Saturday, March 30, 2013

Saturday Stories: Nannies, Homeopathy and the Harlem Shake


Sarah Conly in the NYTs gives 3 cheers for the nanny state

Bioethicist Chris MacDonald questions Rexall's (a Canadian pharmacy chain) homeopathic offerings.

Kevin Ashton explains how you didn't make the Harlem Shake go viral, corporations did.

[And if you don't follow me on Twitter or Facebook, here's this week's US News and World Report piece on the risks of second hand junk food, and embedded below is the Al Jazeera piece I helped with in interviewing Sugar Salt Fat's Michael Moss]



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Friday, March 29, 2013

Heavy Metal Toddler Sings About Laundry and Little Red Riding Hood

She seems like a sweetie!

Today's Funny Friday just goes to show you anyone can love metal.

Have a great weekend.

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



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Thursday, March 28, 2013

What Did You Expect? Coca-Cola's Newest Anti-Obesity Ad Blames Chairs, Not Coke.


So did anyone honestly think Coca-Cola cared about obesity? That the Superbowl Coca-Cola halftime ad that talked of all calories counting meant that they'd encourage people to drink less of their sugar water?

Silly world says Coca-Cola. It's not about the sugar water. It's about chairs. Chairs make people fat.

Here's Coca-Cola's first missive in its new found commitment to "fight overweight and sedentary lifestyle" shows a man rising up against the chairs of the world....and buying the 10 teaspoons of sugar water otherwise known as a fully loaded 12oz Coke.

Again, you really can't make this stuff up.

[UPDATE #1: After you watch the video vilifying chairs, make sure you click here to have a gander at some absolutely delicious sugary irony

UPDATE #2: After a few folks questioned the veracity of the ad suggesting it was a fake or a parody I contacted Publicis Spain (the agency credited) and they responded to tell me that it is indeed a real Coca-Cola advertisement]



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Wednesday, March 27, 2013

Badvertising: Cherry 7-Up Antioxidant. No That's Not a Typo

The next time you get into an argument with an apologist for the food industry who suggests that your concerns for the industry's lack of ethics are unfounded please just pull out this post and photo.

Behold - Cherry 7-Up Antioxidant.

From the you can't make this stuff up file.

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Tuesday, March 26, 2013

Why The Food Industry is Neither Friend nor Foe

This past weekend I had the pleasure and honour of debating Dr. Derek Yach at the American Heart Association's Epidemiology and Prevention, Nutrition and Metabolism Conference and the debate we were asked to have was entitled, "Food Industry: Friend or Foe". While I argued the "Foe" side, I actually think the debate title was a misnomer. Ultimately the food industry is neither friend nor foe as both assume that industry has the luxury of consistent intent beyond profit.

I don't think that it does.

That's not a mean spirited statement, just a truthful one as were a corporation to promote a product or program that ultimately undermined the corporation or their profits, that product or program would be dropped - just as we saw when Campbell's re-salted their soups, when Ruby Tuesday's lost their now legally required pre-emptive posting of calories on menus, and when Dr. Yach's former employer PepsiCo renewed their commitment to their core brands by upping their advertising buys for sugared soda and hiring teen idol Beyonce to be a brand spokesperson despite their stated aim of becoming the world's most profitable health and wellness corporation.

Ultimately if profits align with health then the food industry is absolutely going to be public health's friend. And if profits and health collide, then the food industry is absolutely going to be public health's foe. And honestly I think it's a failure of both sides of this argument to consider industry's ability to circumstantially be both friend and foe that leads to the black and white arguments that we should either be working with, or shunning industry.

My line in the sand in the debate was my usual one. I think dialogue, debate and the individual provision of counsel to the food industry in the grand scheme of things may well be in public health's best interests as it may in fact help industry to find those rare areas where health and profits do indeed collide, however once we add our institutional backing to the food industry I think we provide them with an almost irresistible means to further sales, whether by positive brand associations, misguided co-branded sales, ammunition with which to fight industry unfriendly legislation by validating the claim that they're working with so-and-so to be part of the solution, and the co-branded promotion of nonsensical messaging like balancing energy intake with output (never you mind our sugar water, you just need to exercise). Consequently I don't think public health organizations should formally partner with the food industry.

I'll be using the same slide set at the Canadian Obesity Network Conference in May where I'll be part of a panel discussing this very topic and I'm hoping to post them then. And hey, if you're near to or wanting an excuse to visit Vancouver between May 1-4, the conference looks great!

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Monday, March 25, 2013

The Weight Loss Surgery Foundation of America and Me in May in Vegas

On Saturday May 18th I'll be speaking in Las Vegas on behalf of the Weight Loss Surgery Foundation of America (WLSFA) at their annual Meet and Greet. I certainly won't be the only speaker for this two day event and the keynote speaker this year is Carnie Wilson.

So who are the WLSFA?

They're a charitable organization that raises money to help pay for bariatric surgeries for those who can't afford them.

For those of you who don't know, I'm not a surgeon, but I am a supporter of bariatric surgery. Despite the public's regular knee jerk negativity to bariatric surgery (that folks who need simply aren't trying hard enough, that it's an easy way out, that it's the path of laziness, etc.), when performed by skilled surgeons, and when supported by well designed pre and post surgical education and appropriate patient selection, it increases life expectancy, decreases or cures many medical co-morbidities and improves many aspects of quality of life. I've covered this strange bias before on my blog when it came to the surgical management of diabetes, and if you're in the camp of surgery is just plain wrong, every time and for everyone, I'd encourage you to read it, as the message therein applies wholeheartedly to bariatric surgery as well.

Now bariatric surgery isn't a miracle and it has both risks and adverse effects, but I'll tell you, if I were unable to lose weight and maintain that loss any other way, and if my weight was negatively affecting my quality and quantity of life and health, I wouldn't hesitate to explore it as an option.

My talk will be the first one I'm giving from the pages of my upcoming book, The 10 Day Reset: Why Everything You Know About Dieting is Wrong and How to Fix It, and I'm excited to be able to donate my time, energy and thoughts to this worthy cause. If you or a loved one has bariatric surgery or are considering bariatric surgery, I'd encourage you to come on out.  If you'd like to attend you can either click that link up above, or contact the WLSFA directly by phone at 415-234-9074, or via email at: info@wlsfa.org

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Saturday, March 23, 2013

Saturday Stories: Twix (sort of), Willpower and More on Big Cup Bans

Great short post from my friend Hemi Weingarten the founder of Fooducate on front of package calorie labeling and chocolate bars.

Friend, former overweight kid, now co-founder of Fitocracy and fitness phenom Dick Talens on the myth of willpower.

The NYTs Mark Bittman with a great piece on the failed (so far) Bloomberg cup size ban.

[And if you don't follow me on Facebook or Twitter no US News and World Report column this week, but I did do a segment you can watch with Canada AM on the recent abstract that says drinking soda will kill you.]

Also, here's a research request from some folks over in Toronto working on a new health screening tool for kids:
"Calling all health care practitioners with an interest in paediatric healthcare! Researchers at Holland Bloorview Kids Rehabilitation Hospital and the University of Toronto are looking for Physicians, Dietitians, Nurses and Health Psychologists to participate in a short, anonymous online survey (click here) to share their opinion on the development of a new health screening tool for children: The Healthy Body Scorecard.  It aims to address some of the limitations associated with the use of Body Mass Index (BMI) alone and provide a user-friendly tool that will help identify the heath needs of children aged 2-18. Everyone who completes the survey can enter a draw for a $150 gift card."


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Friday, March 22, 2013

True Facts About the Dung Beetle

Today is Friday! And that means it's time for a break from anger and consternation.

Today's Funny Friday video is more from Ze Frank's brilliant series of "True Facts".

Have a great weekend!

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



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Thursday, March 21, 2013

Biggest Loser Pediatrician Joanna Dolgoff Promotes Unsafe Weight Loss to 7 Million Viewers?

Screencap above and show transcript down below courtesy of Shannon Russell
This story will be told primarily in tweets. Not mine, but rather Dr. Dolgoff's.

So is rapid weight loss in children safe?

Not according to Dr. Dolgoff.

Here's her tweet from January 7th where she appropriately cautioned a 15 year old that losing 36% of her body weight in just 29 weeks and 3 days was not safe.


It's a message reiterated regularly and appropriately by Dr. Dolgoff in her recent Twitter stream.

Here she cautions that weight loss should be "slow and steady",


Here she reiterates that rapid weight loss in children isn't safe,


And here she explains that the Biggest Loser approach, one that sees adults losing between 25% and 50% of their weights in 22 weeks (there's no clear answer as to exactly how long the show is. Best guesses out there are somewhere between 20 and 24 weeks and The Biggest Loser executive producer Dave Broome, when I asked him on Twitter, ignored me) is extreme and unrealistic,


The reason Dr. Dolgoff cautions against rapid weight loss in children is twofold. Firstly the only way to lose weight rapidly is to take on extremes of effort - dramatic under-eating and massive over-exercising - neither of which represent a sustainable strategy for anyone at any age. More importantly though, when it comes to rapid weight loss in children it's thought that rapid weight loss potentially risks negative effects on pubertal development and on lean tissue, while simultaneously putting children at greater risk of developing eating disorders.

But don't take my word for it, here's Dr. Dolgoff's own website from back in 2011 on the subject of rapid weight loss in children (the admonition is still on her program Red Light Green Light's page, but thanks WayBackMachine for providing a version that can't be altered by the site's owners),
"Child weight loss is very different from adult weight loss for many reasons. First and foremost, children need a sufficient number of calories to support their growth and development. We cannot limit fat as much as we do in adults because children need fat for continued brain development. We also don’t want to limit carbohydrates which are essential for growth and energy. In fact, most studies show that low carbohydrate diets are neither safe nor effective for children.

It is not safe for children to lose weight too quickly. Weight loss in children must be closely monitored by a doctor to make sure that no nutritional deficiencies are developing and that growth and development is appropriate. We recommend that all patients see their pediatricians routinely while following our program.

We aim for a slow, steady, and healthy rate of weight loss, approximately one half pound to one pound per week. It is not safe for children to routinely lose weight more quickly than that. Of course, there may be some weeks when your child loses more than one pound but in general, sticking to a half pound to one pound per week is ideal.

Remember, your children are still growing. So even if they don’t lose a pound (but rather maintain their current weight) and continue to grow, they will get thinner. We call this “growing into their weight”. In fact, for younger kids, we don’t aim for any weight loss; we aim for weight maintenance and continued growth
.
"Ok, so Dr. Dolgoff really isn't a fan of rapid weight loss in kids.

Or isn't she?

Last week on The Biggest Loser Dr. Dolgoff was shown congratulating 13 year old Biingo on losing 25% of his body weight in just 11 weeks! Now to be fair, TV is a manipulated media so perhaps that segment was shot past the 11 week mark, but certainly it wasn't presented to viewers as such. Instead it was presented to them as Biingo's 11 week accomplishment. Here's a transcript of what she said to Biingo (and to America),
"I have here a body mass index curve, it's a way to measure levels of body fat, and when we first met you, you were in the purple and at a real risk for medical problems. In just a few months of making healthy choices, you have gone from the purple all the way down to the yellow. Biingo has lost 25% of his body weight."
And here's her excited tweet:


Then at the finale this past Monday we found out that 13 year old Biingo lost 43lbs in the 22 weeks, 13 year old Lindsay 47lbs and 17 year old Sunny 51lbs and though they didn't announce percentiles I'd venture that each and every one of their losses represented somewhere in the neighbourhood of losing near 30% of their body weights in just 22 weeks. For the show's children to lose 30% of their body weights in just 22 weeks puts their results right in line (and even in some cases exceeding) those of the show's adults, especially when considering not fully grown 13 year olds' resting energy expenditures are likely less than those of fully grown, taller, heavier, adults. What that means to me is that the kids, while not living on the ranch but while under Dr. Dolgoff's supervision and oversight, were as or more extreme in their weight loss efforts than the show's over-the-top, run till you puke, never eat a cookie, competing for $250,000/$100,000 adults.

And while these massive weight losses in barely pubertal children may have put the kids at personal risk, what of the viewers' children? Roughly 7 million people watch The Biggest Loser, which means 7 million people have just been taught that children, if pushed hard enough, if they just want it badly enough, can lose dramatic amounts of weight in truly rapid fashion and that pediatricians support that degree of loss. I wonder how many parents who watched The Biggest Loser this year are going to start riding their overweight children and forcing them to undertake incredible amounts of exercise while simultaneously severely restricting their diets thinking that's their kids' tickets to slim?

Sigh.

So are there any thoughts out there as to why Dr. Dolgoff's caution against rapid weight loss for the 15 year old hoping to lose 36% of her body weight in 29 weeks didn't apply to the three children she regularly reports on Twitter that she "loves" whose care she was responsible for overseeing while on The Biggest Loser? Or why she's comfortable serving as a cheerleader for a show that teaches America that rapid weight loss in children is awesome when she clearly appears to have at least once thought differently? Has she simply changed her mind?

American Academy of Pediatrics - would still love to see some actual leadership from you on this one. You need to speak up about kids on this show. You're failing them on this.

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Wednesday, March 20, 2013

Read This If You're Trying to Cultivate a New Habit

People talk about cultivating new habits all the time. While I've busted the 3 weeks myth over on US News and World Report thinking on habits led me to ponder flossing.

Flossing is easy, cheap, quick and good for you. And I'd bet there are truly large numbers of people out there who despite on occasion going through spurts of months of regular flossing, fall off the flossing wagon.

Why?

Because flossing fails to fall into the two categories of things that truly allow us to form "habits". Those two categories are easy to define. There are those things we actually enjoy doing and those things we simply must do. For the actually enjoy category it's certainly not difficult to sustain those behaviours and often this category includes behaviours that may not be "good" for us like snacking on junky yummy food, after dinner drinks, favourite show watching, obsessive social network checking, etc. The must do category on the other hand, that'll include things that we might not honestly enjoy, but things we simply don't have a choice but to do and might include getting up each week day to go to work or school, cleaning up after our kids, etc.

Flossing?

Not sure there's anyone out there who'd say that they "enjoy" flossing, and certainly there's no truly immediate repercussions of not doing it to suggest it must be done, which may well be why in my own life, despite having had 6 month or longer stretches of daily flossing, I've also had those stretches end for no particularly good reason - this despite the fact that I'd been doing it for quite a long time, long enough that I might have thought it was a "habit".

If you're aiming to improve upon your lifestyle, diet or health, your best bet is to try to find a way to truly enjoy your desired change, or more likely, convince yourself that it is something you simply "have" to do (for instance I am not a natural lover of exercise, but I've convinced myself it's something I have to do - both in the context of walking my talk, and also in the context of setting a good example for my children), because otherwise, just like flossing, what might feel like a truly established habit can disappear in a flash....until of course the week before your next dentist appointment.

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Tuesday, March 19, 2013

Juice is NOT a F@*#$*&g Fruit!


In case you're not aware, Canada's official Food Guide formally recognizes half a cup of juice as a fruit equivalent. This of course despite both the Canadian and American Pediatric Societies putting a half cup maximum on juice consumption in young children and a full cup for everyone else.

Not surprisingly  juice manufacturers hone right in on the Food Guide's recommendations and use them as a means to market their products to parents like that seen on the advertisement for grape juice up above. And don't forget too, children are taught the Food Guide as gospel in grade school and it serves as the backbone of any institutional food program (including daycares and preschools).

So are Canadian children drinking too much juice?

Good god yes.

A recent study published in Applied Physiology Nutrition and Metabolism set out to determine Canadian fruit and vegetable consumption.

Their findings?

The average Canadian child between the ages of 2 and 8 is consuming 50% more than their recommended juice maximums. But that's not the whole story. Some kids are chugging tons of the stuff with the 75th percentile of 2-3 year olds drinking 2.5x as much which means 25% of Canadian preschoolers are drinking even more than that!

Juice is sugar water with vitamins. It has drop per drop the same amount of sugar as soda pop and in some cases more (like that grape juice which has double the sugar of Coca-Cola - 10 staggering teaspoons a glass). Liquid calories don't satiate, and they don't pack the fibre and phytonutrients of actual fruit.

So do you think the Food Guide's inclusion of juice as a fruit, or to put it differently the Food Guide's failure to admonish against juice consumption might have something to do with its consumption among Canadian preschoolers?

I sure do. And while it's not true causal proof, looking to Australia, a country where their Food Guide explicitly discourages juice consumption and sets the same half cup maximum as the Canadian and American Pediatric societies, my read of this report has their average 2-3 year olds drinking only a third of a cup of juice a day.

Bottom line?

Our Food Guide stinks and what it says does matter.

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Monday, March 18, 2013

Guest Post: How a 7 Year Old Boy Came to Ask, "Do I Look Fat?"

One of my Facebook readers sent me a message telling me about the experience she had after allowing her son to watch a few episodes of this season's The Biggest Loser. I asked her if I could repost it as a guest blog.

Meet Tara Newman.  She is a mom, fitness enthusiast, and an advocate for healthy living. She has a Master's Degree in Organizational Psychology and works full time as a Human Resources Manager. She spends most of her time trying to keep up with her active family.

How a 7 Year Old Boy Came to Ask, "Do I Look Fat?"

My son recently told me he wants to be 100 pounds so he can be on TV. You’re probably thinking “What an odd comment,” or “Where did that come from?” Well, you see, I allowed my seven-year-old child to watch The Biggest Loser this season – the first to feature kid participants.

I am not writing to critique the show, give advice, pass judgment or claim to have any answers. I am not a doctor, nutritionist, registered dietitian, exercise physiologist or even a personal trainer. I am simply sharing my experience as a mother, fitness enthusiast, and health-conscious individual.

I know some of you started judging me the second you realized I allowed my son to watch The Biggest Loser. That’s okay, I have thick skin. However, I think you will see that I am a fairly rational being who meant no harm. I might even be a bit like you.

I am a working mom with two kids. Like many of you, my life gives new meaning to the word busy. Aside from my own activities, my husband competes in triathlons, and my kids have their fair share of athletics. Family fun day is always an active experience.

We are conscious eaters. Our diet consists of loads of plants and limited prepackaged items. We steer clear of preservatives as much as possible. And absolutely NO high fructose corn syrup or hydrogenated oils. We participate in a CSA (community supported agriculture) program, which allows us to show the kids where our food comes from. If they’re at a birthday party, they eat the cake. We strive for balance without instilling any body image issues or phobias.

When I let my seven-year-old watch The Biggest Loser, my goal was to expand his worldview by observing people who live differently, have him hear what it’s like to be an overweight child, and (hopefully!) help him understand why Mommy and Daddy work hard to ensure we live the healthiest lifestyle for us. I am not an over-analyzer and have a pretty positive personality; it didn’t even cross my mind that allowing my son to watch the show might have any negative outcomes.

Having kids on the show made it seem more appropriate. Otherwise I would have deemed it adult content. I don't usually watch the show. It’s not representative of our lifestyle or beliefs. It seems strange now that we watched this season at all, let alone as a family.

As my son watched these episodes, he did what I expected. He expressed empathy for the contestants as they shared their life stories. He cheered them on as they faced their challenges and weigh-ins. He was angry when these children spoke about being bullied. He spoke about how he felt lucky to grow up in a house where everyone was “healthy” and had active lifestyles.

What I didn't expect were the random “Do I look fat?” or “Am I getting fat?” or “Can I step on the scale?” questions that started creeping into our daily dialogue. I was blown away the day he said he wanted to be 100 pounds or more so he could go on TV. (For reference, my son is about 58 pounds, medium height with a muscular build.)

I didn't dwell on his desire to gain weight so he can be on TV. Not that I didn't take it seriously, I just didn't think it was something I wanted to “play up.” As a mother, my wish to do right by my children trumps all. I do believe when you pay too much attention to something, it begins to grow into something greater than it might really be – kind of like the boyfriend you kept around too long because your parents despised him.

I like to focus my kids on what they CAN do instead of what they can’t do. As the situations above came up, I continued to redirect him (and my daughter) to our family’s healthy habits: we get plenty of sleep, we drink water, we eat lots of fruits and veggies, we try new things (especially foods), and we get our hearts pumping.

Before writing this post, I spoke to my son about his experience watching The Biggest Loser. Did he really want to gain weight just to be on TV?

My son talked about healthy habits but admitted he didn't learn them from the show, he learned them from Mom and Dad. He also admitted that while he knows he shouldn't want to be over 100 pounds, being on TV would be “really cool.” Alas… the mind of a seven-year-old.

I don’t regret my decision. I take full accountability for my actions. I was able to reinforce the importance of positive body image and discuss healthy weight loss with my son. Building healthy, fit, well rounded, and emotionally well adjusted kids starts in the home and has nothing to do with mass marketed ‘reality’ TV.

Be confident in the life you lead, be present in the decisions you make, and be cautious of how you go about trying to expand your child’s worldview.


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Saturday, March 16, 2013

Saturday Stories: Convenience, Losers and Low-Carb Athletics


A must read piece from the Atlantic looking at whether or not convenience meals actually save families time.

This one's an oldie, but an interview with yet another Biggest Loser alumnus on just how awful life on the Biggest Loser ranch is and more behind the scenes dirt regarding injuries and weights.

Here's Alan Aragon recounting his recent debate with Jeff Volek regarding low-carb's value to high level athletes (and in so doing tweaking my own personal confirmation bias that while low-carb may be great for some, one size certainly doesn't fit all when it comes to diets)

[And if you don't follow me on Twitter or Facebook, here's the interview I did on Air Talk with Larry Mantle regarding the ethics of kids being on the Biggest Loser with executive producer David Broome, and here's my weekly column for US News and World Report and what I see as the inconvenient truth of healthy living.].

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Friday, March 15, 2013

There Are Some Papers iPads Can't Replace!

Today's Funny Friday video comes from blog reader Cheryl and in just a few short moments this brilliant advertisement covers at least one piece of paper the iPad can't replace.

Have a great weekend!

(email subscribers head to the blog to watch)



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Thursday, March 14, 2013

Sandbags, Swimming Lessons and Soda Cups


According to the Director of Yale’s Prevention Research Centre David Katz, as a society when it comes to obesity we’re facing a flood. I’d argue we’re facing many. We’re facing a flood of empty sugary calories. We’re facing a flood of childhood obesity and we’re facing a flood of diet related chronic diseases. And all of these floods have been here for some time now. In regard to obesity, rates have been rapidly rising for decades and while there have been a few hesitant blips here and there suggesting a leveling off or even slight dips, in a best case scenario that would signify that our flood waters have crested which while certainly better than rising, is far from reassuring. In regards to empty sugary calories and more specifically those coming from sugar sweetened beverages, the recent and slight dip in soda consumption may well be more than offset in the sharp rise in sugar-sweetened sport and energy drink consumption and still sees soda consumption at rates nearly double those of the 1970s. In regards to diet related chronic diseases what I was taught in medical school in the 1990s as “adult onset diabetes” is now regularly diagnosed in elementary school aged children. There’s no denying these are floods.

When faced with a literal flood rather than these proverbial ones, a government’s responsibility is clear - mobilize resources and get to work - first building levees and then ultimately upgrading infrastructure so as to guard against a future recurrence. Levee building follows a pattern too. Fill more sandbags than are likely required and stack, stack, stack, where no single sandbag would ever be expected to do the job in and of itself.

So what sort of response has government adopted in response to our combined floods of obesity, added empty sugars and diet related diseases? For the most part, and with rare exceptions, rather than build levees and stack sandbags the government’s primary response has been to focus on swimming lessons and to suggest or support the notion that personal responsibility, education and attention should serve to deal with these floods rather than sandbags.

Two days ago we saw the demise of a novel sandbag in New York City when State Supreme Court Justice Milton A. Tingling Jr. quashed the plan that would have seen a New York City ban on the sale of servings of sugar sweetened beverages larger than 16oz - a size which in the 1950s Coca-Cola advertised, “Serves 3 Over Ice-Nice”. Justice Tingling ruled that this sandbag was imperfect as it left other sugar-sweetened beverages like flavored milk off the hook, that it would not be stacked in each and every levee, and that it would be difficult to administer. No doubt there is truth in all of Justice Tingling’s concerns. The cup size ban would be difficult to administer, wouldn’t affect sales of even 2 liter bottles of the stuff in corner stores, and no doubt would not in fact stop the overconsumption of sugary beverages. But it would have been a sandbag.

The inconvenient truth here is that we do have a flood, and until we stop equivocating over making perfect sandbags, people, including our children, will continue to drown as our experiences with the rising flood waters of the past 30 years have clearly demonstrated that no amount of swimming lessons are sufficient to fight the relentless current that’s sweeping us to ill health. Flooding precludes the luxury of perfection, and until the government recognizes that fact for these very real floods and starts stacking sandbags, don’t expect the flood plains to empty any time soon.

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Wednesday, March 13, 2013

Washington's Bethel School District Is Part of the Problem


On February 28th I received an email from an employee who wishes to remain nameless who works for Washington's Bethel School District.

That email contained two emails, sent just 5 hours apart, that clearly demonstrate that Bethel School District just doesn't get it.

The saddest part is that I've no doubt these emails are representative of the norm, not the exception.

We need to disentangle ourselves from our normalized reliance and embrace of junk food and Bethel School District should know that providing every district employee (that's who the emails went out to) with encouragement and permission to eat out is part of the problem and not part of the solution.
2/28 3:05pm

Hey Everyone,

Roy Elementary would like to invite you to join them for their McTeacher Night. It is scheduled for TONIGHT, Thursday, February 28th from 5-7pm at the McDonalds located at 14900 Pacific Ave. in Spanaway.

2/28 8:25pm

Child Nutrition staff are selling Leonardi's pizza to raise money for their chapter (these are delicious pizzas!)

Money raised will be used for a scholarship for a student who will be applying themselves into the culinary arts program. Each kitchen will be taking orders now through March 7, 2013:

Pepperoni Pizza, Sausage Pizza and Cheese Pizza, 2 Pizzas for $15 or $8 each

Orders will be picked up by Child Nutrition staff on March 14th. You will need to pick up your pizza at Liberty Middle School on March 14 between 2pm and 4pm. These pizzas will be just in time for your St. Patrick's Day festivities!

Please contact your school's kitchen staff if you have questions or to place an order.

Checks should be made payable to: WSNA Bethel Chapter 30


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Tuesday, March 12, 2013

What Reading that Give Dieters Money to Lose Weight Article Actually Told Me

Wow did this paper get more press than it deserved, and it's not even a paper!

For background, if you haven't heard people are tweeting and posting links to a story that suggests, "Cash Can Coax Dieters to Lose Weight" while that same story has made headlines the world over.

Not one to post links to abstracts or press releases without reading the paper, but intrigued by the attention, I set out to find the paper and read the study.

So what'd I learn from the read?

Firstly that there's actually nothing to read. There is no published study. Here we're talking about an abstract that was presented 3 days ago at a cardiology conference.

Secondly I learned that regardless of the fact that the folks who were paid cash did better, "better" meant losing 9.1lbs in a year vs. 2.3lbs, and a dropout rate of 38% vs. 74%. Now the dropout rate in the cash group is pretty typical for a behavioural weight loss intervention, perhaps ever so slightly better than average even, but certainly nothing to write home about if the suggestion is that cash helps with adherence. And what's there to be made from the staggering 74% dropout rate in the control group that received the same freely provided intervention? My take is that the intervention they used must be truly awful as how bad does your freely provided weight loss intervention have to be to yield a drop out rate of 74%?

And what of the losses? 9.1lbs? Considering the press release reports the participants' average BMIs ranged between 30 and 40, the 9.1lb intention to treat loss to me sounds like pretty much what you would expect in a well designed behavioural weight management program without cash incentives, while the 2.3lb loss is lower than would be expected of a well designed program.

Lastly I learned that the abstract's presenter/author disclosed a financial relationship with a company called GymPact which as you might guess, uses financial incentives and disincentives in encouraging people to exercise.

The one thing I didn't learn is anything about long-term outcomes. I'd argue that especially with an intervention like monetary incentivization we need the long-term data as I'd bet that for many the money involved might lead them to "try harder" which while you might think that'd be a good thing, my experience has taught me the opposite. Whereby if the money led a person to be all the more strict with their lifestyle changes they'd be far less likely to sustain that degree of strictness when the incentive to do so disappeared.

I can't fathom why this abstract made headlines. The weight loss was minimal. The drop out rate abysmal. The study too short. And it's just an abstract! One thing however is certain - the fact that this abstract with really lame outcomes captured the world's attention is a truly terrifying statement as to what passes for news these days when it comes to obesity.

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Monday, March 11, 2013

8 Year Anorexic's Mom Cites The Biggest Loser as Potential Contributor to Daughter's Illness

In 2008 The Cutting Edge did a documentary on Dana, an 8 year old anorexic and recently a friend on Facebook sent it my way.

In it they cover the rising rate of eating disorders among ever younger children where according to the show in Britain between just 2006 and 2008 the number of children under 10 admitted to hospitals with eating disorders rose by 50%.

Dana did well in treatment and was discharged home and in the wrap up interview her mother pondered the genesis of her daughter's struggles,
"I always feel it was just a few things that clicked together like a jigsaw.  One, she started watching this program called America's Biggest Losers, it's a weight loss challenge. I did see her watching it. I just didn't really consider it dangerous. I didn't you know, she's never been a kid that had even mentioned dieting. It just clicked into place. If you don't eat, you lose weight and watching this weight loss challenge program about how they're all trying to give up food, it was just a combination of things that happened together".
The documentary is frightening. The residential eating disorder treatment home's director had this to say on their increasing number of under 10 year old patients,
"I worry very much that we're so many younger and younger children. They are being robbed of their childhood these days. Children as young as 5 and 6 are sitting in the playground discussing the shape of their bodies, talking about the fat that they've got and the fat bits that they would rather not have. You can't underestimate how serious it is."
If you'd like to watch the documentary, click here or watch below, and please, don't let your children watch The Biggest Loser and better yet, don't watch it yourself:



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Saturday, March 09, 2013

Saturday Stories: Trolls, Cheerleading, Amazeballs and Guerrilla Gardening


The New York Times covers the science of internet trolls.

Tom Laskawy in Grist and a great open letter to Michele Obama explaining how being a cheerleader for the food industry isn't likely to help.

My friend and fellow MD blogger Bryan Chung with some awesome irreverence on the recent eat protein for muscles story (and that's his photo I ripped off up above).

Here's a bonus TED Talk (email subscribers you'll need to visit the blog to watch) from Ron Finley on guerrilla gardening (h/t to CHEO's Dr. Stasia Hadjiyannakis)



[And finally some extras from me. My weekly US News and World Report piece this week was on why I think baked chips are worse than fried, and here's a clip from the CBC with me ranting about the need to stop focusing on individuals and start changing the environment in the context of Ontario's recent Healthy Kids panel report]

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Friday, March 08, 2013

True Facts About the Land Snail

This Funny Friday video appeals to the little boy in me who used to spend Saturday and Sunday mornings watching nature shows, and the big boy in me who's full of snark.

Have a great weekend!

(Email subscribers - visit the blog to watch)



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Thursday, March 07, 2013

How I Earned the Ontario Public Health Association the Threat of a Lawsuit

So as regular readers are aware last week I gave an invited talk to the Ontario Public Health Association at a Marketing to Children conference.

Part of my talk included a screen capture of a press release from Food & Consumer Products of Canada (FCPC) that highlighted the appointment of their Vice President, Food-Policy, Science & Regulatory Affairs, Phyllis Tanaka (that's the screen cap up above, and here's the link to the press release).

According to the Government of Ontario's Newsroom, members of the Healthy Kids Panel,
"are recognized leaders in their fields, possess a broad understanding of childhood obesity, and are connected to different sectors and communities including....consumer products"
According to the FCPC their organization serves as,
"the voice of more than 100 businesses in the consumer packaged goods industry."
and where they report the FCPC,
"promotes sound public policy, champions initiatives that increase productivity and profitable growth and helps to protect the safety and security of the consumer product supply through a commitment to scientific and supply chain excellence and industry best practices."
Among the corporations spoken for with the voice of the FCPC are PepsiCo, Mars, Frito Lay, Hershey's, Nestle, McCain - and the list goes on.

Now for those who don't know, the definition of a conflict of interest includes even the perception of there being the possibility of a conflict, and given that public health is not part of the mandate of the FCPC, it struck me that Ms. Tanaka's inclusion on the panel was in conflict with the panel's expressed aim. And because Ms. Tanaka was in the audience during my talk, rather than simply flash a photo of her in a press release on screen and have people whisper, I mentioned that she was present when I discussed how I felt the FCPC should never have had a voting seat at a table where the votes would impact on their members' products' sales. I also explicitly pointed out that my statement had nothing to do with Ms. Tanaka as a person, that I didn't know her personally, and that my expectation of any member of that panel would be to represent their professional interests and expertise. I also pointed out that when I testified in front of the panel itself the only person who was furiously taking notes was Ms. Tanaka and I speculated that perhaps it was because my concerns, if acted upon or championed by the panel would be of concern to the FCPC's member corporations.

Following my talk Ms. Tanaka corrected me and told me that I had mis-characterized her note taking and that note taking was her habit and she was doing so for her benefit and for the panel. I apologized for the mis-characterization and did not bother pointing out at the time that there were official secretaries present during my talk to the panel. I also asked Ms. Tanaka what would have happened had the panel come out with a recommendation that very negatively impacted upon an FCPC member's product - would that put her in hot water with her boss? She informed me that she was on the panel as an individual, and was not representing the FCPC there.

The interaction was cordial. No voices were raised. No names were called. Nor did I ever dispute or question the veracity of Ms. Tanaka's answers to me.

Yet the next day the OPHA was contacted by the FCPC's Senior Vice-President Derek Nighbor who was very upset that I mentioned Ms. Tanaka by name during my talk. He demanded that said slide (the one with the FCPC press release congratulating Ms. Tanaka's appointment to the panel - the press release that too names Ms. Tanaka) be redacted from my presentation, that a report be made to the OPHA's Board of Directors, and that a letter of apology be sent to the FCPC and Ms. Tanaka. He also threatened to send a letter of complaint to Health Minister Deb Matthews and to sue the OPHA - though he did not make it clear to the OPHA what grounds the lawsuit would cover. He did not however attend my talk, nor did he attempt to contact me with any of his concerns.

I'm writing this blog post to apologize to the OPHA. I'm sorry that me calmly and politely speaking my mind led them to have to expend their time and energy dealing with the FCPC.

I also reached out to the FCPC. Not to apologize as truly I don't feel that it was wrong of me to mention a perceived conflict of interest, nor do I feel I was at any point rude or disparaging of Ms. Tanaka, but rather to try to understand what had gone on from their perspective. You'll find below an unedited response from Mr. Nighbor which as is my convention, is presented without commentary from me.

I know that I had some blog readers at the talk. Would love their opinion as to whether or not my talk or our question and answer period afterwards was disrespectful, and if it was, I certainly would like to extend my apologies to Ms. Tanaka as disrespecting her was not my intent.

What was my intent?

My intent was to point out that Frito-Lay's and PepsiCo's interests should never have a vote or even a perceived representation at a public health table due to the clear conflicts of interests involved in the inclusion of food industry representatives in the creation of public health policy involving food. I'd further argue that the reaction of the FCPC to my talk and what strikes me as an attempt to intimidate the OPHA is a clear example of how the food industry and public health aren't on the same team and that were this really about what I said at the conference, it'd have been me receiving the angry phone call and the threats.
Hi Yoni,

Thanks for your note and the ability to clarify a few things.

Let me be very clear - in my conversation with Ms. Cheng, a formal suit was never threatened against the OPHA.

I merely called Ms. Cheng to state my concern about how you questioned Ms. Tanaka's role on the Healthy Kids Panel as part of your presentation at the OPHA event - and that the positioning of your attack could be perceived as slanderous.

Ms. Cheng unfortunately misplaced the context of that discussion in her letter which makes it quite misleading.

The point I raised with her was my disappointment that, at a public forum, you would use a photo of Ms. Tanaka and name her. To me, it was straight-up inappropriate and a personal attack - as thought a host of others who were there to see the presentation and called to tell me what happened after.

Furthermore, I think it's important that you understand - contrary to your suggestions - that Phyllis' role as part of the Ontario Healthy Kids Panel was treated by her with the utmost of confidence - and that was supported and respected by FCPC.

Phyllis and our organization took this commitment very seriously - so much so that FCPC and our member companies were not privy to any of the HKP discussions - nor the report before it was released to the general public.

Yoni, we will likely disagree on a host of issues, but for me it's about a fair and honest exchange about the issues.

Challenge away at some industry practices, debate the issues, let's in some cases simply agree to disagree - but the attacks against specific individuals should be left on the sidelines.

Many thanks for reaching out and do contact me directly if there's anything else.

Derek.


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Wednesday, March 06, 2013

Why I Don't Support a Junk Food Advertising Ban for Children

Simple.

It's not enough.

It's not enough for a number of reasons.

Firstly it's not enough because why should anything be advertised to a population that has been shown to not be able to discern truth from advertising? If we're talking ethics, it's plainly unethical to allow advertising to target children. Period.

Secondly it's not enough because at least one recent study suggests the possibility that advertisements for food, any food, even healthy food like fruit, paradoxically lead children to increase consumption of calories and unhealthy dietary choices.

Thirdly it's not enough because there's no agreed upon definitions for what would constitute unhealthy food. In turn not calling for a total food advertising ban at best necessitates long and drawn out discussions to try to define unhealthy and at worst, simply paralyzes the process.

Lastly it's not enough because even if a definition of "unhealthy" is agreed upon, food manufacturers will take advantage of the new definition of "unhealthy" to make products that come in one squeak better than that - and then not only continue to market them, but to market them with their newly found health halo - because after all, if they're allowed to advertise them, consumers will automatically assume that they must be "healthy".

And I'm certainly not the only one who feels this way as evidenced by a wonderful paper coming from a whole boatload of Canadian friends and colleagues from across the country. Published just last week in the Journal of Public Health Policy (and freely accessible) is a paper entitled, Restricting marketing to children: Consensus on policy interventions to address obesity where their evidence based consensus opinions include the following stronger than the recent Health Kids Panel report's recommendations:
  • A Canadian (federal) government-led national regulatory system prohibiting all commercial marketing of foods and beverages to children under 18 years of age, with exceptions for 'approved public health campaigns promoting healthy diets'
  • That regulators set minimum standards, assure monitoring of compliance, and impose penalties for non-compliance.
Importantly they also define marketing in a realistically broad sense of the term,
"We recommend adoption of a broad definition of marketing that includes, but is not limited to, all media through which children are or can be targeted, such as ‘sponsorship, product placement, sales promotion, cross-promotions using celebrities, brand mascots, or characters popular with children, Websites, packaging, point-of-purchase displays, e-mails, and text messages, philanthropic activities tied to branding opportunities, and communication through ‘viral marketing’."
So while I was thrilled to see a call targeting advertising in Monday's Healthy Kids Panel report, it's not enough, and moreover, if enacted, would be almost certainly be ineffective and potentially even harmful.

And my bet is, the food industry representatives who were full voting members of that panel - I bet they didn't raise one peep of concern when a junk food advertising ban was suggested as it was the best possible advertising recommendation they could have hoped for. I'd go even further and bet that they were even vocal champions of it during the committee meetings.

Government! Next time, by all means let the food industry come to testify in front of the next such committee and ensure their concerns are heard, but for the love of god, next time, don't give them a vote.

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Tuesday, March 05, 2013

Why Ontario's Healthy Active Kids Panel's Report is so Important and Heartening

If you're an Ontarian by now I'm sure you've heard a fair bit about Ontario's release yesterday of the recommendations made by our Healthy Kids Panel.

I'm not going to go into a point by point discussion and dissection. Overall the report's solid. It makes 23 recommendations and as I was warned in an off the record chat with one of the panel members this past weekend, they might not be my top 23 items, but as I told the panel member, that's not what matters. What matters is that they're not all fluff, and more importantly what matters is that many of them have their sights set very squarely on the environment.

This is not your average Eat Less, Move More report. Instead this is a report that recognizes that the world in which we're raising our kids pushes them into the open arms of food marketers, of piles of sugar, and of boatloads of calories. Kids aren't trying to gain weight, their parents aren't encouraging them to eat poorly - that's just our new default - our new normal.

While it's no doubt going to take more than 23 sandbags to build a levee, and while no doubt some of these 23 sandbags are merely beanbags, while others may have a few holes in them, what's so incredibly encouraging is that this is in fact a levee building report, and not the usual tripe about how we're going to manage a flood by teaching kids how to swim.

More from me on one of the 23 recommendations tomorrow and where I think it missed a crucial mark, but for today, kudos to the panel, and kudos to our Health Minister Deb Matthews for making childhood obesity prevention a priority, and with this panel's help, for rightly identifying that it's the world around our kids that's the problem, and that the kids indeed are alright.

Fingers crossed too that this report, unlike many of our federally funded reports, does in fact translate into action, and isn't simply tucked into a drawer somewhere.

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Monday, March 04, 2013

How Does a Biggest Loser Teen Celebrate her Birthday?

Who knew, but according to Wikipedia we've associated birthdays with birthday cakes since as far back as ancient Rome, while archaeological digs have us celebrating with food for at least the past 12,000 years.

Food isn't just fuel. As a species we celebrate and comfort with food, and when we undertake efforts that deny food those roles in our lives, well those are called diets, and generally in the long run they fail. Human nature simply isn't built to suffer unnecessarily in perpetuity, and while thoughtfulness regarding dietary choice is certainly a requisite for a healthy life, being overly strict surely isn't thoughtful.

I've been highly critical of the inclusion of teens on this year's The Biggest Loser. My two main concerns can be boiled down to:

1) The teens are going to be taught that success requires a lifetime of sacrifice and suffering.

2) Being portrayed as lazy gluttons on prime time television, and being taught that if you just try hard and sacrifice enough you'll succeed, when coupled with the almost statistical certainty of regain in at least one, if not all the teens, puts them at huge risk of both increased future bullying, and tremendous damage to their own personal self worth and esteem.

Now the Biggest Loser has made it very clear - the kids are going to be treated more gently than the adult contestants, but of course the kids will be watching the show and are in fact being managed by the same team that the adults are - are they going to absorb the show's ultimate messaging - that weight is the only determinant of health and that there's no amount of suffering too great to get to some artificial number on a scale?

Sure looks that way.

One of the contestants, 16 year old Sunny, recently blogged about her seventeenth birthday in Seventeen magazine. Did she have cake? Well of course not, the show has taught her that she doesn't deserve cake if she wants to be "healthy". Instead her trainer, after an "exhausting workout", gave her, "a tiny, sweet mandarin orange with a birthday candle stuck into it" which according to Sunny, "was, hands-down, the best birthday cake I’ve ever tasted".

Honestly I wish Sunny and the other teens on the show all the luck and kindness in the world. I hope they prove my concerns to be entirely unfounded, me a blowhard idiot, and that their weight losses are permanent and their lives only blessed by their involvement with the show.

But I can't help but worry about the 17 year old girl who's been taught to think that birthday cakes are tangerines with candles in them.

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Saturday, March 02, 2013

Saturday Stories: Peanut Butter Felonies, Calcium & Vit D supplements, BPA, Cancer, and Death


Too many great stories this week so an extended edition!

Maryn McKenna and a fabulous piece in Wired on the recent peanut butter felonies - Shit, Just Ship It.

The delightful Marion Nestle shares her recent editorial on whether or not we should still be recommending Calcium and Vitamin D supplements.

Trevor Butterworth in Forbes interviews a world expert and non-industry funded expert on phthalates and other environmental chemicals on whether or not we've been told an evidence based truth regarding the risks of BPA

An anonymous woman shares the real life impact her cancer's diagnosis and treatment had upon her marital identity.

Propublica Health Reporter Charles Ornstein with an incredible and personal piece on the recent death of his mother Harriet.

[And in case you don't follow me on Twitter or Facebook, here's this week's US News and World Report column - how to fight back against your children's sugar and junk food pushers.]

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Friday, March 01, 2013

Toddler Takes First Steps and Proves Things can Always Get Worse

Stay tuned to today's Funny Friday past what you think might be the punch line to get to the real punch line.

Have a great weekend!

(Email subscribers, head to the blog to watch)



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