Do You Eat Nutella? You Might Want to Watch This.

I came across this Nutella ad the other day. It speaks of breakfast "loving" Nutella and specifically calls out the "94 Hazelnuts" that are in every jar (small print says every 725g jar).

Clearly that hazelnut shout out is meant to suggest that Nutella is a healthful breakfast choice.

Of course when I saw it, it just made me wonder, what's really in a serving a Nutella? And so, I decided to find out....

Saturday Stories: School Lunch, Big Food and Dying with Dignity

Image Source

Channel 3 News in New Zealand with an eye opening video on the impact of poverty on school lunches 

Michele Simon on how the wrong Obama's getting tough with Big Food.

And here's a video of the late Dr. Donald Low - one of Canada's most prominent physicians during the SARS crisis, on his desire for death with dignity. He died 8 days after filming this video, but not with the death he'd hoped for. Please watch this one - it's important.



[And if you don't follow me on Twitter or Facebook, here's this week's US News and World Report piece that wonders whether or not you're an emotional eater, or if you're just hungry]

A Contender for Dad of The Year

He's been all over the news, and he's today's Funny Friday.

He's also known as "BatDad".

Have a great weekend!

Why Is Ontario Letting Coca-Cola Fund a Healthy Active Kids Conference?

The what's in it for Coca-Cola is clear - it's health washing plain and simple, both in terms of being able to claim they're working together for a solution, and also in terms of dilution. What I mean by "dilution" is that Coca-Cola's sponsorship of the event will almost certainly dilute the speakers' abilities to candidly discuss sugar sweetened beverage (SSBs) taxes, vending machine bans, zoning law preventing fast food or convenience stores from cropping up within walking distance of schools, public health campaigns that vilify SSBs and promote tap water. At the very least Coca-Cola's funding will soften the words of the speakers when considering these issues (and given the subject of the discussion, it would be wholly appropriate for SSBs to be discussed), and at best (for Coca-Cola) it will silence them altogether.

But the question I can't seem to answer is why Ontario allowed it. To be fair, this isn't formally a provincial conference, it's being put on by Toronto's Board of Trade which no doubt has a mandate to serve industry, but it does include the Assistant Deputy Minister, Health Promotion Division, Ministry of Health and Long Term Care, along with the co-chairs of Ontario's government appointed Healthy Active Kids panel. And to be fair too, "allowed" is a nonsensical word when it comes to privately organized events like this one.

But it sure is a shame.

It's a shame because just like the Board of Trade notes in its pitch to potential sponsors, sponsorship allows sponsors (which in this case is Coca-Cola) to,

"Build your brand. Raise your profile through brand exposure on site and in Board media. And make an impression at Toronto’s premier business events, including our Annual Dinner Gala, Business Excellence Awards Golf Tournaments and more.

Develop powerful collaborations. Connect with respected leaders from business, professional services, government, and cultural communities."

Not exactly the platform I'd want the ADM for the Ministry of Health's Health Promotion Division to help extend to Coca-Cola.

[And just in case someone tries to make the case of needing the money and taking it where we can get it, the talk is part of a Pfizer funded series and there's also a non-nominal per person charge for all attendees]

Hey Look, Here's My Book (Cover Reveal and Some Advance Praise)

Just over five months from now The Diet Fix will finally hit the shelves.

It's the book I've wanted to write since 2006, but for some reason, back then, I just couldn't seem to muster up the sitzfleisch (a Yiddish word that loosely translates as ass power) to do it. It was actually frustrating to me as clearly writing is something I'm fond of - why couldn't I seem to get it out? I remember asking an author friend of mine how I might kick myself into gear and he said something to the effect of, "you'll write it when it's ready to come out".

5 years later I asked my wife if it'd be alright with her if I rented a cabin in the woods for a weekend to write - the book was ready to come out.

That weekend I wrote 30,000 words, and since then an additional 65,000, all of which have been polished and tweaked to the point where I couldn't be happier with it.

A very early edition went out to some folks for their thoughts, and here are some of their sneak peeks:

“Few people know as much about weight loss as Dr. Yoni Freedhoff. It is no surprise that he has produced a book that is the perfect combination of evidence-based facts and good, solid, usable advice. There is so much misinformation in the media about dieting. And so many trendy and near useless diets. Yoni’s book is exactly what we need: a science-informed – and fun to read – road map to long-term weight loss success.”

- Tim Caulfield, Canada Research Chair in Health Law and Policy, University of Alberta, and author of The Cure for Everything: Untangling the Twisted Messages about Health, Fitness and Happiness.

"The Diet Fix is a no-nonsense approach to realistic weight management by a recognized expert in the field. Based on simple but time-proven principles including self-monitoring, goal setting, persistence and perseverance, this step-by-step guide to long-term weight management provides the evidence, debunks common myths and is chock full of practical tips - the ultimate diet book for anyone wanting to stop dieting and start living."

- Arya M. Sharma, MD/PhD, FRCPC Professor of Medicine, Scientific Director, Canadian Obesity Network

"Here finally is a book capturing the nuts and bolts of the dieting culture that has gripped North America. With Dr. Freedhoff's clear presentation of fact supported by years of first hand experience, a crystal clear picture of what works, what doesn't and what is myth emerges. The Diet Fix is a service to all."

- Tosca Reno, New York Times best-selling author of Your Best Body Now and the Eat-Clean Diet series

"Millions of people are suffering through restriction, denial, sacrifice, hunger and a frustrating yo-yo cycle of weight loss and regain, yet they still struggle to manage their weight. This serial dieting breeds guilt, shame, depression, despair and binge eating. If you’re one of these “traumatic dieters,” Dr. Yoni Freedhoff’s book, the Diet Fix, will not only provide a much needed sigh of relief, it will be a Godsend. It might even save your life."

- Tom Venuto, International best selling author Burn the Fat, Feed the Muscle, and fitness industry icon.

Thanks to everyone who has helped The Diet Fix get to this point including but not limited to my patients, my family, my co-workers, Yfat Reiss Gendell and Foundry Literary and Media, and Leah Miller and Random Houses' Crown Publishing Group. Can't wait for the launch.

[Were anyone so inclined, you can guarantee Amazon's best price by pre-ordering here.]

Guest Post: Ottawa Brings Back the Mile!

Bringing Back The Mile

By: Geordie McConnell, Founder and Head Coach, Ottawa Running Club and Ottawa Triathlon Club

Two thousand years ago Roman warriors marched through Britain on their conquest, counting their steps. Every 1000 paces (or two steps) the ground was marked, and called a mile.

Two weeks ago, in Ottawa's Wellington Village neighbourhood, a specially calibrated bicycle was ridden on the main street and there too the ground was marked, and it was called The Wellington Mile.

The mile as a distance, was left orphaned some time ago in Canada and is now ready to be reclaimed as the classic running distance. In a culture that seems to crave volume over quality, running has been redefined over the last 20 years. The entry point to the running world is now seen as 5 kilometres and that is too long. Many will be daunted by that distance and decide that running is not for them. If every able bodied individual in our community had the health and fitness to jog one mile (1609m), imagine the increase in our society's overall wellness. Why not train to jog a mile, a much more attainable and sustainable distance? As your fitness increases, you will see that, at the same effort level, the time it takes you to cover the mile will go down as your wellness goes up. If you need goals, there is none more challenging than running a faster mile. Will you break through the 11 minute barrier, or 10 minutes, or even 6 minutes?

Upon entering the running world, participants are soon subject to a social pressure which, for some, can be deleterious; I call it 'Move Up Syndrome'. Once a runner has completed a given distance, a 5k for example, it is inevitable that a friend will press to know when they plan to 'move up' to the 10k. From 10k it's the half-marathon and then on to the marathon. I know an Olympic marathon, someone who, we'll all agree, has found his niche. He was once asked when he would move up to the ultra marathon.

Find the distance that works for you, one that fits your lifestyle and enjoyment level. I believe the mile offers just that to non-runners and runners alike. It is also the perfect distance for kids to both build fitness and also learn to run well. I am among many experts who feel that 5k is not a good distance for kids and that they will benefit greatly if given the support to run faster at shorter distances.

On Thanksgiving Monday in Ottawa, like an increasing number of cities in North America, the mile is making a comeback. It is a distance we can all run, a distance that unifies. Modern society makes keeping fit like a conquest. Take a lesson from the success of the Romans. It starts with one mile.

Visit TheMile.ca for details on The Wellington Mile, or BringBackTheMile.com for information on events in the United States.

As founder and head coach of the Ottawa Running Club and Ottawa Triathlon Club, Geordie McConnell has gained special insight into the sociological side of fitness just as much as the physiological. While regularly advising advanced athletes, it is guiding the journey from couch to start line that inspires him, more so than the journey from start line to podium.

Guest Post: Is Your Feeding Style Cramping Your Child's Eating?

Original image source

Today's guest post come from Jill Castle, co-author of Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School (which our office's RD Mark McGill reviewed here). I reached out to Jill and asked her if she wouldn't mind expanding on the science of the "how" to feed children for my readers.

Is Your Feeding Style Cramping Your Child’s Eating?
By Jill Castle, MS, RDN

Feeding kids is one of the most time consuming (and frustrating!) jobs for a parent. One thing that makes feeding hard is the lack of preparation parents get in nutrition, feeding and child development. While most nutrition buzz focuses on WHAT to feed kids, in my new book, Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School, my co-author and I come at childhood nutrition from a different angle. We know food is important, but so is HOW kids are fed, and WHY they behave that way around food. Understanding this is the secret strategy to feeding and raising healthy children in the 21st century.

Fundamental to your success with feeding is your approach. This is called your feeding style. Feeding styles are characterized by how demanding and sensitive the parent is to the child in the process of feeding. Researchers highlight four feeding styles: authoritarian, permissive, neglectful and authoritative. Of the four styles, only one has been associated with positive outcomes such as eating more fruits, vegetables and dairy foods, being tuned in to appetite signals (hunger and fullness), and a healthy body weight. The other three styles have been associated with impaired appetite regulation, weight problems, and less healthy eating.

Let’s take a closer look.

Authoritarian Feeding Style
Also known as a “parent-centered” feeding style, the authoritarian feeding style is characterized by eating rules and performance, such as “eat three bites of food before leaving the table,” or “finish the meal” before getting dessert. As a result, children may “learn” to dislike mealtime or certain foods, become pickier, or overeat. Rewarding with dessert or other food, restricting certain food or amounts, and pushing kids to eat are parenting practices associated with this feeding style. Children raised with an authoritarian feeding style may show problems with inadequate eating and underweight, a poor sense of appetite regulation, or overeating and weight gain.

Examples:

• The child finishes his meal so he can have dessert, even though he is full.
• The toddler is encouraged to take three bites of vegetables at each meal but becomes pickier about them over time, rather than more receptive.
• The overweight teen overeats candy and sweets outside of the home because these foods are never allowed in the home.

Permissive Feeding Style
A lack of structure and boundaries command this style. Parents are reactive to food requests, complaints of hunger (even when a meal was recently eaten), and may cater to the child’s food preferences. Meal structure is lacking, and frequent eating may occur. Children use outside factors to determine hunger or fullness. “Head hunger” or boredom may trigger eating in addition to “tummy hunger.” Research tells us that children raised with a permissive style may become overweight due to a lack of limits on sweets and snacks. They also may become pickier, less likely to try new foods and underweight.

Examples:

• The picky preschooler will only eat hotdogs, nuggets and applesauce, so that is what his parents prepare because they don’t want him to go to bed hungry.
• The school-age kid spoils his appetite for dinner because he ate too many snacks after school.

Researchers have found these two feeding styles (authoritarian and permissive) to be the most problematic for children’s eating including the amount of food they eat, the type, their appetite regulation and their weight status.

Neglectful Feeding Style
Irregular shopping, empty cabinets and refrigerators, and no plan for meals are signs of the neglectful feeding style. Meal structure and food availability may not be important to the parent, and that affects feeding the child.  Children who experience this feeding style may be insecure about food and eating, unsure of the next meal, if they will like it, and whether it will be enough. They may become overweight or underweight.

Examples:

• The child constantly questions meals and food, and may become anxious at mealtime.
• The teen eats rapidly or overeats when food is available.

Authoritative Feeding Style (The Fearless Feeding Style!)
Authoritative feeding promotes independent thinking and self-regulation, but also sets boundaries. The authoritative feeder may use Satter’s Division of Responsibility (http://www.ellynsatter.com/resources/DORfeeding.pdf), determining what food will be served, when it will happen, and where it will be served, while allowing the child to decide whether they will eat what is prepared, and how much. Structure, boundaries, choice and trust are the basis of this feeding style. The authoritative feeding style is associated with leaner kids who are tuned in to their appetite. Using an authoritative feeding style is a promising avenue for preventing and managing childhood obesity and picky eating.

Examples:

• The child eats a wide variety of foods from all food groups, and enjoys sweets, but doesn’t overdo it.
• The parent doesn’t pressure or limit the child’s eating, but lets him satisfy his appetite.
• The meal table is a low pressure environment and the kids enjoy mealtime with the family.

Most parents have a dominant feeding style, but all four feeding styles may pop up at one time or another. Feeding styles can arise from a parent’s childhood experiences, however, a child’s weight status, his behavior around food, and even the parent’s weight status can influence the feeding style. For instance, if a child is overweight, a parent may use an authoritarian feeding style, setting strict limits on second helpings, food types and access to food. If a parent has a past eating disorder, she may use a permissive feeding style, attempting to avoid a food issue.

The point of all of this is to bring to light the influence of feeding styles on your child’s eating. You can be offering the most nutritious meals, but if it is done without structure or with pressure and absolutes on eating performance, it may backfire and negatively color your child’s relationship with food, his eating, and his health.

The idea is to use a feeding style that allows your child space and time to learn about food and eating in a safe and trusting environment—without ultimatums, bribes, or drastic measures that ultimately backfire.

So, if you’re having trouble with your child’s eating, take a step back and re-evaluate. Do you have enough predictability and structure with meals? Are you being too pushy about food, or too lenient? Is your feeding style getting in the way? The most effective feeding style for cultivating healthy eating and attitudes in the long run is the authoritative style.

So tell me, which feeding style dominates your table? Is it helping or hindering your child’s eating?

Jill Castle, MS, RDN is a registered dietitian, childhood nutrition expert and mom of four. She is the co-author of the new book, Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School You can also find her over at her blog, Just the Right Byte or her website 

Saturday Stories: Facebook, Black Widows and Whole Foods

Wait but Why on how not to do Facebook (a must read for those who use it regularly)

Jackson Landers via the New York Times explains what it's like to apparently live in a home infested with black widow spiders and what it's like to get bit by one.

Comedian Kelly MacLean with an epic rant about Whole Foods I all but guarantee will make your day.

[And if you don't follow me on Twitter or Facebook, here's my column from US News and World Report that calls for an end to nutrition as religion.]

A Rare Funny Friday Double Shot - The Honest Chipotle Ad

Wow.

If you've seen the Chipotle ad with the scarecrow, you've got to do yourself a favour, stop what you're doing, and watch Funny or Die's "honest" version of same!

Honest Scarecrow - watch more funny videos

True Facts About the Frog

Ahhhh Ze Frank for Funny Friday for the win.

Have a great weekend!

Parental No: School Track and Field Edition

Because how better to celebrate your elementary school's fastest runners than by giving them an award of recognition and a gift card to McDonald's?

No doubt winning itself and the award would not have sufficiently made this young man's day. Clearly the school needed to toss in the free advertising and emotional branding opportunity for McDonald's.

Groan.

[Apologies to the reader who sent me this. Both for me taking so long to post it (it got lost) and for me forgetting who it was who sent it making attribution impossible]

Eating 201lbs of Barilla Plus Omega-3 Pasta Nets you the DHA of 2oz of Salmon

Today's badvertising comes from Barilla Plus Omega-3 pasta.

If you were duped by the health washed packaging of Barilla Plus pasta and thought you could consume it as a means to acquire healthy omega 3 DHA fatty acids, to obtain the equivalent amount of DHA that you'd get from eating a teeny weeny 2.6oz serving of salmon you'd need to eat between 11 and 201 POUNDS of pasta (with the amount depending on your body's ability to convert plant based ALA to DHA).

Bon appetit.

[Depending on your source of information between a low of 0.5% and a high of 9% of plant sourced alpha linolenic acid (ALA) is converted by the body to DHA.

75g of salmon contains 1,610mg of DHA.

An 85g serving of Barilla Plus contains 300mg of flaxseed sourced ALA.

0.5% to 9% of 300mg = 1.5mg to 27mg.

1,610mg divided by 1.5mg = 1,073. 1,610 divided by 27 = 59.6

85g x 59.6 = 5,066g = 11.16lbs

85gx 1,073 = 91,205g = 201.07lbs]

Rant Alert! Today's Teens Live More Healthfully Than Those of 10 Years Ago?

That's what the headlines would have you believe.

In fact that's what a recently published journal article would have you believe too. And truthfully, I hope the study's conclusions - that teens' screen time and the consumption of sweets and sweetened beverages are decreasing, while activity, eating breakfast and fruit and vegetable consumption are increasing - are 100% correct, but forgive me for my cynicism, I'm having a difficult time buying it.

Firstly, I don't think a comparison between the self-reported healthy living behaviours of 2001-2002 vs. 2009-2010 teens is possible. As I've pointed out before, teens, especially teens with overweight and obesity woefully under-report dietary intake, suggesting that weight, or more likely the stigma attached to it, leads teens to tell researchers what they want to hear (that they're eating less and better than they actually are). Given rising rates of obesity and more important, the ever-louder clarion calls of concern therein, I'd be shocked were 2009-2010 teens not far more likely to be under-reporting their unhealthy living behaviours and over-reporting their healthy ones than their lighter, less harassed 2001-2002, or even 2005-2006 counterparts. What I'm getting at is that kids who are primed more often as to the risks of unhealthy living by the media, their schools, their doctors and their parents, I'd bet are far more likely, consciously or unconsciously, to exaggerate the efforts they're making therein and it would seem to me our angst and calls to action have increased exponentially since 2001, and dramatically even since 2005.

Secondly their screen time assessment is flawed too as it's impossible to compare true screen time when smartphones and tablets didn't exist back in 2001-2002 or even in 2005-2006 (the first iPhone didn't come out until 2007) and yet are now nearly surgically attached to most teens' hands. So to say that TV watching is going down likely ignores the fact that iPhone/tablet use has gone up from absolutely none, to mind boggling amounts, potentially negating any benefit of a decrease in TV specific screen time.

But my biggest struggle isn't with the findings of the paper, or of their veracity, but rather the paper's conclusions. Taken straight from the abstract the authors state,

"These patterns suggest that public health efforts to improve the obesity-related behaviors of US adolescents may be having some success."

To which I have to respond with a loud WTF! Why? Because the very same paper that is explicitly suggesting that public health efforts designed to tackle obesity-related behaviours are "having some success" also found that BMI went up during the study period! And their follow up line addressing that fact is what really boiled my blood,

"However, alternative explanations for the increase in BMI over the same period need to be considered."

Again, WTF?! Moving a teeny tiny bit more and eating a teeny tiny bit less (and here that's a full on hopeful guess as calories or even amounts the teens are eating aren't quantified or even mentioned) aren't going to do the trick and it's incredibly irresponsible to infer that they ought to have. Meaning that even assuming the study's findings are true, why would the authors suggest to the world that these teeny weeny changes should have led to decreases in BMI such that given we didn't see change, we need to come up with "alternate explanations"? Even if taken at face value these changes suggest an increase of just 0.2 days a week where kids report themselves as being physically active, that kids are watching 40 minutes less TV a day (but still near 2.5 hours of the stuff) and that they've made truly minute changes to their dietary behaviours - why would we need "alternate explanations for the increase in BMI" when no one in their right mind would expect these changes to affect weight? Nearly nothing lifestyle changes don't affect weight - if they did, there would never have been a need for this study in the first place!

Moreover, by tying these findings to obesity, again, even were the findings to be true, lends weight to the let's treat this flood with more swimming lessons approach to dealing with childhood obesity reinforcing the notion that kids who struggle with weight and have not been successful with their swimming are just lazy, TV watching, soda swilling gluttons, when really, they're not inherently different than any kids who came before them - no lazier, and no more gluttonous.

Kids have not changed, the world around them has, and what we really need to be doing for our kids is building them levees, not preaching about swimming lessons.

Just to name a few top of head things we could do - we could establish zoning laws forbidding fast food restaurants and variety stores from setting up within walking distances of new schools; create reformed nutrition education programs; establish school gardens', herald the return of home economics, remove no-name junk food from our kids' cafeterias, and ban the in school use of junk food as the reward for anything and everything a kid ever does. We could put an end to advertising targeting kids. We could could pass front-of-package health claim laws that actually prevent marketing BS from preying on parents and we could regulate a diet industry that sells hope in bottles. We could enact incentive and/or disincentive taxation plans to encourage healthful eating and discourage junk, and we could re-organize farm subsidies to in turn make fruits and vegetables more affordable and junk potentially more expensive.

There is no shortage of sandbags.

Getting excited about likely exaggerated personal lifestyle improvements in the name of tackling childhood obesity, all the while watching rates rise further, is just another distraction from what really needs to change - not the kids, but rather the world in which we're sitting back and passively watching them grow up.

Truly, I'm flabbergasted by the enthusiasm this study has received. Kids haven't suffered an epidemic loss of willpower, nor are any amount of swimming lessons going to lead them to beat this flood. Kids need our help. They need sandbags, not namby-pamby excitement about at best minimal, and at worst totally made up improvements to their swimming, which while no doubt laudable, detracts from the real work of filling actual frickin' sandbags.

Sorry for the rant.

[By the way, that's a selfie of me taken immediately after I first finished reading the article]

Are Teens Who Lose Weight Really More Likely To Develop Eating Disorders?

That's certainly what the recent news will have you believe, but what of the actual science that's been used to generate the headlines?

Looking to the paper in question the first thing to point out is that it's not a clinical trial or even a cohort analysis, but rather is a case study of just two patients.

Both of the two teens in question chose traumatic diets as a means to fuel their losses.

The first patient, Daniel, is described as having approached his weight loss by means of eating no more than 600 kcal per day while running high school cross country. He also apparently eliminated sweets, fats, and carbohydrates, and ate only "diet food".

The second patient, Kristin, is described as having commit to a dietary regimen of 1500 kcal while running 7 miles per day for 3 years.

The authors of the case studies very sagely point out that in children, weight loss, especially rapid weight loss, should prompt primary care providers to explore the possibility of an eating disorder as eating disorders can present at any weight. In the case of these two teens, their eating disorders first manifested in the traumatic diets they both undertook in order to lose weight. Had their family physicians or pediatricians explored their losses when they began, the severity and disordered nature of the efforts might have been uncovered long before these two teens developed their traumatic-diet-induced psychological and physiological signs and symptoms.

What this paper did not however conclude is that weight loss in teens leads to the development of eating disorders and yet I've seen this references to this paper crop up regularly on Twitter since its publication and wielded by various trusted allied health professionals as proof that weight loss in children and teens is in and of itself risky.

What's risky isn't loss, it's traumatic diets, and frankly they're risky for anyone at any age.

The take home message from these case studies is that primary care providers would be well advised to respond to rapid and/or extreme losses of any patient, of any age, as a red flag suggesting their possible adoption of a traumatic diet, but the simple suggestion of the headlines and the no doubt well-intentioned tweeters, that, "teens who beat obesity at risk for eating disorders" leaves out the all-important qualifier of their traumatic means of losing.

Saturday Stories: Cancer, Food Allergies, Water and NuSi

Steven Novella over on Science Based Medicine reassures us that everything causes cancer.

Scott Gavura also on Science Based Medicine provides us with a primer on food allergies.

James Hamblin in The Atlantic tackles Michelle Obama's latest Let's Move push - water.

And because I've been so critical of NuSi in the past, I feel compelled to share their latest press release and point out that the line up of scientists they've put together for this first round of research is both stellar and beyond reproach.

[In case you don't follow me on Twitter or Facebook, Barbara Kay via a number of her articles in the National Post, her comments there and on Twitter provides us with a case study in ignorance and weight bias which I've posted to Storify, and here is my weekly US News column, this one on why I don't think you need need to ensure your children finish their milk.]

Because No One Can Resist Puppies and Kittens

Today's Funny Friday is of the simple sort. But that doesn't mean it isn't funny.

Here are puppies and kittens vs. mirrors.

Have a great weekend!

Are You Giving Your Kids Filling Snacks?

Another great little study by Brian Wansink and crew - this one looking at children's snacking, calorie consumption and satiety depending on the type of snacks they were offered.

201 3rd-6th graders were randomly assigned to receive one of four different snacks: 1. Potato chips. 2. Cheese. 3. Vegetables. 4. Cheese and vegetables. Simulating many homes, the kids were allowed to eat as much of their assigned snack while watching a 45 minute television program. Perceived fullness was measured before, midway through and after the 45 minutes.

While not at all surprising, the findings were dramatic enough that I felt they'd be worth sharing. Kids who ate the veggies and cheese consumed 72% fewer calories than those consuming the potato chips and kids who had overweight or obesity to begin with - 76% less.

Personally I'm all for kids snacking - but as this study dramatically demonstrates, the type of snack you're offering matters a great deal.

Here's Dr. Wansink

Badvertising: Do Children Need Multivitamins and Will Flintstones "Support Immunity"?

So to answer the first question regarding kids and whether or not they need or benefit from taking a daily multivitamin I turned to the medical literature.

Simply put, I was unable to find a single study, not one, that would suggest a need or a benefit to giving a growing healthy child a multivitamin. Full stop.

Now that doesn't necessarily mean that there can't be benefit, just that none has ever been proven or even suggested.

So given that there are no studies proving or even suggesting benefit, how is it that multivitamin marketers are allowed to publish advertisements like the one up above (that I pulled out of a Canadian parenting magazine)?

Moreover, what of the more specific claim of "Immunity Support", or if you look at the Flintstones' product line, "Brain Support", or "Bone Support"?

I sure couldn't find anything to hang an evidence based hat upon. Seems to me that vitamin fortified candy (the two recommended daily tiny gummies contain 3/4 of a teaspoon of sugar) shouldn't be allowed to market itself as healthy period, let alone when there's no actual evidence base that would support the claim.

But of course that's not on Flintstones and Bayer, that's on our government for allowing claims lacking in rigorous evidence to target parents who simply want the best for their children.

And in case it hasn't occurred to you, I must also point out that the fact that there aren't studies on the long term use of multivitamins in children means that not only are the benefits only theoretical, so too are the vitamins' presumed safety. We simply don't know what the long term outcomes of giving growing children multivitamins and supplements on top of their regular diets might be - especially given kids' regular diets these days include an increasingly vitamin fortified food supply - and speaking personally, that's not a science experiment I'm willing to sign my children up for.

A Magic Label Reading Hack For Choosing Higher Quality Carbohydrates

Ok, so it's not magic - it's better - it's evidence based!

With a team of some of the who's who in nutritional epidemiology Dr. Rebecca Mozaffarian and colleagues explored the various whole grain identifiers currently festooned on fronts-of-packages. They looked at that food industry sponsored Whole Grain stamp (up above), whole grain as the first ingredient, whole grains first without added sugars, the word "whole" before any grain in the ingredients as well as the ratio of total carbohydrate to fibre. With each they further investigated their relationship with other health-related criteria including fibre, sugar, sodium, calories, trans-fat and price.

The results?

545 products later and guess what? Products proudly displaying that food industry sponsored whole grain stamp were found to be significantly higher in both sugar and calories. So too were products identified on the basis of a simple hunt for "whole grain" as a first ingredient and the word "whole" before each grain.

The best measure?

The ratio of total carbohydrates to fibre where a ratio of 10:1 or lower was the best measure and identified products that broadly contained more fibre, less sugars, less sodium and less trans-fat, along with fewer calories.

So if you're trying to figure out which bread, cracker or cereal to buy, to help with your decision, simply divide any product's total carbohydrates by its fibre and look for a number less than 10.

Now this isn't a perfect formula as many products nowadays are now being spiked with ingredients such as oat hulls to artificially increase fibre content, but in a pinch, it's certainly an easy rule to remember.

Of course the real lesson to be learned here is one that is not particularly surprising - it's that the food industry sponsored whole grain stamp seen up above should be ignored, as should pretty much all industry sponsored front-of-package claims and programs.

Guest Post: Stellar Review (by my Wife) for Power Hungry Energy Bar Cookbook

[Full disclosure: Was provided with a free copy from the publisher]

Last year at this time, I had about six dozen protein enriched muffins in five varieties sitting in my freezer, ready for school lunch distribution. I was feeling confident, prepared, and pleased that my kids would be eating home-made, nutritionally sound, protein hearty snacks that would keep them satiated and energized for the long days filled with school and various after school activities. My sense of triumph was quickly shattered by rejection in the form of half eaten (at best) muffins returning in the lunch boxes. Sadly, much of the remaining few dozen muffins ended up in my stomach rather than my kids’ who quickly grew tired of the repetition.

Fast forward to August 2013. Just as I am heading into “back to school” mode and the dreary task of packing nutritious lunches for the kids (and the hubby) begins to loom, Power Hungry, The Ultimate Energy Bar Cookbook by Camilla Salsbury, lands on my kitchen counter. Bars. Yes!

With 44 individual recipes plus variations for just about each one bringing that number to over 200 recipes, I am once again feeling confident and prepared. Immediately I pull in my kids, showing them the eye-pleasing photos that accompany each recipe, asking them each to choose one to try. We begin with Nick Bars in the section entitled “Super Natural Knock Offs”. The original recipe, comparable to Clif Bars, leaves you with numerous options even without the following page that gives you 8 bar variations to change it up (from Chocolate Almond Fudge Bars to Gingerbread Bars). In order to make them school safe, we opt for sunflower seeds and sunflower seed butter (a variety of seeds and nuts/seed and nut butters are listed as options in the recipe). With dates acting as the glue in this recipe, two of my kids devour them, while the third finds it a bit too sweet for her liking. All in all, we are off to a good start.

From the same section of the book, we try Moonbeam Bars (a knock off of Luna Bars). Again, we opt for Sunflower seed butter to make it school safe. The recipe calls for orange zest, but we have no oranges, only lemons. My eldest daughter is a big fan of lemons, so we swap it in, although my gut is telling me that zest of any citrus may not play well with this recipe…and as it turns out, my gut, about the lemon zest at the very least, was right. Moonbeam bars as is not such a hit. It is disappointing in that this was a recipe that had over 6g of protein and less than 200 calories per bar. That said, removing the zest would have likely been a success, so we will definitely be trying these again.

Next, we move to the Protein Bars section of the book where we find Banana Blondie Protein Pucks. These look delicious, and with 11g of protein and only 128 calories per serving, they seem perfect for our next experiment. Well, almost perfect. They call for ground almonds, making them anything but school safe. For after school snacks, however, they work just fine for our family. Sadly, but for the child who chose and helped to make these pucks, no one else wanted to eat more than a bite or two. They were dry and fairly bland. Not sure that these can be saved, even with mini chocolate chips sprinkled on top.

Finally, we head back to the first section of the book to try out their Power Grab Protein Bars (comparable to Powerbar Protein Plus Bars or Promax Bars). Not surprisingly, the recipe calls for protein powder, but it is vegan protein powder, which unbeknownst to me is not used equally to whey powder in recipes. Thankfully the author is mindful in adding a “Bar Tips” section for each recipe, where in this one she explains how to use whey protein in lieu of vegan. While the measurements were off (following her instructions for whey protein, I needed to add about an extra 1/3 cup of milk to the recipe to make it work), with a bit of tinkering these turned out AWESOME!!! The kind of awesome that has me handing out these bars to family and friends and making a second batch (the first was with natural peanut butter, the second with soynut butter) to keep in my freezer for the kids and adults in our family. The kind of awesome that will never have me purchasing another protein bar SO LONG AS I LIVE. Seriously. Awesome.

Overall, this is a recipe book worth having. I love how many recipes/variations there are to try. I love that it has the nutritional breakdown for each recipe (although I am not sure how she has calculated some of them where there are a variety of options that vary from nut/seed butters to actual nuts/seeds, to maple syrup/honey/agave nectar, to a variety of dried fruit options). I love that she has a “bar tips” section for each recipe as well as instructions on how to store the finished products. I love the section at the beginning of the book entitled “Power Hungry Pantry” where the author lists the ingredients you will need for most recipes in the book (which I took with me to my local bulk store before I began making any of the recipes in the book). And I especially love the photos – they make choosing recipes with my kids so much more appealing!

So here are the two things I had issues with in this book. First, a number of recipes called for nuts (not school safe). While the author gave alternatives (seeds/seed butters) for some recipes, they certainly weren’t suggested for all of them. Second, and my bigger issue, many of the recipes are terribly high in sugar, averaging 12.7g per bar with numbers as high as 23.2 grams (that’s roughly 5.5 tsp of sugar!). While compared to store bought bars, I’ve no doubt that the ingredients used in these recipes are superior in that they are mainly raw ingredients (ie. whole grains and in their natural state), but let’s face it, sugar is sugar, and whether it is processed (white and powdery) or “natural” (it comes from a tree or a bee), the body processes it pretty much the same way. You know there is too much of it when your kids are complaining that the product is too sweet (is there such a thing??). While the author does mention Stevia early on in the book, it scarcely makes an appearance in the recipes themselves. That said, I am all about experimenting, so am looking forward to making many more of the book’s bars while trying to reduce the sugar. Somebody warn the guinea pigs: this is the year of the bar.

[As always for positive reviews, here's an Amazon Associates link for you to pick up the book - and thanks to my fantastic wife for the review and for the bars!]

Saturday Stories: Crack, Kale, Lyme and Kids

L.V. Anderson explains in Slate why food is not "like crack".

Hunt, Gather, Love's Melissa McEwen brilliantly explains why kale will kill you (and that most folks don't actually read whole blog posts, and that cherry picking data's pretty damn easy).

Harriet Hall over at Science Based Medicine tackles the entity known as chronic lyme disease.

Patrick Mustain over in Scientific American explains that it's simply not true that kids won't eat healthfully and why the USDA school lunch guidelines do matter.

[And if you don't follow me on Twitter or Facebook, here's my first guest post for Greatist where I explain why I haven't missed a day of tracking calories since May 7th, 2007, and my piece on US News and World Report that explains how it is you can't outrun your fork.]

The Star Ship Enterprise Encounters Miley Cyrus

You know I never imagined that a blog post of mine would include Miley Cyrus, but today's Funny Friday proves me wrong.

Whether you fall on the side of the VMA Miley Cyrus controversy, or even if you don't know what I'm talking about, this mashup with Star Trek's sure to bring a smile.

Have a great weekend!

School Vending Machines Raise Very Little Money So I Ask A Principal, "Why Keep Them?"

School vending machines peddle junk. Whether it's health-washed junk (which I've reported before is likely worse for kids given their health halos misinforms children about nutrition), or true junk, when I was a kid, there certainly weren't any school vending machines, there were just water fountains.

Admittedly, we did head across the street to the convenience store to buy junk, but not every day, and really, the argument that kids can just go across the street to buy garbage is nonsensical. In my later high school days I also remember heading across the street to buy cigarettes - bet schools could raise lots of money selling those.

So I wondered aloud on Twitter one day just how lucrative vending contracts are for schools. One kind principal reached out and the answers she provided surprised me some. Sounds like at least here in Canada, schools only raise a few thousand dollars a year by selling nutritional chaff to their students (they used to make far more when sugared soda was still sellable as back then there were more sales and the big soda makers also provided in-kind donations).

Now maybe I live in a dream world, but I would have thought a few thousand dollars return would either a) Not be worth it given what the vending machines are selling, or b) Be able to be raised in a non-harmful way.

I still do think both of those thoughts hold true, but when I put it to the principal and asked her why keep them, she wrote me what I thought was a very thoughtful and practical piece and I asked her if I could share it with you (I've changed identifiers so she doesn't land in any hot water) - it speaks to the fact that there are far bigger issues for our schools to deal with and that it might not be that simple to fix them.

Hi Yoni-

To be honest with you, vending machines haven't really been on my radar until June. The Super met with us in April, and he mentioned that he and the District Education Council were taking a closer look at school compliance with vending policy. The council member who sits on my local parent committee is passionate about healthy eating, so we are certainly going to be under the microscope.

My view regarding the absence of machines in my school is similar to my battle with drugs. As soon as you suspend the drug king pin there are five others waiting to take his/her place. It's a constant Game of Thrones. I see a similar path for vending. They will take off to the nearby convenience stores. Why pay $1.10 for 10 small carrot sticks and dip at the cafeteria when you can get chips at the pizza place 50 ft. from the school property line? I find that kids that really care about what they're eating are bringing bagged lunches. The rest are up for the quick fix. Tim Hortons, McDonald's, Pizza Pizza, St. Hubert's, and China Wok are all within a 5-minute walk from us.

I am in total agreement with you regarding water fountains, but these are viewed as unsanitary by many of the kids. Springfield water is very good as we are on a well system. I do see kids using the fountains. I'll be the first to admit that they are not aesthetically pleasing- they're not as sexy as the machine that picks up the drink and beams it to a vacuumed tube. But they certainly work. Don't forget- some schools are almost 100 years old, with old pipes and hardware. Springfield Elementary was built in 1930. My school had a flood and was repaired in 1986. You push the button, let the water run for a while, then get a drink. It takes a while for the cold water to run through the pipes to the actual fountain. I'm not making excuses by any means, just trying to give you the picture. This is not lost on the teenagers.

We have a very successful hot lunch program on Thursdays. We were so proud of ourselves, we thought we would create a free breakfast program at school. We had a community supermarket partner step up to help us out. We offered a variety of healthy choices, and guess what? The kids didn't eat it. It was open to all 480 students and nobody came. I bet if we had offered Froot Loops and Eggos we would have had a full house. It shut down after a five-week attempt. We were shocked. Let me get this straight, "You would rather pay at the cafeteria than eat for free down here in the culinary tech room?" Unreal. I have been teaching for 15 years- I can count the number of times I have eaten at the cafeteria on one hand. I kid you not. I dry heave just thinking about it.

From my point of view, the money from vending isn't really on my radar. That money would barely cover my biology/physics/chemistry budget for the year. And the gym spends that amount in consumables (shuttle cocks, rackets, balls) yearly. The money comes in, but it's in such small increments that it's just thrown into the kitty.

I don't go the vending/back machine route for disposable income. I'm sure some might, but we certainly don't talk about it in admin. meetings, and we talk about just about everything. Get rid of them? I guess we could, but I don't see this as the answer. Many schools are community partners, with a variety of clubs/organizations using the facitlities in the evenings. The vending offers them a last minute snack or drink, if needed. I'm guilty of using the one at the gym when I have forgotten my bottle for spin class. Those using the gym at school may find themselves in the same boat. I just don't want you to have the perception that we have vending for profit- the profits are not lucrative. We have them because we have them- they've always been there, I guess.

On the flip side, you would be hard pressed to find a teacher that doesn't have a file cabinet full of snacks for kids who have forgotten their lunch.

The quality of these snacks? Well, that's classified information...:)

What Are Walmart Pharmacists Doing Health-Washing Cookies?

Sigh.

That photo up above was sent to me by a disgruntled Walmart pharmacist. This pharmacist had been tasked to hand out to clients a FREE package of "Health and Wellness" products for Fall.

Check out the sponsors of the package and play, "One of these things is not like the other".

Did you catch the Bear Paws?

In case you aren't familiar, Dare Foods' Bear Paws have been featured on this blog before in a guest post that pointed out that not only are they cookies, but that they're targeting children and parents to suggest that cookies make great snacks. Clearly here Dare Foods' marketing arm has decided to market them as healthy by paying for them to be included in a bag handed out by a trusted allied health professional.

To put these cookies into a tiny bit of perspective, a few years ago Nabisco made something called Triple Double Oreos (picture a triple decker Oreo). Comparing nutrition facts, a Bear Paws cookie has 20% more calories and 12% more sugar than one of those Franken-Oreos.

If you have another close peek at the sponsors, you'll catch this line,

"The Pharmacist at Walmart does not endorse or recommend any sponsor or their products or services."

which led my angry Walmart pharmacist whistle blower to state,

"Of note, on the pics I sent you, I love the disclaimer at the bottom about how we don't "endorse" any sponsors products. Well, yeah, we kind of do if we explicitly hand the package over to the patient with the sample in it. I would count that as an endorsement."

So would I angry pharmacist, so would I, and undoubtedly too, so would Dare Foods.

Shame on you Walmart. While I have no issue with you selling all the Bear Paws you want, having your pharmacists hand them out in the name of health just so that you can make a few more bucks is simply abominable.

Why "Just Shop the Periphery" Isn't Necessarily Great Advice - A Photo Essay