Monday, June 30, 2014

Ontario Parks' "Official Beverage" is a Pepsi?

Both eco and health washing in one clean swoop.

Sigh.

[Hat tip to Eileen Mortimer for sending this along.]

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Saturday, June 28, 2014

Saturday Stories: Science Reporting, Eggs, and Fronts-of-Packages

Health News Review's Gary Schwitzer on science reporting, "We’re losing people, drowning them in a sea of questionable or downright useless health information."

Foodist and Summer Tomato's Darya Pino with an incredibly easy and quick egg recipe that I hope to try this weekend.

Yale and Disease Proof's Dr. David Katz, in lieu of Canada's Heart and Stroke Foundation's decision to end their Health Check program, talks about my favourite front-of-package labelling program - his creation - Nuval.

[And if you don't follow me on Twitter or Facebook, below is the segment I did with Australia's Studio 10 morning show where I was asked to weigh in on Dr. Oz' predatory sale of hope.]



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Friday, June 27, 2014

Game of Thrones Meets The Brady Bunch

Warning, there are a few Game of Thrones spoilers in this week's Funny Friday video (though not for this current season).

Have a great weekend!



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Thursday, June 26, 2014

Successful Proof of Concept for an Obesity Vaccine?!

File this under weight is a complex amalgam of dozens, if not hundreds, of individual, environmental and societal contributions as here is a proof of concept paper that, at least in mice, speaks not only to a viral contributor to obesity, but also to a vaccine for same.

In the study mice were either injected with either a vaccine derived from purifed AD36 (a virus shown to contribute to weight gain), or with saline. Both groups of mice were then exposed to the live virus.

The results were dramatic. 14 weeks after exposure to AD36 the vaccinated mice were 17% lighter than the saline injected controls.

While the translation of mouse research to clinical human utility is statistically speaking, hugely unlikely, it doesn't make this study's results any less fascinating.

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Wednesday, June 25, 2014

Ugly, Ignorant, Fat-Shaming, American Academy of Pediatrics, Childhood Obesity Ads

Thanks to Eating Rules' Andrew Wilder for sending me this photo of the fat-shaming, American Academy of Pediatrics (AAP) endorsed ad that he snapped last week in Oakland International Airport.

Not only does this AAP campaign embrace the gluttonous sloth causes obesity narrative, an erroneous narrative that no doubt fuels bullying, it also demonstrated incredible ignorance in its clear suggestion that the primary reason children have obesity today is because they no longer play.

Never you mind that objective studies on the impact of physical activity on childrens' weights reported that even a ten fold difference in physical activity didn't protect children from weight, or that a meta-analysis of school PE programs involving over 18,000 students showed that no amount of PE had a significant weight impact - no - if that boy on the bottom of the see-saw just picked up a damn basketball instead of a bag of chips, no doubt he too would be slim.

So incredibly disappointing to see the AAP having gone down such an ugly road. Kids who struggle with overweight and obesity aren't likely to have any shortage of weight related guilt, shame and embarrassment in their lives and it's beyond awful to see an organization such as the AAP adding to their piles.

I reached out to the AAP who reported that they had thought the campaign, which begun in 2012, had run its course, but that confusion aside, it still begs the question of how it was approved in the first place, for if guilt, shame or simple play helped with childhood obesity, it wouldn't exist. And so I have to ask, how is it possible that the AAP didn't/doesn't already know that?

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Tuesday, June 24, 2014

I Was Going to Write a Dr. Oz Post but then I Saw this John Oliver Video

No need to ever write about Dr. Oz again as every time I have an urge I can just post this spectacularly brilliant, hilarious, and troubling video from Last Week Tonight and John Oliver.

Thanks to all those who sent this my way.



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Monday, June 23, 2014

Ottawa City Councillor and Parkinson Society Push Month Long Milkshakes

As a society, the use of sugar and junk food as drivers of fundraising has become the norm. No doubt if we want to see reductions in the prevalence of diet and weight related diseases we need to actively strive to provide fewer opportunities for junk consumption, and when it comes to food based fundraising, no doubt the charitable cause provides both incentive and permission to eat junk. Consequently, when I see the sorts of partnerships like the one described in the email below sent out by Ottawa City Councillor Diane Deans, I think it's worth pointing out that however well-intentioned it might be, it's not in public health's best overall interest.
Good Afternoon,

I would like to invite you to the Parkinson’s Shake Up! on June 26th at noon at KS on the Keys Restaurant located at 1029 DazĂ© Road.

For the entire month of July, KS on the Keys Restaurant will donate $4 from the purchase of every milkshake to Parkinson Society Eastern Ottawa to help provide programs and services in support of those living with Parkinson’s and those caring for them. To help kick off this month-long campaign; I will be handing out free milkshake samples next Thursday between noon and 1:00 p.m.

For every milkshake purchased, or $5 donation during the event, patrons will be entered into a draw to win a prize! Please stop by, enjoy a milkshake, and together we can help support members of the Ottawa community who are coping with this disease.

For more information please contact me at 613-580-2480 or diane.deans@ottawa.ca

Kind Regards,

Diane Deans
Councillor, Gloucester-Southgate Ward
Assuming the Keys Restaurant's milkshakes are average in their caloric and sugar punch, I'd expect each charitable shake to contain the calories of nearly two Big Macs and a literal half cup of sugar (for instance a medium Baskin-Robbins chocolate milkshake contains 930 calories and 24.5 teaspoons of sugar).

[Thanks to Sally Collins for sharing Ms. Deans' email]

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Sunday, June 22, 2014

Cancer hospital approves free cigarette give away fundraising!


Somehow I doubt it.

I mean, accepting donations or funds raised by corporations whose very products contribute to the burden of disease in your hospital would be anathema to your responsibility as a hospital to promote public health and combat disease, wouldn't it?

But what if your hospital really, really needed the money?

Um, it's a tobacco company handing out free cigarettes and simultaneously asking for hospital donations.

Yeah, there's not too much debate there. It's not good, right?

So why do our hospitals, specifically our children's hospitals, regularly partner up with the purveyors of sugary treats to raise money in their names?

These photos, taken by an anonymous tipster from Toronto, show a recent Dairy Queen Guinness Book of World Records attempt at making the world's largest ice cream cake. Stamped right on the sign, "donations to Sick Kids Hospital will be accepted" in lieu of course of free ice cream cake.

And the same happens here in Ottawa where CHEO regularly partners up with Dairy Queen to raise funds.

I wonder what the HALO team at CHEO think about these partnerships - they're the folks who are busily researching means to try to help combat the rapid rise in childhood obesity in Canada.

Guessing they might think that children's hospitals probably shouldn't be in the brand polishing business for Dairy Queen.

That same tipster did some quick calculations.

The cake?


Through it, Dairy Queen distributed 5,000lbs worth of calories, 4,276.8lbs of added sugars and 44.5lbs of trans fat all with the blessing (they used Sick Kids' logo - they had their explicit blessing) of the Hospital for Sick Children.

These partnerships have got to stop.

I know, I know, fast food's not going away, and children definitely still need to enjoy cake from time to time, but that doesn't mean it's ethical or responsible for hospitals to help in its sale or promotion.

Hospitals used to sell cigarettes too you know.

[If you enjoy Weighty Matters you might want to subscribe via email, follow me on Twitter or join the Facebook page]

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Saturday, June 21, 2014

Saturday Stories: Pranks, Aliens and Cheap Eats

Slate's Rebecca Schuman covers the absolutely brilliant stunt that 56 professors pulled to protest pay gaps in academia.

Wait But Why covers The Fermi Paradox and provides a number of different answers to the question of why we have yet to speak with aliens.

And lastly, here's Leanne Brown's "Good & Cheap" cookbook for healthy eating on the cheap. Many meals for less than $1.50 a serving and the most expensive, with side and dessert, likely under $5.

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Friday, June 20, 2014

Perhaps the Funniest Commercial I've Ever Seen

I genuinely laughed out loud - multiple times - watching today's Funny Friday video, and with 3 young daughters of my own, there's always the remote chance I can recreate it one day were the circumstances in the video to take place in my home.



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Thursday, June 19, 2014

Exercising To Lose Weight Might Lead You to Gain Instead

File this study under reality.

Researchers were curious whether or not labelling exercise "fat-burning" (as many exercise machines do) would have an impact on how much food a person ate post exercising.

The protocol was simple. Subjects were brought individually to a lab and were told they were there to evaluate newly developed training software for bike ergometers. They were then equipped with a heart rate monitor and completed a 20 minute low-moderate intensity cycle. Participants were randomly assigned to have one of two posters tacked to the wall in front of them while they rode. The first had a poster stating, "Fat-burning exercise – developing training software for exercise in the fat-burning zone.", and the second, "Endurance exercise – developing training software for exercise in the endurance zone." Following their rides subjects were told they could help themselves to snacks while completing a survey and were offered water and pretzels. Pretzels consumed were measured by means of a scale before and after each participant.

The results?

"Fat-burning" labels did have some impact, but I'm not going to dwell on it. Instead I want to point out that across both treatments participants burned on average 96 calories during their rides and they then proceeded to eat 135 calories (41% more calories than they burned) of post-exercise pretzels.

Combine these results with those from a study published a few weeks ago that people who went for a walk and told they were "exercising" consumed 41% more calories from indulgent desserts and drinks following a post-walk lunch than those who were told they were walking for "fun".

We do eat because we exercise and I think in large part it's because we've been taught that we're supposed to - both by the food industry (see up above) and sadly too, by public health departments (see down below with the "Less Sit, More Whip" City of Ottawa bus poster) and health professionals who have markedly overplayed exercise's role in weight management.

If you are interested in weight loss, make sure that regardless of how much you're exercising, you're paying attention to to food as well.

Lose weight in the kitchen, gain health in the gym.

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Wednesday, June 18, 2014

BREAKING: Heart and Stroke Foundation Disbanding their Health Check Program

Readers here will know I have long been critical of the Heart and Stroke Foundation's Health Check program. Born in 1999, Health Check was incredibly well intentioned and truly ahead of it's time. Unfortunately, as the years went by, the program didn't evolve with our changing understanding of both nutrition and consumer psychology, and by the mid 2000s, I think the evidence was clear that Health Check was not fairly guiding Canadians' choices, or representative of the good work and trust for which the Heart and Stroke Foundation itself was known.

In a move demonstrating real responsibility the Heart and Stroke Foundation has today decided that the right move for Health Check is to wind it down. I am hopeful that doing so will allow the Foundation to become a far more vocal proponent of produce over products, and in so doing help to steer Canadians out of restaurants and supermarkets' middle aisles and back into the loving embrace of their own kitchens.

Here is their formal announcement.

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Guest Post: Since When Did School Become All About The Food?

Cartoon by Politico's Matt Wuerker
Received an email the other day and reached out to the sender to ask if I could share. It's so frustrating that the institutions that are supposed to care about our kids the most (schools, coaches, camps, etc.) contradict their caring by being promoters and providers of junk. Sadder still that these sorts of occurrences are more often the norm than the exception:
Love your blog & book, wanted to let you know the struggles of a frustrated mom of 2 boys, 10 & 11 in Ontario who is trying to teach her kids healthy eating and moderation. Are we perfect? Not even close but we try.

True events over the last 5 weeks for one grade 6 boy.

Week 1 – hot lunch day at school – Mac & Cheese, there were leftovers so my child had 5 helpings. Hence a discussion that night about moderation.

Week 2 – EQAO testing. The tests are about 1-2 hours long. The teacher allowed the kids to bring in snacks. Then, another discussion about food choices and your performance. Plus the fact that I thought he could go 2 hours without eating. We agreed he could bring in plain popped popcorn no toppings. Did I mention the testing lasted 3 days. By the third day he asked if he could bring chips and pop because that is what everyone else was bringing in. I caved and chips could be purchased only if he bought them with his money. He woke up early the next day just so he could ride his bike to the store to purchase them.

Week 3 – Hot lunch again at school. Our school has 1 hot lunch a month plus a pizza lunch. A discussion at the beginning of the year about finances & food choices allows them to have one or the other but not both. Today it was hot dogs, cookie and drink box.

Week 4 – School fun day at lunch time. What was on the menu? Pizza, pop, jumbo freezies, chips and ice cream sandwiches. Another discussion the night before about how much money they could bring & what could be purchased. Each took $5, my youngest returned with $2 change, by oldest spent it all. 3 pieces of pizza, jumbo freezie, pop ,chips and ice cream. (He received $2 extra when a boy gave him money if he could cut in front of him in the pizza line) Hence a discussion about gluttony. And the fact that he didn’t eat any dinner and had a stomach ache.

Week 5 – School dance in the afternoon for grade 6,7 & 8. No interest in girls yet but the snack table of pop, chips and sour keys was a huge success .

Next week – Year-end trip to the movies. The note home said
the concession stand will be open if you child would like to purchase refreshments
Did I mention they are going at 9:00 am in the morning? Then another discussion about how you don’t NEED popcorn or pop in the morning. That’s OK mom he said because afterwards when we get back to school we are having a pizza party & everyone will be so full from the movies there will be more pizza for me. Then, like a broken record we repeated our discussion about moderation.

Since when did school become all about the food?

Frustrated Mother,
Melissa Parsons

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Tuesday, June 17, 2014

Rewarding Exercise with Food is a Rampant Part of the Problem

3 little words that we often say before that extra indulgent meal or treat,
"Because I exercised"
And even if somehow you personally don't reward your sweat with food, given there are advertising campaigns speaking to the phenomenon like the one up above, I'm pretty sure you're in the minority.

If people burned large numbers of calories through physical activity you wouldn't be reading this right now as our species, one that evolved in times of extreme dietary and caloric insecurity, simply wouldn't have made it if hunting and gathering burned significant calories. Our caloric efficiency evolved out of very real necessity.

Oh, and it's not just advertisers getting in on this, it's everywhere - even children's hospital's as evidenced by this 2nd Annual Running Room race to benefit Edmonton's Stollery Children's Hospital. It's called the 2nd Annual Fun Run for Pie, and it targets young children and families with its 5km and 1km walk or run courses.

So what's a Pie Run? It's a run where,
"Every walker and runner will be rewarded with a slice of pie, complete with your choice of whip cream and/or vanilla ice cream."
Oh, and don't worry, if your child doesn't happen to like pie as,
"for those kids who do not like pie we will have delicious cupcakes and a topping bar for the ice cream."
And if you think for a moment this run's an exception, you'd be very, very wrong as my quick Google image search proved.

[Thanks to my friend, pharmacist Tony Nickonchuk, for sending along the Saucony ad and to RN and Kinesiologist Jennifer Bothe for sending along the Edmonton race link]

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Monday, June 16, 2014

Coca-Cola Never Ever Markets to Kids....Unless They're Vietnamese?

Despite Coca-Cola's contention that they never do it, this blog has seen many examples of how Coca-Cola is absolutely committed to marketing to kids (if you click the link, just scroll down below this post and you'll see many more examples), and this latest one from Vietnam is about as blatant as they come.

It's called Coca-Cola 2nd Lives, and it's a genuinely and non-sarcastically ingenious campaign currently in Vietnam that allows empty Coca-Cola bottles to be used again by the distribution of 16 different caps that in turn provide 2nd lives to the bottles. Just pony up four regular Coca-Cola bottle caps and the kit is yours.

The replacement caps include a water mister, soap dispenser, detergent dispenser, condiment dispenser, salt and pepper shakers, LED light, and dumbbell kit.

Oh, and then there's also a water gun, soap bubble wand, kid paint brushes, pencil sharpener, and totally indefensibly, a baby rattle as seen up above.

To really get a sense of just how directly this targets Vietnamese children, watch Coca-Cola's own promotional video:



[On the off chance I have readers in Vietnam, I sure would love a set of these for my collection]

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Saturday, June 14, 2014

Saturday Stories: A Must Read, Interval Training Risk, and Lots of Not Sitting

Gisela Voss's open letter in the Boston Globe to the graduating class her son left behind is truly a must read piece.

An MD friend of mine told me a horrifying story - apparently an Ottawa Heart Institute cardiologist told my friend's CME family doctor study group that interval training beyond the age of 40 carried with it more risk than benefit. I kicked that over to a few friends on Twitter and one of them, Runner's World's Alex Hutchinson, turned it into an awesome blog post.

Here's Dan Kois in New York Magazine detailing his experimental month of never sitting down.

[And if you don't follow me on Twitter or Facebook, here's the interview I did with CBC's Q and Jian Ghomeshi on why the food industry's involvement with public health is a concern, and here's a story from the Globe & Mail where I weighed in on Coca-Cola's latest commercial that's designed to make you want to reward exercise with food.]

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Friday, June 13, 2014

Watch As this Adorable Puppy Turns Into a Terrifying Monster

If I had a dog you know I'd be trying out this Funny Friday the 13th's puppy to monster conversion kit.

Have a great weekend!



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Thursday, June 12, 2014

Road ID: A Simple, Indispensable, Free App for Cyclists, Runners, andHikers

[This is a completely unsolicited and uncompensated review]
Cycling on city streets is a sometimes harrowing experience. While years ago I purchased my own Road ID bracelet so that should something bad happen someone could easily find my brief medical history and emergency contacts, it was only last week that I downloaded Road ID's new self-titled app and took it for a few literal test drives.

The app's purpose is to keep your loved ones appraised of where you are, and in the event of trouble, alert them. By means of email or text message (or both) when setting out on a run, cycle, or hike, the app will send what it calls an "eCrumb" to up to 5 contacts letting them know how long you expect to be out along with a link to where they can track your progress superimposed on a Google map. And if something renders you stationary for 5 minutes, the app will send out a second set of texts and emails to your contacts to let them know you haven't been moving and where you're located (it sets off an alarm before it sends out the alert giving you the option to cancel the alert if you've stopped moving on purpose).

While it's certainly not able to prevent an accident, I'm sure glad it's on and running when I am.

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Wednesday, June 11, 2014

No, Low-Fat Doughnuts Aren't Going to Cure Obesity

Sigh.

I had many people send me a piece from the Ottawa Citizen entitled, "People line up for Almonte inventor's lower-fat doughnuts" that included their inventor Ed Atwell's unopposed comment,
"I believe this is a technology that is going to curb if not eliminate the obesity epidemic"
I guess he's never read any of Brian Wansink's work that suggests the doughnuts' "low-fat" label will likely contribute to obesity's rise, rather than help it's fall. Why? Because the label and the story provide a health-halo that the evidence would suggest will lead people to consume more calories from these purportedly "healthy" or at the very least, "healthier" doughnuts than if they just hit the full strength versions (something to which the store's out the door lineup to buy speaks directly).

My favourite part of the story though has to be the nutritional information disclosure.

Apparently Ed's average obesity-fighting miracle doughnut contains 190 calories.

Want to know how many calories are in Tim Horton's classic chocolate dip?

190.

Blargh!



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Tuesday, June 10, 2014

More on the "Almost Impossible" Feat of Maintaining a Weight Loss

So spurred by the CBC report that called the maintenance of weight loss "almost impossible" last week I reposted a older piece of mine as a rebuttal.

This weekend I was re-reading the Look AHEAD data on weight and I came across another bit worth sharing. Have a peek at that graph up above. It categorizes the percentage of folks in Look AHEAD's control Diabetes Support and Education (DSE) arm and their Intensive Lifestyle Intervention (ILI) groups who 8 years later met different degrees of weight loss.

The most striking part of that graph to me has to be from the DSE controls. The DSE, for those who aren't familiar, wasn't a particularly involved intervention. Here's how it's described in the study,
"For the first 4 years, DSE participants were provided three 1-hour group meetings per year that discussed diet, physical activity, and social support, respectively [20]. These sessions offered information but not specific behavioral strategies for adhering to the diet and physical activity recommendations. Years 5 to 8 provided one such session per year. Persons who desired more help with weight loss were referred to their PCPs, who were free to recommend whatever interventions they considered appropriate."
It's quite heartening to see that after 8 years, for 35% of the DSE control group, 3 1-hour group talks a year were sufficient to help fuel a sustained weight loss of 5 percent or more of their presenting weight, and for 17% of them, enough to fuel and sustain a greater than 10 percent loss.

Now this study population may have a bit of an advantage. These weren't likely folks whose motivators were aesthetics. These folks were older, and no doubt hoping to help improve the management of their diabetes. I wonder if in turn they were more likely to set goals of improving their health as a whole and not as likely to focus on numbers on the scale to tell them how they were doing. And perhaps it's our inability as a society to share that focus that leads many of us to struggle with weight management.

What I'm getting at is that I think what makes maintaining weight loss seem "almost impossible" are the goal posts society has generally set to measure success. No doubt, if the goal set is losing every last ounce of weight that some stupid chart says you're supposed to lose then the descriptor "almost impossible" may well be fair. On the other hand, if the goal is to cultivate the healthiest life that you can honestly enjoy, subtotal losses, often with significant concomitant health improvements, are definitely within your reach.

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Monday, June 09, 2014

American Youth Soccer Organization Encourages "Refueling" with Sugar and Fake Fruit

Because what could be better than chocolate syrup to refuel children after they play recreational soccer?

So I decided to poke around the American Youth Soccer Organization's (AYSO) site where I learned AYSO's selling your children's health not just to Nestlé's Nesquik, but also to Dole's creepy squishy "fruit" bags, "fruit" leather wrapped cheese sticks from Kerrygold, and to Herbalife, a company currently being sued for allegedly being a pyramid marketing scheme, and their so-called "H30 Fitness Drink".

Soccer parents - your kids don't need to "refuel" or to "recover" but if you're worried, how about water and orange slices just like this photo taken from AYSO's Facebook page that's reportedly circa 1965 where it would seem at least one commenter would agree and notes,
"Yes, back in those days we received orange slices and water! Now it's like a giant buffet".
[Thanks to Manning Peterson for sending the Nesquik partnership ad my way]

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Saturday, June 07, 2014

Saturday Stories: Protein, Beliefs, and Lulu

Alex Hutchinson in Runner's World succinctly breaks down everything you need to know about exercise and dietary protein.

Maria Konnikova in The New Yorker on why people have such an easy time believing things that aren't true.

Jackie Rosenhek in Doctor's Review with a brief biography of Lulu Hunt Peters, the grande dame of calories.

[And if you don't follow me on Twitter or Facebook you should know that our office is looking to add a part-time RD (with room for growth) - click here for more details]

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Friday, June 06, 2014

The One Where Wolverine Gets Fired From The X-Men

I love this series.

But I'm a bit of a nerd.

Have a great weekend!



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Thursday, June 05, 2014

Is it Really "Scientifically Impossible" to Keep Your Weight Off?

I've had many requests to comment on the recent study and reports that permanent weight loss is impossible. The stories remind me of a piece from the New York Times a few years ago that also said we're all doomed to regain our lost weights and I'll repost my blog on that below, but briefly, if a meta-analysis of randomized trials of weight management fails to show long term success with weight management does it mean the people in the included trials failed to maintain their interventions, or does it mean that the interventions were too crappy to be sustainable in the first place? Having read what feels like hundreds of weight loss studies my bet is definitely the latter and therefore learning that poorly designed, or overly strict, or poorly supported interventions don't help people in the long run really isn't all that surprising.

Here's my lengthier discussion in that repost:

If you haven't read Tara Parker Pope's Fat Trap in the New York Times, her premise is pretty straightforward - permanent weight loss is virtually impossible, and for those who succeed it requires near superhuman willpower.

Why?

According to Tara, the body adapts to weight loss in multiple ways that make weight gain easier, and it's basically a full time job to keep it off from a vigilance perspective.

I think Tara's article's great and highlights two tremendously important points. Firstly, that there's way more to all of this than simply pushing away from the table, as the body keeps tucking people right back in. Secondly, that society's approach and attitude towards weight management is just plain broken - and I suppose it's here where Tara and I effectively diverge.

Tara talks of extremely restrictive diets as if they're what are required to lose. I couldn't disagree more (I'll come back to this).  Then she discusses the ongoing and incredible vigilance of successful losers, quoting Yale's Kelly Brownell as stating,
"Years later they are paying attention to every calorie, spending an hour a day on exercise. They never don’t think about their weight."
That does indeed sound rather severe, and she definitely writes about it with the spin of negativity.

What do I think?  I think negative depends on approach and attitude.  For instance where Tara might use the word vigilance, I'd use the word thoughtfulness and that being aware of every calorie doesn't mean you're not eating indulgent ones.

Tara picture though is definitely the incredibly strict life that typifies society's eye view of "dieting".  But even if severity's what's required, why can't people just stay hard core?  Superficially you might think people would in fact be able to remain hard core, because people really, really, really want to keep the weight off and I imagine this confuses many folks, including Tara.

How badly do people want this?  In a now classic study, Rand and MacGregor revealed that formerly obese, bariatric surgical patients would rather be of normal weight and deaf, dyslexic, diabetic, legally blind, have very bad acne, have heart disease or one leg amputated, than return to being severely obese. If you felt that way about something, for whatever the reason, don't you think you'd do whatever it took to keep that weight off, even if it were a hardship?

So why do people gain it back if it's so important to them? If they'd rather be blind or have a leg amputated, why can't they just keep up with their weight management efforts? Is it because as Tara describes their bodies work against them? Certainly in part, but I think the bigger reason is because they've likely chosen inane methods of loss and maintenance - like those described by Tara. To lose their weight they've gone on highly restrictive diets, they're denying themselves the ability to use food for comfort or celebration, they're regularly white-knuckling through hunger and cravings, they've set ridiculous Boston Marathon style goals for their losses, and they'll often possess highly traumatic all-or-nothing attitudes towards their efforts. In short? They've chosen suffering as their weight management modality.

Suffering as their plan?  Go figure it ain't working.  Incredible desire or not, people aren't built for long term, relentless, suffering.

I guess what I'm getting at is that there is zero debate about the fact that weight management, whether it's losing or just not gaining, does require effort. What I'm positing here is that if your effort is personally perceived as a misery, given human nature, eventually you'll fail, not because you're weak willed, but rather because you're human, coupled with the fact that the world we live in is now a Willy Wonkian treasure trove of calories and dietary pleasure.  This calorically non-intuitive wonderland is also why without ongoing thoughtfulness in terms of choices, lost weight comes back even for those who do it smart.

My weight management philosophy has always been rather straightforward - whatever you choose to do to lose your weight, you need to keep doing to keep it off, and therefore choosing a weight loss modality you don't enjoy is just a recipe for regain.

So is there one right way to do this?  I don't think so.  As far as weight loss and maintenance go there are many different strokes for many different folks, but there is one essential commonality for those who succeed where others fail - if you're going to keep it off you've got to like how you've lost it enough to keep doing it.

Now back to Tara's premise that almost no one keeps it off.

That graph up above?

It's from a recently published study of something called the Look AHEAD trial where Tom Wadden and colleagues studied those factors associated with long term weight loss success. The factors? Paying attention to intake, exercising, and applying the education they received from their expert research team. And would you take a look at that graph!  By year 4, of the folks who'd lost more than 10% of their weight in the first year, some did indeed gain it back, but 42.2% kept off nearly 18% of their presenting weight for the full 4 years! In fact they kept off virtually all of their year one losses. Moreover, looking at all comers of the trial and not just the folks who lost a pile in year one, nearly 25% of all participants maintained a 4 year loss greater than 10% of their initial weight.

That's sure a far cry from no one.  In fact if those results came from a pill some pharma company would be making billions of dollars.

So it is indeed doable, but ultimately weight loss and maintenance require lifelong effort, therefore if you don't like the effort required, you're not going to keep it up and your weight's going to return.

Somehow I wouldn't have thought an article that reinforces the fact that if you don't like the life you're living, you're not going to keep living that way would grace the pages of the New York Times.

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Shouldn't Newspapers be Ethically (or Legally) Bound Not To Sell Ads Like These?

This advertisement (continued below) wasn't published in a tabloid. Nope, it appeared coast-to-coast in Canada's Postmedia newspapers late last week.

And I'm honestly curious, shouldn't there be a law, or at the very least a corporate policy, that would preclude the printing of this sort of predatory nonsense?

(For a review of the efficacy of Garcinia cambogia, here's a recent meta-analysis).

[Thanks to the lovely Ximena Ramos Salas for sending the pics my way)

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Wednesday, June 04, 2014

Ben & Jerry's Greek Yogurt? Ugh. Just Eat the Damn Ice Cream!

Sure, Ben & Jerry's Blueberry Vanilla Graham Greek Frozen Yogurt has only 10.5 teaspoons of sugar per cup as compared to the 11.5 teaspoons per cup of their fully leaded Cherry Garcia, and yes that same cup of Greek has only 420 calories rather than Cherry Garcia's 480, but really, are those differences worth passing up the real deal?

I'd honestly be surprised to learn that there were folks out there who truly preferred the taste of Ben & Jerry's Greek Frozen Yogurt to Ben & Jerry's actual ice-creams and so here's betting that most of those who buy the Greek stuff are doing so thinking that they're coming out way ahead nutritionally. They're not. Dessert is dessert and food isn't just fuel. So despite what this ignorant CMAJ blog post might posit, everyone, not just those with "healthy" weights, is entitled to use food at times for comfort and at times for celebration, and so if you've decided Ben & Jerry's is worth it, just eat the damn ice cream (but the smallest amount of it you need to be happy).

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Tuesday, June 03, 2014

Canadian Physician Trade Magazine Recommends Fat Shaming App to MDs

Doctor's Review is a monthly glossy magazine that's freely distributed to Canadian physicians.

While leafing through this month's issue I across a section called, "Best MD Apps" and a story on "five noteworthy apps that make for healtheir and safer patients".

The first?

Carrot Fit, which according to the article tracks your weight and,
"if your weight loss is less than anticipated an irritating robotic female voice berates you and throws insults your way."
What sort of insults? Presumably insults like those seen in the accompanying screenshot calling the crying woman who has apparently gained 2.2lbs a "MEATBAG", and explaining her gain as gluttonous stating,
"I guess somebody has to eat all that food."
While I can't say I'm surprised that the app exists given our world rife with weight hate, I am dismayed that it's being highlighted to physicians as a noteworthy app that makes for healthier and safer patients.

If guilt and shame fuelled sustainable weight loss the world would be slim indeed as sadly those are the two most common things the world does its damnedest to ensure those who struggle have plenty of.

It's disappointing that Doctor's Review has encouraged Canadian physicians to recommend this fat shaming app (and in so doing reinforce hateful and health-care harming weight stereotypes), and if the folks there want a quick course on fat shaming, here's a link to Yale's Rudd Center's Resources.

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Monday, June 02, 2014

Guest Post: Check Out This Dreamy New Ottawa School Food Program!

Norman Johnston Alternate Program's New SNACk team with Chef Cezin of Wawatay Catering
This guest post is from Sally Collins, a local teacher and real food enthusiast who was inspired to try to make a difference in her students' education by ensuring their education included a healthy focus on healthy food. Here's how she's going to spend the $50,000 grant she received from Ontario's Ministry of Education in support of healthy eating initiatives. (Who says I never post happy stories?)

I'm a teacher at the Norman Johnston Alternate Program, a high school in Ottawa primarily serving at-risk youth. Our students are great…but their eating habits are horrid! In fact, we did a survey one day and found that only 15 out of 45 students polled had eaten breakfast, and only 10 out of 45 had brought something for lunch. We don’t have a cafeteria, so they weren’t planning to buy a meal, healthy or otherwise; they were just going to go without food. If students do bring food to school, they usually bring it in a McDonald's or a Tim Horton's bag…Ughhh. Not surprisingly, our students often complain of hunger and sign-out early because they are too hungry to concentrate on their work. When they leave the building they tend not to continue working, which means they are not completing their credits and not moving towards graduation.

So, when the Ministry of Education recently advertised grants for schools that wanted to promote healthy eating, we knew we had to apply. Eleven pages of government forms later, including evidence of student need, photos of successful past endeavours, SMART goals galore, curriculum tie-ins everywhere, and signatures of people I have never even met…our part was done. Two weeks later, the Ministry told us that we had received a grant for $50 000!!! Fifteen months from now, our school will hopefully be filled with students who are excited about growing, cooking, and eating healthy food. As I type this it seems much harder than when I was dreamily writing it up in the application…

The first step will be to get the students on board; this initiative needs to be student-led for it to carry weight with their peers. Interested students will join our “SNACk” team – the Student Nutrition Action Committee (with a non-existent “k”). To get things started, we’ll take our keeners away to a camp and offer them some intensive training. In the kitchen, Chef Rose will instruct them in cooking skills, and the rest of the time I will teach them leadership skills and nutrition. When the students get back to school, they will be encouraged to engage others in healthy eating activities. They can create activities such as free lunchtime salad bars, start up healthy eating poster campaigns, or organise a Norman Johnston Iron Chef competition—anyone up for a kale cook-off challenge?

Students will also team up with seniors from a residence across the street to plant a vegetable garden and fruit trees on our school property. The carpentry class will build raised boxes to hold the plants at a level that is comfortable for everyone to reach. The project will not only provide us with healthy food, but partnering with the residence will, in itself, be beneficial. We find that developing intergenerational relationships with seniors or small children brings out the best in all involved.

The produce we grow will be used in our food and nutrition classes and at special healthy eating events. About once a month, a different local chef will be invited to teach students to cook a healthy meal. As relationships are formed between the chefs and our school, we will be able to place students in co-op positions alongside the chefs. Students will gain valuable, hands-on experience in the restaurants and then come back to the school and teach others how to make great meals.

To make sure that students know what makes a meal healthy, we also have a dietitian, Rob Lazzinnaro, who will be partnering with us. He will be teaching students the basics of nutrition, as well as ways to make nutritious food delicious. He’ll also work with the SNACk team to plan a family day, where all students will be encouraged to bring their parents and siblings to the school. We’ll provide food and entertainment while Rob teaches parents and kids to make healthy meals together.

More learning will happen through our partnership with Algonquin College. We’ll be sending students to the college to try out culinary courses for a day or even a full credit. College culinary students will hopefully also give presentations to our students. We will even be able to hire a part-time Algonquin professor to refine our food and nutrition teachers’ culinary skills.

After all of these activities, we will still have enough money left over for a new student kitchen. Our current one is about the size of a walk-in closet; there is no chance we can get our entire SNACk team in that room. By the end of next year, my classroom will be equipped with an oven, a fridge, a dishwasher, counter-space, and cupboards!

We’ve only been able to use the grant for a few weeks so far, but things are already under way. Last week, the chef from Wawatay Catering came in and taught students to cook traditional Algonquin food, including a moose she had hunted and cleaned herself. Next month, our dietitian will give his first presentation to the students, and a carver from the Cordon Bleu cooking school will do a demonstration. Before the end of the year, we’ll celebrate it all with a home-made pizza party.

The entire project is going to be delicious!

Sally Collins has been teaching with the Ottawa Carleton District School Board since 1998, but just started teaching food and nutrition last year. This was when she developed a passion for cooking and eating real food as she worked towards her own 85lb weight loss. She is now somewhat of an evangelist, telling the unenlightened how much better life can be with healthy food. She especially loves cooking for her family, Scott, Sage (7), and Riley (5).

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