Tuesday, September 30, 2014

Just Because it Came from a Supermarket Doesn't Mean it's not Takeout

A short post.

You know those counters in the supermarket where you can buy prepared meals?

Well I've met quite a few folks over the years who believe because supermarket meals are prepared in an actual supermarket that somehow they're healthier than restaurant meals.

Sad to tell them (and you), that take-out's take-out, no matter where it's made. And chances are those supposedly healthier supermarket offerings are just as salty, sugary, and calorific as anything you'd buy in a restaurant.

Monday, September 29, 2014

Guest Post: Can a Food Charity Reject Food Industry Funding and Fundraising?

Today's guest post comes from Nourish Nova Scotia's Executive Director Margo Riebe-Butt. Nourish is a non-profit organization that supports nourishment and food literacy programs in school communities, and Margo reached out to me a little ways back to let me know how Nourish was set up from the get-go not to rely on food industry dollars and to overtly reject junk food fundraising and that it did so by way of governance. A good read for all health organizations and I've no doubt that were you to want a copy of Nourish' complete policies and procedures that Margo would be happy to oblige.

Dear Dr. Freedhoff,

It’s kind of you to understand the struggles charities face when trying to fund important programs and organizational operations through various fundraising activities, and I applaud you for calling out those that ought to know better. Charities are under constant pressure in an extremely competitive environment to get the almighty donor dollar. It appears in this day and age anything goes when it comes to bringing much needed funds—even if it runs counter to the cause. But does it have to be that way?

At Nourish Nova Scotia, we don’t believe this needs to be the case. We believe there is a different way, and we’re living that reality today. We will not accept money from Big Food!

We are people who believe that real food is the food your grandmother would recognize—minimally processed and wholesome. We are nutritionists, home economists, educators and parents who care deeply about the future of Nova Scotia. We are members of our communities who know that eating real food helps keep people, communities and our economy healthier.

At Nourish we know that well-nourished kids have better health and education outcomes. We work to support nutrition programs in schools to help achieve this. Our goal is to support the nutritional well-being of children and youth and to build their food knowledge and skills so they can feed themselves well into a healthy future. Right now we support 366 breakfast programs in Nova Scotia, and we have dreams of building on this foundational program to support school gardens, farm to school initiatives, lunch, snack and cooking skill programs. Our dreams are tempered by reality, and the reality is the need for money in order to do what we need to do.

Learning from the experiences of other agencies we realized in the early days that we could not follow the well-worn path by accepting money, partnership and sponsorship incongruent with our mission, while still remaining true to our purpose for being. We had to be brave, innovative and make bold decisions not to enter into partnerships that would compromise our integrity and more importantly, the health of those we serve. We decided to take the time to formulate an internal fund development/gift acceptance policy to guide our actions and decisions. It’s a comprehensive policy, and in the interest of brevity, I’ll share only pieces pertinent to charitable fundraising in this email.

Nourish Fund Development Policies and Procedures

Purpose of Policy
  • In order to achieve Nourish’s vision that all Nova Scotia children and youth are well nourished to live, learn and play, individual citizens as well as the public, private and corporate sectors need to be engaged. Nourish inspires support by maintaining the highest ethical standards in all its actions, demonstrating wise stewardship of its resources and employing equitable and transparent processes to this end.

  • Nourish Nova Scotia believes integrity is paramount in fulfilling its vision mission and purpose. Its intention at all times is to put the nutritional health and well-being of Nova Scotia’s children and youth first. Therefore its financial responsibilities will always be balanced against its social responsibilities. To that end, Nourish chooses its partnerships thoughtfully and carefully, in order to protect its brand and, most importantly, the children and youth that it serves.

  • The second of eight principles states:

    2. Nourish will seek to form meaningful relationships with individuals organizations and corporations that share our vision.*

    This principle is further defined:

    * Given the complexity of the food system, Nourish has made a conscious decision not to seek or enter into partnership with food industry. Exceptions to this decision may occur at some point in the future but involve only those that grow, produce, harvest and promote, what in our expert opinion constitutes real, whole-foods. Whole-foods contribute to the healthy development of children and youth and the good food environment we wish to co-create with generations of Nova Scotians. A careful and stringent review process will be followed to assess any such partnerships prior to any decision to partner.

    We also gave thought to our organizational structure, and how that effects decision making, most notably at the board level. We’ve all had experiences on boards where well-meaning volunteers bring their own fundraising ideas to the table. Board dynamics may be such that these ideas-which often run counter to the charity’s purpose, are accepted anyway. To that end we have developed a community engagement model structure that brings new volunteers and potential board members into the organization on one of four leadership teams. It is here that the bulk of the work for the organization is conceived and actualized. Volunteers have the opportunity to become orientated to the purpose and mandate of the organization over the course of a year or more, ahead of the opportunity to be nominated to the board of directors.

    We were very intentional in developing these policies and structures after we became incorporated and before we became a full-fledged charity. It was difficult to invest so much time and effort on policy development at the front-end of building a new charity. Because of our backgrounds and experiences we knew how imperative these foundational documents would be to the strength and integrity of our organization, and how these investments would serve us well down the road. If you would like more information on how our organizational structure helps to keep volunteers focused on our purpose, I would be happy to share.

    We face the same financial challenges as all of our charitable colleagues. We are proud to differentiate ourselves by taking the road less traveled and keeping the children and youth we serve at the centre of our work.

    Like you, we believe every health charity should be focused on wellness, and not fundraising by selling illness.

    In the sage words of Kermit the Frog….."It’s not easy being green.”


    Margo Riebe-Butt, RD
    Executive Director, Nourish Nova Scotia

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    Saturday, September 27, 2014

    Saturday Stories: Smoke Jumpers, Genetic Testing, and Tomatoes

    Glenn Hodges in National Geographic covering Russian smoke jumpers.

    Denise Grady and Andrew Pollack in the New York Times do a great job of covering the slippery slope of genetic testing.

    Daniel Gritzer on Serious Eats explains why there's nothing wrong with refrigerating your tomatoes.

    Friday, September 26, 2014


    Today's Funny Friday documents the marriage between a GoPro camera and a bunch of adorable puppies!

    Have a great weekend!

    Thursday, September 25, 2014

    Big Beverage Pledges to Take Credit For Pre-Existing Consumer Trends

    I imagine you've heard of "the big announcement" from Big Beverage, but in case you didn't, a few days ago, on stage at the Clinton Global Initiative Annual Meeting, The Coca-Cola Company, Dr Pepper Snapple Group, PepsiCo and the American Beverage Association, together pledged to reduce beverage calories consumed per person nationally by 20 percent by 2025.

    And it would seem much of the world has swallowed it.

    All Big Beverage is actually doing is pledging to take credit for the decade from now outcome of the rapidly shifting and growing consumer sentiment that has already led to a marked reduction in sugar-sweetened beverage sales - a reduction that's likely to accelerate as the World Health Organization's recommendation that added sugar be capped at 6 teaspoons daily is formally accepted, as nutrition fact panel reform that specifically calls out added sugar goes live, and as the science fingering excess free sugar consumption as a bad plan continues to accumulate. In fact given the growing groundswell against free sugar, I'd be genuinely surprised if sugar sweetened beverage sales don't go down by more than 20% over the coming decade.

    This is all just smoke and mirrors. Hitching themselves to the already rapidly decreasing consumer interest in their products is a brilliant move that will likely help Big Beverage to forestall soda taxes and legislation by allowing them to pretend that they're part of the solution.

    What sorts of consumer campaigns would convince me that Big Beverage really did want to drive down their own profits (which of course they legally can't because of their fiduciary responsibility to their shareholders) and change American's beverage choices?

    Campaigns telling consumers that they should immediately and dramatically minimize their consumption of soda, that switching to artificially sweetened beverages is only a shift to a lesser evil and that their consumption too should be minimized, and that tap water is hugely preferable to bottled water as bottled water is an entirely unnecessary and expensive environmental blight. We might also see food industry pledges not just to make smaller sizes, but to stop selling larger ones, slashes to advertising budgets, and a commitment to immediately stop using Santa Claus, polar bears, teen idols, and sport and entertainment industry celebrities and stars to hawk their products.

    Anything less than the above is just lip service and I for one can't wait for the day (and it'll come), when society stops listening to the food industry's wholly explicable, and ultimately unhelpful, self-serving machinations and starts treating them as the non-evil, profit-driven corporations that they are who by definition must place profits and self-preservation ahead of public health.

    Wednesday, September 24, 2014

    Another Meta-Analysis Confirms that Kids Can't Outrun Their Forks

    Wouldn't it be great if childhood obesity could be tackled with PE classes and after-school sports?

    Unfortunately believing or wanting something to be true doesn't make it so and study after study looking at the impact of activity levels on children's weights demonstrate that while incredibly good for their health, exercising doesn't tip the needle on the kids' scales.

    Well add this meta-analysis to the mix. Published in Preventive Medicine the authors pulled randomized controlled trials of 6 months or longer in duration that looked at the impact physical activity interventions had on body mass index, blood pressure, total cholesterol and triglycerides. In total there were 11 such trials that together included 10,748 children.

    The results were pretty clear. 6 month or longer physical activity interventions weren't associated with reductions in BMI, but they may have a positive impact on the kids' blood pressures and triglycerides.

    Yes, I know I'm a broken record, but for the record, weight is lost in kitchens, health is gained in gyms.

    Tuesday, September 23, 2014

    Book Review: 100 Days of Real Food (Guest Post)

    Today's post is a guest post cookbook review from our office's fantastic RD Rob Lazzinnaro.
    100 Days of Real Food

    Full disclosure: I was provided a free copy of Lisa Leake's 100 Days of Real Food by Dr.Freedhoff to review, and I have no ties to the author.
    I tend to review all cookbooks with two guidelines:
    1. Are the recipes attainable, nutritious, and is nutrition information provided.
    2. If the cookbook has nutrition tips (which many do these days) is the information accurate and would I be comfortable recommending it as a registered dietitian.
    Let’s start with praise. Overall this is an excellent book with a great message and some excellent recipes. Its central message is one we all still desperately need to hear, which is to cook more, eat more whole foods, and rely on highly processed foods less.

    The message is stated clearly from the book’s get-go - we eat too many highly refined and ultra-processed products. Why is that significant? In depth, eating more processed food often means consuming portions deceptively high in calories, ingredients that are proven harmful to our health (trans fats), and foods that are often devoid of essential nutrients.

    Leake’s definition of what REAL food is:
    • "Whole food that typically has only one ingredient…
    • “Packaged foods made with no more than five unrefined ingredients. (based on Michael Pollan’s food rules).
    • Dairy products like whole milk, unsweetened yogurt, eggs, and cheese.
    • Breads and crackers that are 100 percent whole grain.
    • Wild-caught seafood
    • Locally and humanely raised pastured meat products like chicken, pork, beef, and lamb
    • Dried fruits, nuts and seeds
    • Naturally made sweeteners including honey and maple syrup
    • More a product of nature than a “product of industry”. "

    The Meal Planning Tips and Recipes Section; Chapters 4-5 & Part Two:

    The book shines in its practical “how to” managment tips, and particularly in the chapters Getting Your Family On Board” and “Food Budget Tips and Meal Plans. The last half of the book includes the 100 recipes, and the majority are enticing, and more importantly, not intimidating . Without question most parents will especially enjoy the lunch box recipe ideas for kids. With respect to nutrition within the recipes, Leake is not a believer in counting calories or macronutrients, but I am, so I put some of her most indulgent recipes to the test.

    If you had a serving of the Quinoa and Sausage Stuffed Peppers on pg. 242 you would consume:

    ~455 Calories/18g Protein/400mg Sodium/5g Fibre

    Pair it with a serving of Spinach Salad with Warm Bacon Dressing on pg. 214 you would consume an additional:

    ~347 Calories/16g Protein/591mg Sodium/2g Fibre

    Essentially, what that means is that the book’s most indulgent meal would be ~800 Calories. The rest of the recipes tend be much less caloric and fall somewhere between 200-300 calories per serving. For me this hammers home two points.
    1. When you cook at home from whole ingredients the majority of your meals will naturally fall within a reasonable calorie range and consequently tracking calories isn’t as necessary as it would be were you to be assembling boxes and hitting restaurants rather than cooking.
    2. Not all meals are created equal and just because they are cooked from scratch some meals will still fall into the eat less often category and so if your recipe sounds indulgent, it may be worth crunching the numbers.
    The Nutritional Information Sections, Chapters 1-3:

    There is some very solid advice in these sections ranging from what are whole grains, healthy oils/fats, label reading, not aiming for perfection and the problem with added sugar which Leake covers succinctly,
    The problem with sugar is honestly not sugar itself, but the quantity in which it’s being consumed
    Unfortunately, Leake’s solid nutritional advice is at times followed up by non-evidence based statements. As many in the real food (whole food) movement are, Leake seems guided in part by natural fallacy - the belief that only something “natural/real” necessitates healthy and good; everything else is a compromise. I worry that this false construct and focus may lead some to ultimately struggle as not everyone has the budget, access or interest to cook the majority of their food, let alone do so with organic, grass fed, and speciality ingredients. I can’t help but wonder whether some of the fierce attacks on home cooking of late by journalists and bloggers as being elitist, aren’t bolstered some by recommendations that in a sense, put too many rules on home cooking.

    At the end of the day this is a great resource for those looking to eat and cook with more whole foods; keeping in mind that it is perfectly fine if you choose to cook/bake with white flour once in a while ;)

    If you'd like a copy, here's an Amazon Associates link to pick one up.

    Monday, September 22, 2014

    More on Why The Biggest Loser Contestants Are Doomed To Fail

    I've written a great deal about The Biggest Loser.

    I've covered the fact that according to previous contestants the vast majority gain their weight back, I've covered the metabolic slow down that occurs consequent to the show, I've covered the cruelty of the show's inclusion of children, I've covered how watching the show actively discourages viewers from exercising, and I've covered the ethics of being a physician involved in its production.

    Today I'll leave you with this tidbit.

    In a study published early online last week in the journal Obesity, when compared with matched gastric bypass patients, following their respective losses, contestants on The Biggest Loser had 5x less circulating leptin in their bloodstreams.

    Leptin, in case you aren't aware, is one of the body's primary satiety (fullness) hormones.

    With 5x less circulating leptin, and metabolisms that are slowed down twice as much as their gastric bypass counterparts', it's no small wonder the majority of The Biggest Loser's contestants are reported to have gained their weights back as it's tough to be a metabolic slug and be hungry.

    Saturday, September 20, 2014

    Saturday Stories: Farmaceuticals, Sustainable Seafood, and Vegetative States

    Here's Brian Grow, P.J. Huffstutter, and Michael Erman with an impressive Reuters special investigation on the abuse of antibiotics on farms.

    Here's Nathanael Johnson on the potential of sustainable seafood.

    And lastly here's Maclean's Kate Lunau with a fascinating story involving Alfred Hitchcock and a not persistent vegetative state.

    Friday, September 19, 2014

    The World's Most Awesome Don't Walk Signal!

    Today's Funny Friday is both awesome and reportedly extremely effective.

    Don't walk. Dance!

    Have a great weekend.

    Thursday, September 18, 2014

    Why Did Toronto Mayoral Candidate John Tory Shoot A Pringles Commerical?

    On the down side, clearly junk food is so normalized that John Tory, the front runner in Toronto's mayoral race, didn't have any issue shooting a Pringles commercial in the name of his campaign. And I think it'd be fair to say too that the ad's existence also means that the food environment isn't anywhere near Tory's radar.

    On the up side, at least he doesn't smoke crack.

    (Tory comes in at 1:06, just after the appearance by David Zimmer, Ontario's Minister of Aboriginal Affairs)

    Wednesday, September 17, 2014

    Food Banks Canada Now Teaming Up With 7-11 To Sell Slurpees!?

    I do get it. Charities feel they need to take whatever monies they can get.

    But given I've never seen a co-branded cigarette sale to raise money for this, that, or the other, clearly there are lines drawn that charities don't cross in their cross promotional activities.

    As I mentioned over on US News and World Report, charities, especially those tied to public health, given diet and weight related illnesses are North America's primary causes of preventable death, should be on the front lines of actively working to decrease the number of opportunities for junk food's consumption.

    And could there be any "food" junkier than a Slurpee?

    Fundraising by selling illness isn’t in anyone’s best interest, and health charities of all folks, ought to know that without being told.

    Tuesday, September 16, 2014

    Did You Know that Coca-Cola Basically Owns Emory University?

    I'm rarely speechless.

    I was close yesterday though.

    It was yesterday that I learned of a long-standing Emory University tradition. Apparently, unabashedly, and transparently, in part no doubt consequent to the $105 million endowment provided to Emory by a former Coca-Cola CEO, and in part no doubt due to the reported fact that 16% of Emory's $6.3 billion endowment fund is made up of Coca-Cola stock (down from 63% in 1998 and 47% in 2002), all first year Emory University students are brought together as they start school to toast their futures with a Coca-Cola beverage.

    And just as Coca-Cola notes in their own coverage of this marketing scheme tradition (highlighting mine),
    ""To our rebirth!”—three words, two memories, and a new Coke connection that will forever live in their hearts and minds."
    It'll be interesting to see what Emory chooses to do about their Coca-Cola ties over time. I'm guessing history will eventually see them as rather unwise.

    And to round things off, here are some videos from Coca-Cola Emory University:

    Monday, September 15, 2014

    Guest Post: The Pharmacist Who Refuses to Sell Soft Drinks

    Last week the media was abuzz with reports of a pharmacist from Nova Scotia who had elected, despite the financial disincentive, to stop selling soda and other sugar sweetened beverages in his pharmacy. His name is Graham MacKenzie and his pharmacy, Stone's Pharmasave in Baddeck, Nova Scotia, is a testament to doing the right thing. Huge kudos to Mr. MacKenzie. Wish there were more like him. Here's what he did and why in his own words:

    Roughly six months ago I started serious consideration after repeated studies that came out documenting the bad effects of sugared drinks. The consideration was whether or not to continue selling the sugared beverages in my pharmacy, Stone’s Pharmasave in Baddeck, Nova Scotia. The reasons to drop this category were simple. The consumption of just one of these beverages daily was proven to cause adverse metabolic traits including metabolic syndrome, which is a cluster of symptoms including high cholesterol, diabetes, abdominal obesity and high blood pressure. In our nutraceutical consultations we often stress the importance of nutrition in overall wellbeing and improvement of health related issues. Having a customer leave the store by walking past the pop and juice coolers on their way out after that talk made zero sense.

    Customers would ask me if there was a safe level of consumption. The best way I could explain it is if you hold out your hands and I pour marbles into them - it is relatively easy to catch all of them without dropping any at first. The marbles represent insults to your body: either sugar, pesticide, herbicide, fertilizer, heavy metal, radiation, processed food, poor nutrient consumption, air pollution and so on. At first you are young and you have no issues, later on as you get older, more and more marbles fill your hands and eventually you drop one, or two. This is the tipping point where your body now expresses disease or injury. Sugar is a big part of this contribution.

    So, I sent out a press release on September 11, 2014, which can be found here: Nova Scotia pharmacy stops selling soft drinks and other sugary beverages

    We pulled the pin before we opened that morning by removing all juices, soda, sport drinks and vitamin water from the store. I figured all would be quiet for the most part, a few blank stares a couple of frowns and that would be it. We have been overwhelmed by the positive response on all of our social media channels. People are now alerted to the effects of sugar and how much sugar themselves and their families have been consuming. They have become more aware that it is better to eat the food rather than drink the juice. For example, eating an apple gives you fiber, which slows the glucose absorption, plus you don’t get as much juice. They now know that by consuming one or two of these beverages daily, they have the same chance of increased diabetes risk as a smoker does. By raising awareness, people now ask what high fructose corn syrup is and why it is particularly important to avoid this dangerous visceral fat absorbing sugar.

    My overall goal was to raise awareness of the adverse health effects of drinking soft drinks and sugary beverages. At some point, disease prevention needs to become part of our world-class medicine we have available to us. Treating patients symptom by symptom is too much of a downstream activity to really act in our favour. I want to promote healthy living for my customers and I think this was a step in the right direction. Perhaps it was nothing more than a symbolic moral gesture to spark an educational thought not only among my customers, but those globally. In a television interview in the pharmacy the following day, with camera rolling and the interviewer present, one of our biggest pop buyers walked in for his regular case of soda. When he found out there was none sold there anymore he turned to the empty cooler, then looked at the water filled cooler next to it and picked up two bottles of water. “These are better for me anyway I guess!”, as he purchased them and went on his way out the door.

    Overall, it has been a great week. For my customers and me.

    Graham MacKenzie graduated from St.F.X.U. In Antigonish, Nova Scotia, Canada in 1989 (BSc chem) and Dalhousie U College of Pharmacy in Halifax, NS in 1993. He went to Stone's Drug Store in Baddeck, NS at that time. In 2001 he purchased the store and renovated it inside and out to include a compounding lab and new dispensary. He has developed a one on one Nutraceutical Consultations, developed a 40 minute Healthy Grocery Shopping Tour and continues to actively educate on alternative and conventional therapies to his patients and globally. He actively blogs on his website, www.stonespharmasave.com, and you can follow him on Twitter.

    Saturday, September 13, 2014

    Saturday Stories: 23andMe, Red Delicious Apples, and Turtle CPR

    Julia Belluz on Vox.com with a great story on the unintended consequences of home genetic testing.

    Sarah Yager at The Atlantic on the awful reign of the red delicious apple.

    And on Slate, here's David Steen on what it's like and why he gave mouth-to-mouth to a turtle.

    [And if you don't follow me on Facebook or Twitter, here's my US News and World Report column that explains why sandwiches, eggs and roasted chickens aren't elitist or unrealistic]

    Friday, September 12, 2014

    True Facts About Marsupials

    Today's Funny Friday is from Ze Frank. I need not say any more.

    Have a great weekend!

    Thursday, September 11, 2014

    Health Canada So Sure of Self, It Sets Policy Before Scientific Review?

    In case you're wondering what we're up against here in Canada when it comes to public health and Health Canada, this story sums it up pretty well (and is applicable to many government health agencies the world over).

    Carly Weeks, one of Canada's foremost health reporters, published a story a ways back on how the Canadian Medical Association, the Childhood Obesity Foundation, the Canadian Institute for Health Research and the Libin Cardiovascular Institute of Alberta, have all added their voices in demanding that Health Canada change it's lame, industry appeasing, sugar policy. For whatever reason, I only just read this Valentine's Day piece yesterday.

    In it, Weeks quoted Norm Campbell, the CIHR Canadian Chair in Hypertension Prevention and Control as stating,
    "We’re talking about the leading risk for death and disability and [the federal government is] doing nothing.”
    Next up she quoted former Canadian Medical Association President Louis Hugo Francescutti,
    "At the end of the day, I think we know what we need to do. We don’t need any more studies, but we need to develop a fairly robust national strategy."
    And she also snagged this quote from Tom Warshawski, pediatrician and chair of the Childhood Obesity Foundation,
    "I think Health Canada is not really doing their job. They look for industry to self-regulate.
    And while those quotes are damning in and of themselves, they weren't what really caught my eye. It was this.

    Weeks lead the piece off noting that the increased concern from public health groups stemmed in part from a recent study published in JAMA that concluded folks whose diets included 25% or more calories from added sugars were found to be 3x more likely to develop heart disease.

    Well Weeks got Health Canada on the phone and here's what she reported they said (highlighting mine),
    "On Friday, a spokesman for Health Minister Rona Ambrose said the department will review the JAMA study, but ruled out setting limits on sugar added to food or adopting consumption guidelines."
    And with that one line that Health Canada spokesperson, unless it was a slip of the tongue, made clear that Health Canada makes decisions in advance of, and potentially despite, the science.

    Such a shame for the health of Canadians.

    Wednesday, September 10, 2014

    Food Banks Canada Demonstrates the Folly of Working with the Food Industry

    Yesterday's story showed how the Heart and Stroke Foundation's divorce from the food industry finally allowed them to speak their mind.

    Today's story's not like that.

    Today's story is about Food Banks Canada and their partnership with "Breakfast Cereal Canada" (a food industry organization) who for a measly $25,000 bought Food Bank Canada's imprimatur and endorsement for their new, "What's in the Bowl" hurray for breakfast cereal promotion.

    Want to guess what What's in the Bowl has to say about the fact that in many cases breakfast cereals are just bowls of pulverized white flour sprinkled with sugar?
    "When you consider sugar consumption, it’s important to look at the total amount of sugar in your diet from all sources. In the case of cereal, it’s worth noting that studies have found that less than five percent of the total daily sugar in Canadian diets typically comes from cereal – and that includes the pre-sweetened varieties. At the same time cereal often provides fibre and important vitamins and minerals, including iron, zinc, B vitamins – and the research shows that without adequate intake of these nutrients at breakfast, most people don’t make up for the shortfall later in the day."
    Really, you have to love that 5% number. It's a per capita number and consequently it's useless in terms of describing the total daily sugar cereal provides to actual consumers of cereal given not everyone eats cereal for breakfast and perhaps as many as 1/3 of the population don't eat breakfast at all. The only reason to use a per capita number here is to make the number seem much lower than it actually is for cereal eaters.

    The campaign has even purchased the services of consulting RD Lydia Knorr who added her two cents on sugar in breakfast cereals in the press release,
    "As a dietitian, it makes me happy to hear that consumers are taking factors such as sugar and additives in their foods seriously and want to know more. But what many people don't realize is that cereals can provide more iron, folic acid, zinc, B vitamins and fibre than other conventional breakfast choice."
    Gotta love those magic nutrients that make everything else in the bowl a-ok. Krave, Cinnamon Toast Crunch and Honeycombs for everyone! And hey, can someone please fortify alcohol with vitamins for us adults?


    Tuesday, September 09, 2014

    Canada's Heart and Stroke Foundation Issues World Leading Sugar Statement!

    Huge kudos to Canada's Heart and Stroke Foundation.

    For years I've pointed out that public-private partnerships with the food industry necessitate watered down public health messages so as not to offend the industry partner's products or positions. With this in mind, my hope had been that in unchaining themselves from their food and restaurant industry partnered Health Check program, Canada's Heart and Stroke Foundation (HSF) would suddenly be free to take on a leadership role in the area of food and public health - and if today's news is any measure, the HSF is doing just that and is positioning itself to be Canada's voice of dietary reason, and a world leader in health charity driven public health advocacy.

    Today's news has to do with their release of their new position statement, "Sugar, Heart Disease and Stroke", which is as hard hitting as any I've read, and runs in line with the World Health Organization's recommendation to limit added sugars to between 5-10% of daily calories. I vastly prefer the HSF's use here of the term "free sugar" rather than "added sugar", as free also covers sugars freed from their fruity origins and would include juices and products made with juice/fruit concentrates and purees.

    The position statement goes on to provide a slew of recommendations, most of which simply could not have been made while the HSF wore the yoke of their public-private Health Check partnership. Here are just a smattering:

    For Consumers:
    • Limiting restaurant meals out
    • Limiting processed foods
    • A call to return to cooking from fresh, whole, ingredients
    For the Federal Government:
    • Adopting the HSF's proposed sugar thresholds
    • Restricting marketing of all foods and beverages to children
    • Taxing sugar sweetened beverages and using funds generated therein to subsidize fruits and vegetables
    • Avoiding public health partnerships with producers and suppliers of foods high in free sugars
    For Provincial Governments:
    • Taxing sugar sweetened beverages and using funds generated therein to subsidize fruits and vegetables.
    • Adopting a Bloomberg style large cup ban (if you want to drink a litre of Coke, you'll still be able to, you'll just need to buy two cups)!
    For Municipal Governments, Regional Health Authorities, Workplaces and Schoolboards
    • Adopting a Bloomberg style large cup ban in food service outlets
    • Banning sugar-loaded beverages in recreation centres, hospitals and schools
    • Ensuring potable drinking water made more readily available in parks and public facilities
    • Creating zoning laws to prevent the establishment of fast food outlets and convenience stores within walking distance of schools
    • Banning the practice of junk food fundraising.
    The only thing missing from these recommendations (though it's certainly implied), is a direct call to action for the overhaul of Canada's 2007 Food Guide and with it the Guide's inclusion of free sugar limits, and the removal of the Guide's inane recommendation that half a cup of sugar water with vitamins (juice) is a fruit serving equivalent.

    Whether or not you agree with the HSF's recommendations, one thing's incredibly clear, the HSF is no longer the food industry's partner - and that news is tremendous for Canadians as it's amazing how forceful and broad-sweeping public health organizations' recommendations can be when there's no worry about upsetting industry partners.

    [I also must add, while reading this position piece and in it the HSF's clear, unadulterated by industry voice, I couldn't help but wonder what sort of forces Dietitians of Canada and the American Academy of Nutrition and Dietetics could be were they to divorce themselves from their throngs of food industry partners, for as it stands now, they're both rather toothless and certainly not describable as drivers of change or true champions of health.]

    Monday, September 08, 2014

    Supermarkets Should Not Legally Be Allowed to Do This

    It's bad enough we have fronts of packages telling us that all manners of food-like substances are in fact healthful, and truly, there should be a law preventing front of package health claims, but check out these top of aisle health claims that an RD reader of mine found displayed at her local Ontario Metro Supermarket.

    Healthy cookies?

    Healthy juice?

    Those of course are oxymorons.

    The soups - sure soups can be healthful, but given most store bought soups contain well over 1,000mg of sodium per bowl, a healthy label is a bit of a stretch.

    The onus shouldn't be on the consumer to scrutinize labels to determine if claims are true, the onus should be on the food industry, and in this case the supermarket industry, not to lie to or to deceive consumers.

    Friday, September 05, 2014

    Joan River's Triumphant Return to The Tonight Show

    I adored Joan Rivers. For today's Funny Friday here's a 7 minute clip that embodies her special genius. She will be greatly missed.

    Have a great weekend!

    Thursday, September 04, 2014

    How Much Greek Yogurt is in Tim Horton's New Greek Yogurt Smoothie?

    Sure it sounds healthy.

    After all, it has the words "Greek yogurt", "fruit", and "smoothie" in its name.

    But what's in the smoothie?

    A crapload of sugar where its 14 teaspoons of sugar (in the large) account for 77% of its total calories.

    So how much Greek yogurt is in this sugar delivery vehicle? Looking at the nutritional breakdown of generic Greek yogurt and the online nutritional information provided by Tim Horton's for this large "Greek yogurt" smoothie, my best guess is that the 18oz smoothie only contains between 2 and 2.5oz of Greek yogurt as that's how much Greek yogurt you'd need to add to reach the smoothie's reported lonely 7 grams of protein.

    Putting this another way, for every teaspoon of Greek yogurt in a Tim Horton's Greek Yogurt smoothie there's also a teaspoon of sugar.

    Or how about this way? In every giant 18oz Tim Horton's Greek Yogurt Smoothie my math puts only half a single serve portion of Greek yogurt in it (and less than 1/4 of a single serve portion in a small).


    Wednesday, September 03, 2014

    What I Learned By Actually Reading That Low-Carb Is Best Study

    So the world is abuzz with the news that in a 1 year randomized trial, a low-carb diet led to greater losses than a low-fat diet. Anahad O'Connor covered the story and some of its implications in yesterday's New York Times and included some terrific quotes from Dr. Dariush Mozaffarian, but as per my practice, I didn't want to share or tweet about it until I actually read the study itself.

    Here's my take.

    Firstly the low-carb diet recommended in the study was actually a low carb diet, where the recommendation was for subjects to maintain an intake of digestible carbohydrates of less than 40g daily. That's a rarity among low-carb studies, as to date many have instead focused on what might only be described as "lowish" or "lower" carb intakes - but more on this in a bit. As far as the low-fat dieters, they were told to keep total daily energy intake to less than 30% of total daily calories from fat, and to ensure that 55% came from carbohydrates. Worth mentioning too is the fact that participants in both arms received 1 meal replacement a day for the study's duration, and also received 20 hours of RD counselling and support over its course. Dietary recall was used quarterly to assess compliance and consumption.

    Results wise, after a year the low carb folks lost on average 11.7lbs while their low-fat counterparts only lost an average of 4lbs.

    Before we go any further, just a quick reminder, it's been known for some time that low-carb diets lead those on them to automatically consume fewer total calories. Some folks, including me, think the reasoning therein lies more with protein than carbs whereby folks on low-carb diets are usually more regular with their inclusions of protein at all meals and snacks which in turn is more sating. Consequently the lower the carbs, the higher the protein and likely the lower the total calories consumed due to increased overall satiety.

    Now back to this data. Looking at it a bit more closely it turns out that 88% of the extra weight loss enjoyed by the low-carb folks was accumulated during their first 3 months on their diets - their honeymoon period if you will where participants would likely be paying more care and attention to their diets' details. The honeymoon concept is definitely borne out by the data as well, as looking at the initial daily dietary composition data reporting it would seem that during those first 3 months the low-carb folks were consuming 80g of digestible carbs daily representing 28.9% of their calories but by the end of the study these numbers had increased to 112g and 34% respectively.

    And what of protein? The low carb folks started at 25.6% of total daily calories which fell to 23.6% by study's end, while the low-fat folks stayed around 19% throughout.

    Looking at calories (because yes, they still count), calories were lowest during the first 3 months for both study arms, but especially so for the low-carb folks where during those first 3 months they reported consuming 190 fewer daily calories than the low fat folks. That difference decreased as the study went on. In fact compared with their first 3 months' reporting, by year's end the low-carbers had upped their total daily calories by 15%, while the low fat folks had only upped theirs by 7.5% with the gap between them now being fewer than 100 calories. Consequently I'd also have loved to see longer term outcomes as I don't think it's a given that there'd be any real difference 2 years out given the more rapidly rising calorie (and carb) counts of this study's so called low-carb arm.

    But is this really a low-carb diet study?

    Nope. This simply isn't a low-carb study. It's not a low-fat study either by the way.

    It's plainly not a low-carb diet study as the low-carb folks, though they were certainly prescribed a low-carb diet, never adhered to one, where even during their diets' honeymoon phase they were consuming over 25% of their total daily calories from carbs, a percentage that rose to 34% by year's end - both far higher than a true low-carb diet would require. Similarly for low-fat where participants weren't even prescribed a low-fat diet, as a diet with 30% of calories coming from fat by definition isn't low-fat. All that said, I'd be willing to wager that the protein distribution among the low-carb diet folks was in fact markedly different from the low-fat folks, as during those 20 hours of RD counselling I've little doubt that the utility of consuming a protein source with every meal and snack in helping to stick to a low-carb approach was emphasized.

    It's also important when considering this study and participants' losses not to forget the meal replacement they were provided daily.

    So for me this study's overarching take home messages are firstly that our overly saturated-fat phobic national dietary guidelines that still steer people to diets consisting of 55% carbohydrates probably aren't necessary. Secondly, it would seem that for individuals, if you're not planning on tracking calories, having a daily meal replacement while reducing carbs somewhat may well be a viable way to go for a modest amount of weight loss, and perhaps more importantly, for improvements in many metabolic parameters. And thirdly, if the aforementioned approach only leads you to lose a little bit of weight (remember, in this study the average loss for the so-called low-carb dieters after a full year of dieting was only 11.7lbs) I'd encourage you to start keeping a food diary (with more on that from me here), to ensure you include protein with every meal and snack, to markedly reduce liquid calories, to make a concentrated effort to include more produce than products and to re-relegate restaurant meals to special occasions only.

    Lastly, it's important to note that if the question is whether you personally should go low-carb, low-fat, or in-between this study certainly doesn't answer that. Ultimately the best diet for you is the one you actually enjoy enough to keep living with, as merely tolerable diets won't last, and any and all can work so long as you enjoy them enough to sustain them as seen in this meta-analysis published yesterday in JAMA.

    Putting this all another way it's important not to forget that one person's best diet is undoubtedly another person's worst, and that folks who are stuck dogmatically promoting only one "best" diet can be safely ignored.

    Tuesday, September 02, 2014

    Coca-Cola's Latest Campaign Is Specifically Targeting Your Teens

    At least that's what this Bloomberg article surmises, and I don't disagree:
    "This summer the company printed the 250 most common names of U.S. teens on Coke bottles, hoping that millions of kids will want to buy drinks with their names on them. So far it seems to be working: In the last three months, sales of Coca-Cola have inched up 1 percent in North America."
    Moreover, do you really think that these cans and bottles won't target your preteens too?

    And it's not just a theory they're going after your children with this campaign. According to promomedia, one of Coca-Cola's many marketing agency partners noted,
    "The heart of this campaign was the physical customization of Coca-Cola cans (Brand Experience) for TEENS."
    No surprise though as this quote from Michael Moss' fabulous Salt, Sugar, Fat - How the Food Giants Hooked Us (which I reviewed here) explains, where the quote is from a Coca-Cola executive discussing Coca-Cola's (rather empty) promise not to target kids under 12,
    magically, when they would turn twelve, we’d suddenly attack them like a bunch of wolves."
    [And just in case you're tempted to try, the online Share a Coke generator won't let you design a bottle for "Diabetes". I know because I tried.]