I'm not suggesting the researchers don't know all of the above, but I can tell you, I've read plenty of papers, where the results weren't even remotely surprising given the study's design, and where the conclusion of a lack or gain of utility, may not be applicable in a real world clinical setting, perhaps for reasons unfamiliar to the study's bench-side researchers.

If you're a researcher and you're doing a study that you're hoping might have clinical relevance in weight management, and if you don't have a bedside clinician to run things by, find one. They might well have suggestions that would improve your methodology and consequently the "so what" factor of your research.

(And BTW, my bedside's always open)



Bookmark and Share

Monday, November 21, 2011

Life's not a straight line (and some runs stink).


Further to my post on accepting your personal best as great, one more point.

Life's not a straight line.

Pick anything in life - education, relationships, work - they'll all have their ups and downs. Sometimes for obvious reasons, but sometimes for no good reason at all. Life includes its fair share of inexplicable funks.

As with any real funk, the most important thing is recognizing it for what it is and soldiering on through to the other side.

Running's a great example. From my office I have 3 set running routes. One's 4km, another 5km and the last 7km with the amount of time I have at hand in part determining which route I take.

A few weeks ago I ran my best 4km. I felt strong, breathing was easy, my strides natural. All in all feeling really great allowed me to push. Fast forward a week later, same route, same time of day and within 1km I knew I was in for a crummy run. I hurt, my breathing was laboured, and I spent the last 3km mentally forcing myself to finish. It was anything but a fast and easy run.

Was I upset that my run stunk and my time was markedly slower than just a week earlier? Nope. I was proud as hell I finished because that run. It wasn't about speed. It was simply about finishing despite not really wanting to, and doing the best I could while feeling crummy.

Whatever your aim, whatever you're trying to accomplish, some runs will feel great, and some won't. Your job (and yes, I know I'm a broken record)?

Do your best, and love it!



Bookmark and Share

Saturday, November 19, 2011

Friday, November 18, 2011

Who Knew Liam Neeson was so Damn Funny?

Looking for a straight man to be in your funny movie?

Today's Funny Friday proves ever so conclusively that you should look no further than Liam Neeson.

Have a great weekend!



Bookmark and Share

Thursday, November 17, 2011

You Can Always Do Your Best!


Ever have a write-off day?

Where stuff happens that leads you to feel like the day's a write-off and there's no point in even trying?

There's no need for that if your best is your goal.

What do I mean?

Although we'll all have days when our great intentions go awry, that should never preclude the fact that you can still do your best.

Your best when things have gone awry may well not be the same as your best when all systems are go, but it'll still be your best.

If your goal is to do your best, and you remember that your best changes by the hour let alone by the day, it'll take the pressure of perfection off your shoulders.

And really, other than weight is there any other area of your life where you wouldn't accept your personal best as great?

The best you can do if you're hungry or have cravings will be different than the best you can do when you don't. The best you can do on your birthday will be different than a plain old Thursday. The best you can do after a really crappy or stressful day will be different than a boring one. And so on, and so forth.

Perfection's an awful goal.

Do your best.

Bookmark and Share

Wednesday, November 16, 2011

Enjoy every sandwich!

Do yourself a favour. Watch this video, and when it's available, consider buying the book.



[Hat tip to my inspirational friend and colleage Dr. Derek Puddester]

Bookmark and Share

Tuesday, November 15, 2011

Why Cholesterol Screening for Kids is the Wrong Idea


If your ears are tuned to the health-o-sphere, I'm guessing you've heard that America's National Institute of Health's NHLBI has recommended screening children starting at age 9 for hyperlipidemia, and doing so by means of a blood test.

While I won't debate the gravity of the rising tide of childhood hyperlipidemia, diabetes, obesity, hypertension, etc., I really do scratch my head about their recommendations.

Firstly I don't believe in ordering blood tests where there's a low likelihood of clinically relevant consequent intervention. What I mean is, doctors shouldn't order tests unless the results have a clear cut, reproducible and clinically effective response.  So what type of response will there be?  Obviously it won't be the kids intervening themselves as it doesn't matter what you tell a 9 year old about their cholesterol, they're 9 years old! Does anyone really think a 9 year old has the necessary insight to react rationally to an elevated serum cholesterol? The problem is, neither do adults. In fact we as a profession seem to be almost wholly incapable of inspiring lifelong change even in supposedly insightful adults with elevated cholesterol.  I wonder therefore why we think we're so good at it so as to ask a child to endure a screening blood test at age 9.

Secondly, even if we could affect lasting change, are the recommendations provided proven to be a clinically reproducible, useful and efficacious dietary pattern?

Well, from what I can gather, fancy expert panel or not, they seem to have simply regurgitated the same low-fat message that recent years have pretty much proven to be non-helpful in preventing cardiovascular problems in adults. And despite regurgitating old, proven to be ineffective with adults advice, what's perhaps more shocking is what they didn't recommend. From what I read there's not one word about whole-food cooking, and not one word about the processed food environment in which these kids are drowning.

I find that absolutely astonishing. Much ado was made about how we have to work with best available evidence in terms of testing 9 year olds rather than wait for the clinical trials. How about the best available evidence that from a dietary perspective society's nutritional fracture is the loss of the ability, desire, time, and/or motivation to regularly transform raw ingredients into meals? Where's the advice to actually cook from scratch? To minimize all meals out and not just "fast" food? To stay away from boxes? Instead all I see is the DASH diet, a call to avoid eggs (good grief), and a call to avoid full fat milk.

Lastly, do we really need 9 year olds to endure a blood test to know that they're on an unhealthy path, and moreover and more importantly, are high cholesterol, sugar or blood pressure really the barometers of dangerous dietary or lifestyle dysfunctions?  Does that mean that kids who eat atrocious diets and live unhealthy lifestyles but don't have signs of traditionally adult diseases are safe?

Whether they've got elevated cholesterol, sugar or blood pressure or not, how about we teach doctors to take detailed eating and lifestyle histories from every kid, at every annual visit?

What sort of history?

Well for starters, how about questions like:
  • How many meals out a week (including cafeterias, take out and restaurants)?
  • Who, if anyone, is cooking?
  • How much juice?
  • How many sweetened beverages?
  • What are their patterns of eating like?
  • Do they struggle with any disordered eating?
  • What are their usual meals for breakfast, lunches, dinners or snacks?
  • How often do they exercise (and what do they enjoy doing)?
  • What does their parental healthy living role modeling look like?
  • How many hours of screen time?
  • What time do they go to sleep?
  • How is their body image?
  • How is their self-esteem?
In medical school I was taught that over 90% of diagnoses can be made on the basis of history alone. Rather than recommending a blood test, how about recommending physicians take lifestyle histories and that way, instead of just focusing on those kids who are unfortunate and predisposed enough to be developing "adult" style chronic diseases at a frighteningly young age, we can focus on all kids, including those whose youth might still be protecting them against an awful lifestyle.  Don't those kids need help too?

My view from the trenches for those folks in their ivory towers?

We don't need a blood test from a 9 year old to know if a kid needs help, and looking at the actual recommendations these experts have put forth, I think it's pretty clear they need some help too.

So my two cents addition to this expert report (and I'll keep it short and sweet)?
  1. Lifestyle history from all kids starting at birth (obviously with parental input until the kids are old enough to answer for themselves).
  2. As a family: Cook.  From scratch.  More often than not. (oh, and mixing things from packages together isn't actual cooking).
  3. Live the lives you want your children to live.


Bookmark and Share

Monday, November 14, 2011

Is your spouse sabotaging your weight management efforts? Please RT!


Spousal sabotage is a common complaint.

Whether it's pressure to regularly eat out in restaurants, frequent gifts of hugely calorific indulgences, or worst of all, regular weight related derision, spouses can certainly challenge our best weight intentions.

If you've experienced what you would describe as spousal sabotage, would you mind taking a few minutes to help further some research?

Amanda Harp, for her PhD dissertation at Clark University, is studying the phenomenon, and perhaps, through her work therein and your contribution, we'll gain a better understanding of just what we're facing with less than helpful spouses.

Amanda's put together an online questionnaire. Have a peek at the inclusion criteria, and if it's you, please consider helping out:
"1) Have you been participating in a weight loss program for the past 5 weeks?

2) Have you been in a committed, co-habitating relationship for the past 2 years?

3) Do you ever feel like your partner/spouse gets in the way of your weight loss?

If so, you're invited to participate in an anonymous, online survey:

This survey should take approximately 30-45 minutes to complete. Responses cannot be traced back to participants. Any question may be left unanswered. Participation is voluntary and may be withdrawn at any time. If eligible to take this survey, you may opt to enter a lottery for $100.

Please direct questions about this study to Amanda (aharp@clarku.edu) or Dr. Cordova (jcordova@clarku.edu)"
Regardless of whether or not you participate, have you ever experienced spousal sabotage? If you have, what'd they do, how'd it impact upon your efforts, and were you able to figure out a successful way around them?

Bookmark and Share

Friday, November 11, 2011

This video almost makes me want to buy a dog.

My children, if you're reading this, please note that I said almost!

Today's Funny Friday involves a dog who really, really, wants to play with the baby.

Have a great weekend!

(Email subscribers, head to the blog to watch)



Bookmark and Share

Thursday, November 10, 2011

Book Review: Hold that Hidden Salt!


[Full disclosure. I was sent this book by the author]

Today's guest post is from my office's Registered Dietitian Mark McGill. Mark's been spending a great deal of time these days in the kitchen, in part because I keep on giving him cookbooks for review. Today's example comes from registered dietitian Maureen Tilley who after coming to one of my talks, asked if I'd like a copy of her books. Reading Mark's review, I'm glad she did:

Maybe it’s because you’ve been diagnosed with high blood pressure, or are at increased risk of stroke or heart disease.

Perhaps you simply want to lead a healthier lifestyle.

Whatever the reason, the question I hear on a regular basis is: How do I lower my sodium intake? Throwing away the salt shaker is a great start, but given the incredible saltiness of most supermarket purchased packaged foods, it’s often not enough.

What’s the solution?

Cooking.

Registered Dietitian and author of Hold That Hidden Salt! Maureen Tilley understands this and has created a cookbook that provides "recipes for delicious alternatives to processed, salt-heavy supermarket favourites".

Canadians average 3400 mg of sodium per day with 75% coming from processed foods. The average adult needs only 1500 mg daily. So why is there so much sodium in our food supply? According to Maureen, it’s to generate profits for salt manufacturers and food companies who use it to cheaply preserve foods and improve their flavour. Food companies argue that without the amount of salt they’re using their products would be tasteless. They’ve even attempted to demonstrate this by providing product samples without salt to show how ‘poor’ they are without it. What they conveniently forget to mention is that if they were required to reduce the amount of sodium they would have to switch to more expensive substitutions which would negatively affect their bottom line, substitutes that they don’t add into the foods with the removed sodium.

If you’re trying to reduce your home’s sodium intake, I highly recommend picking up Maureen’s book. It is well organized, easy to read and if nothing else will get you cooking more foods from scratch – something we should all do more frequently if we want to live healthier lives (and save money!).

The book begins by explaining how to determine the amount of sodium in a food accompanied by a list of which foods are high in sodium. Some are more obvious than others – e.g. frozen meals are a main culprit whereas breads may not come to mind as quickly but are often quite laden with the stuff. Also discussed are daily sodium requirements by age, and easy to follow explanations of high blood pressure and the DASH (Dietary Approaches to Stop Hypertension) dietary guidelines.

Recipes are divided into the following categories: Breakfast Foods and Breads, Snacks and Appetizers, Soups, Salads and Side Dishes, Condiments, Dressings, Sauces and Seasonings and finally, Main Dishes. In each section, Maureen presents a brief commentary on why a type of food (e.g. salsa, chip and veggie dips, meatballs) is high in sodium and an accompanying nutrition facts panel based on a specific example (e.g. Old El Paso Salsa, Ruffles Dip, President’s Choice Blue Menu Lean Italian Beef Meatballs). She then suggests alternative made-from-scratch versions that are lower in sodium. How much lower? The following examples are particularly eye-opening:

Knorr Frozen Shrimp, Asparagus and Penne (1300 mg per 340 g serving) vs. Maureen’s Garlic and Basil Shrimp Medley recipe (141 mg per serving).

Quaker Blueberry Muffin Mix (300 mg per 38 g serving) vs. Maureen’s Blueberry Bran Muffin recipe (87 mg per 54 g serving).

Quaker High Fibre Raisins & Spice Oatmeal (220 mg per 43 g serving) vs. Maureen’s High-Fibre Oatmeal recipe (37 mg per serving)

Heinz Ketchup (140 mg per tbsp) vs. Maureen’s Ketchup recipe (9 mg per tbsp(

I prepared two recipes: curry, lentil and sweet potato burgers (p. 117) and cinnamon garlic sweet potato and turnip fries (p. 74). Both recipes were easy to follow and took less than 45 min (prep and cooking time). The burgers were tasty, filling and high in fibre (7 grams per burger) while the curry paired well with the sweet potato. The fries were certainly different as using cinnamon and garlic together is not something I’ve tried before. I was pleasantly surprised by the combination, though I found the cinnamon over-powered the garlic as I was eating them. I only really noticed the garlic about thirty minutes later. I prepared them for my younger brother (who is a very picky eater) and my mother on two separate occasions. Both enjoyed them and stated that they would have them again. As for the sodium: We saved 378 mg per burger (compared to M&M Angus Beef Burgers) and 283 mg per serving for the fries (compared with McCain Superfries Xtracrispy Straight Cut Fries).

Some may argue that they need to add salt to food to make it taste good. The reality is food tastes good without salt – we’ve just become accustomed to food containing too much of it. It is possible to retrain your taste buds to like foods without added salt, to experience foods as they were meant to be enjoyed. As Maureen correctly points out: “After a couple of weeks of moderate daily amounts of salt, you’ll find that many of the items you used to find ‘normal and ‘tasty’ will seem excessively salty.”

In the end, I can confidently recommend this book to not only those looking to reduce their sodium intake but to anyone who wishes to live healthier by consuming less processed food and more home-cooked meals.


Bookmark and Share

Wednesday, November 09, 2011

The LA and New York Times Forget Something Important


What'd they forget?

That study outcomes don't always matter.

Both were reporting on a new study that found that "soda bans" in schools don't in fact impact upon sugar sweetened beverage consumption by students.

The New York Times' headline was, "Soda Bans in Schools Have Limited Impact", while the LA Times reported, "Soda bans in schools don't stop sugary drink consumption, study says".

I can't fault their factual accuracy as indeed it's true that this study didn't find any impact from sugar-sweetened beverage bans in schools.

My response?

Putting aside methodological questions and the usual arguments surrounding correlation and causation, my most important response is, "So what?".

What am I getting at?

If there were a study that suggested banning smoking in schools didn't curb childhood tobacco use would that be a reason not to ban smoking in schools?

Of course not.

And while I can't fault the LA and New York Times' for the accuracy of their reporting, and while perhaps it's even unfair of me, I can't help but wonder whether or not in this world of headline rather than study readers, whether these types of articles will be used in the fight against wise public policy by those who value profits more than health.

Schools shouldn't be selling kids sugar sweetened beverages. Sure, kids might buy them on their own outside of school grounds, but that still doesn't make selling them in schools a good idea.

Bookmark and Share

Tuesday, November 08, 2011

Are you Trying to Qualify for the Boston Marathon of Weight Loss?


This year I turned 40.

In so doing, it bought me an extra 5 minute cushion for my Boston Marathon qualifying time.

But here's the thing.

I'm an incredibly slow runner, and I've yet to run a marathon. That said, I'd like to run one, and I figure a realistic time for me will likely be somewhere around the 4:30 mark.

But let's say I get it in my head that my goal isn't just to run a marathon and try my best, but rather my goal is to run a marathon and qualify for Boston.

The way I see it, there are only two possible outcomes:

1. I qualify.
2. I don't.

Unpacking outcome number one, qualifying sure wouldn't come easy. In order to qualify, in a best case scenario it would likely involve me killing myself training for nearly a year. And I mean killing myself. I'd have to neglect my family to the point of my wife threatening to leave, I'd have to abandon my patients and I'd have to hurt all the time from the insane amount of running I'd be doing.

Here's something else I'm pretty sure of. If I did qualify after killing myself training, I'm certain that when I finally ran Boston my time would be slower than my qualifying run. Why? Because why would I sustain a level of training that very negatively impacted my quality of life if I already achieved my goal?

Unpacking outcome number two, if after killing myself training for a year I didn't come anywhere near qualifying, chances are I'd just stop, because after all, what'd be the point of continuing to try if my goal was qualifying for Boston and I came up way short after all that incredibly hard work?

I think you probably see where I'm going with this.

Setting a massive numerical weight loss goal simply isn't wise. If you have to kill yourself to get there, you probably won't stay there, and if you kill yourself only to fall short, you'll probably stop killing yourself.

For me, my running goal will simply be running. Yes, a marathon is actually on my bucket list, but if every time I started running distances I began to hurt too much, or simply hated it, chances are I'll just take it off my list. Really, at the end of the day, my running goal is to be able to look back upon my training and feel like I did my best. Not the best I could tolerate, but the best I could enjoy.

That's not so strange. Generally we accept our personal bests as great at most everything, and if I feel I tried my best, I'll be alright with that.

What's truly strange is that somehow, when it comes to weight, people tend not to want to accept their personal best as great. Somehow when it comes to weight, everyone seems to think the goal isn't their best, but rather it's to qualify.

Well I'm here to tell you, your best is great, and whatever weight you reach when you're living the healthiest life you enjoy, that's damn great.

So if you qualify for Boston, well that's a heady bonus, but your real goal? Just enjoy your running, pace and time be damned.

Bookmark and Share

Monday, November 07, 2011

Red Mountain Resort - a Healthful Getaway!


I get a great many PR pitches.

Most get deleted almost instantaneously, but this one caught my eye.

It was for a resort in St. George, Utah, called Red Mountain Resort, and while I'm pretty sure they practice some questionable woo with some of their treatments or recommendations (for instance they offer nonsensical "detoxification"), it still looks quite interesting.

Sports, hiking, fitness, fancy spa stuff, beautiful accommodations complemented by what appears to be luxurious, yet calorie reduced, dining, where all entrees and desserts are lower than 550 calories.

Some examples?

• Deconstructed Blueberry Cheesecake (266 calories) with blueberries and graham cracker crust

• Chocolate Fondue with Bananas, Strawberries, and Pineapple (223 calories)

• Jerk Seasoned Roasted Quail with goat cheese and agave pomegranate glaze served on a bed of wild rice pilaf (389 calories)

• Scallops and Orecchiette Pasta, with crimini mushrooms, diced tomatoes, poblano pepper, shallots, dark chili powder, white wine, lime juice & cilantro (341 calories)

• Southwestern Bison Medallions with sautéed onions and bell peppers served on red skin potatoes with chives (304 calories)

• Quinoa, Vegetables, & Feta Cheese with asparagus, red and yellow bell peppers, leeks and garbanzo beans (276 calories)

• Peach Upside Down Cake (192 calories) topped with brown sugar, cinnamon, and nutmeg

• Prickly Pear BBQ Pork Loin topped with leek straws served on smoky cheddar cheese polenta wedge (382 calories)
Sadly the PR pitch didn't come with any perks for me to enjoy were I to write about it, but it's an interesting sign of the times that this type of resort is able to thrive.

Sure contrasts sharply with the average don't move and eat as much as humanly possible vacation that most of us tend towards.

Bookmark and Share

Saturday, November 05, 2011

Saturday Stories - X-rays, fitness and evil Weetabix!


An interesting read on how those airport X-Ray scanners were rolled out without much scientific oversight.

Alex Hutchinson over at SweatScience is surprised that average male fitness has seemingly increased since the 1970s.

The Guardian has a great read on the evils of modern day branding whereby Weetabix is pimping out kids to be "brand ambassadors"

Bookmark and Share

Friday, November 04, 2011

Eating Marshmallows = Crazy Japanese Game Show

God bless Japanese game shows.

Today's Funny Friday involves this simple equation:

Marshmallows + bungie cords = Funny Friday.

Have a great weekend!

(email subscribers have to head to the blog to watch)



Bookmark and Share

Thursday, November 03, 2011

The Heart and Stroke Foundation Thinks Ordering in Pizza is Healthy?


Sigh.

The Heart and Stroke Foundation, a Foundation whose reported mission is to,

"lead in eliminating heart disease and stroke and reducing their impact through: The advancement of research and its application; the promotion of healthy living and advocacy"
has just given it's Health Check seal of approval to pizzas over at PizzaPizza, a national Canadian fast food pizza chain.

In so doing the Heart and Stroke Foundation is continuing its mission to further normalize restaurant meals and also continuing to ignore research that shows Health Halo'ing at restaurants leads to increased consumption, and that simply having Health Check'ed items on the menu, might lead to people ordering less healthy choices due to "vicarious goal fulfillment".

The fact remains, responsible health organizations should be encouraging people to eat out less frequently. Given people are likely to eat more than a Health Check approved serving (2 slices from a medium, but you can't just order the 2 slices, you've got to order the whole medium), that they may well order sugared sodas or appetizers, that less health aware family members may not like the Health Check'ed options, that they'll be forgoing the opportunity to cook a more healthful meal at home, all the Heart and Stroke Foundation is doing with its abhorrent restaurant program is discourage home cooking and put a veil of health on an incredibly unhealthy behaviour.

How many slices of a medium pizza do you generally eat at a sitting, and do you think encouraging and enabling meals out is a good plan?

Way to promote "healthy living" and "apply research".

Bookmark and Share

Wednesday, November 02, 2011

The 2012 Cadbury Chocolate Olympics have Arrived!


Today's post will be short and sweet.

As you might be aware, Cadbury is the main sponsor of the 2012 London Olympics.

Their marketers have unleashed the first wave of feel good marketing inviting all of England to record themselves singing tunes to inspire the athletes.

To start with there's already a YouTube channel, a Facebook page, and a Twitter account, but unfortunately I can't access them all being that I'm from Canada.

Now the Olympics might not seem like a health organization to any of you, and it's not, but it is publicly funded. Governments spend an absolute fortune hosting the Olympics and consequently it can certainly be thought of as a public (as in Government) private partnership.

Cadbury's going to take a wonderful ride on the emotional branding associated with the joy, majesty and excitement that makes up an Olympic Games, and I'm willing to wager here and now, Cadbury's 2012 sales, especially in England but likely the world over, will be the very best they've ever had. I'm also willing to wager that we'll be seeing special Cadbury chocolate medals around the necks of children.

So my question to you is this. Do you think it's a good idea for host countries to sell Olympic sponsorship rights to corporations like Coca-Cola, Cadbury and McDonald's, and in so doing help to fuel likely dramatic increases in the consumption of junk food and sugar in the name of televised sport?

Bookmark and Share

Tuesday, November 01, 2011

Breakfast for Learning needs to Learn the word NO!


Remember Breakfast for Learning?

They're Canada's,

"leading national non-profit organization solely dedicated to child nutrition programs"
They also happily take money from the folks who make Nutella who then use Breakfast for Learning's good name by leveraging their partnership to inspire co-branded sales.

When I called them out on this practice, Wendy Wong, Breakfast for Learning's President and CEO wrote to me to tell me that I misrepresented things and that their,
"relationship with Nutella does not mean that we endorse their product".
Well an anonymous tipster out there read that post and sent me a 2009 press release from another Nutella/Breakfast for Learning co-branding.

This was a press release that appears to me at least, to have been put out by Breakfast for Learning as that little blurb at the end of the release steers back to Breakfast for Learning and not to Nutella or Ferraro.

What'd the release say? Well among other things it called Nutella a,
"long time breakfast staple"
and then sent readers to a Nutella based now defunct website www.nutellabreakfastchallenge.com, to,
"learn about the top five reasons kids should eat breakfast, find easy recipes for on-the-go families and learn tips to encourage kids to eat breakfast."
There was also these quotes from Wendy Wong,
"Through participating in the Better Breakfast Challenge, families are helping ensure that students across the country get the proper nutrition they need for healthy development"

"With the current economy and rising foods costs, we are seeing a greater reliance on child nutrition programs. By signing up for the Challenge, parents can help their own children develop life-long healthy eating habits, as well as make an investment into a bright future for thousands of others who rely on our programs.
"
And while the website's now gone dark, I think it's fairly safe to say that it recommended Nutella as part of a nutritious breakfast and as a life-long habit.

So is Nutella nutritious?

A few months ago Journalist Marie Allard from French newspaper La Presse decided to compare it to No Name Chocolate Icing.

What'd she find?

Compared with Nutella, per tablespoon the chocolate icing had 25% fewer calories, and 27% less sugar.

Amazing.

So I decided to write to Wendy and ask her two simple questions.

I asked her,
"Given Nutella is basically nutritionally interchangeable with chocolate icing, I’m wondering too if you might comment why you and Breakfast for Learning would want to support its use in breakfast? Would chocolate icing based breakfasts be better than no breakfast in the eyes of Breakfast for Learning?"
Initially she ignored the questions (I'd asked a few others - get there in a second), so I asked it again differently,
"To flesh the question out – if the makers of chocolate icing wanted to donate money to Breakfast for Learning and to recommend it be spread on bread for breakfast for children, would Breakfast for Learning allow that?"
Her answer?
"To be honest, I do not really find it very constructive to respond to purely hypothetical questions like the one you have posed. BFL does not endorse any products period, the reality is that we are simply trying to ensure that children have access to breakfast and without our financial assistance many may go without."
How these types of co-brandings aren't endorsements is really beyond me, but to Wendy, things are crystal clear. Here's another of my questions followed by her answer,
"Wondering if you might have some comments for me as to whether or not the press release I’ve included constitutes promotion of Nutella by Breakfast for Learning?"
Her answer?
"In any donor driven campaign Breakfast for Learning is simply the recipient of funds. The quote attributed to me, was in support of the Nutella’s financial commitment to Breakfast for Learning and the importance of eating breakfast."
Sigh.

While there may be some shades of gray in public private partnerships with Big Food, I really would have thought that Wendy's answer to the chocolate icing question would have simply been, "No". The fact that it wasn't, and the fact that Wendy at least publicly denies the reality that co-branding misinforms parents and stains her and Breakfast for Learning's credibility and integrity, is more than astounding, it's tragic.

Bookmark and Share