Tuesday, April 30, 2013

All or Nothing Thinking Will Always (Eventually) Get you Nothing

Is there an area of life that is more all or nothing than dieting and weight management?

Truly everything else in our lives we'll happily accept our personal bests as great, and more importantly, we're realistic about them. We appreciate that while we can no doubt always do better or try harder that there are fair limits to how hard we can try.

I remember trying to get into medical school. Boy I spent a lot of time in the library and when I didn't get in to medical school on my first try, following my rejection I didn't wish I'd truly eliminated every last ounce of my social life to study - I was disappointed, but I was sure that I had done my best knowing full well that at the expense of real life no doubt I could have done more.

Bests aren't perfection. Bests are affected by real life. Bests need flexibility. And bests change depending on circumstances.

Those folks who head into weight management thinking their bests need to be perfect, that they need to always be on? No doubt in my mind for the vast majority it's just a matter of time before they've frustrated and disappointed themselves often or badly enough that they'll quit trying altogether.

All or nothing almost always gets you nothing.

Monday, April 29, 2013

Badvertising: Does Kellogg's Lead the World in Nutritional Bafflegab?

"Nourish your radiance"

"specially designed with essential nutrients"

"manage your shape"

"nourishment is a beautiful thing"
Really? Nourish your radiance? And you're supposed to nourish it with Special K?

You know what I think's a beautiful thing?

Advertisements that don't rely on made up nonsense to try to sell food.

That ad up above?

It ain't beautiful.

Saturday, April 27, 2013

Saturday Stories: Terrorism vs. Guns, Sedentary Living, Real Food and Supplements

A great piece from Michael Cohen in The Guardian discussing the differing American responses to terrorism and guns.

A very easy to follow infographic from Exuberant Animal on the vicious cycle of sedentary living.

Summer Tomato and Foodist author Darya Pino updates her essential, "How to Find Real Food at the Supermarket" flowchart.

As an added bonus - if you've got a question about a supplement - any supplement - check out the work done over at Examine.com.

[And if you don't follow me on Twitter or Facebook here's this week's US News and World Report column on the 7 steps you need to take for successful family meals.]

Friday, April 26, 2013

True Facts About the Sea Pig

Today's Funny Friday video had me scratching my head as I'm certain I've met many people who I presumed breathed through their anuses, and yet they weren't sea pigs.

Have a great weekend!

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

Thursday, April 25, 2013

Why I Oppose McDonald's and Coca-Cola's Sponsorship of the Canadian Obesity Network Summit

Among this year's sponsors of the Canadian Obesity Network's Scientific Summit are Dairy Farmer's of Canada ($30,000), McDonald's ($10,000), Coca-Cola ($10,000), food industry front group Food and Consumer Products of Canada ($10,000), and the Canadian Beverage Association ($5,000). I'm sure it won't come as a surprise to any reader here that I think these partnerships are ill advised.

But first a bit in CON's defense. To be fair and clear, the Canadian Obesity Network was born out of industry and for industry, where CON's actual stated mission is,
"to act as a catalyst for addressing obesity in Canada and to foster knowledge translation, capacity building, and partnerships among stakeholders so that researchers, health professionals, policy makers, industry and other stakeholders may develop effective solutions to prevent and treat obesity."
Where I struggle today is that CON is no longer simply a networking tool.  Due to the tireless hard work of its team and members, over time, CON has become so much more than a network. Today CON serves the public, the media, and policy makers as Canada's go-to organization for opinions, ideas and support on matters pertaining to obesity's treatment, prevention and policy interventions. CON has very much become the public face of obesity in Canada, and events like the Summit and the many practical workshops CON puts on throughout the year are not simply geared for networking, but rather for education, and do undoubtedly help to steer this country's course in dealing with this issue. As a further testament to just how important CON has become to obesity policy in Canada and just how far it has grown from a simple network, if there were a federal or provincial program focused directly or indirectly on obesity that CON was not somehow involved in as an adviser or participant, I'd honestly be shocked. It's these hard earned roles outside of networking that give me pause with CON's food industry partnerships,.

While there's a great chance that most CON members would never think that they themselves might be influenced by taking money from industry or by attending food industry sponsored events, research on both food and drug industry involvement and sponsorship suggests the contrary to be true. Remember too that conflicts of interest are defined simply by the potential or the perception of a conflict. Among the many potential risks of the food industry sponsoring CON's Scientific Summit, consider whether or not reliance or acceptance of food industry dollars might impact upon CON or CON's members abilities to speak forcefully and critically on issues such as mandatory menu board calories, soda taxes, advertising bans, or cup size bans, or whether consciously or unconsciously food industry partnership and reliance will water down, limit or influence opinions therein? Unfortunately, there's no doubt these conflicts of interest sully CON and its members' reputations and scientific authority - a fact made clear to me by the many emails of concern and disdain that I've received from both individuals and organizations who independently discovered the Summit's sponsorship page and Coca-Cola and McDonald's involvement.

As for what this will buy industry - well it will literally buy them entry into the, "we're not part of the problem, we're part of the solution" club, and in turn their partnership and support of CON will be wielded to help deflect scrutiny and industry unfriendly legislation, as well as provide them with access to CON's hard earned emotional, scientific and ethical capital with which to associate their brands. In Coca-Cola's case an additional $16,000-$24,000 (numbers dependent on how many seats they're renting) their sponsorship dollars are buying them them a 90 minute infomercial to be delivered to the country's leading obesity related policy makers, researchers and clinicians by Coca-Cola vice president and chief scientific and regulatory officer Dr. Rhona Applebaum. Her talk is entitled,
"Can a Beverage Company Make a Positive Difference in the Fight Against Obesity?".
As to what Dr. Applebaum's going to say, I'm confident it'll include the position she regularly champions, that singling out sugar sweetened beverages - the largest sole source provider of calories in North America - is misguided in the fight against obesity as she states so clearly here,
"If we are really honest with ourselves, we know that no one group or sector can solve this problem alone and searching for a silver bullet that miraculously stops obesity is just not realistic. Targeting scapegoats or pointing fingers is simply a waste of energy."
Though it would seem that so long as the finger pointing isn't directed at sugar sweetened beverages and that instead it's pointed at some drop in energy expenditure, that pointing is just fine by her,

Dr. Applebaum's talk will also undoubtedly include Coca-Cola's overarching message - that the answer lies in "balancing" energy-in vs. energy-out (and likely too the purchase of artificially sweetened beverages) - that consuming their sugar laden products is dandy so long as a person exercises, and that "all calories count", meaning an oversized can of nutritionally bereft, sugar-spiked, Coca-Cola's is no better or worse for health or weight than anything else. And how Coca-Cola is spinning that message publicly is noteworthy too. Check out this recently released advertisement that details how drinking a can of Coca-Cola buys you 140 "Happy Calories" and then shows you all the fun things you'll be able to do consequent to drinking them,

Or this recent piece where they launched an assault on chairs (yes, chairs),

And here's betting Dr. Applebaum doesn't bring up the multi-year advertising campaign specifically targeting children that Coca-Cola announced yesterday which will include co-branding with their 16oz and 20oz bottles.

Were CON simply a networking organization, while I still would be unhappy with food industry sponsorship, I likely wouldn't have felt compelled to pen this post. But given the important and substantial role CON has so rightly earned for itself as a leader in Canadian research, policy, education and discourse on obesity, I think these sponsorships sell short CON, its membership and the public.

[When writing this post I emailed CON's scientific director and hopefully still my friend Arya Sharma and invited him to write a post on why he supports food industry sponsorship. I'd encourage you to read his posting too so you can hear the other side to this argument. Click here to read Arya's thoughtful post.]

Wednesday, April 24, 2013

Children's Hospitals Selling Out for Peanuts in Misguided Slices For Smiles Eat Pizza Campaign

Have you heard of Slices for Smiles?

It's the Pizza Pizza partnership with children's hospitals and their Foundations that literally raises money by means of selling pepperoni pizzas. The flyer posted up above (which arrived in my mailbox a few days ago) reports the partnership includes the Children's Miracle Network, SickKids Foundation, Raising Hope Children's Health Foundation, the CHEO Foundation and the McMaster Children's Hospital.

As I've blogged about before, associating Pizza Pizza with fundraising helps to elevate Pizza Pizza's brand a number of ways: The insanely low prices for pizza coupled with children and charity drive customer loyalty and increase frequency of fast food consumption, while the explicit provision of support for fast food's purchase by children's hospitals furthers the normalization its consumption which in turn help to drive the ever increasing pace of diet and weight related diseases in kids. Moreover the tie in with such an incredibly heart felt charity generates an emotional feeling that gets bound to Pizza Pizza's brand.

So do the hospitals at least make a killing by selling the seeds of illness?

Doesn't look that way.

According to Pizza Pizza's Slices for Smiles Foundation homepage since 2007 the campaign has raised $1,000,000.

That's $1,000,000 over 6 years split up at least 5 ways.

That's $33,333 a year each.

An unbelievable bargain for Pizza Pizza (remember too, they're donating "a portion of proceeds" from their sales - this isn't straight philanthropy).

An incredible sell out of the kids these hospitals and Foundations are supposed to protect and champion.

Tuesday, April 23, 2013

Parental "No" Files: Canadian Hockey Continues to Sell Access To Your Children

Today's Parental "No" comes from mom and blog reader Shari Kneen whose 9 year old son received the coupon for Pizza Pizza fries from his coach for playing a game of "penalty free" hockey. Is there anything a child does in an organized manner these days that isn't rewarded with junk food or candy? Wouldn't simple praise from coaches and parents suffice for "penalty free" hockey played by a group of 9 year olds?

What's in it for Pizza Pizza of course is a whole fresh crop of young customers who will hopefully associate Pizza Pizza with fun, sport, a job well done and reward - messaging they'll potentially carry with them for life and potentially pass on to their own kids.

What's in it for the Ontario Minor Hockey Association and the Greater Toronto Hockey League is undoubtedly money.

Good business for Pizza Pizza, but a real shame both the OMHA and the GTHL seem to value money more than kids' health when one might argue that healthy kids are their primary businesses.

Here are Shari's thoughts,
"Just when I thought I hadn't seen food rewards lately on my kids sports teams - here we go again! I hate the message we are sending to our kids. Companies shouldn't be allowed to do this. I blame OMHA for even accepting this sponsor!"
Me too Sheri, though to be fair, the OMHA and GTHL probably didn't give a second though to the promotion - society has so normalized this sort of practice that no one even thinks to question it.

And therein lies the problem.

[Update: Thanks to @teacherace for pointing out that in order to get the free fries you need to purchase a slice of pizza and a can of soda]

[For past Parental "No"s and Canadian Hockey click here, here, here, and here.]

Monday, April 22, 2013

Support Cooking Skills for Kids And Gain a Chance to Visit Jamie Oliver in England

I'm a big fan of Jamie Oliver's, and in case you're not into the food or nutrition scene, Jamie's a ballsy British chef who has used his celebrity status and cooking talents to further the improvement of school lunches and attitudes towards real food and actual cooking worldwide.

What I was only recently made aware of was that Jamie has set up a nonprofit in the US - The Jamie Oliver Food Foundation - and its aims are so perfectly in line with what I think we as a society ought to be doing, that I'm writing this post today to promote its most recent fundraising drive.

Before I get to the drive, here's what the Jamie Oliver Foundation is all about,
"The Jamie Oliver Food Foundation is Jamie’s US non-profit that campaigns to bring food education to schools and youth groups, businesses and communities. It offers hands-on training to teach food skills and instil knowledge, and founds partnerships that enable us to grow nationally and spread the word. The charity fulfils this ambition by raising awareness in the media to promote changes in food policy at a local and national level."
The fundraiser's great too. It's a Prizeo campaign which means your contribution to the Foundation also enters you into a draw where the grand prize includes an all-expense paid trip from wherever on the planet you happen live over to England to meet and cook with Jamie.

Now of course if you enter (as little as a $3 donation puts your name in the hat) I'm hoping you'll be in line for the runner up prize because I'm also hoping that this Jamie fan boy's going to win.

If you'd like a chance to meet Jamie, or more importantly if you'd like to make a donation to a worthy food related cause, just click here and you'll be whisked away through the interwebs to Jamie's contest's donation page. And you might want to hurry - there are only 8 days left in the contest.

Good luck!

[Still undecided? Watch this video]

Saturday, April 20, 2013

Saturday Stories: Good Deaths, Book Review, and Football Bans

The New York Times with a photo essay on one man's good death.

Science-Based Medicine's Harriet Hall reviewing a book on type 2 diabetes that she loved.

Malcolm Gladwell in a long but fascinating video hosted on the Atlantic makes the case for why football should be banned.

[And if you don't follow me on Twitter or Facebook, here's this week's US News column on why the fact that food's not just fuel matters.]

Friday, April 19, 2013

If You Need Something Uplifting To Watch - This Is It.

It sure has been an ugly week.

Rather than Funny Friday, this week's video is a testament to good people out there.

I'm not going to describe it - just watch it, and feel good about humanity.

Have a great weekend!

(email subscribers, head to the blog to watch)

Thursday, April 18, 2013

Badvertising: Nestlé Calls Vitamin Spiked Nesquik Plus "Medicinal", Provides "Dose" for Kids

Want more proof corporations don't give one hoot about your health?

Look no further than Nestlé's Nesquik Plus. It's quite literally vitamin fortified chocolate syrup, and it's being marketing to parents as a means to improve the health of their children.

Nestlé is the largest largest food corporation in the world. As such what it does can fairly be considered representative of the food industry as a whole.  The fact that this product exists, let alone Nestlé's marketing of it as containing "medicinal ingredients" replete with "dosage" recommendations and health and function claims, I'd argue is proof positive that the only thing that concerns the food industry are profits.

So who's this product aimed at? Here's copy from Nestlé's 2011 product announcement,
"Enhanced with Vitamins B2, B6, B9, B12, C, D, E, Calcium and Iron and made with less sugar, NESQUIK PLUS is ideal for moms who are concerned about their kids’ diets as it adds even more nutrients to a glass of milk"
Because what could be healthier than multiple daily "doses" of Nesquik Plus where each "dose" contains 3 teaspoons of vitamin-fortified-sugar goodness?

Click on the image to see the "Recommended Dosage" and the "Medicinal Ingredients"
What's also fascinating is that the product is currently being sold on Canadian supermarket shelves. My understanding was that the discretionary fortification of food (the addition of vitamins and minerals to foods at the discretion of the food manufacturer) wasn't in fact legal in Canada, let alone the discretionary fortification of frickin' chocolate syrup.

A few days ago the Canadian government launched a new healthy living program. In the launch video Health Minister Leona Aglukkaq states,
"Today I am pleased to announce that we are building on the momentum of the national Eat Well campaign that helps parents and children adopt healthier eating habits"
Carla Ventin the VP of Federal Government Affairs for the food industry's representative organization Food and Consumer Products of Canada in that same presser stated,
"This is a really important campaign for Canadians because what it does is improve the awareness and provide tools to consumers so that they can make better choices at the grocery stores for their families"
So here's my thought.  Rather than simply improving awareness and providing tools that I sincerely doubt more than 0.1% of Canadians will actually access and utilize, maybe a smarter choice would be to prevent companies like Nestlé from preying on parents with products like "medicinal" chocolate syrup and actually create and police robust labeling laws that in turn wouldn't put the onus on Canadians to carefully investigate each and every product they buy for bullshit? Or maybe at the very, very least, create laws that would deny the food industry the ability to literally add vitamins to candy as a marketing ploy?

Seems to me that the one of the main reasons we might need these campaigns is because either way our government has dropped the ball on protecting Canadian supermarket shoppers from the food industry, and this product's a great example. If Nesquik Plus is actually legal then I'd argue the government truly doesn't give the tiniest of craps for the parents its Eat Well campaign purports to champion. If it's not legal, then they're doing a piss poor job of policing the shelves as according to Nestlé the product's been duping Canadian parents since October 23rd, 2011.

[Hat tip to my undergrad classmate and now stellar intensivist Dr. Hy Dwosh for snapping and sending me the photos]

Wednesday, April 17, 2013

Should We Be Banning the Marketing of Insane Meals?

Thanks to blog reader Chris for sending along a photo and the nutritional breakdown for what Wendy's is calling the "Ultimate Canadian Combo".

To save you the trouble of clicking or magnifying the photo this "Ultimate Canadian" combo of a Baconator, poutine and a medium Coke weighs more than a kilogram and contains a cool 1,860 calories, 3,380mg of sodium and thanks primarily to the "medium" Coca-Cola, 17 teaspoons of sugar.


Makes me wonder whether or not a day will come when politicians will try to ban the advertisement (not the sale) or the discounted bundling of combos containing more than a predetermined amount of calories or other nutrients?

Monday, April 15, 2013

The Chair of the AMA's Council on Science and Public Health Works for Coca-Cola?

Sweet holy hell what a coup for Coca-Cola.

Meet Dr. Sandra Fryhofer. According to her website she's a board certified doctor of internal medicine in Atlanta and a Clinical Associate Professor of Medicine at Emory University School of Medicine. She's also the past President of the American College of Physicians, a former committee member with both the Centers for Disease Control and the Institute of Medicine, and through 2015 she's the Chair of the American Medical Association's Council on Science and Public Health.

Dr. Fryhofer is also a seasoned top-notch medical journalist writing a regular column for WebMD and having been a correspondent for CNN between the years 2001-2005 with appearances on NBC’s Today Show, CNN, CNN Streetsweep, CNN Talk Back Live, FOX News Network, NBC Nightly News, ABC World News Tonight, and ABC News NOW.

So what does this undeniably talented MD with an illustrious career who currently holds a terrifically influential public health position with the AMA have to do with Coca-Cola? Well it would seem as if she's their new ace reporter.

In a series of 4 videos paid for by Coca-Cola and posted last week on their YouTube channel, Dr. Fryhofer champions the Coca-Cola friendly ideas that all calories count, that intake can be "balanced" by output, that non-nutritive sweeteners are awesome, and that high fructose corn syrup is just plain misunderstood. The videos are all embedded down below (email subscribers you'll need to head to the blog to watch), but my favourite by far was the one on high fructose corn syrup (HFCS) where Dr. Fryhofer explains how sugar's sugar. Now to be clear, for most intents and purposes I agree with her. The science to date suggests sugar is sugar -both HFCS and sugar are worth minimizing in our diets - and while there may be some unique properties to HFCS as they pertain to the development of fatty liver disease do have a peek at the language Dr. Fryhofer uses to explain HFCS vs. sugar to viewers,

"They're both about half glucose - brain cell fuel - and half fructose, the sugar in fruits, honey and root vegetables

HFCS is popular because it's less expensive than regular table sugar, has nicer texture and color, and stays fresher longer
There you have it. HFCS is brain cell fuel akin to what you'd find in fruits and root vegetables but it's more popular than sugar because it looks and feels nicer and is fresher. Funny, that's not quite how I'd have described it.

So what do you think? Do you think there's a potential conflict of interest for the Chair of the American Medical Association's Council on Science and Public Health to be working with Coca-Cola, or are the interests of the AMA and Coca-Cola aligned?

The AMA has clear guidelines on conflict. I'll post them here for Dr. Fryhofer's benefit. Perhaps she's forgotten about them.
"A Member would be unable to act in the best interests of the AMA and another company if the fundamental goals of the two organizations were in conflict. Acting in the best interest of one organization would necessarily mean breaching the duty of loyalty owed to the other organization. In these situations, the Member should resign from one of the organizations."

Energy Balance


Energy Drinks

Saturday, April 13, 2013

Saturday Stories: Secret Marijuana Study, Obese Airfare, Paleo Breakup & the Mantis Shrimp

Perhaps the craziest story I've read this year - this one about a secret 1972 Canadian experiment studying the impact of 98 days of state sponsored marijuanna use on the productivity of young women.

Dr. Arya Sharma in the Globe & Mail with his thoughts on pay what you weigh airlines.

A very thoughtful piece by Hunt Gather Love's Melissa McEwen on her breakup with paleo

And a bonus Oatmeal comic on the amazing mantis shrimp.

[For those who don't follow me on Twitter or Facebook, my US News and World Report piece this week asks, You'll Happily Die for Your Children; Why Won't you Cook for Them?, and here's an hour of Q&A with me and Kathleen Petty on CBC's Ontario today]

Friday, April 12, 2013

I'm Absolutely Certain That Me Finding this Video Hilarious Means I'm a Moron

But I did, I really really did.

Today's Funny Friday video is an educational video of sorts on how animals eat their food.

Have a great weekend!

(Email subscribers you need to head to the blog to watch)

Thursday, April 11, 2013

Badvertising: Who Needs Spinach, Oatmeal and Blueberries When You Can Eat This Cookie?

I think perhaps it's safe to say that WhoNu? are the world's most healthwashed cookie giving us a lesson in both badvertising and proof that corporations aren't people because I can't fathom a person who wouldn't be ashamed to market Oreos with the following sales pitches,

"As much Fiber as a bowl of Oatmeal

As much Vitamin C as a cup of blueberries

As much Vitamin A as an 8oz glass of tomato juice

As much Calcium and Vitamin D as a glass of milk

As much Iron as a cup of Spinach

As much Vitamin E as two cups of Tomato juice

As much Vitamin B12 as a cup of Cottage Cheese and Fruit

Excellent source of Calcium, Iron, Vitamins A, B, C, D, E.

17 Essential Vitamins and Minerals
Conspicuously absent is this statement,
"As much sugar as 4.7 Oreos"
Or this one,
"It's just a frickin' cookie we've injected with vitamins to pretend it's good for you"
Sadder than the fact that this cookie and advertising campaign exists is the fact that WhoNu? are likely legally allowed to make these claims, and in so doing, dupe a desperate populace.

Shouldn't the Jelly Bean Law apply to this nonsense?

[h/t to blog reader RD Susan MacFarlane for sending my way]

Wednesday, April 10, 2013

Parental No: I Can't Believe What They're Feeding Kids in Illinois & What the Heck is "Treat Thursday"?

Looking at elementary school menus like this one I wonder how it's possible there are any healthy kids out there.

Honestly. If this is what schools can rationalize serving elementary school aged kids - in Illinois in this case - well then clearly society as a whole is broken.

But it's worse than just Bosco sticks (stuffed bread sticks from local pizza place) with pizza dipping sauce, BBQ ribs on a bun, Nachos Supreme, stuffed crust cheese pizza, hot dogs, mini corn dogs, cheese burgers and meatball subs. This particular photo was kicked my way by a concerned dad. He's been allowing his kids to have one hot lunch a week and this month their school initiated "Treat Thursdays" where hot lunch was accompanied by cookies, Rice Krispie squares and other treats.

Here's what he had to say, but before you read it, consider that treats aside, by means of what's being served to children in their cafeteria, that school is teaching those kids that fast food is normal and healthful and that it should be consumed daily. With "Treat Thursdays" they're also suggesting that treats just because it's Thursday make total sense. Even for parents who care, like the dad who emailed me, even if they do exercise their "parental no" power, this undermines their authority and teaching on healthful eating on a daily basis and that undermining comes from a place that the children inherently trust to teach them what's what.
I'm a blog follower and concerned father of two young boys. They're constantly bombarded with messages that encourage them to eat more junk food. Imagine my disappointment when they showed me their April school lunch menu (bad enough as is) that has the new feature of a "TREAT THURSDAY" every Thursday in April. Ugh. They get to select one day a week to eat hot lunch and I'm constantly redirecting their choices as it is. Now, you can see their first choice this week- pick the meal with the cookie. Sometimes I feel like for every step forward, we take two back.

Tuesday, April 09, 2013

When Stupid Met Ice - Behold The Functional Popsicle

They're Chapman's "Electrolyte Enhanced Sport Lollies"

And the're gluten free to boot!


Monday, April 08, 2013

Brecia College Nutrition Professors Move to Shut Down "Sweet" Offers of Admission

Last Thursday saw a guest post from a student who had applied to the University of Western Ontario's Brescia College for a nutrition program who along with her acceptance letter, received candy to mark her "sweet offer" of admission.

Well this story has a happy ending as the food and nutrition faculty at Brescia, when they heard about these "sweet" offers, immediately set out to rectify them. The fact is, a small handful of M&Ms in and of itself isn't the problem but rather the problem is the societal normalization of candy and junk food at every turn.

Kudos to Brescia College for sorting this out and here is the letter that I received from them on the very day the original guest posting went live,
Brescia’s Food & Nutritional Sciences faculty have heard the message from the guest blogger on Dr. Freedhoff’s website, and we strongly agree that sugary treats are a common and unnecessary reward that needs to addressed in all policies. Providing a “sweet offer” to prospective students is a new practice Brescia’s Registrar’s office implemented during the Valentine’s and Easter mail out and while it meant no harm, it was unfortunately a decision that was not communicated in advance to the staff and faculty in Nutrition & Dietetics.

At Brescia, we teach our students to think boldly, lead passionately, and make positive changes in our communities by taking action and leading by example. In particular, our nutrition faculty teach our students to consider the food environment and its impact on individual food behaviours. Drs. Dworatzek and Matthews, together with food services, have even implemented a peer nutrition education program called FRESH which aims to change the food environment on campus.

The comments made by this prospective student mirror the values we try to instill in our learners, and it would be an honour for Brescia to accept such a bold young leader who is working hard to make a difference. Her comments have not fallen on deaf ears; Brescia’s Division of Food & Nutritional Sciences immediately addressed this issue internally and have committed to work closely with the rest of the College to ensure that both our environment and our communications are health-promoting. Thank you for bringing this to our attention so that we can take the lead, in practicing what we teach!

Dr. Paula Dworatzek (on behalf of ALL the food and nutrition faculty at Brescia)
Associate Professor
Division of Food and Nutritional Sciences
Brescia University College, at the
University of Western Ontario

Saturday, April 06, 2013

Saturday Stories: Waxwings, Time Magazine Cures Cancer, Pandemics and ActivityStats

A great essay from the New York Times on the fleeting nature of time in terms of waxwings and autism.

Slate covers the wrongness of Time's recent cancer cure cover

The amazing Helen Branswell covers the potential new pandemic bird flu.

And lest you think I never promote pieces contrary to my confirmation biases, here's Runner's World's Alex Hutchinson questioning the ActivityStat hypothesis of childhood exercise.

[And if you don't follow me on Twitter or Facebook, here's my weekly piece from US News and World Report on the most important skill of successful weight management.]

Friday, April 05, 2013

Don't Insult Dead Bats by Asking to have Espresso Poured Over Ice

While I do love a great cup of coffee (I actually roast my own beans and use an Aeropress), I'm not as crazy as the ladies on this week's fabulous Funny Friday video.

Have a great weekend!

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

Thursday, April 04, 2013

Guest Post: Is This the World's Most Ironic Use of Candy?

If it's not, it's certainly a contender.

And when I talk of the normalization of candy I'm referring to the fact that society as a whole has gotten to a point where there's often zero effort made to find ways to celebrate, entice, entertain or reward with anything other than candy. Candy's cheap, candy's easy and candy always hits its mark.

But it's not particularly healthful now is it?

Imagine your surprise then if you were a University student and had applied to a program to become a Registered Dietitian via The University of Western Ontario's Brescia College and along with your acceptance letter came a pile of M&Ms to accentuate the point of their "sweet" offer of admission. And if you don't want to imagine it, here's a guest posting of a letter from a student who did receive this very package (her name's been removed so as not to cause her grief next year should she choose to accept her "sweet" offer).
Hello Dr. Freedhoff,

I'm a student currently in between degrees, trying to decide what path to choose next. I've been following your blog for the past few years. In that time, I've become more interested in food marketing and nutrition to the point where I think I would like to pursue a career towards improving public knowledge in those areas. One route to this end is becoming a registered dietitian, so I applied to Brescia University's Foods and Nutrition program (affiliated with Western University). This past weekend I received a package in the mail, reminding me to accept my offer and how to go about it. Their exact words: "A 'sweet' offer awaits you at Brescia!", were accompanied by a package of candy covered chocolates, like smarties.

This struck me as surprising; for although I've read many articles and seen examples on your blog of how kids are regularly exposed to this, I thought my age group was a little beyond bribery with candy, particularly in university. Apparently not. This school thought it was appropriate to send smarties to potential students, all aged 17+ (this program is actually known for being a popular second degree program with many applicants aged 22+), who had applied to the program to be educated about healthy nutrition. I'm even prepared to overlook the juice, cinnamon buns and strudels overcrowding the fruit tray served at the spring Open House, but this was surprisingly deliberate.

I understand that admission's services meant well and of course everyone likes candy surprises, but it does seem like a good example of how common unnecessary sugary treats are. To me, being offered admission to school, while certainly a positive achievement, doesn't constitute celebration with junk food. It didn't for my first degree. For the record, this particular program at Brescia is one of 4 programs in Ontario that are accredited by Dietitians of Canada. I just found it ironic and a little disappointing that such an institution would send candy to its students, who, in all likelihood, intend to pursue a career as a RD. Where is one supposed to learn about healthy food choices when even an accredited educational institution readily accepts candy as a part of all occasions big and small?
I just thought you might find that interesting.

UPDATE: Brescia College taking steps to immediately correct the unfortunate oversight. Post on Monday.

Wednesday, April 03, 2013

Diet Book Review: The Fast Diet

[Full disclosure: I was given a copy of the book by the publisher]
The question everyone seems to be asking today is whether or not intermittent fasting (meaning an occasional fasting period of up to a day not a lengthy fast/cleanse) is a viable weight loss strategy.

The answer's rather simple. If a person can happily incorporate fasting of any sort into their lives, and that in turn lowers their weekly available energy intake, then yes, fasting may well be a useful strategy. On the other hand, if fasting challenges your quality of life sufficiently to make the intervention too much to bear long term, well then no, fasting's not for you.

As far as fasting goes, there seem to be three primary schools these days. There's Martin Berkhan's Leangains system (the system popularized without credit in The 8 Hour Diet) which at its base involves fasting for roughly 16 hours a day, there's Brad Pilon's Eat. Stop. Eat. which at its base involves 1 or 2 weekly 24 hour food fasts interspersed with healthful eating, and there's today's featured review of The Fast Diet which takes researcher Krista Varady's work on what she's called alternate day modified fasting (ADMF) and bookifies it for the masses. At its base, ADMF (and The Fast Diet) simply involves ensuring there are two days weekly where calories consumed are in the 500-600 range.

The book was written by non-practicing physician turned journalist Dr. Michael Mosley and his journalist co-author Mimi Spencer and it leads with the theory that because humans evolved during times of severe dietary insecurity, where fasting was the unavoidable norm, that fasting has unique properties that in turn are healthful and protective. And while that may be true, it certainly has yet to be proven as the science is nowhere near conclusive yet just as the authors themselves point out on the second introductory page,
"Scientists are only just beginning to discover...".
Putting aside the fact that many of our closest primate relatives do in fact graze all day (chimpanzees for instance), I'm not sure this theoretical line of reasoning really matters in lieu of evidence, though certainly it does provide a reason to consider the possibility that fasting has interesting properties.

Sadly, the cautionary comment that the science of fasting is young was a rarity in this book that takes hyperbole, conjecture, anecdote and hope to truly dramatic levels and even just 5 pages following the "just beginning" statement the state of the evidence has somehow morphed into,
"The scientific evidence was extensive and compelling".
Odd that statement in the context of this book given the vast bulk of the book is quite literally built off the personal (and clearly conflicted) anecdotal evidence of Dr. Mosley and Ms. Spencer's own experiences with their diet - one might have thought that were there actually extensive and compelling evidence a medically trained award winning journalist might have preferred to rely on it to tell the story rather than what he ate for breakfast.

When The Fast Diet does venture into evidence based research the bulk of it comes from mice and rats - useful models to start with no doubt, but of course results from rodent studies are not automatically translatable into humans. One of the book's primary theories is that fasting is helpful because it reduces circulating levels of IGF-1 (insulin like growth factor 1) which in the case of a particular strain of mouse, might be implicated in many disease processes including aging and cancer. And while I am by no means an expert in intermittent fasting or IGF-1, it strikes me as odd that in the few studies I found on medline that specifically looked at IGF-1 levels and intermittent fasting in human subjects following the ADMF protocol espoused by The Fast Diet, there wasn't a consistent effect on IGF-1. One study I looked at showed a decrease in IGF-1 only when energy restriction was accomplished by means of a 10 week liquid ADMF diet, while the other, actually showed little change or even a small rise in IGF-1 levels following a full 6 month trial of ADMF dieting by overweight women. But rather than report on the effect one of the longest and largest trials of ADMF dieting in overweight humans that showed no change to circulating IGF-1 Dr. Mosley chose to report on his own personal drop in IGF-1 levels while following his diet - an odd thing considering the randomized trial he didn't cite was in fact conducted by Dr. Krista Varady - the researcher responsible for The Fast Diet's actual regimen and one of the book's most regularly featured personalities.

Dr. Mosley's self reporting doesn't end there. He also happily self reports that his fasting glucose level went down consequent to his fasting....but of course he also happened to have lost 10% of his body weight - an amount more than sufficient to explain his biochemical improvements, and he reports that his memory seemed to have improved as evidenced by his results in an online test he took twice.

Dr. Mosley's section covers other purported benefits of ADMF fasting - most propped up almost entirely by theoretical or non-human based underpinnings with his take being that ADMF fasting staves off Alzheimer's, prevents cancer, improves chemotherapy, lengthens your lifespan, improves your memory, decreases depression, and of course helps you to lose weight and improves your cholesterol.

The next half of the book was written by Ms. Spencer who doubles down on the "evidence" by stating,
"There is evidence from trials conducted by Dr. Michelle Harvie and others that this approach will help you lose weight, reduce your risk of breast cancer, and increase insulin sensitivity",
though Dr. Harvie's provided citation refers only to a paper looking at the impact of fasting on biochemical markers and not in fact fasting's actual impact on long term weight management, breast cancer risk or insulin sensitivity. Later on she goes further to describe intermittent fasting's benefits as,
"widely accepted disease-busting, brain-boosting, (and) life-lengthening".
But really her section is more about how to actually wield the diet - one which no doubt includes putting up with hunger. Here's how she describes it,
"While hunger pangs can be aggressive and disagreeable like a box of sharp knives, in practice they are more fluid and controllable than you think".
Unfortunately there's yet to be long term data to back that up as she herself notes a few pages further in,
"While the long-term experience of intermittent fasters in still under investigation, people who have tried it comment on how easily it fits into everyday life".
Now whether that's true or simply the effect of post-purchase rationalization it flies some in the face of Dr. Varady's work with ADMF dieters which showed that folks randomized to intermittent fasting ala The Fast Diet's style for 6 months were far less likely than those randomized to more traditional caloric restriction to want to sustain the intervention (58% vs. 85%).

And it's Ms. Spencer's section that really dives into the nonsensical stating that despite losing weight, and with no recommendation to exercise, by fasting you'll not only not see a drop in muscle mass, you'll see a rise, and that your food preferences will change such that,
"you'll start to choose healthy foods by default, not by design".
She also goes on to state that,
"heavier subjects respond brilliantly to intermittent fasting",
yet did not provide a reference. And that's rather crucial in a book that relies on personal anecdote rather than published evidence, or at the very least, clinical experience. From what I can gather neither Dr. Mosley nor Ms. Spencer actually work with individuals who struggle with their weights and I don't think it's a given that the experiences of a woman whose starting BMI was 21.4 (or Dr. Mosley's of 26.4) would necessarily be applicable to those who struggle with their weights to begin with.

Putting my many objections to the reporting of hope and theory as fact, one thing bothered me throughout. If the putative benefits of fasting stem from evolving during centuries of dietary insecurity why would fasting's benefits be expected of diets that even on "fasting" days provided 1/3-1/4 of most folks' daily calorie requirements? Seems to me if you are convinced by the early evidence, and indeed there is some, that fasting confers some biochemical advantages then you should in fact fast, rather than eat and call it fasting.

Ultimately here's a diet book based primarily on theoretical conjecture and mouse studies that's propped up almost exclusively by the personal experiences of two professional journalists neither of which had obesity to begin with nor working with patients trying to manage their weights, where statements such as,
"studies and experience show that intermittent fasting will regulate the appetite, not make it more extreme"
fail to come with citations, and where on the very same page the statement,
"It all points to a healthier, leaner, longer old age, fewer doctors' appointments, more energy, greater resistance to disease"
coexists with the butt covering,
"yet science is only just starting to catch up".
So if you want to try fasting as a means to control available energy intake - by all means go for it, but as the authors in rare moments of clarity between wild conjectures and unsupported statements point out, the science is still far too young to be conclusive.

Remember, as always, the most important factor to consider when analyzing your diet is whether or not you like your life while you're losing your weight, as whatever weight you lose with an effort you ultimately abandon is almost certainly going to return when you head back to the life you were living before you lost.

Tuesday, April 02, 2013

Guest Post: Do Medical Schools Teach Future Doctors About Weight Management?

In my day to day I often will supervise residents or medical students who have taken it upon themselves to learn more about obesity medicine. I say taken it upon themselves because despite diet and weight related/responsive conditions being huge contributors to a physician's caseload, medical schools and residency programs don't seem to think that nutrition and weight management are worth teaching.

For the past few weeks, Jill Trinacty, a fourth year medical student from the Annapolis Valley, Nova Scotia who will be graduating from Dalhousie University this spring, has been shadowing me here in the office. She will be completing her upcoming residency in Internal Medicine in Ottawa. She enjoys running, cycling and has an interest in obesity medicine, and when I asked her if she'd be willing to write a blog post on what she'd learned about obesity medicine prior to joining me here, she happily obliged. And to be clear - I asked her to focus on what she'd learned regarding obesity yet long term readers here know that healthful living is of concern to anyone at any weight and that the principles that might be involved in weight management and obesity specifically no doubt apply to everyone, and that scales measure neither health nor lack thereof.

Here's what she had to say:

I am in my fourth year of medicine. I have one week left of clinical placements. One exam left to write. One stage to walk across and then I will be set loose on the world as an MD!

But wait.

I entered medical school four years ago knowing I wanted to be a “doctor”. I didn’t know which kind or what exactly it would entail but I envisioned myself changing lives and promoting “health”. Health to me meant eating nutritiously, being physically active, and generally being well. It seemed pretty straight forward. I wasn’t sure how I would go about inspiring people to be healthy but medical school would teach me that – right?

First year medical school set about teaching the basics of anatomy and physiology. Surely they would talk about obesity, weight management, basal metabolic rate, energy expenditure. No? Ok. Second year came around and again more physiology and medical basics. They measured our heights, weights, fasting glucose, lipids. Awesome! Now you’re going to demonstrate how to use these seemingly meaningless numbers to segway to leading a healthy lifestyle. No? Ok.

Clerkship. This is it. Rotating through all these medical specialties will be when I learn how to counsel people about healthy lifestyles, nutritious food, physical activity. After all, it applies to every area of medicine right? I started with surgery. Between gallstones, bariatric surgery, knee replacements, cancer, there were lots of opportunities to discuss obesity management. I heard a lot about obesity on those rotations, but it came in the form of murmurings and harsh comments. Pediatrics – this is the place to talk about it! We touched on nutrition and slightly on obesity in one lecture. We talked about iron deficiency anemia and growth theoretically. We practiced asking about dietary consumption. Did I once counsel on obesity? No. Ok. OBGYN, surely with all the risks of obesity during pregnancy and the opportunity to teach women to live a healthy life in hopes they will pass that on to their child. No? Ok. Psych, you’re up! The side effects of obesity and metabolic disorders from medications alone should provide ample opportunity to counsel on lifestyle, especially in a population that may have limited means of income. No? Ok. Internal medicine, you’ve got it all! Hypertension, diabetes, heart attacks, obstructive sleep apnea, hypoventilation syndrome. I was lucky enough to rotate through endocrinology department but the clinic was pressed for time and resources, and very few students experience this rotation.

So now I am finished medical school. I realize I have learned very little about how to manage and counsel on obesity – and so have my classmates. In a recent poll of my class of 2013, although many felt comfortable discussing obesity, they felt ill-prepared to effectively manage it and those that did say they felt they had some weight management strategies found that it came from a few select doctors or their own personal weight management challenges. Obesity affects a great deal of the population, affects every specialty and subspecialty and yet we don’t learn how to effectively manage it? We need to do a better job of recognizing the problem, reflecting on our own health behaviours and prioritizing teaching on the issue. If we’re not teaching our future physicians how to manage obesity effectively, who can people turn to for weight management help?

Monday, April 01, 2013

Badvertising: Christie's Now Calling Cookies "Fruit Krisps"

In case last week's posting of Cherry 7-Up Antioxidant still didn't convince you the food industry will say or do anything to sell food, here are Christie's new "Banana Fruit Krisps".

You know you have to hand it to Christie's marketing department as their new "Banana Fruit Krisps" sure do make cookies sound more healthful, especially since they're made with "REAL FRUIT" and are a "Sensible Solution".

Because that's what they are - cookies - as Banana Fruit Krisps' calories and sugar content are virtually identical to Chips Ahoy's, yet I'm pretty sure these are meant to sound good for your children, whereas Chips Ahoy - at least those you know are treats.

[Hat tip to my wonderful wife]