Saturday, June 23, 2018

Saturday Stories: False Hope, Dr. Ruth, and Opioids

By Rhododendrites - Own work, CC BY-SA 4.0, Link
Lindsay Gellman, in Longreads, on German alternative cancer treatment clinics catering to foreigners and selling very expensive hope .

George Packer, in the New Yorker, with another reason to adore Dr. Ruth.

Elisabeth Poorman, in Common Health, with her personal take as a physician on the opioid crisis.

[And if you don't follow me on Twitter or Facebook, here's a recent episode of my much neglected Weighty Mutters podcast where I chat with my 11 year old about sports drinks and track and field days]

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Wednesday, June 20, 2018

ParticipACTION Report Cards Remind Us Every Year How Badly We're Failing Canadian Children

(Originally posted in 2016. Since nothing's changed, reupping it with 2018 data)
We suck at helping our kids to be active.

Here are the past 14 years of ParticipACTION kids' activity report card grades (click on 2018 for this year's edition):

2018: D+
2017: Didn't happen
2016: D-
2015: D-
2014: D-
2013: D-
2012: F
2011: F
2010: F
2009: F
2008: F
2007: F
2006: D
2005: D

So what has Canada done about it?

From my vantage point, it sure doesn't seem like much.

As to what we could we doing, I'm honestly not sure.

One thing I am sure of though, simply telling kids to be more active (or telling them and/or their parents how inactive they are) clearly isn't doing a whole heckuva lot. We need changes that change the default.

If you're a parent, I've blogged about the simple solution you could employ to help your kids move more (move with them).

If you're an educator, how about making every classroom/student reward an active one instead of relying on junk food (same goes for all of your various fundraising endeavours)? Oh, and get rid of inane over-protective schoolyard rules like bans on hard balls that effectively stifle active play.

If you're a city planner, how about more time and attention paid to developing safe, comprehensive, and unified biking and walking infrastructure?

And consider too the fact that decreasing kids' physical activity may well also be influenced by their rising weights (and not the other way around). I've worked with so many parents who report that as their kids gained weight, suddenly their interest in favourite activities waned. The why is something people either forget or overlook. Kids are cruel. Being picked last because you're slow, or simply not being able to keep up, would make most kids not want to play. One comment about "jiggling" while a kid runs is liable to lead a kid to stop running. Not wanting to change in front of your peers because of fat jokes and weight bias makes is another common hurdle. Here we need to see calls to action to tackle weight bias, and continued work towards improving the way we use food with our children, and ideally ending the regular use of foods by our kids' schools, teachers, coaches, cities, scout leaders, friends' parents, etc. to reward, pacify, and entertain them at every turn.

So how many more years of reading these depressing report cards before we either stop issuing them, or actually do something about the problem?

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Monday, June 18, 2018

Dear @ChronicleHerald, Publishing Industry Talking Points As "Commentary" Does A Disservice To Your Readers

More than one person shared this "Commentary" published last week by The Chronicle Herald entitled,
"Keep Canadian juice on the table for better health"
It was written by Pierre Turner and it asserted that 100% fruit juice is a source of essential nutrients and phytochemicals and that by extension juice is
"essential in helping to treat or reverse some of our leading causes of death, including heart disease, type 2 diabetes and hypertension."
The commentary goes on to talk about how juice helps combat food insecurity, that it's nutritionally equivalent to fruit, and that the food guide is going to explicitly encourage people to consume moderate amounts of ice-cream and bacon, but to avoid juice, and that these recommendations in turn will worsen Canada's rates of diabetes, obesity, and heart disease.

Now as ridiculous as the piece is, it's not particularly surprising given the author is vice-president Quality, Sustainability, Research and Development at Lassonde Industries. It even says so at the end of the piece.

Want to take just one guess as to what Lassonde Industries produces?

So did The Chronicle Herald, who reports in their Vision statement that they're proud of their integrity, get paid for this juice industry advertorial disguised as opinion, and was this just an example of their promise to,
"innovate to remain a relevant and competitive channel for advertisers to reach their consumers."?
Or was this just poor judgement?

Either way, publishing industry talking points as if they're thoughtful commentary does a disservice to readers, who instead should be taught to eat their fruit, not drink it, and also that the World Health Organization, Canada's Heart and Stroke Foundation, the American Academy of Pediatrics, and more all recommend explicitly limiting fruit juice's consumption. Yes, if people followed these recommendations it would be decidedly bad for the juice industry, but why that's a concern of The Chronicle Herald (unless they're being paid), is beyond me.

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Saturday, June 16, 2018

Saturday Stories: Plagues, Emotional Abuse, And Being Black in America

Triumph of Death by Bruegel the Elder
Ed Yong, in The Atlantic, with his sobering thoughts on what will happen when the next big plague hits.

Chloe Dykstra, in Medium, writes about her years of emotional and sexual abuse at the hands of her then partner.

Olga Khazan, in The Atlantic, with her masterful must read story covering why being black in America is hazardous to your health.

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Thursday, June 14, 2018

Guest Post: Celebrated Canadian Chef Fred Morin Reflects Darkly Following His Friend Anthony Bourdain's Death

I've had the pleasure of knowing Fred (co-owner/chef at Montreal's Joe Beef, Liverpool House, Le Vin Papillon, and Mon Lapin) since we met on a panel during the 2012 Trottier Symposium. One of the things I never did, but always wanted to, was ask him to let me know when his friend Anthony Bourdain was coming to town as I, like it seems everyone, found Bourdain's authenticity and manner intoxicatingly cool. I didn't ask because it would have been the opposite of cool to do so, I'd have been comparably, insufferably, boring, and it would have overstepped our friendship, and so too, when I heard the news of Bourdain's death, and my mind immediately turned Fred, and I wondered what his thoughts were and how he was doing, I didn't feel it would be appropriate for me to add to his likely large pile of inquiry. All that said, he contacted me a few days later with some dark reflections, and I think they're very much worth reading, even if they may shine a light on things in a manner that is unsettling. People, and life, are complicated.
Recently as I lost a friend, we all lost a hero. Most struggle to grasp why our culinary knights while basking in praises and porcine dripping can still pay rent on such a dark den within the tenements of their souls. Here is a short tale of how and why based on my livings.

There is an ancient proverb that say’s that war killed many folks but not nearly as much as the table!

The chubby teen didn’t attend prom, for a slew of made up reasons, mostly because he was a chubby teen. He failed at getting shit done although all the while labelled as somewhat a genius, I could extend, explore and extrapolate on the topic and throw his parents and teachers into the crosshairs of his own failure, but he pays a good chunk of cash weekly to decipher what is etched deep in the confines of his “why”.

School, life and jogging were arduous tasks that he fractioned into infinite parts of bearable duration, hoping that soon enough more had passed than remained to come, until it was over for good. Until someone told him that cooking might be what he was chasing since his early days, and whatever academic pursuit that stood in his path should be dropped out of, wise words.

Time spent cooking, the coup de feu, the dinner rush, there was no “prior”, there was no later, all the boxes on the list; checked! The shrieking grind of the dot matrix printer sounded to him like a cheer from his corner-man, 45 veal chops to prep, 45 veal chops to cook, 45 veal chops to re-order, bliss! Nothing left undone, forgotten, no neglected to-do’s . Everything tasted great, when he left, surfaces were clean and reeked appropriately of bleach.

The pudgy teen had fun, but he couldn’t find sleep, 44 chops were great but the 45th was a bit rough, perhaps he who ate it didn’t know real veal from tenderize Tyson shit!? The waiter dropped the wrong knife? Or the supplier sent us shit calf! Anyway, he rehearsed the shit stew he will lay thick onto the innocents. He fell asleep, but printer woke him up, there was no printer.

55 veal chops, 75 veal chops, 90 veal chops; the pudgy teen is a warrior, a hero, his skin now bears the seared branding of his culinary kin. The printer still shrieks at 4 am but he doesn’t hear it because he hopped along with the tribe for some beers, a lot of them.

He missed the shriek of the printer, but the calls he didn’t, he got up, sobered up and went, he picked up his tribe-mates, from the ground they fell on, from jails and from the psych wards.

Now half an hour after the printed used to buzz, he would expects the phone to bling, most of the time it doesn’t, when it doe’s he’s there in an instant to sanitize the grounds and heal the troops after the bloodbaths. Sometimes it rings and it’s just bad news, but he’s not going back to bed; overdoses and murder suicide are no lullabies.

The beers, Jagger bombs and Player lights no longer dampen the bleeps of the 4 am calls, furthermore, it sorts of make you tired. Cocaine is conveniently priced and packaged, it certainly doesn’t mute the rings, but the buzz generated by this circle jerk of tongue chewing dick heads redoing the world with false promises effectively muffles it.

Among the fans of pudgy teen’s veal chop are a few doctors, and pudgy teen, not completely honest, opens up about his anxiety and his inability to sleep. Sure, he omits a few details; the thefts, the betrayals, the powders and the liquids. After all the life of a chef without the inclement add-ons it's harsh enough to legitimize a Xanax script!

Solace! The beer numbs the anger of the night’s mistakes, the vodka catalyses the beer’s effect, but cocaine is there to help you go further, Xanax will soon shield the rising sun, awesome.

Most of his culinary heroes count their achievements in vintages and grams, anyways, he looks up to them, they seem happy doing it, he will get there someday, just has to dial in the dosage.

He misses the phone calls, fish didn’t come in, later that night, 5 or 6 veal chop sucked. Of course, it not his fault, he’s not cooking them anymore, using the people skills he learned however he could, he addresses the situation, a dish basket nearly misses his head, later the dishwasher stabs a happy go lucky manager with a bottle.

Pudgy kid took from his paycheck to pay the night chef on site, so the House could serve Grey Goose until 3am.

Earlier that night, a food writer managed to snatch a table at 9:30, between the Buddha Bar replays and the budding DJ remixes of U2. Not glorious, it’s obvious. Will be either stars in print or stars on pills.

Pudgy teen worked long shifts so now another voice joined the choir of screams, he’s never home, leaves too early and can’t stop looking at his phone. But he’s a cool dude now and he drinks champagne, he’s an epicurean Mohican, not a trashy line cooks that drinks beer, he tells himself that.

When the Champagne swells his forehead a bit too much he moves to craft beers and small batch spirits, helping the small farms and artisans in the process. He makes wise decisions, socially inclined choices of intoxicants. He drinks from magnums to lower his bottle count, lays down early, or so he was told.

But he’s not cooking 45 chops a day anymore, there’s no ways he could. People who flock in love him for who he has become, a legendary glutton, an emotional cesspool of epic proportions who turned to wheat grass and one liners to limp his way thru service.

He stacks fatty cuts, and metaphors, skillfully intersects them with meaty opinions, he gets quoted by media folks.

Pudgy kid is grown up, mostly happy now, but still stuck; between wine soaked layers of truffles, pills and crafty banter.

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Wednesday, June 13, 2018

The American Heart Association's Alliance For A Healthier Generation Labels Diet Coke and Pop-Tarts (And More) As "Smart Snacks" For Kids

In case you're not familiar with it, the Alliance For A Healthier Generations is the name given to the partnership program founded by the American Heart Association, The Clinton Foundation, and The Robert Wood Johnson Foundation with pretty what at first glance looks like pretty much every food industry corporation on earth.

The Alliance's stated mission is,
"to create healthy changes that build upon one another and create a system, a nation, that makes the healthy choice the easy choice"
So what are some healthy choices according to the Alliance's Amazon based,
"One Stop Shop for Healthier Generation vetted Smart Snacks and products for students in and out of school"?
Here are some select choices:

How is it possible that the American Heart Association, The Clinton Foundation, and The Robert Wood Johnson Foundation would describe a child washing down a bag of Doritos or a Pop-Tart with a can of Diet Coke as them consuming a Smart Snack?


(My answer of course is because the Alliance For A Healthier Generation is a partnership with the food industry whose job is to promote sales, not to protect health, but as to why these particular products were deemed Smart, and the larger question of why partnering with the food industry was considered a thoughtful plan, there you've got me)

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Saturday, June 09, 2018

Saturday Stories: Anthony Bourdain, Jamie Oliver, and Salt

By Anthony_Bourdain_on_WNYC.jpg: WNYC New York Public Radio. Cropped and edited by Daniel Casederivative work: Adriankwok (talk) - Anthony_Bourdain_on_WNYC.jpg, CC BY 2.0, Link
Anthony Bourdain, in The New Yorker, with his debut piece in 1999 Don't Eat Before Reading This (I, like everyone else, adored his work and will miss it/him greatly).

Laura Thomas, Sarah Dempster, Helen West and Rosie Saunt's open letter to Jamie Oliver asking him to stop (indirectly) fat shaming children.

Sarah Zhang, in The Atlantic, on the prison study that may provide more insight into how bad salt is or isn't for our health.

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Wednesday, June 06, 2018

You'll Never Guess Why My 11 Year Old Daughter And Her Friend Are Excited For Their School's Track And Field Day

It's not for the track and field.

It's for the junk food.

In my daughter and her friend's case, they're specifically excited about the sport drinks the school sells the kids at the event (they also sell them Freezies, chips and popcorn).

You see neither have ever tried one.

Honestly, it's not because my wife and I are dietary ogres who deny our kids any taste of sugar sweetened beverages, but clearly we don't have sport drinks at our house because if we're going to give our kids candy, we're going to give them candy way better than sport drinks, and without sport drinks' undeserved health halo.

And it's a health halo that my daughter's elementary school is helping to solidify given that according to my her, last year's track and field day saw the school bringing all sorts of different brands and flavours of sport drinks to the meet.

A meet where by the way, if you ran every single event you'll have run a grand total of 3km, done a long jump, and thrown a shot put.

Not a single kid on that field would benefit from or need a sport drink, yet plenty will further internalize the notion that exercise requires or deserves them.

Schools shouldn't be in the business of peddling junk food to children, and instead should be taking advantage of events like Track and Field Day to teach them that sport drinks are just liquid candy, bad candy at that.

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Thursday, May 31, 2018

"Everything In Moderation" Does Not Apply To Giving Candy To Other People's Kids

I heard it most recently from a teacher explaining why it's no big deal that she gave her 8 and 12 year old students Smarties (Canadian M&Ms), Lucky Charms Bars, Smart Food, Goldfish Crackers and Freezies for various reasons including most recently, writing a standardized test.

It's just a variant of the, "but it's just one" cop out.

Both suggest that the indulgence is small, therefore the questionable offering is no biggie.

And for individuals, it's true. I don't think that there should be any forbidden foods. We should all be consuming the smallest amount of indulgences that we need to like our lives (my four food kryptonites are Sour Patch Kids, Ruffles, dark chocolate Reese's Peanut Butter Cups, and scotch).

But it's not true when referring to teachers choosing to give Smarties to 8 year olds because they were writing a standardized test.

Because firstly, it's not just one, and consequently it's not a moderate amount, because as anyone with children today knows, it's "just one" for other people giving kids junk food virtually every day, and some times multiple times a day.

And yes, while I have zero issue with children eating Smarties (mine just came back from Manhattan where one of their favourite stores was the M&Ms store), teachers teaching their 8 year old students that there's no occasion or effort too small to not warrant candy or junk food does not fit into my definition of a message that's healthy even in moderation.

With very rare exceptions (like another kid's birthday party, or Halloween), parents, and parents alone, should be the arbiters of how much candy or junk food their 8 year olds are offered, not teachers, who instead could/should serve as role models as to how to reward and inspire without messages like the one that same teacher who wanted me to know it was ok because "everything in moderation" posted to Twitter,
"Nothing says #inspirationaltreat like @Nestle #Smarties!"

Not an end of test dance party? An extra period of recess? Painting a celebratory class mural?

Though it's harsher than might be fair, and clearly written in exasperation, there was a comment left on my Facebook page by Robin Nelson VanDyke that I have a difficult time disagreeing with,

Honestly, and as I've been saying over and over again, it's not that teachers don't care, they do, it's that junk food for everything is so entrenched and normalized that when challenged people get defensive rather than reflective.

[If you're a teacher looking for non-junk food ideas, here's a great list and backgrounder to peek at]

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Tuesday, May 29, 2018

A School Principal Blocked Me On Twitter Because I Suggested That 8 Year Olds Need Not Be Rewarded With Oreos For Writing A Test

In Grade 3 in Canada, many students write a standardized test for the Education Quality and Accountability Office (EQAO).

At one school, the kids' Principal tweeted out her note of encouragement, along with a photo of the test packages that the school had prepared for the 8 year olds. Included with each was a package of Oreo cookies.

My response was to point this out as a great example of how there is no longer any occasion too small to not use junk food to reward, pacify, or entertain children.

She blocked me.

Next the chief psychologist of a school board weighed in to state,
"I’m missing the reason for concern. I hope it isn’t unusual for children to be celebrated in schools for all sorts of achievements, activities, or just building a positive school culture."
Call me a dreamer, but I don't think positive school culture needs to be built out of Oreos.

That a principal, and the chief psychologist of a school board, both of who I have zero doubt care tremendously about their students, see no problem with schools teaching 8 year olds that junk food rewards effort and/or relieves stress really speaks to just how entrenched and normalized our unhealthy relationship with junk food has become.

How about an extra 15 minutes of recess in between test blocks if stress is a concern? Or stickers for a job well done, or a come in your PJs to write day if reward is the issue?

And taking a step even further back, should we really be teaching 8 year olds that the simple expectation of their writing tests in life is an event worthy of anything other than being proud that they did their best in writing and/or studying for it?

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Saturday, May 26, 2018

Saturday Stories: American Anti-Semitism, Forgotten Palestinians, And On Being Smaller

Edward Joffe and Leon Kanner, murdered by Rasmea Odeh in her bombing of a supermarket in 1969
Karen Bekker, in The Forward, wonders why American anti-Semitism is no longer publicly disqualifying.

Terry Glavin, in Macleans, discusses how the Palestinians in Syria have all but been forgotten.

Colin Gillis, in Avidly, on being smaller.

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Thursday, May 24, 2018

Kudos (Maybe) To Calgary Police For Handing Out Recreation Passes For Kids' Good Behaviour Rather than Sugar (Like Here In Ontario)

So here's the story.

Recently I saw a tweet highlighting a new Calgary Positive Ticket campaign whereby Angie Thiessen's daughter received a coupon redeemable for free access to a Calgary recreation facility because she was "caught" learning to ride her bicycle with a bike helmet.
Fantastic, right? Here's a longer piece discussing the program.

But then I saw this story about Calgary's positive ticketing program having handed out 2,350 coupons redeemable for a Macs Milk hot chocolate or Frosty over the course of the past 18 months.

So if the program's changed (and zero doubt that it should) from targeting kids with free advertising and emotional brand washing for sugar sweetened beverages, then kudos to Calgary.

Here's hoping!

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Tuesday, May 22, 2018

Metabolically Healthy With Obesity, But For How Long? And Does It Matter?

Image Courtesy of the Canadian Obesity Network
I faced the first question a few weeks ago when I was speaking with a group of medical residents. The latter I'm asking here.

I had presented the EOSS related data that showed the risk of dying with an EOSS score of zero (meaning a person had a BMI greater than 30, but had no physical, metabolic or quality of life related signs or symptoms related to obesity) over the course of 6 years, was no higher than a person without obesity.

The residents wanted to know what percentage of patients with an EOSS score of zero remained at an EOSS score of zero, and moreover wouldn't there be benefits to trying to work on weight as a means to prevent progression even with an EOSS score of 0?

I pointed out that "working on weight" is fairly meaningless goal, but rather it would be exploring a patient's lifestyle related to food and fitness and then providing them with guidance on how to improve both that clinicians ought to be doing. More importantly I pointed out that this exploration should be undertaken with each and every patient regardless of their weights.

But it's a fair question, and there are a few studies looking at this including this one which was recently published in the Journal of The American College of Cardiology.

In it, the authors quantified what percentage of patients with metabolically healthy obesity (MHO) went on to develop metabolic syndrome over the course of the next dozen years.

The answer was of the 1,051 patients with MHO at the start of the study, 48% developed metabolic syndrome by the study's end. Those who did develop metabolic syndrome, unsurprisingly, were shown to have a heightened risk of cardiovascular disease (but not of all cause mortality by the way).

All this to say, there's little doubt that obesity increases the risks of developing various medical conditions, but in my opinion, and as I expressed to the medical residents, weight shouldn't dictate whether or not a physician explores a particular patient's lifestyle. Whether a person has an EOSS score of zero, or whether their weight is "normal", shouldn't preclude considering nutrition and fitness as important determinants of health.

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Thursday, May 17, 2018

How Many Calories Your Meal Has May Depend On Which Tracker You're Using

First, let me get this out of the way.

The currency of weight is calories. True, not all calories have the same impact on health or satiety, and also true, people aren't walking math formulas, but that doesn't change the fact that you need a surplus of calories to gain and a deficit to lose, and that the false dichotomy suggesting it's only worth caring about either quality or quantity of calories is just plain dumb.

But the story here isn't about that. The story here stems from the fact that my office is currently in the development stage of a mobile app which in turn will include a food diary.

Right now we're trying to figure out which calorie and food database to licence, and as part of that process one of our office's terrific RDs, Lauren Lejasisaks, chose 4 online recipes and crunched numbers using myfitnesspal, calorieking, and another third party database that we're considering licensing.

Turns out, they're all different. And not by small margins! The very same ingredients entered into those 3 different databases yielded results that differed by as much as 40%.

As to which is right?

I have no idea.

And it probably doesn't matter as much as you might think.

Though there's certainly value in having an inkling of where you might be at calorie wise (or carb wise if you're tracking that instead), probably the bigger value of record keeping is in the context of its service as a conscious reminder of the behaviours that you're trying to change. And if you're keeping a food diary regularly, you'll be reminding yourself multiple times per day, and so long as you don't use your food diary as a negative, blunt, tool of judgement, those reminders will help you to make more informed and thoughtful dietary decisions.

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Tuesday, May 15, 2018

The Ontario Science Centre Just Hosted Cheetos' 3-Day, Immersive, Kid-Targeted, Advertisement

From the WTF files comes Ontario's Science Centre's hosting of the Cheetos Museum this past Mother's Day weekend.

What's a Cheetos museum?

It's a mobile, immersive, advertising experience for Cheetos.

Was there any science you ask?


The "promotional activity" (that's what it was called by the Ontario Science Centre in a now no longer hosted webpage online) involved hunting for Cheetos with identifiable shapes, swinging on a Cheetos branded swing, and taking pictures with Cheetos' mascot Chester.
So why would the Ontario Science Centre have hosted it?


I mean it's difficult to imagine it was there for any other reason given there's zero scientific content. The timing also seems to suggest money as the likelihood is that Mother's Day weekend is one of the Science Centre's busiest of the year - and that would command higher dollars.

All this to say, a live exhibit demonstrating the science of marketing junk foods to kids, by marketing junk food to kids, probably isn't one I'd have recommended to the Ontario Science Centre.

(And I don't think the Ontario Science Centre is all that proud of it either given there's not a tweet or a Facebook post from them to be had about this particular promotional activity.)

[Thanks to Michelle Bernardo for sending my way]

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Saturday, May 12, 2018

Saturday Stories: Blue Blood, Obesity, and "Silencing"

© Hans Hillewaert / 
Sarah Zhang, in The Atlantic, on the last days of the blue blood harvest.

Harmony Cox, in Narratively, on her life as a public health crisis.

Nathan Robinson, in Current Affairs, on being loud despite being "silenced".

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Thursday, May 10, 2018

Pro-Tip: Copying Food Industry Press Releases Is Neither Helpful, Nor Journalism

So I saw this story published by Global News. It's about grain consumption in Canada and the headline sure is strong,
"University of Saskatchewan study shows importance of grain to Canada’s diet".
When I clicked through I read about researchers who by way of a cluster analysis of Canadians' grain consumption patterns, concluded that 80% of Canadians aren't eating enough grains and that as a consequence, they're apparently at risk of deficiencies in folic acid, some B vitamins and iron.

Oh, I also learned that
"there's less research supporting the benefits of enriched grain foods, sometimes referred to as refined grains"
and that refined grains are,
"important food sources for delivering key nutrients in the Canadian diet".
And that
"research suggests eliminating grain foods from diets is not associated with the body mass index (BMI)."
That the story reads like a press release is not a coincidence, because the same day the story ran, so too did this press release from the Healthy Grain Institute.

When I compared the two, it turns out that the Global News story was 49.5% identical to the Healthy Grains Institute press release.

Personally, I don't think the information in the press release warranted any news coverage, but if you're going to actually cover it, at the very least it'd be useful (and I think expected) to see:
  • That there actually isn't a published study, but rather just a presentation at a conference that was being hyped by a press release. 
  • Anything at all about what confounders were considered (or not considered) in the cluster analysis.
  • The proven and significant limitations of food recall based analyses.
  • The risks associated with increased intakes of refined grains. 
  • The funding of the "study" (not suggesting the research isn't useful, but rather that there isn't yet a published study to evaluate) by the Saskatchewan Wheat Development Commission (SWDC), the Alberta Wheat Commission (AWC), the Grain Farmers of Ontario and Mitacs, a Canadian not-for-profit funding agency supporting industry-academia collaborations
  • That Nutritional Strategies Inc. (the quoted co-researcher's employer (he's the VP)) provides food, nutrition and regulatory affairs consulting services for numerous food and beverage companies and food-related associations
Small wonder why people are confused about nutrition if food industry press releases about unpublished studies are copied and repackaged as news.

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Monday, May 07, 2018

Why Do We Report on Diet Studies As If Patients Adhered To Their Prescribed Diets?

It happens all the time.

Researchers recruit participants for a diet study and randomize them to particular diets.

The participants don't adhere to said diets particularly well (and this is putting aside the known and glaring inaccuracy of dietary recall), and the macronutrient breakdowns of what they report eating are nearly always different from the macronutrient breakdowns of what they were instructed to eat.

And yet the researchers write up their studies as if their prescribed diets were followed, and consequently so too do journalists.

So here are my two asks.

1. Unless you're writing or reporting on diet studies conducted in metabolic wards, please treat their results with tempered enthusiasm.

2. And if the difference between two dietary outcome arms isn't likely to be clinically meaningful (like say the difference between weight losses of 3.3 kg, 4.6 kg, and 5.5 kg at two years (and bonus points if you get this reference right out of the gate)), maybe hold off on declaring one diet to be the world's best?

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Saturday, May 05, 2018

Saturday Stories: Stolen Torahs, Yonah Krakowsky, and Cudjo Lewis

Erik Overbey Collection, The Doy Leale McCall Rare Book and Manuscript Library, University of South Alabama. Colorization by Gluekit
Daniel Estrin, in NPR, with an incredible whodunnit covering good (and bad) Samaritans, ancient torahs, and theft (replete with just gorgeous photos)

Yonah Krakowsky, in Toronto Life, on his life as both an Orthodox Jew, and as a gender-reassignment surgeon.

Zora Neale Hurston, posthumously in Vulture, with the story of of Cudjo Lewis, the final slave-ship survivor.

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Thursday, May 03, 2018

If You Need Proof The Food Industry Doesn't Care About You, Look No Further Than Smucker's "No Sugar Added" Jam

So I was shopping the other day.

We were making a dish that included apricot jam in a sauce and I was having a peek at the various offerings on the shelves.

I grabbed Smucker's Apricot Jam and noted that the front of its package highlighted the "fact" that it had "no sugar added".

The label of course told a different story.

It told me that the second ingredient was "white grape juice concentrate", which is likely on the order of 60% sugar by weight.

So yes, sugar was added.

I expressed my indignation on Twitter and Smucker's responded to tell me that they appreciated my feedback, that the concentrated white grape juice was meant to add "fruit flavor" as well as serve as a sweetener, and that according to the letter of the law, it was legal for them to state that their product contained no added sugar.
Now the good news is that at least in Canada, the addition of white grape juice concentrate, which of course is just the addition of sugar, will soon preclude Smucker's front-of-package "No Sugar Added" claim.

But of course if Smucker's actually wanted to do right by its customers it wouldn't be waiting for the Canadian Food Inspection Agency's regulations to change.

But that's not what Smucker's is about. Smucker's, like pretty much all publicly traded food industry players, is about profit, and their "No Sugar Added" jams are great case studies in how we shouldn't wait for the food industry to do the right thing, because unless the right thing aligns with profits, they're not going to do it.

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Monday, April 30, 2018

What Is It About Diets That Make Some MDs Believe There Can Be Only One?

It seems like it's a growing phenomenon.

MDs, enamoured by a particular diet, strongly recommend it to all of their patients, their colleagues, and even write op-eds in the media about why the entire country ought to be following it.

It's such an odd thing.

In part it's odd because there's no doubt that the evidence on "best" diets, whether for weight management, or overall health, is far from conclusive, is fraught with confounding, and is built, regardless of what diet we're talking about, on evidence buttressed by the inherent flaws of food frequency questionnaires and dietary recall.

It's also odd because doctors, more than most, ought to know that different treatments work differently for different people, and that adverse effects are both real and unpredictable.

Whether it's depression, hypertension, high cholesterol, arthritis, etc. - there are a myriad of treatment options and patient considerations. What works well for one patient may not work for another, and what is well tolerated by one patient, may drive intolerable side effects in another.

Yet here some MDs seem intent on promoting the notion that when it comes to diet, there can be only one.

If you do come across an MD who's doing that, maybe best to move on to another MD.

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