Saturday, December 30, 2017

Saturday Stories: The UN, The Skid Row Fixer, And Polar Bear Propaganda

By Arturo de Frias Marques
Daniel Gordis, in Bloomberg, cogently explaining why Israelis don’t care how the UN votes.

Eddie Kim, in DT News, on Wendell Blassingame, the skid row fixer.

Tim Edwards, in The Walrus, with the problem with polar bear propaganda.

Bookmark and Share

Thursday, December 28, 2017

How Your New Year's Resolution To Up Your Exercise Might Lead You To Up Your Weight

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014 and given it's New Year Resolution time, figured this might be worth revisiting.
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.

Bookmark and Share

Tuesday, December 26, 2017

Docs! Please Stop Telling Patients How Many Pounds They Need to Lose!

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.
I don't think a week goes by without a patient in my office recounting how at their last physical their doctor told them how many pounds they ought to try to lose. Sometimes those MDs will be going by BMI tables and aiming patients at a BMI less than 27. Othertimes those MDs will be pulling those numbers right out of their proverbial butts with random guesses of how much would be "good" or "healthy".

No doubt too, in the majority of cases, the recommendation to lose a particular amount of weight didn't come with any useful advice on how exactly those pounds were supposed to get lost.

So fellow MDs, if you're reading this, if you think weight is having a negative impact on one of your patient's health or quality of life I do think a respectful discussion of the issue is warranted. But before you go down that road you need to know a few things.

Firstly you need to know that despite what society teaches, we don't have direct control over our weights. Sure, indirectly behavioural choices can influence weight, and yes, we can likely suffer ourselves down to whatever weight we choose, but suffering doesn't last, and consequently the direct control of losing "x" pounds - that's nonsense - if desire, guilt or shame were sufficient to lead to specific amounts of loss the world would be quite slim.

Secondly you need to understand that if you have no useful weight management advice to offer beyond the less than useful, "try to eat less and move more", all you're really doing is undermining your doctor-patient relationship as the likelihood of your patients not wanting to lose if their weights are truly affecting their health or quality of life, is likely close to zero, and yet here you are, their doctor, telling them something they already know, inferring quite clearly that you think that if they just put their minds to it they could make it happen, while simultaneously offering them no actionable help or support whatsoever.

Docs, if you're concerned about one of your patients' weights, make sure you have a realistically actionable plan to help them with. If you yourselves are providing lifestyle advice, please consider personally living by that advice for at least a month or two to ensure it's remotely realistic and to help you to understand what your patients might face as challenges with it. If you don't plan on providing any advice yourself, please explore your community's options and find an organization or an individual that you personally research in regard to their program's safety, efficacy and ethics. And lastly, don't ever target numbers on scales as there's simply no way to ensure your patients will get there, nor is there necessarily any need that they do given that markedly subtotal losses, when combined with lifestyle changes (or even lifestyle changes alone without weight loss), are likely more powerful medically than any drug you have ever prescribed.

Putting this another way, as my friend Dr. Jamie Beckerman is liable to say, the goal is the road, not the destination.

Bookmark and Share

Wednesday, December 20, 2017

Does Your Doctor Know How To Weigh Your Child? I'm Betting Many Don't.

Image Source
As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.
On the surface it doesn't sound all that difficult.

Ask child to stand on scale. Weigh. Record weight. Done.

Working with parents of children with obesity, it seems many doctors nowadays feel it's important to add in some judgement or scary statistics such that after 'weigh' and before 'done' comes a speech on the dangers of weight along with the implicit or explicit suggestion that the child is responsible - either for gaining the weight or for not losing it.

I don't think that's fair. Moreover, I don't think it's helpful and I think it may well do harm.

It's not fair, especially with younger children, given that they're not in charge. They don't do the grocery shopping. They don't cook the meals. They don't set the example. They live the lives their parents teach them to live. They're life's passengers, not the drivers.

It's not helpful because speeches or stats without action plans by definition aren't helpful.

It's potentially harmful because the negative emotions bound to be generated by this sort of an interaction may well erode a child's self-esteem, body image, and their relationship with food. It may also lead that child's parents to adopt a knee-jerk pattern of restriction, guilt and shame that is far more likely to make matters worse than better.

The safest way for a physician to weigh a child is to tell the truth as to why weights are important. The truth is that children need to be weighed because medication is dosed dependent on a child's weight and therefore physicians need to have fairly current weights on their growing patients in case they fall ill and require a prescription. And should a physician have a concern about a child's weight I'd encourage them to have a discussion with that child's parents with the child absent and clearly, there's not much point even having the discussion unless that physician has suggestions or resources beyond the tritely useless truism of "eat less, move more".

Bookmark and Share

Tuesday, December 19, 2017

Nothing Good Can Ever Come From Weighing Your Child

Today's post was first published on US News and World report back in 2013
I'm not suggesting your child should never get weighed – certainly I'd encourage annual weigh-ins with your child's pediatrician or family doctor to track your child's growth curves – I just don't want you weighing your child.

There are three main reasons for a parent to want to weigh his or her child. The first would be a worry about a child not growing sufficiently – and herein I'd encourage you to defer to your child's doctor to determine whether or not worry is warranted.

But the second and third reasons are the ones that concern me. The second reason is a parent's belief that his or her child's weight is too high. The third reason is the second reason's corollary, where a parent might be weighing a child to see if the child has lost weight or to keep track of the rate of gain.

The thing is, scales don't measure anything other than weight. They don't measure the presence or absence of health; they don't measure whether a child is being fed a nutritious diet; they don't measure whether a child is regularly active; and they don't measure self-esteem. But they sure can take away self-esteem, can't they?

And while I haven't seen a study that proves it to be true, I'd be willing to wager that scale use in children has played a formative role in the development of many mood disturbances and eating disorders over the years. I worry greatly about the impact of weighing children on their self-esteem, body image and relationships with food.

Yes, childhood obesity is worrisome. And yes, if you're worried about your child's weight – especially if it's having a negative impact upon his or her health or quality of life – you might want to try to help. But weighing your child doesn't actually do anything. All weighing your child does is teach him or her that scales measure success, self-worth and parental and personal pride – and that weight is all that matters.

You might think that tracking your child's weight loss on a scale may be motivating, but celebrating a loss on a scale is no less risky than shaming a gain; they're flip sides of the same coin – the coin that says scales measure success. And what happens if that child who is losing one day gains?

A child's actual weight doesn't really matter, at least not in any constructive, formative way. Ultimately, a child's weight is not something that is directly controllable. Weight's primary levers – eating behaviors and activity levels – have dozens, if not hundreds, of drivers and co-drivers, and many of them won't in fact be modifiable.

Genetics, peer groups, socio-economic status, coexisting medical conditions (both mental and physical and for both child and parent), food available at school and after-school activities and many more factors all have a very real impact on weight, while none are particularly changeable. Moreover, weight management is a struggle for highly motivated, fully mature adults with various weight-related medical conditions. Should we really be expecting children to accomplish a task that eludes most grown-ups?

If you're worried about your child's weight, look to those weight-relatable behaviors that you might actually help to change instead of weighing your child. For example, consider the source, quality and quantity of their calories and of the meals you're providing them. Perhaps pick up a set of smaller plates, bowls and cups (for the whole family, not just the child) as a study that came out just last week found kids ate 52 percent more cereal when eating from a large bowl instead of a small one.

Look to your own examples for fitness, and cultivate active family outings. Review your home's screen-time rules, and certainly rid all bedrooms (again, including your own) of televisions (which has been shown to dramatically increase risk of obesity in children. Cut your cable (and hence, eliminate the constant food advertisements your children are exposed to), and ensure that your child's bedroom and habits are conducive to adequate sleep (as short sleep duration is also strongly associated with increased weight).

While it's true that there are things affecting your child's weight that you won't be able to change, it's also true that there are many things affecting their weight that fall within your parental discretion to change – and it's there where you should expend your energies. Importantly, do so without explicitly putting a focus on weight as the cause of your home's changes or the child as their sole target; instead, put the focus on improving the health of your family as a whole, with your changes affecting every member of the home, as the cultivation of healthy living behaviors provides benefits to everyone at every weight.

Bottom line: If you're concerned about your child's weight, don't rely on a number to tell you or your child how he or she is doing. Simply measuring weight does nothing to help you understand how it got there, nor will it do anything to help it go away, but doing so may make your children hate themselves just a little bit more each time you put them on that scale.

Bookmark and Share

Monday, December 18, 2017

High School Phys-Ed Horror Story Highlights Risk of Tying Exercise To Weight Loss

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.
Thanks to Jonathan Clow for sharing this story with me.

So last year a PE teacher at Huron Park Secondary School in Woodstock, Ontario had their Grade 10 co-ed class use scales and measuring tapes in front of one another to calculate their body mass indices. Why? Because his gym class for the semester was to include once weekly circuit training that consisted of ten 90 second stations of burpees, weighted squats and other squat variations, mountain climbers, with no breaks, then a water break then 2 more circuits at 60 seconds and 30 seconds each without a break in between. At the end of the semester the kids were to once again publicly re-weigh and measure themselves in order to see how much weight their once weekly circuit training helped them to lose.

Oh, and he also allegedly informed the kids whose BMIs were elevated to begin with that they would likely develop diabetes.

No doubt the PE teacher was well-intentioned and felt that both public shame and just a bit of moving around would help his students because as far as he was concerned weight is an "energy balance" issue between in and out and that if he just had the kids up their "out", the problem would be solved. I've no doubt too, that his sentiments represent the societal norm rather than an exception.

I'm told the kids mounted a boycott and letter writing campaign to the school but am unsure on how it all shook out. Fingers crossed for the kids.

I'd imagine there are many more such PE based horror stories out there, and if the teacher or school is reading this, perhaps he might have a peek at this meta-analysis of school PE programs which demonstrated yet again (and yes I know I'm a broken record), that weight wise, kids aren't going to outrun their forks, or this study that suggests negative experiences in high school PE may well discourage the adoption of a commitment to lifelong exercise.

Bottom line for all of us - exercise should be cultivated and promoted on the basis of health and fun, and fat shaming has no place (or utility) in society let alone in a high school's curriculum.

Bookmark and Share

Wednesday, December 13, 2017

Juice is NOT a F@*#ing Fruit Part II

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014 and this piece on juice.
Juice is an incredibly frustrating beverage. Despite packing the same caloric and sugary punch of Coca-Cola, unlike sugared soda, juice's undeserved health halo regularly leads to its provision, consumption (and often over consumption) in the name of nutrition - especially to and by our children.

And kids really shouldn't be drinking the stuff, or at the very least, not in the name of health.

The Canadian Pediatric Society and the American Academy of Pediatrics both recommend that juice be capped for kids at half a cup daily. And make no mistake, the capping isn't because juice is so damn good for the kids that we don't want them to drink too much of it, but rather because every glass contains 5 teaspoons of sugar (or more) and calories which won't be compensated for with decreased portions at their next meals.

The World Health Organization also considers juice to be nothing more than a sugar delivery vehicle and in their recent draft guidelines on sugar consumption specifically call out juice as a source of undesirable free sugars.

Yet there's this piece that came across my Newswire just last week. It was a press release put out by Coca-Cola (makers of Minute Maid) and Breakfast Club of Canada and it featured Teresa Piruzza, MPP for Windsor West and Minister of Children and Youth Services launching the newest Ontario Breakfast Club, which judging from the press photo up above involves the indoctrination of children into believing that fruit juice is a healthy part of their breakfast and the provision of juice boxes (containing more juice than our experts' daily recommended maximum), festooned with cartoon characters that in turn might further increase a child's consumption and desire for same.

Can you imagine a similar scene with the Minister of Children and Youth Services grinning and handing out Vitamin C fortified soda, in cartoon covered cans, to children in the name of breakfast?

According to the press release,
"Breakfast Club of Canada supports healthy breakfast programs at 1,266 schools, supporting nearly 130,000 children and serves close to 21 million breakfasts every year and that Minute Maid® has partnered with Breakfast Club of Canada since 2003, donating Minute Maid® juices to support programs across Canada."
Breakfast I'm all for, but marketing sugar water to children and washing it in BS "corporate social responsibility", food insecurity, and health, is incredibly misguided, and incredibly sad.

(And if you're looking for Juice is NOT a F@*#ing Fruit Part I click here)

Bookmark and Share

Monday, December 11, 2017

Teaching Your Kids To Cook Is More Important Than Teaching Them To Play Soccer Or Hockey

Source: USAG-Humphreys' Flickr
So this post, originally published at US News and World Report a few years ago, will be the last of this recent sled of in defence and support of home cooking.
Once upon a time, not so long ago, people ate out for a reason. Maybe it was in celebration of an anniversary, a birthday or a promotion. Maybe it was out of necessity to seal the deal with an important prospective client. Or maybe it was the understandable consequence of travel. But one thing's for sure — we didn't used to eat out simply because we could. Eating out was special.

Growing up in the 1970s, meals out were exceedingly rare for my family. Aside from our every-other-year family vacations, I'd bet we only ate out once every few months or so — and almost always to mark an occasion. I don't think we were atypical in how we spent money on food back then; as a society, the 1970s saw roughly 30 percent of our food dollars spent on food prepared outside of the home. Today North American society is over 50 percent.

Working in my office, I'd venture my average patient is eating out three to four times a week. And yet, it's not laziness that drives their frequent meals out. Regular meals out are simply North America's new normal. And it's a new normal that I think is a huge player in our collectively poor health.

While there is no one singular cause for our societal struggle with diet and weight-related conditions, one of the primary drivers is our unbelievably frequent use of restaurants, cafeterias and take-out food. Sometimes we justify these choices because there's a "low-fat", or "low-carb", option or something that sounds safe and healthful, and sometimes we convince ourselves it's due to a lack of time — that we honestly don't have the five or so minutes it would take each morning to brown-bag a lunch.

But I'd bet that most of the time we don't even think about whether we should or shouldn't be eating out. And we don't think about it, because the regular use of restaurants, or of supermarket take-out, or of nuking a box or assembling a jar of this with a box of that and calling it cooking, is just what we all do. And generally people don't question conventions that simply reflect regular behaviour.

I'd go further and say that families are often looked at with scorn when the vast majority of their meals are transformed from minimally processed and fresh whole ingredients. The "normal" of convenience has people seeing the cooking family as having an "obsession" with health or nutrition beyond what "normal" people consider to be healthy.

At the end of each day, we're all consumers of the exact same amount of time. While no doubt, there are those who have far tougher lives than others, and some work far longer hours, there was a time when each and every last family out there, regardless of how rough their circumstances, was obligated to find the time to prioritize cooking as part of day-to-day requirements, because there simply was no alternative. And while there are definitely people whose life circumstances truly make regular cooking an impossible and unreasonable goal, there are definitely others who have been convinced, or have convinced themselves, that it's not doable.

Now I'm not trying to romanticize the foods we all once cooked. I'm certain many a meal from those days would have turned many a dietitian white with horror. But I'd argue that the simple act of cooking — a health-preserving life skill — is a skill that risks extinction. In some families, regular home cooking is a phenomenon not seen for three generations.

My guess is that even the worst home-cooked-from-fresh-whole-ingredients meals from back then were likely to be lower in calories, sodium, and sugar than many healthy-sounding restaurant choices today. More importantly, those meals were far more likely to involve shared meal preparation and cleanup along with their consumption as a family ritual, around a table free from today's drone of kitchen-based TV sets and the pings and beeps of emails, tweets and Facebook updates from our electronic leashes.

So what have we prioritized in cooking's place? Kids' organized sports? Longer work hours? Our favourite TV shows? Text messaging? Social media?

Boiling it down to its essence, ultimately what we've prioritized as more important than cooking is convenience. Moreover, we go out of our way to convince ourselves (as does the food industry) that convenience can still confer health, that those boxes that claim they contain healthy nutrients and those menu items that include vegetables are in fact good for us. But looking around us — and given the urgency of the problem and the never-ending call to arms to fix it — it sure doesn't seem as though convenience is doing a very good job.

The inconvenient truth of health is that healthy living does require effort. There are no shortcuts.

And if you're looking for the one thing you can do that would most dramatically improve your or your family's health, my money would be on you prioritizing the regular, uninterrupted use of your kitchen. Prioritize it at the expense of your electronic tethers and, yes, even at the expense of your children's after-school sports, as teaching your children the life skill of cooking trumps their need to learn how to play soccer - and if you have time in your life for that, you definitely have time in your life for this.

And please don't misread this as if I'm suggesting that change need be absolute or all at once. Maybe commit to cooking one additional meal a week, and it certainly need not be complex. The goal is to cultivate love affairs with our kitchens, but that doesn't mean you'll be madly in love from day one, and while I don't think we should stop taking advantage of the miraculous times that we live in and should still enjoy and savour some wonderful meals out, we should be aiming at making eating out special again — a rare and exciting treat. In other words, aim to eat out for occasions, and not just because it's Tuesday.

Bookmark and Share

Thursday, December 07, 2017

Introducing #15by15, My Wife's Life Skill Challenge For Our (And Your) Family

Our family's current week's meal plan as laid out by our 10 year old on Sunday (it's a magnetic whiteboard that lives on our fridge)
Today's guest post comes from my wonderful wife Stacey who has recently implemented a new challenge for us - she calls it #15by15 - where 15 is the minimum number of meals we want each of our kids to know how to make, entirely by themselves, by the age of 15.
Fifteen by fifteen”. That’s what I told my kids when they recently helped to make our menu plan for the week, and this time were instructed to add in one meal each that they would cook from scratch, with or without my help.

I’m not going to lie, there was some whining. My three kids, now aged eight, ten and thirteen, have been helping to create menu plans that include breakfast, snacks, lunch, dinner and even treats for several years now (ht stands for "Halloween Treat" - they generally last them an entire year), as well as cooking with me and/or my husband. The kids take turns doing this from week to week because they recognize that we all have different favourites, and they want to make sure that theirs are included.

Our kids also recognize that for a household to run well, and for their mom to yell less (because, well, life is stressful enough without having to worry about each meal and snack that comes next), we all need to pitch in and help. This includes other household chores, like doing the laundry, loading and unloading the dishwasher, setting and clearing the table, taking care of the cat's food and litter, and taking out the trash, among others. My kids know that while these are not particularly fun activities, they are life skills, and that they aren’t likely to be taught how to do them anywhere but home.

In my mind, perhaps the most important of all of these life skills, is the skill of cooking.

From the time my kids were old enough to provide constructive criticism of mine or my husband’s cooking escapades, they have also been asking that we teach them how to make particular favourites before they move out. And so, with that, came our promise to them,
"When you leave home, you will leave with a cookbook of family favourite recipes, an Instapot (because they’re awesome), and a minimum of fifteen meals that you can make completely on your own from scratch."
And while there may have been whining when first announced (and perhaps even a bit of trepidation from me as I thought about the mess that would be my kitchen on at least a tri-weekly basis (I'm not including the nights my husband cooks, god-bless his mess)), my kids have fully embraced this new goal, reminding us that it is their turn to cook, with my older two kicking us out of the kitchen when they're up – which is beyond awesome, because they know that I have difficulty stepping back and allowing them to do their thing, and clearly they are more than capable.

While I can’t say that there hasn’t been an impact on the cleanliness of my kitchen, I can say that the mess has been worth making in reaching the goal of my kids becoming self-sufficient and capable of cooking with fresh, whole ingredients. They are well on their way to being able to cook fifteen meals by the time that they are fifteen years old, and, at least to date, they continue to be excited in finding and cooking new recipes, and full of pride as our family consumes them.

If you have a young family, perhaps you can consider taking on the #15by15 challenge too.

Bookmark and Share

Tuesday, December 05, 2017

You'll Gladly Die for Your Children; Why Won't You Cook for Them?

Today the Heart and Stroke Foundation published a report by Dr. Jean-Claude Moubarac that found Canada's biggest consumers of ultra-processed food are our children. Canadian kids between the ages of 2-18 are consuming over half of their calories from ultra-processed foods, and kids aged 9-13, are closing in on 60%. When I read the report, one which clearly suggests that cooking is a lost art, it reminded me of this article which I first published in USNews and World Report in 2013 (and I'll have more on this subject from my wife on Thursday)..
I'm a parent of three. I hold no illusions that I'm a uniquely dedicated parent or that my love for my kids is greater than anyone else's. And like all parents, should the opportunity arise, I'd gladly, immediately and unquestioningly give my life for their's. And it's my firm belief in the incredible and powerful love of parents for their children that regularly leads me to scratch my head and wonder: Why it is that while most every parent would happily die for their children, it's an increasingly rare parent who will cook for them?

I've heard all of the explanations—time, cost, after-school activities, lack of cooking skills, picky eaters, etc. But ultimately, I think the real reason parents who would die for their children are comfortable feeding them from boxes and drive-thrus isn't due to a lack of love or concern. It's because society has been so firmly and conclusively duped into believing that doing so is both safe and healthful that it has become our new normal.

Remember that the foods we feed our children are, quite literally, their building blocks. Consequently, we are building a nation of children constructed from the food industry's deceptively and, at times, deceitfully marketed salt, sugar and fat offerings of convenience.

But more than that, the manner in which we feed our children is the model from which they're likely to draw upon to feed their futures. If fast and processed food assembly make up the bulk of their childhood "cooking" experiences, where actual cooking is a grumbling rarity relegated to holiday dinners, do you think your children are likely to take the time to cook and look after their nutrition as young adults or as parents themselves?

The statistics are ugly. Nearly half of our food dollars are being spent on restaurant and out-of-the-home convenience foods. In our homes, the percentage of food dollars being spent on processed foods has doubled since just the early 1980s. But again, we're not eating this way because we don't value health or love our children. We're eating this way because the food industry has festooned boxes of salt, sugar, fat and pulverized white flour with claims of added "nutrients" and health benefits; they've also convinced us that mixing, pouring, stirring and adding is "cooking."

The fact the food industry has succeeded in doing this in part may have to do with our species-wide desire for convenience, because, at the end of the day, it's simply not about time. Recent reports put the average American in front of a television for 34 hours a week and on the Internet for another eight–sure sounds like time's something of which we actually have plenty.

Fixing this problem will require more than just trying to make parents feel guilty. At this point, many parents have been led by lax front-of-package labeling and advertising laws to faithfully believe that the boxes they're feeding their children do in fact conveniently and healthfully replace fresh, whole-ingredient cooking. Plus, they themselves may have grown up in homes where actual home cooking was anything but the norm and may not know how to cook.

So what should we do? Here's a start:

• We need to take away the food industry's upper hand in the supermarkets. We need to change labeling laws and hamstring the ability of the food industry to hoodwink harried parents into believing that a sometimes-comfort food like mac and cheese can ever be a smart choice. Why should the onus be on the consumer to turn boxes over to study the nutrition facts panel to ensure that the claims on the front of the package are supported by its actual contents? Moreover, are consumers actually equipped to do this from a nutrition-education perspective?

• We need to bring back home economics. Sadly, there are many families in which regular home cooking was last seen three generations ago. I think children shouldn't be allowed to graduate high school without knowing how to cook 10 simple, healthful, fresh, whole-ingredient meals on their own. As well, we should consider using our schools' abandoned kitchens after hours to help teach basic cooking skills to families as a whole.

• We need to denormalize the reliance on convenience when it comes to feeding our children. As a society, we need to prioritize our kitchens as the healthiest and most important rooms of our homes. And we'll likely need hard-hitting public health campaigns that criticize the food and restaurant industry as well as nutrition education in schools.

The shift from regular home cooking to the mess we're in now didn't happen overnight, and it's going to take time to reverse. We need to rise up and reclaim our kitchens and shift the balance of power from the food industry to loving moms and dads who no doubt would die for their children and, if empowered to do so, I've no doubt would cook for them, too.

We need to champion produce and not products, and we needed to have started yesterday.

Bookmark and Share

Saturday, December 02, 2017

Saturday Stories: Professor Piffle, Opioids, and Weight Lifting

By U.S. Navy photo by Mass Communication Specialist 1st Class Brock A. Taylor [Public domain], via Wikimedia Commons
Ira Wells, in The Walrus, with a story more for we Canadians on Jordan Peterson, the Professor of Piffle.

Admiral James Winnefeld, in The Atlantic, on how no family is safe from the opioid epidemic.

Alex Hutchinson, with his new gig in Outside, on how if you want to delay death, you should probably be lifting weights.

[And thanks to the great generosity of friends, family, and readers, this year's Movember fundraising amounted to $4,553. If you'd like to watch my kids shave off my moustache, here's that video]

Bookmark and Share

Wednesday, November 29, 2017

Picture Books Shouldn't Teach Toddlers To Be Self-Conscious About Weight

A patient brought in this picture book.

It's apparently from a series of picture books about "Pot Bellied Buddies"

It's about a bunny who as a consequence of eating too many carrots, no longer fits in his bunny hole.

And so what did the bunny do?

Well he decided to "cut back a little, and exercise"

Another patient brought in a Thomas and Friends book.

In it, kids are introduced to, "The Fat Controller"

And when exploring other Thomas and Friends characters I learned there's also a "Thin Controller". There are no other body based descriptors of any other characters. Weight is apparently an important distinction.

In the past I've noted weight biased messaging in:

A beloved and award winning children's author's book
Harry Potter
The Princess Bride
A kid's movie whose entire premise rides on the suggestion that being fat is horrific
The Muppets reboot
Scooby-Doo
Johnny Test
Max and Ruby

and

An attraction at Disney's Epcot Center.

That weight hate and stereotyping is so prevalent in children's books and movies speaks to how deeply ingrained weight bias is in society today. Parents, please be on the lookout for this sort of messaging, and when (not if) you come across it, use it as an opportunity to have a thoughtful discussion with your kids about why it's wrong.

Bookmark and Share

Monday, November 27, 2017

Whether Or Not You Can Outrun A Bad Diet Depends On Your Finish Line

If you're trying to run away from weight, the likelihood of you succeeding without also addressing your diet is pretty darn low.

On the other hand, if you're trying to run towards health, well then my money's on your feet.

Exercise is, second only perhaps to not smoking, the most important health behaviour anyone can cultivate.

Whether you're running to reduce the risk or burden of most chronic diseases, or to preserve and improve your functional independence, or to reduce pain, live longer, improve sleep, bolster mood, gain strength, lengthen endurance etc., increasing and sustaining regular exercise, regardless of weight and independently of diet, is incredibly powerful.

And I'm not aware of there being any credible voices suggesting otherwise.

Bookmark and Share

Saturday, November 25, 2017

Saturday Stories: Window Girl, Graffiti Kids, And Iron Lungs

Lane Degregory in Floridian on the girl in the window (apparently an update to this 2008 story is imminent).

Mark McKinnon in The Globe and Mail on the graffiti kids who sparked the Syrian war.

Jennings Brown in Gizmodo on the last few people living in iron lungs.

Bookmark and Share

Wednesday, November 22, 2017

10 Easy Non-Junk Food Rewards Teachers Can Dole Out

It happens in my kids' classes too. Teachers use junk food to reward academic accomplishments, good behaviour, fundraising and other social initiatives.

I'm sure the intentions are good. Rewarding desired behaviours reinforces the behaviour. Of course it also reinforces the rewards.

Teachers teaching their students, usually their very young students, that candy and pizza are rewards for every job well done no matter how small, might not be a great lesson for kids.

Moreover, there are so many better rewards that could be metered out.

In no particular order, here are ten (some whole class, some single kid), and please feel free to share this post and list with the your children's teachers. Honestly, they care about your kids, but they may not have thought about the issue much, and they're just doing what's nowadays considered to be normal.

1. An extra period of recess
2. An in class dance party
3. Dress up (or down) days (PJs, costumes, fancy clothes, whatever)
4. Class put in charge of school PA system for the day
5. Painting a hallway or classroom mural
6. Stickers or temporary tattoos
7. Sit wherever you want for a period (teacher's chair, floor, under desk)
8. Get out of one night of homework free card
9. Phone a kid's parents to tell them how terrific their kid is
10. Scrabble/boggle/other sort of educational game competition/hour

Bookmark and Share

Monday, November 20, 2017

Of Course You Can Be Fit And Fat

Undeniably fit ultra-marathoner Mirna Valerio (from a 2015 Runner's World story (am quoted))
How about I pose a different question.

Can you be fit and have diabetes?

Of course you can. It'd be ridiculous to suggest otherwise.

So why doesn't the question of whether or not a person can be fit and fat sound equally ridiculous?

Why instead do we regularly see articles like this recent one from the New York Times that cover the "controversy" of the fit fat person?

In part it's because these stories conflate fitness with being free from other chronic diseases and/or from the risk of developing other chronic diseases.

But is that the average person's definition of fitness?

I don't think so.

I think most people think of fitness as the thing one gains as a consequence of regular exercise. That's why when it comes to the question of can you be fit and have diabetes, it sounds ridiculous as of course you can exercise and have diabetes.

Well guess what, you can also exercise and have obesity.

And in fact, that same study on which the New York Times based their article, didn't even try to quantify whether or not exercise provided health and/or quality of life benefits to people with obesity (of course exercise does). It simply looked at the heart disease risk of people with obesity, who didn't have other chronic medical conditions.

So basically the study concluded that obesity ups cardiovascular disease risk, not that those with obesity couldn't be fit.

And exercise mitigates, to varying degrees, the risks associated with virtually all chronic diseases, and obesity is no different.

Coming back to why we see stories in even the world's most reputable newspapers framing fitness and fatness as a controversy, well I think it just comes down to weight bias - specifically the trope that assumes that anyone with obesity must be lazy, because without that bias as a backdrop, there really isn't much of a story.

Bookmark and Share

Saturday, November 18, 2017

Saturday Stories: Gene Drives x 2, and The Uncounted

By Mariuswalter (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
Ed Yong, in The Atlantic, on how New Zealand's war on rats might change the world (and not necessarily for the best).

Carl Zimmer, in The New York Times, on why scientists believe gene drives (like the one discussed in Ed Yong's article) are too risky to employ.

Azmat Khan and Anand Gopal, also in The New York Times, with an incredible piece of journalism on the accuracy, or lack thereof, of America's bombing of ISIS.

And lastly, if you enjoy my blog, please consider a donation to my Movember fundraising for men's health initiatives. Thanks to the generosity of friends, family and readers, I'm 91% of the way to my $3,500 goal. You can give anonymously and it's fully tax deductible. Just click here! No donation is too small.



Bookmark and Share

Thursday, November 16, 2017

Physicians Best To Have Practiced What They Preach Regarding Lifestyle

A few days ago I put out a tweet that stated that physicians (and with more characters here I'll say other allied health professionals as well) shouldn't give lifestyle advice unless they've followed it themselves. Given it led to a varied discussion, thought I'd expand more here.

First, I'm talking primarily about diet and fitness advice which pertain to any diet/fitness responsive condition or simply on healthy living as its own aim.

Second, while I think it'd be terrific if all physicians continually walked their talks, this isn't a reasonable expectation. What is however reasonable, at least in my opinion, is that a physician providing lifestyle advice has spent at least some time following their own advice (barring of course any physical or medical limitations that might preclude same).

Living the whys, wherefores, real-life challenges, and logistics, of their own lifestyle advice provides physicians with insights and empathy that in turn will help in their understandings of their patients' struggles and barriers. That understanding is likely to improve the counselling and support those physicians provide.

Whether it's keeping a food diary, following a particular diet, cooking the majority of meals from fresh whole ingredients, exercising a particular amount each week or day, mindfully meditating, etc - spending a real amount of time doing so (my non-evidence based suggestion would be for a month at least) will make you a better clinician.

[And to be clear, as there were those online who wanted to extrapolate my statement into one that suggested physicians must themselves all live incredibly healthful lives and maintain certain weights - that's definitely not what I'm saying, nor of course does weight provide real insight into the health of a person's lifestyle (as plenty of people with obesity live healthy lives, and plenty of people without don't).]

Bookmark and Share

Tuesday, November 14, 2017

Early Childhood Physical Activity Does Not Vaccinate Against Obesity

By Pete (originally posted to Flickr as determination_0970) [CC BY-SA 2.0], via Wikimedia Commons
It's not uncommon when I meet parents of children with obesity for them to tell me either that it doesn't make sense because their child is extremely active, or that inactivity is to blame for their child's struggles.

And while my confirmation bias is that weight leads to inactivity in kids rather than inactivity to weight, data is somewhat mixed, with some studies finding total daily energy expenditure in very young children is associated with lesser weight gain, and others, not.

One of the shortcomings of prior studies were that they focused primarily on energy expenditure measured during a child's first year of life, and didn't cover the period known as adiposity rebound whereby BMI typically decreases until the age of 4-7 years before beginning to increase through late childhood.

A recent small study, High energy expenditure is not protective against increased adiposity in chldren, included that time period.

Briefly, 81 subjects who were classified as either at low risk of developing obesity (in that they had lean mothers with an average BMI of 19.5), or at high risk (mothers with an average BMI of 30.3), were recruited, and 53 remained through to the study's conclusion of 8 years. Three measures of adiposity at 8 years were collected - BMI percentile, BMI Z-score, and percent body fat. Total energy expenditure was measured using doubly labelled water at 4 months, 2, 4, 6, and 8 years of age (though only 58% of all total measurements were collected). Body composition was measured by way of bio-impedance analysis at ages 0.25 and 2 years, and by way of DEXA at ages 4 and 6.

What was found was that total daily energy expenditure increased with body size, but,
"there was no evidence supporting the hypothesis that a low habitual TEE for that body size leads to subsequent increase in BMI or % body fat"
Nor was there an association between measures of adiposity at age 8 and total energy expenditure between the ages of 0.25 and 6 years.

The authors overarching conclusion is that when it comes to the genesis of childhood obesity, it's energy in, not energy out.

I can't help but wonder, were that to be the prevailing belief, would parents with concerns about their children's weights be more conscious of their children's diets (especially liquid calories and purchased meals) as energy-in is something that many parents deemphasize during our initial discussions.

Bookmark and Share

Saturday, November 11, 2017

Saturday Stories: Trump's USDA, ORBITA, and 'Woman, Black',

Michael Lewis in Vanity Fair on Trump's USDA.

James Hamblin in The Atlantic covers the ORBITA trial and wonders how much of heart disease is a state of mind?

Future physician Chika Oriuwa with her spoken word poetry slam 'Woman, Black'



Bookmark and Share

Thursday, November 09, 2017

More Evidence That More Exercise Doesn't Up Total Daily Calorie Burn

Why is it that exercise doesn't seem to help appreciably with weight loss (and for those who enjoy building strawmen out there, note I'm talking about weight loss, not fat loss, nor fitness, nor health)?

One possible reason is that many people eat back their exercise in the form of a reward for doing it, or because they have been taught by savvy marketers that they need to refuel or recover something or other.

Another possible reason is that upping intentional exercise may lead bodies to decrease unintentional calorie burn (decreased fidgeting/NEAT, decreased autonomic tone, etc.) and also by way of improved exercise efficiency.

Overarchingly the latter theory is called constrained energy expenditure, and the evidence on all of this is early, and somewhat mixed.

Well a few months ago another block was added to the pile (at least for older women without obesity) suggesting constrained energy expenditure is a real phenomenon. It was a study published in Physiological Reports and it detailed the impact that a 4 month long moderate-intensity walking program had on the total daily energy expenditures of older women without obesity.

The study's 87 included participants reported being physically inactive, and weren't found to have any significant medical issues. The group was randomized into either receiving one of 2 doses of moderate intensity exercise for 4 months. Importantly, the exercise itself was supervised. Before and after measurements included resting energy expenditure (via indirect calorimeter), total daily energy expenditure (via doubly labeled water), body composition (via DEXA), graded exercise test (via treadmill VO2 max), physical energy expenditure (TDEE*0.9-RMR (to account for thermic effect of food reduced by 10%), and NEAT (by subtracting exercise energy expenditure - physical activity energy expenditure).

When it was all said and done, the lesser group added an average of 105 minutes of walking to their weeks, while the higher group added 160 minutes to their weeks.

There was a teeny tiny bit of weight lost in both groups (1.7lbs), and a tiny change to body fat percentage (-0.7%), but there were no between group differences. Expectedly, V02max improved more in the larger amount of exercise group.

What didn't change?

Everything else.

Despite marked increases in intentional exercise, and marked differences in adhered to doses of exercise, there were no differences found for participants' total daily energy expenditures, resting metabolic rates, NEAT, non-exercise physical activity or even total physical activity.

These results changed some when they further analyzed the data as they determined that those patients with higher baseline levels of physical activity showed lower levels of NEAT (important to note, difference did not reach statistical significance) post 4 months of exercise, whereas those with lower levels of baseline activity experienced decreases to resting metabolism with exercise (authors suggested latter might be due to weight loss, but given how small weight loss was, I find this confusing as the RMR drops were not small).

All this to say when it comes to exercise and its impact on calories burned, it's clearly far from a simple math formula. It's also incredibly unfair to weight. But as always, when it comes to improving health, nothing beats it.

[Thanks to Matt Woodward for sharing this study with me]

Bookmark and Share

Monday, November 06, 2017

Guest Post: Special K Nourish Ad Perpetuates Supermom Nonsense

I've never been a fan of Kellogg's Special K's pretending to give a crap advertising, and so when I received an email from longtime reader Rosemary, who was unimpressed to say the least with one of their latest ads (embedded at the end of this post), I asked her if I could share her thoughts. She kindly agreed. Raw to say the least, and though I don't fully agree with every sentiment expressed herein, I'm betting they'll resonate with many.
I know soooo many women (and men!) that eat these products - thinking they are a whole / healthy choice.

This ad is so much ugh. Of course they had to throw in the shot of the well-endowed woman in the bra. "Casually getting dressed" ... while literally stuffing her face. Geneen Roth would not approve! Lol.

The whole "I am woman hear me roar - I can do anything - I am fierce - around food / being in charge of the food / feeding the kids - this media trope is so such nonsense. I dont know any women that work / live / eat the way this ad depicts.

Just perpetuating that myth -women- no, we don't deserve time carved aside to eat calmly - we are just too damn busy being everything to everyone. Just perpetuates this super mom woman role nonsense.

Most women I know / especially those with young school age children LOATHE grocery shopping / planning meals / making lunches / cleaning up (cuz let's face it, cooking proper whole foods is more work) / and just generally feeling the societal pressure to excel to be creative (and inspired! (Oh shut up Jamie Oliver))- about feeding their families. (And isn't this just code for "if you love your family you should be obsessing about this too like every other delusional Martha Stewart wannbe? Most of us are just so exhausted from overwork / we lose the motivation. In secret, we all admit how much we hate it and what drudgery it is.)

And there Kellogg's is trying dutifully to hit all their "diversity notes" - woman motorcycle mechanic / buzzcut lgbt-ish rainbow wristband girl - / It is all so contrived.

They are depicting the overworked woman - and they are the solution, when in fact, eating their crap that masquerades as "breakfast" and "food" probably actually contributes to feeling exhausted - re unstable blood sugar - carby weight gain - making one less energized to shop and prepare. It's a cycle.

I know when I eat next to no processed food - my energy levels are great. After about 4 days of not eating any crap.

The cereal is 10g's of sugar per 3/4 cup serving. That would maybe cover the bottom of the cereal bowl. No one eats only 3/4 cup of cereal when they pour a bowl.

And the granola bars are even worse - palm oil - and many different forms of sugar. Cane in the chocolate and corn syrup.

No reply necessary - yer bizzy - just wanted to pass it along.



Bookmark and Share

Saturday, November 04, 2017

Saturday Stories: Global Trolling, Pain Empires, and Fake News Towns

A non-bylined piece (at least not that I could see) in The Economist explaining how the world has been trolled and why social media is to blame.

Patrick Radden Keefe in The New Yorker on the Sackler family and their empire of pain.

Caitlin Dickerson in the New York Times on what fake news did to Twin Falls, Idaho

[If you find this blog entertaining, interesting, and/or valuable, know I'll never ask you for money to read it, nor will I subject you to ads, but I will, once a year, ask you for donations to support my #Movember efforts. Please to report I'm nearly halfway to my $3,500 fundraising goal! Click here to give. No amount is too small, you'll get a tax receipt, and if you don't want it known by me or anyone else that you hang out here from time to time, you can give wholly anonymously as well.]


Bookmark and Share

Wednesday, November 01, 2017

And So It Begins (#Movember)

And so it begins (again).

This month I pledge to grow my something of a Pedro Pascal inspired lip-terpillar in the name of raising awareness (and $s) for men's health.

If you enjoy my blog, a blog fully free from advertising, I'd like to ask you to donate to my Movember fundraising efforts. I've kicked them off by donating $100 myself and I'm hoping to raise more than last year's $3,500.

Contrary to what some believe, Movember is not a prostate cancer charity per se, and though some of its funds do support prostate cancer research and treatment, Movemeber supports multiple men's health initiatives including those involving mental health, suicide, body image, eating disorders, testicular cancer, substance abuse, and more. Regarding prostate cancer, I was pleased to see that Movember encourages patients to speak with their physicians about the value (or lack thereof) of PSA screening, rather than suggesting it's a good idea for one and all.

Donating is easy. Just click here and give! And of course, Movember is a registered charity, so all donations are fully tax deductible.

In return I vow to continue to blog freely, to never allow advertisements, and to regularly post pictures of what might well have been an effective form of birth control in my home had I sported it year round back in the day.

For me the ask is also personal. My father was diagnosed with prostate cancer when I was in medical school, and soon I'll need to start wrestling with whether or not with that strong family history, I should walk the slippery slope of testing. My oldest cousin Marshall - we lost him to substance abuse.

Every dollar counts, no donation is too small.

(And if you want, you can make your donation anonymously so no one (me included) will know you hang out here from time to time.)

Bookmark and Share

Monday, October 30, 2017

Food Industry Furious With Health Canada's Front-of-Package Plans

If Health Canada takes Chile's lead, we too might see Frosted Flakes boxes change from looking like those on the left to looking like those on the right.
When industry is furious with a government proposal it's a safe bet that proposal is likely to affect their sales, and so when I learned that the food industry was incensed by Health Canada's front-of-package plan proposals (Aric Sudicky, a final year medical resident who was rotating through our office at the time, watched the recent roundtable style consultation hosted to discuss the implementation of what will be a Canada wide front-of-package program, via teleconference and reported to me that industry was none too pleased), I wanted to learn more.

Now this post isn't going to delve into whether or not those are the best 3 targets for front-of-package symbols, instead I want to focus on the lobbying and machinations of industry.

First though, a tiny bit of background.

In creating a new front-of-package symbol for Canadian consumers, what Health Canada doesn't want is a program that emphasizes so-called positive nutrients as 50 percent of Canadian package fronts already have those (put there by the food industry directly to help sell food), or one that requires a second step of thinking to interpret (eg studying the nutrition facts table) as that has been shown to lead to misunderstanding, or a hodgepodge of programs (as more than 150 front-of-package labeling programs have already been documented in Canada) .

What Health Canada does want is a single, standardized system, that involves a prominent symbol, that's consistently located, that doesn't require nutritional knowledge to understand, to help consumers identify products with high levels of nutrients that Health Canada deems are concerning to public health, that by itself provides the required interpretation for its meaning. Such a system would be consistent with the core recommendations made by the U.S. Institute of Medicine.

Breaking it down further, what Health Canada wants is a system that conveys simple to understand information, rather than one that presents data requiring interpretation.

Further still?

Health Canada wants warnings.

In their recent meeting, Health Canada presented their wants to food industry stakeholders, as well as the evidence they feel supports them, and invited them to submit their thoughts and suggestions for a symbol to fit Health Canada's 4 design principles:
  1. Follow the "high-in" approach
  2. Focus only on the 3 nutrients of public health concern (sugar, sodium, and saturated fat)
  3. Be 1 colour (red) or black and white; and
  4. Provide Health Canada attribution
As to what this might look like, here are some mockups put together jointly by the Canadian Cancer Society, Canadian Medical Association, Canadian Public Health Association, Diabetes Canada, Dietitians of Canada, and the Heart and Stroke Foundation.

Given that warning symbols aren't likely to be good for business, I was curious as to industry's response to the ask.

Suffice to say, industry is indeed unhappy.

The Retail Council of Canada wants Health Canada to implement instead an instruction for consumers to turn products around and study their nutrition facts tables, and they don't want Health Canada's name mentioned on the symbol. They are apparently worried that including Health Canada's name on the symbol might be misinterpreted as a government endorsement which in turn would lead consumers to eat more of the products with the warning labels. They're also apparently simultaneously worried that if the symbol utilized is already recognized to be a danger symbol, it could lead consumers to believe there is a food safety risk, and that if used, children, accustomed to seeing these symbols on foods, might lead them to think that cleaning supplies with danger symbols are safe to consume.

The Food Processors of Canada used bold to point out that, "the meeting didn't agree to anything", and that, "Health Canada has lost its way on the obesity issue". They think that what's needed is more public education, not a front-of-package warning program.

The Canadian Beverage Association expressed their, "deep concerns", and that though they were happy to have been included in the meeting, their definition of "deep and meaningful dialogue" with industry should include a process whereby industry participants would all discuss and agree upon what the program would entail.

Food and Consumer Products of Canada also wanted to express their disappointment that they weren't provided the opportunity to be more directly involved in crafting the proposal's criteria and their concerns about "the integrity and transparency of the consultation process". They sent a second note expressing their hope that the criteria still have room to evolve and that their preference is for traffic lights as they believe, "information – good and bad – builds on consumer literacy".

Dairy Farmers of Canada expressed their concern that the proposed warning system lacks the nuance required "to distinguish between nutrient-dense and nutrient poor foods" (sweetened milk will likely be slapped with a high in sugar warning), and that they'd be happy to support, especially, "if coupled with exemptions for nutritious dairy products", those programs that would provide data for consumers to study and interpret (like for instance the Facts Up Front program illustrated below).

There was however, one response from industry that was heartening. It was from Nestlé, whose representative reported being, "a little embarrassed" by how industry presented their views during the roundtable, and, "that Nestlé is not fully aligned to some of the comments that were made by some of our trade associations, and a few of us are feeling very frustrated."

Whatever comes of all of this, one thing's for sure. The food industry's near uniform opposition to Health Canada's proposed front-of-package warning label criteria is strong indirect evidence in support of their utility, as for the food industry, salt, sugar, and fat are the drivers of profitability and palatability, and they'll oppose anything they worry might limit their use.

So kudos to Health Canada for sticking to their guns, and also for honouring their pledge to make this process transparent by sharing with me industry's responses.

(and if you clicked on any of the industry letters to read, this is the post roundtable letter from Health Canada to which they're all referring).

Bookmark and Share

Saturday, October 28, 2017

Saturday Stories: Motherisk, Blood Tests, and Kim Jong Nam

CC BY-SA 3.0, Link
Rachel Mendleson, in the Toronto Star, with Part I of her incredible reporting on the fallout from the Mortherisk scandal.

Christie Aschwanden, in Five Thirty Eight, details her experiences with direct to consumer blood tests in the name of athletics.

Doug Bock Clark, in GQ, with the strange but true story of Kim Jong Nam's assassination.

Bookmark and Share

Monday, October 23, 2017

Hey American Youth Soccer Organization, Kids Don't Need Sugar To Play

It's difficult to overstate just how aggressively the American Youth Soccer Organization (AYSO) allows Nesquik to push chocolate milk on their young players.

The reason why is simple. In 2014, AYSO partnered with Nesquik and named it, "the official “Chocolate Milk” of AYSO."

Nesquik's AYSO enabled health washing centres around the supposedly "ideal ratio" in chocolate milk of carbohydrates to protein that "can help refuel and restore exhausted muscles".

"Exhausted muscles"?

I did a straw poll on Twitter of parents whose kids play soccer.

94% of the 269 respondents reports their kids as actually moving for less than 60 minutes per soccer outing, with vast majority of respondents reporting less then 30 minutes of movement.
Those poll results correspond nicely with those found by objective measures and published in Pediatric Exercise Science whereby accelerometers revealed that kids only spend 17 minutes of a 50 minute soccer match engaging in moderate-to-vigorous activity.

Now putting aside the discussion of ratios and whether chocolate milk has a special role in "refueling", it's difficult for me to imagine that anyone would suggest that kids moving for less than 30 minutes at a stretch (or even an hour), have "exhausted muscles" that need any special attention.

But I'd be wrong, because Registered Dietitian Tara Collingwood is out there for Nesquik to tell parents that chocolate milk is a healthy, perhaps even necessary, choice.

I know this because a close friend of mine and father of recently AYSO soccer enrolled twin 8 year olds and a 5 year old, has been sending me the signed by Collingwood promotional materials that arrive courtesy of AYSO in his inbox.

Here are Collingwood's "Hydration Guidelines" that recommend not only post game chocolate milk, but also suggest kids quaff 4-8oz of a sports drink for every 15 minutes played.

Here's Collingwood's post game snacks handout which of course includes chocolate milk.

Here's Collingwood's grocery list that includes chocolate milk (with its nearly double the per drop calories of Coca-Cola along with 2.5 teaspoons of added sugar per cup) in her list of "best foods"

Here's Collingwood's game day recommendations, which if my calculations are remotely accurate, would provide my friend's barely moving 5 and 8 year olds with somewhere between 400-600 game based calories, and more than a day's worth of added sugar (especially if drinking sport drinks ever 15 minutes as she recommends) apiece.

And here's Collingwood touting chocolate milk as one of 5 "must-have" foods alongside spinach, salmon, bananas, and whole wheat wraps.

And please don't think that AYSO cares enough about your kids to not allow Nesquik to target them directly with marketing either.

Nesquik has also paid Latina Mommy Bloggers to spread the word about the miraculous marriage of soccer and sugar-sweetened milk.

Here's another

And another

And another

In fact there are many, many, more.

AYSO, if you honestly cared about kids' health and sports nutrition, you'd put an end to this partnership, as Collingwood's love of chocolate syrup notwithstanding, it's nutritionally indefensible.

Bookmark and Share