Monday, December 31, 2012

Dietitians, the Media, and Conflicts of Interest.


Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2009.
According to my friends over at Fooducate, at this week's American Dietetic Association (ADA) conference there was a talk regarding whether or not we can trust industry sponsored nutrition research. The reason that's in question is because sadly right now there are no guidelines in place to help expose conflict of interest in dietetics. It was the absence of such guidelines which led Marion Nestle in 2001 to write a fascinating journal article about how food company sponsorship impacts on the profession's credibility. Ultimately it led Marion to resign her ADA membership. According to Fooducate,the lecture was not a popular one at the ADA conference and was very poorly attended.

Of course it's not just research articles that demonstrate conflicts and bias, we can see non-evidence based industry bias in a far more dangerous place - the mainstream media.

Case in point?

Yesterday there was a CBC report about an Ipsos-Reid survey which according to the CBC was, "conducted on behalf of Dietitians of Canada" (DC). What the CBC article later reported was that the survey was cosponsored by the Dairy Farmers of Canada. The DC and Dairy Farmers of Canada joint press release on the survey drew these 4 conclusions (highlighting is mine, not theirs):
"1. Consumption of all four food groups is far below recommended levels;

2. A significant number of Canadian adults had not consumed any milk and alternatives or any vegetables and fruit on the day prior to the survey.

3. Many Canadian adults report they have barriers to healthy eating.

4. A majority of Canadian adults are not aware of the many health benefits of milk and alternatives and vegetables and fruit including their role in reducing the risk of some cancers, hypertension and other chronic diseases.

5. When made aware of these important health benefits, Canadians report they are motivated to increase their intake of foods from these food groups."
Well last week we covered how milk doesn't appear to actually have a benefit on hypertension and that calcium supplementation alone impacted on cancer risk while dairy might in fact up the risk of prostate cancer and given milk's failure in preventing osteoporotic fracture and in weight loss, I'm not sure what magic milk is meant to do.

Looking at the actual survey the bias is obvious. The only specific questions regarding choices and healthfulness have to do with either "dairy and alternatives" or "fruits and vegetables" and of the 5 conclusions of the press release, 3 directly relate back to dairy (2, 4 & 5). Absent was information regarding the health benefits of whole grains, nuts, legumes or fish.

The thing is I get it. I fully understand why the Dairy Farmers crafted the survey - it was designed to report that Canadians don't drink enough milk; that there are umpteen-million magical "benefits" to milk consumption; that milk's as healthy and important as fruit and vegetables; and that if we just teach people more about unbelievably healthy milk they'll drink more of it, but the question I've got is why do you think the Dietitians of Canada decided to lend their name and credibility to a survey that ignored multiple food groups and is basically a milk advertisement?

Unfortunately the media certainly treated it like more than simply a milk ad and they ran with it prominently featuring DC's involvement. Had the poll simply been one from the Dairy Farmers of Canada I imagine the coverage of the report, if any, would likely have been very different. As well, in this case, the media also oiled the slippery slope of corporate dietetic collaboration by failing to identify quoting dietitian Kathy Furgala's corporate allegiances referring to her instead as a "Toronto-based dietitian". Frankly it was in fact Kathy's quote from the CBC story that got me riled up enough to write this post and explore the survey in the first place. She was quoted as saying,
"For people who say, 'I don't want to worry about the food groups,' just look at your plate, and see if you can't throw in one veggie or some cheese"
Yup, the two most important things you could ever add to your plate if you don't want to "worry about the food groups" - a single vegetable or of course, some cheese.

I'm not sure what's worse. DC signing off on a milk ad disguised as a national eating survey, a dietitian who would give the advice that all your plate needs for your meal to be healthy is one lonely vegetable or a hunk of cheese, or a reporter who chooses to identify that dietitian as a "Toronto area dietitian" while omitting the fact that she's in fact a nutrition educator for the Dairy Farmers of Canada in an article whose focus is on increasing dairy based on the results of a survey paid for by the Dairy Farmers of Canada.

[Oh, and in case you noticed - the survey found that "consumption of all 4 food groups is far below recommended levels". Strange in a country where over 65% are already overweight or obese. Could it be that the recommended levels recommend too much? Tune in tomorrow for more discussion.]

Nestle, M. (2007). Food company sponsorship of nutrition research and professional activities: a conflict of interest? Public Health Nutrition, 4 (05) DOI: 10.1079/PHN2001253

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Saturday, December 29, 2012

Saturday Stories: Charlatans, Fitness Lies and Type 2 Diabetes Vlogs

For those looking to supplement their income Edzard Ernst has some instructions on how to become a charlatan.

A fun piece from Men's Journal to start off the New Year - everything you think you know about fitness is a lie.

The Calgary Herald covers the story of a former Coca-Cola employee's video blogging of the battle he ultimately lost with type 2 diabetes.

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Friday, December 28, 2012

The Best Thing to Hit the Internet This Year (2009)

Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, I'm posting some favourites from back in 2009.
That's what one of the youtube commenters had to say about Funny Friday's Muppet Show version of Queen's Bohemian Rhapsody.

My advice, click the little HD button on the video to watch in streaming 1080p for your ultimate viewing pleasure.

Have a great weekend!



(Email subscribers, hit the blog to watch)

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Thursday, December 27, 2012

Hydroxycut - A Case Study in Scumbaggedness



Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, I'm posting some favourites from back in 2009.
And if that's not a word yet, in this case it should be.

Remember a few months back when Hydroxycut was pulled from the market because it injured livers and killed people?

Well guess what?

It's back!

And not only is it back but reportedly the only ingredient left from the original formulation is caffeine.

Pretty neat stuff eh? Bing-bam-boom and a bit of bibbidity bobbidy boo and presto - a new fantastic supplement that, "really works!". Clinical trials are so 1990s!

So what does it work at?

Well that's a great question.

According to Iovate's new Thermogenic Hydroxycut Advanced website, it
"Boosts Metabolism to Burn Calories"
How you ask? Well according to the fine print,
"Increased energy and boosted metabolism to burn more calories is supported by its key ingredient, caffeine"
So I guess it's like an awesome cup of coffee and yet unlike the box of Thermogenic Hydroxycut Advanced I've never seen a Starbucks cup that brags about its,
"SCIENTIFICALLY RESEARCHED PRIMARY INGREDIENT".
So is coffee a weight loss supplement?

Um, no.

Is Hydroxycut Thermogenic Advance a weight loss supplement?

Looking at the box you might think so as right there at the top in big banner letters you'll read,
"From the makers of America's #1 selling weight-loss supplement brand of 07-08"
(I'm guessing it was also America's #1 killing brand of 07-08 but somehow that doesn't have the same zing)

Well guess what, if you read the smaller letters you'll find out that not even Hydroxycut's parent company Iovate calls it a weight loss supplement as in the tiny fine print you'll note they say,
"It is not a weight control product"
Yeah, I know, caveat emptor but do remember emptors, what you've got to caveat are scumbags that try to pawn off expensive, overhyped, deceptively marketed neutraceuticals "that really works!" as useful where the only "scientifically researched" ingredient is one you can get in a cup of coffee.

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Wednesday, December 26, 2012

Is "Vicarious Goal Fulfillment" Why You Ordered Those Fries?

Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2009.
Here's a strange one.

We've talked about health halos before - if you think a food's healthy you're more likely to consume larger portions of it. Things like "low-fat" front-of-package claims and even restaurants (Subway) have been shown to have health halos that lead to less healthy consumption patterns.

This one has to be the strangest health halo yet. This one states that if there's salad on the menu you'll be more likely to order the fries.

In this study, when menu choices included healthier ones individuals were more likely to choose less healthy options than when the exact same menu was provided minus the healthy options. When salads were on the menu, fries were eaten more frequently, bacon-cheeseburgers when veggie burgers were available, chocolate covered Oreos when 100 calorie packs of Oreos were present etc. In fact there was not one menu in this study with which this phenomenon was not found to occur.

The researchers called the phenomenon, "vicarious goal fulfillment" whereby the mere ability of being able to meet their goal of eating healthier actually caused individuals to feel that they had already met their goal and therefore could order the less healthy, more indulgent option.

Wow - brains are crazy places.

Wilcox, K., Vallen, B., Block, L., & Fitzsimons, G. (2009). Vicarious Goal Fulfillment: When the Mere Presence of a Healthy Option Leads to an Ironically Indulgent Decision Journal of Consumer Research DOI: 10.1086/599219

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Tuesday, December 25, 2012

How The Food Industry Influences Food Policy

Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2009.
Simple - they're invited to the table and once there they're able to extend their considerable influence and spin on the proceedings (how many public citizens, scientists, doctors or dietitians have teams of PR folks and scientists helping craft their messages?).

I've blogged about this a great deal in the past and commented on how bad an idea it is to bring people with a vested interest in national food policy to the table when trying to develop new national food policies.

Rather than go through all that again I strongly encourage you to spend 6 minutes of your morning watching the following video. It does a great job covering just who it is who attends and gets involved in the consultations surrounding national food policy development.

While this particular video deals with American school lunch programs, rest assured this video could have been filmed at every "public" consultation surrounding Canada's Food Guide and of course the non-public, stakeholder invited consultations as well.


(Thanks to Marion Nestle for featuring the video on her blog)

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Monday, December 24, 2012

Read How Two Little French Towns Are Curing Childhood Obesity

Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2009.
Fleurbaix and Laventie, France - combined population 57,819. Not exactly the big time, not exactly household names - yet.

Why might that change? Because they are perhaps the only two towns in the world where childhood obesity rates are in fact dramatically declining.

What's their secret? Special mineral springs? Treadmills instead of desks? A fast food ban? 10 hours of phys-ed a day?

Nope.

Their secret?

Education - lots of it, to many different players.

In Fleurbaix and Laventie healthy living education began in 1992 and for 5 years schools were recruited to teach children about characteristics of foods and nutrients, healthy eating habits, food processing and food labelling in lessons that were implemented throughout the teaching syllabus (not just in gym or home economics). Teachers at the school were trained by dietitians. There was no focus placed at this time on physical activity. Impressively classes were augmented with cross-cutting initiatives including cooking classes, visits to farms, visits to supermarkets and dietitian monitored school based family breakfast programs. This first stage was meant to last for 5 years only but given the success of the program, it's still running today.

The second stage began in 1997 and continued through 2002 and while it was meant to simply be an observational period, as the teaching from stage one became more pervasive, community involvement continued to grow. So much so that in 1999 two dietitians were employed to perform school interventions and also to present to town councils and other adult meetings. The town councils in turn started to support actions in favour of physical activity, built new sporting facilities, hired new sport educators, and created walking schoolbus programs while family activities started to focus on fitness and various local stakeholders (GPs, pharmacists, shopkeepers, sporting and cultural associations etc) set up further family activities that focused on healthy living.

From 2002 through 2007 intervention entered the home whereby a free home based healthy living checkup was offered to 3,000 residents (a full 5% of the population). The visit included blood testing, a clinical exam and a questionnaire aimed at screening for unhealthy habits. Individuals thus identified to be at risk were offered family oriented advice delivered by a dietitian on healthy eating and physical activity and if necessary were referred to a GP for specific health issues (including childhood obesity).

Over the 14 years of study the local media became involved and multiple newsletters and press releases supported the project. As a whole 212 articles appeared in local newspapers, 190 in the medical press, 208 in the national press and there were 25 television reports and 75 radio reports.

The results?

In 2005 childhood obesity rates in the control towns (and much of the UK) had reached a staggering 17.8%.

In Fleurbaix and Laventie?

8.8%.

What Fleurbaix and Laventie did was what has been missing from every other public health intervention I've ever come across. They treated this as a disease of the environment, rather than a disease of the individual.

Every public health professional interested in obesity should be encouraged to read this paper and study the interventions put forth in Fleurbaix and Laventie. We need to start pressing for similar changes yesterday.

(Want to know what Canada has done? We've created a food guide that ignores calories and recommends far too much food, spent $5 million on television advertisements that in isolation tell people they ought to exercise more and we have a Public Health Agency that explicitly and purposely refuses to label obesity a disease. Think we're in trouble? International readers if you're wondering about the TV commercials, here's a parody that sums them up pretty quickly:)



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Saturday, December 22, 2012

Saturday Stories: Paella, Saying Hello, and a Top Ten

Just the usual brilliance from medicine's poet laureate David Katz - this time on how diet advice and eating well is just like paella.

A beautiful story out of the Times of Israel on how the simple act of resolving to say, "Hello", can have a truly wonderful (and sometimes sad) impact.

Science-ish' Julia Belluz awards her 2012's top 10 most outrageous attacks on science.

[And in case you don't follow me on Twitter or Facebook, here's my take on the best resolution you can set this New Year from US News and World Report and also from US News and World Report, why this holiday should be free of both wrist slaps and write offs.]

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Friday, December 21, 2012

The World's Toughest Baby

So it's had 24,000,000 views and therefore I'm pretty sure some of you have seen it, but if you haven't today's Funny Friday's worth your minute. It's a video of the world's toughest baby.

Have a great weekend!

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



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Thursday, December 20, 2012

News Update About My Book Why Diets Fail and How to Make Yours Work

Most of my regular readers may know that I have a book forthcoming, currently titled “Why Diets Fail and How to Make Your Work”.

My editor and I worked together for more than 8 months to shape a book that we are both extremely proud of. My publication date was supposed to be this Spring, but when my editor moved from Simon & Schuster’s Free Press to Random House’s Crown/Harmony Books, I chose to follow her, which has delayed my publication date to Spring 2014.

The upside is that I have an incredibly enthusiastic team at Crown/Harmony who can't wait to help me spread my message as far and wide as possible. I now also have the time and the resources to work on designing a smartphone app to accompany and complement my book.

The downside is that I’ll miss my hard working Simon & Schuster US and CA teams, and that you're going to have to wait a little bit longer to get your hands on it.

But I promise I'll make it worth the wait.

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So How Normal is Fast Food in Our Children's Lives?

When you were a kid how often did your family eat out?

In my family it was exceedingly rare.

Yet nowadays for many families it's an entirely normal, and if not everyday then certainly every week, part of life.

Psychologist Angela Pfammatter sent me a picture yesterday that in a sense helps to illustrate how normal fast food has become. It's so normal that a group of Canadian teachers created a math book for Grade 3-6 students to learn math skills by means of,
"Real-Life, Fast Food Menu Situations"
Here's a shot of some of the menus:


Long sigh.

Sure they might learn some math, but no doubt in so doing they'll be further normalizing the notion of convenience meals - something that truly wasn't "normal" when we were kids but clearly is something that is pathologically normal now.

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Wednesday, December 19, 2012

Parental "No" Files: All Organized Sports - Your Kids Are For Sale

Want your kids to be involved in after school sports?

Better start practicing your "No"s as there'll be plenty.

I've done stories already on hockey, lacrosse camp, and kid triathlons, and just over the course of this past week I received these 3 "No" opportunities:

More hockey - here's a Facebook encouragement from the Ottawa District Hockey Association sent to me by Kevin that encourages group members to activate their Hockey Canada Club Card (meant for kids) to get a free Mars bar and Delissio Pizza


Here's some photos sent to me by Jenn from some cross country ski racers who in turn have been turned into little skiing advertisements for chocolate milk (lait au chocolat)


And here's what was sent out by the West Ottawa Soccer Club (and to me by Lara) - an enticement for 5 free meals at East Side Marios for kids 10 and under (and of course special offers throughout the year):


The take home message here is simple. The folks who organize kids after school sports have no qualms whatsoever selling access to your impressionable children to the purveyors of junk food. And my bet too, like the example I provided yesterday, many would defend these practices either by way of suggesting all you need to do to fight them is invoke your parental "No", or that one chocolate milk, Mars bar or meal out for dinner won't hurt anyone.

The problem of course - it's a constant barrage and even if you did manage to constantly and consistently say "No", there are undoubtedly also countless opportunities where parents aren't around to  exercise that parental option.

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Tuesday, December 18, 2012

Parental "No" Files: The But It's Just One Gingerbread Man Argument

So on Sunday I went to our local supermarket with my 5 year old.

When we got to the checkout aisle the teenage cashier asked me if I wanted to buy my daughter a giant gingerbread man for just $2.99 so that $1 could go to help support the Children's Hospital of Eastern Ontario's (CHEO) Foundation.

Exercising my right as a parent, I said, "No thank you".

You know I'd have happily spent $1 on a sticker for CHEO. Heck, I'd have spent $1 just for CHEO by means of an addition to my bill. But spending $3 to give $1 to CHEO so my child can be fed a bunch of pulverized white flour held together by 5 teaspoons of sugar and emotionally tying together for her the purchase and consumption of junk food and doing a good deed? No thank you.

And I know too there are those of you out there who think I'm just crazy. That, "it's just a gingerbread cookie and it's Christmas time!" - but that's not a whole picture argument. There no longer seems to be any cause, holiday, sporting event, or gathering that doesn't have someone enticing my children with junk food and sugar. It honestly seems as if not a single day goes by where my kids aren't offered junk food by someone other than their parents. It's a never ending parade of garbage and we've normalized it to the degree that to question this junk food cavalcade is deemed more surprising, upsetting and offensive than the cavalcade itself. And each and every time and instance has someone rationalizing the practice with the, "but it's just one (insert junkfood here)" argument.

It's a hugely shortsighted argument.

Somehow I'd have hoped that of all folks out there, the good people over at CHEO would want to decrease the normalization and constant provision of junk food to our children, let alone be used as a means to make the sale itself.

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Monday, December 17, 2012

Dear Mr. Weston, 98.5% of Canadian Children Live Outside of Newfoundland (an open letter)

Dear Mr. Weston,

On December 10th Brandon Fields penned an open letter to Loblaws that he posted to Facebook.

In it he was critical of Loblaws' display of the National Enquirer issue seen up above in the checkout aisles.

His concern was straightforward,
"These magazines, which are displayed prominently at every checkout, are a very real form of bullying. What's more, they further perpetuate the idea that women should have flawless bodies, thereby exacerbating the problem of negative body image, particularly among female youths, but also among all sexes and age groups.

As a schoolteacher, how am I to demonstrate to my students the importance of treating others with respect when everywhere they look society is sending a message to the contrary?
"
To Loblaws' credit, the offending issue was removed from your aisles, but only in Newfoundland.

So my question to you Mr. Weston, as the executive chairman of Loblaws, if your company felt it appropriate and justified to remove the offending issue from shelves in Newfoundland (and kudos to you folks for that), why not remove it from the store shelves in the rest of the country where the remaining 98.5% of impressionable Canadian children reside?

Sincerely,
Yoni Freedhoff, MD

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Saturday, December 15, 2012

Friday, December 14, 2012

Move Over Shake Weight! Make Room For the Tug Toner!

Thanks to the traffic from my disinvited food industry talk I have a great many new subscribers.

They might not know that Friday's are my day off being frustrated. Fridays are "Funny Fridays" and this week's Funny Friday is Jimmy Kimmel's take on the Shake Weight.

Have a great weekend!

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



[Hat tip to perhaps the world's fittest MD, Lift-Heavy's Dr. Bojan Kostevski]

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Thursday, December 13, 2012

Do You Confuse How You're Doing With What You Weigh?

It's certainly what society teaches.

If you're trying to lose or maintain your weight the scale will tell you how you're doing.

Bollocks.

The scale never tells you how you're doing. The scale only tells you what you weigh.

How you're doing is what you're actually doing. Are you cooking healthful meals? Are you organizing your dietary timing, calories, and proteins? Are you minimizing meals out? Are you being thoughtful? Are you keeping track of your choices and intake? Are you exercising? Are you consistent in your efforts?

Boiling it down even further ask yourself,
"Am I living the healthiest life that I can honestly enjoy?"
If the answer's yes, you're doing great - scale be damned.

The fact is sometimes you weigh more than how you're doing even when you're doing great.

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Wednesday, December 12, 2012

Is Dietary Sodium Just a Marker For A Crappy Diet?

I once referred to salt as a "dietary red herring", whereby I wondered whether or not in modern first world nations the risks extended to high dietary sodium consumption might be indirect whereby high dietary sodium consumption serves as a marker for the consumption of nutritionally awful, highly processed garbage which in turn confers the risk.

A paper published online just 2 days ago in the journal Pediatrics fits that narrative.

In it authors looked at the dietary recall data from 4,283 Australian children between the ages of 2 and 16 (obviously the younger ones' data came from their parents). They explored the relationship between reported dietary sodium consumption and the consumption of sugar sweetened beverages.

Unfortunately that's pretty much all they looked at diet wise. The quality and quantities of macronutrients weren't explored or controlled, nor was where the food was purchased (restaurant vs. home made). This of course makes real conclusions impossible. But that said, they found that kids who consumed more dietary sodium also consumed more sugar sweetened beverages.

The authors postulated that dietary salt intake might be increasing physiologic thirst and that consequently the saltier the food, the more soda they drink.

Yup, possible.

Also possible is that kids who eat the saltiest foods are the ones with the worst overall dietary patterns. More restaurants, more processed foods, and yes, more soda pop.

Whatever the mechanism, when it comes to dietary sodium reduction, and things like regulations and task forces, it may be worth looking beyond the usual debate about blood pressure and also consider whether or not sodium has a unique role in driving hyper-palatable and junk food consumption, or whether or not it really is just a red herring and that folks who are found to consume a great deal of sodium, just have crappy diets.

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Tuesday, December 11, 2012

Beyoncé, Why Do You Hate My Children? (an open letter)

Dear Beyoncé,

I have 3 beautiful little girls - 8, 5 and 3. While they're not quite old enough yet to know who you are, I've no doubt they'll both discover and adore you over the course of the next few years. What you say to them, what your advertisements will say to them, will likely carry a great deal more weight than what I might say - after all, I'm just their dad, whereas you, you're Beyoncé. And apparently you're going to tell them, either directly or indirectly, that you love drinking Pepsi Cola.

The New York Times reports that your recently inked Pepsi deal will last for years, cost them $50 million, and for Pepsi it's meant, "to enhance its reputation with consumers".

Of course it's also meant to sell Pepsi - at least $50 million dollars more worth.

Beyoncé I'm sure you're aware that these days the world isn't the healthiest of places, and that the consumption of huge amounts of empty and often sugary calories is contributing to the burden of chronic diseases like diabetes, heart disease, and obesity - and here I'm not even talking about adults. With truly terrifying regularity, kids under the age of 10 are being diagnosed with what was once referred to as "adult-onset" diabetes. Teens are having heart attacks. In your own lifetime, childhood obesity rates have tripled. You might even be aware that in North America, teen girls get 15% of their daily calories from soft drinks. Why would you want to perpetuate that tragedy? In fact I'm virtually positive you're aware of all that given your involvement with Let's Move. So I have to ask: Is your star fading? Did you make some terrible investments? Do you think sugared soda's not as bad as the medical community makes it out to be?

I can't fathom why a star as successful as you would want your own wagon and brand selling Pepsi. While I appreciate that you owe my little girls nothing, I would have hoped that someone with your star power wouldn't need or want to sell children sugar water.

Beyoncé, why do you hate my 3 little girls?

Sincerely,
Yoni Freedhoff, MD

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Monday, December 10, 2012

The Talk The Food Industry Couldn't Bear To Hear

A little over a month ago I was invited by the Ontario Medical Association to give a talk at a food industry breakfast. I was asked to speak about what I thought the food industry could do to help further public health.

3 days prior to the talk, after my flights and hotel were booked, after I cancelled a day of patients, I was dis-invited. Apparently the conference organizer, Ron Reaman, a Senior VP of the international PR and communications firm Fleishman-Hillard, decided that it would be better if I didn't come. Why he decided that I can't tell you because despite being a Senior VP at an actual communications firm, he didn't do me the courtesy of communicating to me his concerns or offering me an apology - instead he had the Ontario Medical Association simply tell me that I was no longer welcome.

The good news is the internet's a much bigger venue than that small breakfast symposium and given I'd already put together my slide set, I figured why not post it online. Online I don't have a time keeper and given I'm not speaking solely to the food industry, I don't need to be as gentle with my messaging as I'd planned. Also good news is who I'll now be able to reach. My blog is read by policy makers, public health authorities, chief medical officers, professors, physicians/dietitians and other allied health professionals, journalists and nutrition bloggers the world over - folks that wouldn't have been attending that small, intimate, food industry sponsored breakfast. You'd almost think Mr. Reaman and Fleishman-Hillard were working for me and not for the food industry as uninviting me will enable me to communicate my message far further than I ever would have done otherwise.

So here's my talk. It's about what the food industry could do to improve public health, why they're not going to, and what we can do about it. But before you click it, a quick request - I want you to share it by means of every socially networked channel and email contact you have (any Redittors here?), because if Fleishman-Hillard the communications firm hired by the food industry to help cultivate good Big Food PR didn't want it heard, I figure it probably ought to get spread.

[Fair warning too - at one point I get a bit heated and use the word "ass", and believe it or not, I wasn't using it to refer to the food industry, or even to Ron Reaman.]



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Saturday, December 08, 2012

Saturday Stories: Evidence shmevidence, Saving Your Family, & Insulin (again)

Science Based Medicine's David Weinberg on how Dr. Andrew Weil is rejecting the results of the randomized trial he himself designed and conducted on one of his alternative medical treatment theories.

I adore this video blog by Summer Tomato's Darya Pino on how food saved her family.

Whole Health Source's Stephan Guyenet takes on a recent paper that many have suggested proves the insulin hypothesis of obesity. Stephan begs to differ.

[And if you don't follow me on Twitter or Facebook, here's my US News and World Report column on exergaming - more game than exer.]

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Friday, December 07, 2012

New at McDonald's - Your Personal Shame Mask

Today's Funny Friday really spoke to me.

It spoke to me because truth be told, my mouth enjoys the taste of McDonalds and occasionally I'll even buy some.

Good thing this isn't a real product otherwise I'm guessing I'd hit the arches more often.

Have a great weekend!

(email subscribers head to the blog to watch)



[Hat tip to Zoomphoto's Joe Elliot]

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Thursday, December 06, 2012

Hockey Canada Selling Access to Our Children to Pepsi, Mars, McDonald's & More

Big Food shoots and scores, and scores, and scores, and scores as they pretty much own minor hockey in Canada.

What am I talking about?

Well I was first tipped off to Hockey Canada completely selling out to Big Food with Mars' Play Your Part campaign - where buying Mars bars helps to fund local community rinks.


Here's their television advertisement that very clearly spells out what's in it for Mars - the cultivation of deep emotional brand loyalty and goodwill along with direct sales built on the Canadian institution that is hockey:



That campaign though took me to Hockey Canada, where Hockey Canada is the backbone of official hockey in Canada as it's involved pretty much every step of the way at pretty much every level and age category of competitive hockey. Once there I found their sponsorship page which detailed not only who the sponsors are, but what their purchase of Hockey Canada bought them:
  • General Mills: "provides nutritious snacks for attendees at all of Canada’s national and international championships"
  • McDonalds: "delivers multiple in-venue promotions during Hockey Canada’s national events to enhance the experience and atmosphere for fans, and have recently launched the atoMc Hockey program, which, with the help of atoMc ambassadors Tessa Bonhomme, Drew Doughty and Marc-André Fleury, provides minor hockey teams with a full set of pro-style jerseys and socks, along with official Hockey Canada Atom coaching materials"
  • PepsiCo: "Pepsi, Gatorade and Frito Lay products – can be found on the benches and in the locker rooms of all of Hockey Canada’s national teams and at all Hockey Canada’s national events."
  • Kraft: "Kraft launched its Kraft Assist program, where consumers can win head-to-toe Bauer hockey gear by entering their unique PIN on the Kraft website."
  • Boston Pizza: "Boston Pizza has had major promotions in their restaurants during recent IIHF World Junior Championships, giving away Team Canada prizes, including a set of collectable glasses and a Team Canada jersey."
  • Delissio: "Delissio has exclusive promotional rights in two categories – Frozen Pizza and Ice Cream– as well as full event sponsorship benefits at all Hockey Canada-hosted events."
Food sponsors are also included in the newly minted, "Club Hockey Canada" the launch of which was explained thusly,
"So really, it was a board-driven directive to ensure that kids feel that they’re a part of the same team as Hayley Wickenheiser and Sidney Crosby and Greg Westlake."
And what do kids on Hayley Wickenheiser, Sidney Crosby and Greg Westlake's team get with their membership? Among other things discounts for McDonald's, PepsiCo, Mars, Boston Pizza, and Delissio.

And when they say kids, they mean kids. Check out this video that was posted to Club Hockey Canada's Facebook page:


And what else will the kids be receiving?

Free Mars bars.


Is anyone else out there sad that Hockey Canada, the official face of Canadian Hockey, is comfortable selling junk food purveyors explicit and regular access to even our youngest kids' hearts, minds and waistlines, or am I making a 3 game suspension out of some simple high sticking?

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Wednesday, December 05, 2012

Hamilton Wentworth School Board's "Food Drive for Student Nutrition" Culminates in Pizza Party?

Full disclosure. I adore pizza. I mean really adore it. So much so that when my kids asked me the other day what food I would pick if I could only eat one food for the rest of my life I unhesitatingly answered, "Pizza".

That said, I don't order Pizza very often.

But you know who loves pizzas even more than me?

Schools.  But they don't have many qualms about how often, or even simply how, they use them.

Up above's a photo of the Hamilton Wentworth District School Board's incentive to participate in their "Food Drive for Student Nutrition".  The reward?  A pizza party for the class that brings in the most donations.

Sigh.

Honestly is there any fast food product more firmly entrenched in schools than pizza?

Check out these fundraising photos both sent/taken just in the past week.  The first is from Domino's, the second from Boston Pizza.



While I feel for the schools, raising money by selling products that children should be eating less of, not more, and using junk food to reward good behaviour, is contrary to the school system's primary job of building healthy children. Furthermore, it undermines parents who try to keep these sorts of foods at a dull roar in their children's lives.

What else could schools do? Fresh produce drives. Garden kits. Crafts. Garage sales. Community cleaning runs. Grandparents' days. There are in fact many ways to raise money without resorting to the easy way out of increasing fast food consumption among the student and parental bodies.

Pizza and schools should not be married.  Would love to see someone start some divorce proceedings.

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Tuesday, December 04, 2012

Parental "No" Files: Hockey Tournaments

Received an email from my friend, fellow Trench Talker, and bariatric surgeon Dr. Laz Klein. He wanted to share an email he received from the coaches of his 10 year old's hockey team. They were about to head out for a weekend tournament and the coach was requesting that parents chip in to bring some supplies.

What did the coach want brought? Among other things,
"4 cases of bottled water, 24 cans of Coke, 24 cans of Diet Coke, 24 cans of Sprite, plus another misc case of pop… AND a couple cases of juice boxes"
Now the good news for this team's parents, with Laz involved they're not going to need to say "No" as his immediate response quashed the plan,
"Thanks for bringing bottled water. Certainly we can also help with that. However, do you think it's reasonable to limit the amount of pop that our kids drink this weekend?

I spend all day telling my patients how this stuff is poison and I really can't turn around and give it to our kids. There really should not be any acceptable time for children to drink this stuff. Juice is not much better. Instead of apple juice have them eat an apple. Gatorade is just pop with better marketing. There's also no acceptable time for adults either but that is a separate matter.
"
But I'm guessing there are far more hockey tournaments for 10 year olds with buses filled with pop, than there are tournaments where one of the parents is frustrated enough to forcefully and authoritatively say "No"

What's the worst thing your kids were given to eat in the name of organized sport?

[The winner of the $100 gift card draw from yesterday was Cynthia Dunlavy.  Cynthia please email me your mailing address at yonifreedhoff over at that gmail place.  Thanks to everyone who entered and shared their goals.]

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Monday, December 03, 2012

SMART Resolution Give Away ($100 Sport Chek Gift Card)

A little while back I was invited to get involved with Canadian fitness retailer Sport Chek and their "Your Better Starts Here" campaign.  Viewing it I felt it resonated with own philosophy surrounding healthful living - live the healthiest lives that you can enjoy, and while there's no doubt that effort will be involved, striving to be perfect shouldn't be.  On the other hand, striving to be "better"? That fits.

Last week Sport Chek sent me a $100 gift card. They said I could give it away to whomever I chose.

So here's how it'll work. It's nearly the time of year where people resolve to improve aspects of their lives. Leave me a comment with something you're hoping to do better and if your resolution is a SMART one, you'll be entered into a draw for the gift card. I'll post the winner at the end of tomorrow's blog post and if you send me your address, I'll mail you the gift card.

Remember, SMART goals are specific, measurable, attainable, relevant and realistic, and time-bound, meaning a goal to "exercise more" won't qualify, whereas a goal to walk, 3 days a week, for 20 minutes, over lunch hours, for a month - would. Similarly a goal to "eat healthier" won't cut it, whereas a goal to eat out fewer than 3 times per month for the next two months would.

I realize that Sport Chek's a Canadian retailer so international readers - sorry - but feel free to leave your own resolutions in the comments and simply make note of the fact you're not from Canada.

[Special Ottawa bonus giveaway - I have 12 leftover Halloween coupons valid for a free admission to the Walter Baker Centre for a swim or a skate. They're at my front desk (575 West Hunt Club, Suite 100) and they'll be first come first served to pick up with the limit being the number of kids in your family - when they're gone, they're gone]

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Saturday, December 01, 2012

Saturday Stories: Facebook vs. Health Check, Denmark's Dead Fat Tax & Dairy

So Global News published a piece about my criticism of the Heart and Stroke Foundation's misleading Health Check. Then they asked for public opinion on Facebook. As of my typing this, of the responses that were either critical or supportive of Health Check, 25 of 27 were highly critical..

Marion Nestle talks about the demise of the poorly thought through Danish fat tax.

Yale's David Katz brilliantly summarizes the evidence on whether dairy is magic fairy food, or Satan sauce.

[And if you're not a Facebook or Twitter person, here's my weekly US News and World Report column - Of course there's such a thing as a bad food]

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Friday, November 30, 2012

Would You Pay Starbucks $7 For a Cup of Their New Confirmacebo Biaffect Blend?

This week's Funny Friday video featuring Jimmy Kimmel's crew giving people two identical cups of plain coffee and telling them one's uber-fancy suggests to me that if you do buy one, you're going to love it.

Not because it'll necessarily taste remarkably different, but rather because we as a species aren't all that bright.

The blend is actually called Costa Rica Finca Palmilera but I like my name better.

Have a great weekend!

(email subscribers, head to the blog to watch)



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Thursday, November 29, 2012

If You Ever See This Product Endorsement - RUN!

Saw this as part of an ad for some weight loss snakeoil.

As mentioned, if you ever see this endorsement - run, don't walk, away from the product it's stamped on.

Here's the full ad for those who're curious:



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Wednesday, November 28, 2012

Parental "No" Files: Public Libraries Push Junk Food on Preschoolers Now?

The next in the never ending line of insane examples of entirely unnecessary junk food provision to children comes from a fellow health blogger's local library in Ketchum, Idaho.

It's called The Children's Library and their in-library events are clearly geared at pre-school and elementary school aged kids.

Looking at their December schedule, of the 24 days they're open, 7 of them involve giving kids food. Junky food. Pancakes, holiday cookies, 2 days of gingerbread houses, hot chocolate, popcorn and drinks, and of course, "hot chocolate and donuts all day" - because what screams out reading more than donuts?

Sigh.

Since when was food even allowed in libraries, and more importantly, why would libraries feel the need to ply children with junk food in the first place? Aren't libraries places to go to cultivate a love of reading? Of learning? Aren't there plenty of other opportunities to cultivate a child's love of donuts?

So parents in Idaho (and perhaps elsewhere too), add children's libraries to your list of places where you're going to need to say, "No" at when your child is offered junk food that you yourself hadn't planned on giving them.

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Tuesday, November 27, 2012

Want to See Kellogg's Latest Cereal Marketing BS?

Yes, my kids like Rice Krispies, and yes, we even buy some from time to time.

Pulling out the box yesterday morning I noticed that brand-spangled new claim up above,
"Goodness of a Simple Grain"
The way it's featured and highlighted and the word, "goodness", all scream health benefit.

But of course it means absolutely nothing.

Except likely sales.

And for the record - I don't blame Kellogg's for front-of-package health claim cow pies, I blame the government for not giving a crap.

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Monday, November 26, 2012

Canada's Heart and Stroke Foundation Calls Fast Food Burgers Healthy, Nutritious & Good for You

The Heart and Stroke Foundation's "visionary mission" is,
"Healthy lives free of heart disease and stroke. Together we will make it happen."
And among their stated values is,
"Integrity – acting ethically to ensure transparency, accountability and public trust."
So how then can one explain the Heart and Stroke Foundation's Health Check program which just last week extended their imprimatur to Harvey's - a Canadian fast food burger joint? Yup, you can now buy Health Check'ed Harvey's veggie, chicken and regular burgers, where the veggie and chicken burgers contain 930mg and 950mg of sodium respectively (nearly 2/3 of the Heart and Stroke Foundation's daily recommended aim of 1,500mg).

What? Your family doesn't feel like burgers tonight? They want fast food pizza? No problem - Health Check'ed fast food pizzas exist too:

And you may as well wash it down with Health Check'ed grape juice containing double the calories and 30% more sugar than Coca-Cola, and why not have some Health Check'ed "fruit gummies" for dessert even though Twizzlers contain less sugar?

No self-respecting dietitian or health organization would ever claim that encouraging eating out in restaurants, drinking juices containing 10.5 teaspoons of sugar per glass, and eating faux-fruit candies that contain more sugar than actual candy could possibly be good for living healthy lives. And yet that's exactly what the Heart and Stroke Foundation is actively teaching Canadians with their disgraceful, and nutritionally unethical, Health Check program.

In fact they're abusing the very public trust they consider one of their core values - a trust that they use themselves to market the Health Check program. Here are some facts and figures from a 2004 Heart and Stroke Foundation press release on the Health Check program,

  • 8 in 10 consumers say they can trust Health Check because it comes from the Heart and Stroke Foundation of Canada.


  • 68% of respondents agree with the statement: “I can rely on Health Check to help me make healthy food choices."


  • 64% of those surveyed by Ipsos-Reid indicate they are more likely to purchase a food or beverage from a grocery store if it bears the Health Check logo.


  • According to a report on Food Information Programs published in the Canadian Journal of Dietary Practice and Research (summer 2002), information logos are three times more popular than detailed nutrition information for helping to select between food products. The Health Check symbol reassures consumers that they’ve made a healthy choice.

  • A 2005 press release had this to say,
    "The Health Check symbol complements mandatory nutrition labelling, in a 2004 research study, sixty-five percent of consumers recognized the Health Check logo as meaning the food is 'nutritious', 'healthy', 'good for you' or 'approved by the Heart and Stroke Foundation."
    Really? Fast food burgers and pizzas, along with juices and candies that pretend they're fruit are "Nutritious, healthy, and good for you"?

    Dietitians of Canada (both the organization and individual RDs) - where are you on this? Journalists - how about you?

    It's beyond shameful.

    Make your voice heard, or at the very least, consider voting by closing your wallet the next time the Heart and Stroke Foundation comes looking for your support, and when you do, make sure you tell their canvasser why. The Heart and Stroke Foundation, despite the incredible amount of good work that it does, is blatantly and callously misinforming a nation, and it absolutely and undoubtedly knows better and we shouldn't be letting them get away with it.

    There are no ends that justify these means and how the powers that be at the Heart and Stroke Foundation sleep at night knowing that Health Check is out there and is actively misinforming Canadians is truly beyond me.

    [Hat tip to Dr. Paul Boisvert who alerted me to this most recent Health Check'ed nonsensical fast food endorsement]

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    Saturday, November 24, 2012

    Saturday Stories: Coca-Cola Buys Chicago, Robinson Crusoe, and 4 Hour Chefs

    The incomparable Marion Nestle on Coca-Cola's purchase of Chicago's parks.

    The amazing and true story of an internet millionaire turned penniless real life Robinson Crusoe.

    Summer Tomato's Darya Pino reviews Tim Ferris' The 4 Hour Chef. Might have to grab me a copy one day as I'm not aware of any other book that apparently includes a section on surviving the zombie apocalypse on squirrel and pigeon.

    [And for those who don't follow me on Twitter or Facebook, here's me on US News and World Report talking about how many meals you should eat a day]

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    Friday, November 23, 2012

    Thanksgiving Etiquette For Children (LOL Funny)

    I'm glad I didn't have a mouthful of coffee while watching this week's outstanding Funny Friday video.

    Hope my American readers had a happy Thanksgiving!

    Have a great weekend!

    (email subscribers head to the blog to watch - this one's definitely worth it)



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    Thursday, November 22, 2012

    Parental "No" Files: Hurricane Sandy Relief Efforts?!


    So today Royal Roads Public School in Ingersol, Ontario is selling their students $2 "candy bags" to support Hurricane Sandy's relief effort.  It doesn't breach Ontario's Healthy Schools Food and Beverage Policy (as that allows for 10 days of junk food fundraising speaking to the value of the policy), but no doubt it does undermine some parents' efforts to limit their children's exposure to and consumption of candy.

    Is there truly no other way to raise money than to sell candy?

    But no worries.  As they likely have to do multiple times a day consequent to the world's constant thrusting of junk food at their children against their wishes including in deeply trusted institutions such as our publicly funded school system, parents can just say "No".

    [Hat tip to disgruntled parent and healthy living advocate Dr. Jonathan Clow]

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    Wednesday, November 21, 2012

    If This Isn't Proof Society Is Broken, I Don't Know What Is

    Thanks to my friend Kev for forwarding to me this actual photo of his microwave that clearly identifies what the world must perceive "Kids Meals" to be - mac and cheese, chicken nuggets and hot dogs.

    If that's kid food, what do you think those kids who are eating it regularly are going to gravitate to as grownups, let alone what they're going to feed their future children?

    Parents - as far as I'm concerned it's your obligation to ensure that before your children move out, that they can cook 10, healthy, calorie-controlled, from fresh whole ingredients, meals. And if you're not there yourselves as parents - this Christmas put some cookbooks on your list.

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    Tuesday, November 20, 2012

    If Coca-Cola Never Markets to Kids What's it Doing in Comic Books?


    Just wanted to remind you of a quote from the Coca-Cola company advertisement that I found a few years ago in the Canadian Medical Association Journal,
    "Parents tell us they prefer to be the ones teaching their children about beverage choices. That's why for over 50 years we've adhered to a company policy that prohibits advertising soft drinks to children."
    Now I've blasted that claim out of the water a few times. First with the 17 YouTube videos that I pulled up in a matter of moments that clearly demonstrate Coca-Cola's predatory practice of targeting kids, and then later with a post highlighting all the toys Coca-Cola brands for children.

    Today let's add comic books.

    There's the co-branded book up above, and here's an ad that appeared in comic books themselves that tell kids Coca-Cola Classic is, "Always Great for Good Sports"


    And here's another Hulk co-branded Coca Cola comic


    Coca-Cola also made a series of comic books featuring hockey legend Brett Hull along with McDonald's


    And just in case you missed it here's the photo from yesterday's blog post with the 2007 Vancouver Rogers' Christmas Parade Coca-Cola float that couldn't possibly be targeting kids.


    Right Coca-Cola? That float, and the parade itself, clearly they're not meant to target kids.

    You know I've got nothing against Coca-Cola peddling its sugar water to children, that's what free markets allow corporations to do (whether free markets should is a whole different topic) - but blatantly lying to society about not doing so and pretending to be good corporate citizens who care about your children - that's just not cool.

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    Monday, November 19, 2012

    The Big and Fast Fooding of Thanksgiving and Santa Claus Parades

    My close friend Brad sent me a photo from his local Hamiltonian Santa Claus parade. It was of the happy gang of McDonald's mascots.

    And indeed - pretty much every holiday parade comes replete with fast food mascots in float or balloon form.

    Of all the holiday parades, none's bigger than Macy's and according to Wikipedia, over the years the Macy's Parade has included the following fast food balloons and floats:
    • Ronald McDonald (3 different versions including the one pictured up above)
    • The Pillsbury Doughboy
    • M&Ms
    • Kraft KD's Cheeseasaurus Rex
    • The Honey Nut Cheerios Bee
    • The Nesquick Bunny
    • The Kool-Aid Man
    • Jell-O
    • Goldfish on Parade (the crackers)
    • Hamburger Helper
    • Jimmy Dean
    • Oceanspray
    Interestingly, I can only find reference to branded foods' Macy's inclusion from 1987 onwards.

    Nearer to me Toronto is the home to a truly world famous Santa Claus parade.

    Its current sponsors include: McDonald's, Coca-Cola, Redpath Sugar, Nestle's Turtles, Kraft Foods, Tim Horton's, Plantars Peanuts, Shopsy's Deli, and Villagio White Bread.

    And when I simply googled iconic fast food brands and parades, thousands of pictures came up. Those pictures included this one of a Coca-Cola float from the 2007 Rogers Santa Claus parade - this from the same Coca-Cola company that regularly claims it doesn't market Coca-Cola to kids. Guess they thought the parade was geared to Santa loving adults.


    So if you're a parent, and if you're keen on trying to reduce your children's exposure to fast food branding, you'll have to have your kids sit out your local Santa Claus parade.

    Sigh.

    Is there anywhere or anything out there geared towards kids that the food industry hasn't co-opted to market their brands?

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    Saturday, November 17, 2012

    Saturday Stories: "Kid Food", "Wrong" diets, & Calling Yourself Beautiful

    The inimitable Marion Nestle on why kids don't need kid foods.

    Skeptic North's irreverent Erik Davis on how he lost 40lbs "doing everything wrong"

    Amanda on the ignominy of self scrutiny around kids and why she's started telling her daughters she's beautiful (an awesome piece).

    And if you missed it, my piece from US News and World Report this week on why you should be inviting Charles Darwin over for dinner.

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    Friday, November 16, 2012

    Have You Ever Watched Honest Trailers?

    They're genius, and having just come off a flight to and from Alberta where I watched the Amazing Spiderman I can tell you that this week's Funny Friday, an Honest Trailers feed that includes their Spiderman take, is a gem.

    Have a great weekend!

    (email subscribers head to the blog to watch)



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    Thursday, November 15, 2012

    What's In the Average Vending Machine Snack?

    Friends in Edmonton recently published a paper on the tug of war between health concerns and sales concerns when it comes to community centre food sales.

    While the paper's an important read for folks trying to encourage local community centres' health reforms, something stuck out for me. It was a chart that highlighted the average calories/sugar in vending machine snacks.

    So if it's your practice, or your kid's practice, to have a drink and a snack from vending machines daily, according to the paper on average, the drink and snack together will contain 433 calories (a Quarterpounder worth) and an astonishing 60g of sugar (15 teaspoons!).

    The worse news?

    Even when the vendors fully adhered to Alberta's Nutrition Guidelines for Children and Youth, grab a drink and a snack and you or your child will be grabbing on average 342 calories with 41g of sugar (10 teaspoons!).

    My vote?

    Get rid of the frickin' vending machines! How hard is it for parents or people to pack snacks and do we really need to be making money on the backs of our children's health?

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    Wednesday, November 14, 2012

    Did You Hear the One About Disney Not Marketing Junk Food to Kids?

    Picture's worth a thousand words, no?

    (or in this case perhaps a thousand calories)

    Photo above taken by me at Heathrow airport, but admittedly, it was this past May - before Disney's big announcement on not marketing junk to kids.....

    Yeah.

    This trailer for McDonald's Happy Meals with toys from the coming kid movie Rise of the Guardians?

    It came out today.



    Update: Am told the movie isn't being distributed by Disney....but that Disney's Wreck It Ralph also had a Subway tie in.

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    Tuesday, November 13, 2012

    Guest Post: Pharmacist Blasts Canadian Diabetes Association Over Juice Endorsement

    His name is Tony Nickonchuk and he's a pharmacist, a blogger, and an all around evidence-based good guy.

    He's also a certified diabetes educator and as such he receives a regular publication produced by the Canadian Diabetes Association called the Diabetes Communicator.

    He was horrified to find in the most recent edition, an advertorial for the consumption of fruit juice that was paid for by PepsiCo. So horrified in fact that he penned a letter to the Editor-in-Chief of the publication along with the President and CEO of the Canadian Diabetes Association.

    He kindly included me on the letter's cc list and at my request, allowed me to include it here as a guest post.

    A fascinating read
    Dear Ms. Rand:

    I opened the latest issue of The Diabetes Communicator ready to learn. The stated purpose of The Diabetes Communicator is “to inform members of the activities of DES (Diabetes Educator Section), and to publish relevant, practice-based diabetes education information...[and] strives to be accountable and accessible to the DES membership”(1). As a DES member, I now ask you to demonstrate this accountability by removing corporate- sponsored advertorials from all future Diabetes Communicator releases.

    I speak of the PepsiCo promotional document entitled The Juicy News(2). Although disguised as an evidence-based clinical practice tool for Certified Diabetes Educators, it is nothing but sciencewashing, an advertorial designed to increase consumption of PepsiCo fruit juice and fruit drink products.

    The premise itself, that Canadians don't get their required servings of fruits and vegetables, is scientifically sound. The solution the document offers (I cannot say "authors" because they are not listed, only the reviewers), that 100% fruit juices are an appropriate replacement for whole fruits and vegetables, is not. Nor are the claims that consumption of 100% fruit juice may reduce the risk of cardiovascular disease and contribute to maintenance of a healthy body weight.

    The Canada Food Guide(3) does state that 125mL of 100% fruit juice is an acceptable choice as a fruit and vegetable serving. However, this does not make it true. Britain's National Health Service recommends much the same, but adds the caveat that only ONE serving per day should include juice(4). As does Ireland(5). Not surprisingly, and counter to the obvious purpose of this document, Ireland and Britain have much lower per capita fruit juice consumption than Canada, which leads the way among developed nations(6).

    The document then shows a comparison between fruit juice and whole fruit that states that by 100g fresh weight of edible portion, the two are practically identical. The comparison is disingenuous. To honestly compare the two we need to compare one serving of fruit as per the Canada Food Guide to one serving of fruit juice. Using grapes as an example, 20 grapes are listed as a serving in the Food Guide, containing 68 calories, 18 g of sugar, and 1 g of fiber(7). Tropicana 100% Grape Juice contains 85 calories, 20 g of sugar, and no fiber per 125mL (1 Food Guide serving)(8). In reality, 125mL of Pepsi-Cola comes closer in nutrient content to whole fruit, containing 53 calories and 14.5 g of sugar(9). But stating, based on this, that soft drinks are a nutritious alternative to whole fruits would be just as absurd as claiming that 100% fruit juices are.

    The authors then attempt to prove that consumption of 100% fruit juice reduces cardiovascular disease. One cited study(10) contained 24 subjects, a sample too small to allow for meaningful conclusions. The other(11) used surrogate markers like atherogenic gene expression, the clinical relevance of which is limited, providing no evidence as to impact on morbidity, mortality, or cardiovascular disease outcomes. Yet, on the basis of these small studies, the document states that “the area of cardiovascular disease appears to show the most convincing evidence from epidemiological and clinical studies for the beneficial effects of fruits and vegetables and their juices.”(2) The reality is there is not a single well designed and well executed study, nor a systematic review or meta-analysis to support the notion that consuming 100% fruit juice reduces cardiovascular disease.

    This hawking of bogus science continues with the claim that the “consumption of fruits and vegetables has been shown to be correlated with a reduced risk of becoming overweight or obese”(2). An honest evaluation of the literature shows nothing of the sort. One quoted study(12) only showed correlation, not causation. It was based on a population-based study that relied on self-reported fruit juice consumption and self-reported body weight, data collection methods fraught with potential for error. As well, all individuals with chronic diseases were excluded from the report, eliminating all patients with coronary heart disease, diabetes, or stroke, thus leaning the results squarely in favor of juice consumption. If you take all the people out of the study that may be overweight and obese, like those with diabetes and high risk of heart disease, you eliminate a whole cohort of subjects who may have had their bodyweight negatively impacted by consumption of fruit juice. Effectively you can conclude nothing meaningful from this study.

    Nor can you from the second study used by the authors to support their premise(13). Once the study adjusted for confounding factors, only obesity was negatively correlated with fruit juice consumption, and the association came close to non-significance. Interestingly, although they measured 16 potential confounders at baseline, they only adjusted for(13), not controlling for chocolate milk consumption, fat intake, or tea intake. Not doing so with the first two in particular calls into question the conclusions of the study. It is possible that adjusting for these factors, given their impact on total caloric intake, could have eliminated the small relationship shown in the study. Sadly we'll never know because the authors chose not to publish those results. Of course, this is not surprising given that the lead author of the study was an employee of the Juice Products Association.

    And let us not forget about diabetes, since this publication was placed inside the envelope containing the Diabetes Communicator. Although the document makes no claims with regards to the appropriateness of fruit juice consumption in diabetes, the CDA implicitly supports consumption of 100% fruit juice in place of fruits and vegetables by including this publication with their own. I could data mine like the authors of The Juicy News and point to one study(14) that shows an increased risk of diabetes in women the higher the consumption of fruit juice. Or another that shows that frequent intake of juice “is associated with an increased risk for development of Type 2 Diabetes”(15).

    But I don’t have to. The CDAs very own Just the Basics document, aimed at teaching patients how to make healthy food choices, states that “if you are thirsty, drink water [because] drinking regular pop and fruit juice will raise your blood glucose”(16). The NICE guidelines from Britain don't even mention the word “juice”, only recommending consumption of a variety of fruits and vegetables(17). The International Society for Pediatric and Adolescent Diabetes in their guideline for nutritional management of diabetes in children and adolescents suggests eliminating high sugar and high energy beverages “such as soft drinks and juices”(18).

    I can forgive PepsiCo for producing the document they did. They are a profit-driven multinational corporation, their sole purpose being selling products to realize profit. I could even excuse the reviewers of Juicy News, one of which (CS) is an employee of PepsiCo, the other (HS) a consulting dietitian with multiple corporate clients(19). In this case their employment depended on overlooking the blatant data mining and cherry picking of scientific papers.

    But I cannot, for the life of me, understand why the Canadian Diabetes Association would approve the placement of this document in an issue of The Diabetes Communicator. The CDA is trusted by Certified Diabetes Educators and other health professionals for evidence- based, professional educational material to advance their knowledge and clinical practices. Presenting this information under that pretense is shameful.

    I understand the need for corporate sponsorship but this kind of partnership with corporate donors is inappropriate. The CDA itself makes a stance on their relationship with corporate sponsors stating that they maintain “editorial independence and operational separation from [their] corporate sponsors” and that they make “decisions about information [they] provide without interference from [their] corporate sponsors and none of [their] health information is altered or edited by [their] corporate sponsors at any time”(20) (emphases mine) Placing this document into one of their publications is no different than having PepsiCo edit their health information. Like it or not, doing so suggests that they support the content of the document.

    In the future, keep corporate advertorials out of The Diabetes Communicator. They have no place there and their presence threatens the integrity not only of the publication, but of the Association itself.

    Sincerely,
    Tony Nickonchuk, BSc. Pharm., RPh., CDE, APA

    1 Canadian Diabetes Association [homepage on the internet]. The Association: Toronto; [cited Nov 8 2012]. The Diabetes Communicator; Available from: http://www.diabetes.ca/publications/tdc/

    2 Smith H, Saunders C. Juicy News. PepsiCo Canada [homepage on the internet] Fall 2012 [cited Nov 8 2012]. Available from: http://pepsico.ca/en/downloads/Juicy%20News%20ENGLISH.pdf

    3 Eating Well with Canada’s Food Guide [homepage on the Internet]. Health Canada: Ottawa; [cited Nov 8 2012]. Available from: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

    4 National Health Services [homepage on the internet]. [cited Nov 8 2012]. 5 a day: What Counts? Available from: http://www.nhs.uk/Livewell/5ADAY/Pages/Whatcounts.aspx

    5 Department of Health and Children, Ireland [homepage on the internet]. [cited Nov 8 2012]. Your Guide to Healthy Eating Using the Food Pyramid. Available from: http://www.dohc.ie/publications/pdf/ YourGuide_HealthyEating_FoodPyramid.pdf?direct=1

    6 Fruit Juice Consumption by Nation [homepage on the internet] [cited Nov 8 2012]. Available from: http:// www.nationmaster.com/graph/foo_fru_jui_con-food-fruit-juice-consumption

    7 Dietitians of Canada [homepage on the internet] [cited Nov 8 2012]. Eatracker. Available from: http:// www.eatracker.ca/food_search.aspx?current=1&text=grapes

    8 Tropicana [homepage on the internet] [cited Nov 8 2012]. Tropicana Pure Premium Original Nutrition Facts. Available from: http://www.tropicana.ca/EN/products_pure.php

    9 PepsiCo Canada [homepage on the internet] [cited Nov 8 2012]. Pepsi Soft Drink Nutrition Facts. Available from: http://pepsico.ca/en/Brands/Pepsi_Cola-Brands.html#Pepsi_reg_soft_drink_fb

    10 Morand C, Dubray C, Milenkovic D, Lioger D, Martin JF, Scalbert A, Mazur A. Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers. Am J Clin Nutr. 2011;93(1):73-80.

    11 Milenkovic D, Deval C, Dubray C, Mazur A, Morand C. Hesperidin displays relevant role in the nutrigenomic effect of orange juice on blood leukocytes in human volunteers: a randomized controlled cross-over study. PLoS One. 2011;6(11):e26669.

    12 Akhtar-Danesh N, Dehghan M. Association between fruit juice consumption and self-reported body mass index among adult Canadians. J Hum Nutr Diet. 2010 Apr;23(2):162-8.

    13 Pereira MA, Fulgoni VL III. Consumption of 100% fruit juice and risk of obesity and metabolic syndrome: findings from the national health and nutrition examination survey 1999-2004. J Am Coll Nutr. 2010 Dec;29(6):625-9.

    14 Bazzano LA, Li TY, Joshipura KJ, Hu FB. Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care. 2008 Jul;31(7):1311-7.

    15 Odegaard AO, Koh WP, Arakawa K, Yu MC, Pereira MA. Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: the Singapore Chinese Health Study. Am J Epidemiol. 2010 Mar 15;171(6):701-8.

    16 Canadian Diabetes Association [homepage on the internet]. The Association: Toronto; [cited Nov 8 2012]. Just the Basics; Available from: http://www.diabetes.ca/files/jtb17x_11_cpgo3_1103.pdf

    17 National Institute for Clinical Excellence [homepage on the internet]. [cited Nov 8 2012]. Type 2 diabetes: National clinical guideline for management in primary and secondary care (update). Available from: http://www.nice.org.uk/nicemedia/live/11983/40803/40803.pdf

    18 Smart C, Aslander-van Vliet E, Waldron S. Nutritional management in children and adolescents with diabetes. Pediatric Diabetes 2009;10(s12):100-17-

    19 Heidi Smith Nutrition. [homepage on the internet] [cited Nov 8 2012]. About Heidi. Available from: http:// www.heidismithnutrition.com/Home10.html

    20 Canadian Diabetes Association [homepage on the internet] The Association: Toronto [cited Nov 8 2012]. Disclaimer: Advertising and Editorial Independence. Available from: http://www.diabetes.ca/about- us/policies/disclaimer/


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