An Apology to Carolyn Kallio

In the earlier days of this blog I once wrote a piece that was highly critical of the very pro-beef messages being put forward by then Beef Information Centre registered dietitian Carolyn Kallio.

My view on beef at the time was that it carried with it more risk than I now think the evidence actually supported. I don't think I took enough time to read the red meat studies with sufficiently critical glasses and instead trusted others' opinions without doing my own truly due diligence. At the time I was concerned about increased cancer, diabetes and cardiovascular disease risks with red meat consumption, and while there may well be some slight risks to red meat not shared by other protein sources (especially with processed red meats), my take was overblown.

I've written more positive pieces on red meat since then (including this one on how it's almost certainly not going to kill you if consumed moderately), and I think too for the most part my writing style has softened over the years, and while I can't change the past, I can correct it.

Carolyn, I'm sorry. I was wrong both in how I interpreted the literature, and also in how I wrote about your work, and I have deleted that post from my blog.

UK says eat less beef & Canada spends tax $s encouraging eat more.

Peter Fricker from the Vancouver Humane Society noticed an interesting contrast a few weeks ago.

First the UK's Scientific Advisory Committee on Nutrition recommended people aim to consume less than 70g per day of red and processed meat. Their Department of Health agreed, and indeed, their national dietary recommendations now include, aiming for a maximum of 70g daily.

They based their recommendations on their take of the medical evidence, which was by no means slam-dunk conclusive, but was suggestive enough to them (and me for what it's worth), to recommend limits.

Contrast those recommendations with these two recent Canadian announcements.

1. Agriculture ministers announce 19 pilot projects for enhanced meat trade

"Farmers and processors are proud of their safe, high quality meat and we're working together to help them sell their steaks or chops to their provincial neighbours," federal Agriculture Minister Gerry Ritz stated in a release following Friday's ministerial meeting. "Breaking down trade barriers at home and abroad will yield greater returns for our meat industry and benefit all Canadians."

and,

2. Canada Government help for giant beef processor

"Canada's biggest domestically-owned beef packing firm will get $1.6 million in government grants toward new systems expected to help double its ground beef processing capacity at Brooks, Alta"

So while the UK Government urges its citizens to scale back on their red and processed meat consumption, Canada extends helping hands (and taxpayer money) to encourage growth in meat sales, production and consumption.

And Health Canada's recommendation? 150-225g daily.

How's that possible? It's the same pot of evidence.

It's possible because nutritional epidemiology isn't mathematics. There isn't one obviously right answer and therefore it's always up for interpretation and interpretation can be influenced by a whole slew of things.

Take Canada for instance. Do you think the facts that Canada's the 6th largest beef exporter in the world and that beef's a $23 billion industry here could have anything to do with our Government's meat generosity?

Too bad nutrition's not as clear cut a science as we all wish it could be, and too bad that politics and industry will always be a huge influence on the recommendations of Health Canada - a non-arms length arm of Government.

Supermarket endorses Meatless Mondays - Beef Information Centre busts a spleen

So it started harmlessly enough. Sobey's (a grocery chain) printed its Spring issue of Inspired Magazine which featured an article on how to "be green".

Among their three suggestions was, "Try going meatless once a week" with reference to the Meatless Monday's movement. They also suggested that eating less meat overall could help to lower your intake of cholesterol and saturated fat.

That ticked off Laura Bodell.

You see Laura's the co-owner of Bella Spur Innovative Media Inc., an Edmonton based company that caters to the beef industry. Laura read the article in Sobey's Inspired magazine and according to coverage in trade magazine Western Producer, decided to launch a letter writing campaign on Facebook because, "My clients’ livelihood is based on the popularity of beef."

Now while I can't find any such campaign on Facebook, the Beef Information Centre, the marketing snout of the beef industry, did get wind of this outrageous outrage and jumped into action. Ron Glaser, their Executive Director of Communications sent a comical letter to Belinda Youngs, Sobey's Chief Marketing Officer.

The letter lays out beef's defense.

Wait for it.

Beef's good for you because, hmmm.

Wait for it.

Beef's good for you because regardless of the incredible variety of cuts and types of fresh and processed beef there exist 8 cuts that qualify for the Heart and Stroke Foundation's Health Check!

It's also good for you because it's included in Canada's Food Guide and contains, guess what, nutrients!

Ron then goes on to talk about how cattle are raised on lands that couldn't be forests and that the methane produced by cow flatulence depends on feed quality and that Canadian feed quality is top notch.

I guess that means also top notch is our cow flatulence, and reading the letter I couldn't help but be surprised that Ron didn't try to make the argument that Canadian cow farts actually smell like roses.

Viva Meatless Monday!

[For the other side of the beef/environment argument head over to Meatless Monday's site where you can find all sorts of information that I'm sure Ron Glaser would find fault with.]

[Hat tip to Meatless Monday aficionado Peter Fricker from the Vancouver Humane Society]

My Food Inc. Review

Just in time for the holiday season Food Inc. has been released to DVD.

For those of you not familiar, Food Inc. is a documentary film that details the industrialization of the American food supply with lenses trained primarily on corn and beef.

I have mixed feelings about the film. On the one hand it's a tremendous tour of what's wrong with how we get and subsidize our food. On the other hand, it doesn't really offer up any solutions and the folks they chose to champion change in many cases are indeed great on camera but shy on authority. While it's wonderful to have the wise, sustainable agriculture farmer waxing philosophic on the food supply I do wonder whether or not his means of farming are in fact scalable to supply the masses.

One thing's for certain however, the movie is both powerful and frightening. While I'll often blog about the health risks associated with red meat consumption and the development of various chronic diseases, Food Inc. takes the viewer on a tour of the acute diseases associated with contaminated ground beef and I found the story so chilling that I've decided to give up mass market ground beef.

To that end some kind folks at Cookware.com sent me a meat grinder to try out to see what grinding your own meat's all about. I tried it out this past weekend and clearly I've yet to get the hang of it. I did succeed in grinding out 4lbs of beef, but I think I used meat that wasn't quite frozen enough (semi-frozen is apparently the way to go) and the grinding took multiple attempts, many cleans and a great deal of frustration.

Despite the movie's shortcomings, I highly recommend this film though be forewarned, I'd bet this film has birthed its fair share of vegetarians in the past 6 months - it's that jarring.



(If anyone reading this has any meat grinding tips, I'm all ears!)

Eat Red Meat - Die?

That's what a new study from the Archives of Internal Medicine suggests is more likely to happen to you if you eat lots of red meat.

The researchers followed more than a half million adults aged 50 to 71 who completed food-frequency questionnaires for a decade during which some 48,000 men and 23,000 women died.

The study controlled for confounding variables including: Weight, smoking, physical activity, education, age, marital status, family history of cancer, race, total energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption and menopausal hormone replacement therapy.

So after controlling for everything what did they find?

"There was an overall increased risk of total, cancer, and CVD mortality, as well as all other deaths in both men and women in the highest compared with the lowest quintile of red meat intake in the fully adjusted model."

"There was an overall increased risk of total, cancer, and CVD mortality, as well as all other deaths in both men (Table 2) and women (Table 3) in the highest compared with the lowest quintile of processed meat intake"

"When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women"

Translation?

People who at the most red and processed meat had higher rates of total deaths, cancer deaths and cardiovascular deaths while white meat seemed to confer some protection.

The authors conclude that these results further bolster the call to reduce red and processed meat consumption.

According to an article written by Sharon Kirkey from Canwest the Canadian Cancer Society has already responded by reportedly lowering their recommendations for red meat consumption to 500grams weekly.

Constrast that rapid response with that of the Heart and Stroke Foundation whose spokesperson's quote suggests she didn't even bother reading the study saying,

"But the biggest meat eaters in the study were also more likely to be "out of shape and overweight."

despite the fact that the study adjusted for the obvious confounders of weight and fitness.

And yes of course the Heart and Stroke Foundation's Health Check misinformation program still happily sells their seal of approval to red meat and Canada's Food Guide still allows for women to consume 1,050grams weekly and men 1,575grams weekly - facts that I'm sure the Beef Industry press releases and letters to the editor are bound to mention in the coming days.

Eat red meat - go blind?

Probably not.

Much as you might think that I only like to criticize red meat (for things like increasing the risk of cancers and death and such), here's a study that doesn't worry me too much.

It was published in the American Journal of Epidemiology and it details a cohort study of 6,734 people aged between 58 and 69 and compared their incidence of age related macular degeneration (ARMD - a condition that can lead to central blindness) versus their consumption of red meat and chicken.

The findings?

People who ate more red meat were more likely to develop ARMD.

So why am I not concerned?

Because the group at risk was the group that reported red meat consumption greater than 10 times weekly.

10 times a week?

Who eats red meat 10 times a week?

You think maybe the folks who eat red meat at least 10 times weekly might in fact have some rather unique lifestyles that in turn may be responsible for the finding?

Cause and effect are tough things to suss out of a cohort study.

Meat Slammed by Yet Another Major Study

This time it was with regards to its contribution to the risk of heart disease.

The study, run out of Canada's McMaster University by Dr. Salim Yusuf, was not a small study. It analyzed the dietary patterns of 16,000 individuals in 52 different countries and concluded that what we've been saying for years is still true - diets higher in fruits and vegetables and lower in fried foods and animal meat are healthier for you, and in this study specifically healthier for your heart.

Dr. Yusuf, in one of his many interviews with the press had this to say,

"What we've shown is if you eat a healthy diet you can actually reduce the risk of heart attack by about 30 to 40 per cent. That is bigger than most drugs we have for protecting against heart disease. It's even bigger than an angioplasty or bypass"

The study was funded in part by the Heart and Stroke Foundation.

Foundation spokesperson Dr. Beth Abramson Assistant Professor of Medicine, University of Toronto and Director, Cardiac Prevention Center and Women’s Cardiovascular Health at St. Michael’s Hospital commented,

"It's a large international study that I would say reconfirms what is suggested in the literature in smaller studies that we are what we eat"

I'd agree. It does "reconfirm" what we already know to be true. Here we've "reconfirmed" that meat's in fact bad for your health whereupon folks who ate the most meat (by quartile) had an increased risk of heart attack.

Take this new data and add it to that which concluded that diets higher in red meat are associated with dramatically increased risks of multiple cancers, (colon was the strongest where every 48 grams of red meat consumption beyond a weekly limit of 500grams increased colon cancer risk by 15 per cent) and diabetes (for every increase in the number of daily servings of red meat there was a 26% increase in the risk of developing diabetes), and you've got to wonder how any credible medical or public health organization can actually recommend its consumption.

As I always say, while I think red meat's absolutely delicious I don't kid myself (and more importantly anybody else) into thinking it's good for me. Along those lines, can someone please explain why the Heart and Stroke Foundation's Health Check program, a program they report,

"makes healthy choices easier by helping you quickly identify products that can contribute to a healthy diet"

still includes red meat?

So for the scorekeepers out there - here's more evidence, this time from a Heart and Stroke Foundation funded study, "reconfirming" what we already knew about red meat consumption, evidence that states that meat consumption raises the risk of heart disease, and yet here we also have a Heart and Stroke Foundation who happily stamps its Health Check logo all over it and Health Canada who publish a "Food Guide" that doesn't caution against its consumption.

Any guesses when either will change their tunes?

Calgary Stampede Serves New Zealand Beef?

Thanks to my Calgarian friend Julie the strange world we live in column just grew one item longer.

Julie's one of those multi-tasking folks...CBC reporter, chef, cookbook author, blogger, mom etc. and apparently she's kicked up something of a sh*tstorm when her reporting uncovered the fact that the beef at the Calgary Stampede, one of Alberta's premiere tourist attractions, comes from New Zealand and Wichita Kansas despite the fact that beef is, as aptly reported by Julie, "Alberta's signature agricultural product".

Another example of how at the end of the day sadly it's all about the almighty dollar.

[Be sure to check out Julie's remarkable blog Dinner With Julie where she's been chronicling through photographs, prose and recipes ever dinner she and her family eat for the year (she's up to day 188)]

The Heart and Stroke Foundation Needs Remedial Math!

You know, the fact that I think the Health Check program is nutritionally bereft and a national disgrace is debatable for some and indeed there are folks out there who disagree with me and think Health Check's great.

I think they're wrong of course (and so too does nutritional evidence) and certainly I've posted plenty on why Health Check stinks in the past.

Of course even the folks who disagree with me the most aren't going to be able to squirm their way out of acknowledging that math is certainly not Health Check's strong point.

Today I'd like to look at a page I've scanned in from Health Check's recent publication, "A Woman's Guide to Healthy Eating and Active Living" that my wonderful wife picked up for me at Sobey's.

Click the page for a larger view (the red highlighted areas are my added emphases)


So here the fantabulous dietitians of the Heart and Stroke Foundation are once again endorsing the consumption of beef. According to them,

"Choosing leaner beef is part of healthy eating"

"Beef, Goodness in Every Bite"

and,

"Eating well is easy by adding lean beef to your busy mealtimes"

Now let's put aside the fact that eating beef is certainly NOT a part of healthy eating (for more information click on the Beef tag at the end of this post to see my various concerns regarding beef). Instead I want to focus on lean ground beef.

I've gone through this math before on my blog, but for the sake of the Heart and Stroke Foundation (clearly they need some help), let's go through it again:

Following the Food Guide and eating Health Check'ed-dietitian-approved lean ground beef women are allowed 150 grams a day and men, 225 grams a day.

Lean ground beef in Canada by definition is 17% fat (extra lean is 10%).

17% of a woman's 150 gram allotment = 25.5 grams of fat.

17% of a man's 225 grams = 38.25 grams of fat.

There are 9 calories per gram of fat.

25.5 grams of fat = 229.5 calories.

38.25 grams of fat = 344.25 calories.

Health Canada, as evidenced by our food labels, believes the average adult needs 2,000 calories daily (though that's likely too much for the average woman and too little for the average man).

If only 30% of our daily calories are supposed to come from fat, 30% of 2,000 calories would mean that Health Canada recommends that we get no more than 600 calories from fat daily.

However, 229.5 calories divided by the recommended 600 total daily fat calories = 38% of the recommended daily intake of fat, while 344.25 calories divided by the recommended 600 total daily fat calories = 57% of recommended daily intake of fat!

So in case you didn't follow all of that the end result is that if you choose the Health Check'ed lean ground beef that Heart and Stroke Dietitians say, "is part of healthy eating" and you even actually restrict your portion to those recommended by the Food Guide (and let me tell you, that's not a ton of meat), then in that single serving if you're a woman you'll be consuming 38% of your total daily recommended intake of fat and if you're a man 57%.

That sure sounds like a lot.

Apparently that's even a lot for the Heart and Stroke Foundation given that highlighted on the left hand side of the page is there admonishment not to consume foods containing more than 10% of your total daily recommended value of fat.

So here we have the left hand telling us no more than 10% and the right hand telling us 38%-57% is just dandy.

Brilliant work Health Check!

(Oh, and of course I'd be remiss if I didn't point out the admonishment not to consume more than 10% also applies to sodium, yet doing the math on sodium, Health Check allows single items to contain between 21% and 57% of current daily recommended maximums and between 32% and 87% of those the Heart and Stroke Foundation themselves endorsed in signing the National Sodium Policy Statement)

Any of my readers grade school math teachers that want to do a good deed? Maybe you can give the HSF a call and offer your help.

Another Reason Not to Eat Beef

Assuming of course you care about the environment and are worried about global warming. If you don't and you're not, this post doesn't apply to you.

There's a new word being bandied about to go alongside words like carnivore or vegetarian and that word is locavore and it refers to individuals who strive to eat locally with their predominant rationale being that it'll help the planet to not truck tomatoes in from Mexico or garlic in from Chile.

Strict locavores may limit their dietary choices to foods that come from within a 50 mile radius of where they live. The word (and presumably the practice) has become so trendy as to have been voted the 2007 word of the year by the New Oxford American Dictionary.

Well a study in the journal Environmental Science and Technology says that while indeed eating local does reduce greenhouse emissions, if you're a local carnivore who likes beef, you're probably not helping much.

The researchers estimated that shifting to an entirely local diet would reduce greenhouse gas emissions by the equivalent of driving a hypothetical 1,600km (1,000 miles) less per year.

They also estimated that switching one day's beef meal to anything other than beef would likely have the same impact.

Why?

Because transportation of food apparently only contributes 4% to total food supply greenhouse gas emissions, while production of food contributes 83%.

And what food contributes the most?

Beef. Delicious, bad for you, cancer-inducing, beef. On average beef production contributes 2.5 times more greenhouse gas emissions than those from emitted during the production of chicken or fish.

What's the second worst?

Dairy.

Really want to help the environment?

Become a vegetarian - the study authors estimate that doing so would be the equivalent of reducing greenhouse gas emissions by a hypothetical 12,800 transport kilometres (8,000 miles) per year and this is even if you're not a locavore.

Food for thought?

[Hat tip to loyal blog reader and eagle-eyed Rob]

Health Check and the attack of Bizarro Beef

Let's go back to that press release from the Beef Information Centre where Heart and Stroke Foundation Registered Dietitian Carol Dombrow tells us that lean ground beef is a healthy choice,

"With ground beef burgers being one of the most popular meats in the summer months, having the Health Check symbol in place now helps consumers understand that lean and extra lean ground beef can be part of a healthy diet."

Now for the sake of today, let's pretend that we don't know that beef consumption increases our risk of cancer and therefore let's ignore the argument that regardless of "lean-ness", beef is a food we should limit.

Today I'd like to talk about fat.

Now I'm not personally, terrifically scared of saturated fat. Trans I avoid and unsaturated I maximize but saturated, the stuff of beef, I simply try to minimize.

Health Canada on the other hand, really doesn't like fat and it puts a blanket limitation on its consumption at 30% of your total daily calories and since the Heart and Stroke Foundation reports that it models its Health Check program off of Health Canada's recommendations, therefore they too recommend that you limit fat to 30% of your total daily calories.

The Heart and Stroke Foundation adds additional caveats to fat consumption in the directives we saw yesterday, "

"Look for a lower (10% or less) % Daily Value for fat, saturated and trans fat, cholesterol and sodium."

and

"Get less of these nutrients: Look for a lower % Daily Value (10% or less) for nutrients such as fat, saturated and trans fat and sodium"

So that seems pretty clear. Health Canada says that we should get less than 30% of total daily calories from fat and the Heart and Stroke adds that we should avoid foods containing more than 10% of our total daily fat value.

Now back to lean beef (and sorry, some math too).

Following the Food Guide and eating Health Check'ed lean beef women can have 150 grams a day and men, 225 grams a day.

Lean beef by definition is 17% fat (extra lean is 10%).

17% of women's 150 grams = 25.5 grams of fat.

17% of men's 225 grams = 38.25 grams of fat.

There are 9 calories per gram of fat.

25.5 grams of fat = 229.5 calories.

38.25 grams of fat = 344.25 calories.

Health Canada, as evidenced by our food labels, believes the average adult needs 2,000 calories daily (though that's likely too much for the average woman and too little for the average man).

If only 30% of our daily calories are supposed to come from fat, 30% of 2,000 calories would mean that Health Canada recommends that we get no more than 600 calories from fat daily.

Therefore, 229.5 calories divided by the recommended 600 total daily fat calories = 38% of the recommended daily intake of fat,

and,

344.25 calories divided by the recommended 600 total daily fat calories = 57% of recommended daily intake of fat.

So in case you didn't follow all of that the end result is that if you choose the Health Check'ed lean ground beef that Heart and Stroke Dietitian Carol Dombrow says can be part of your healthy diet and you actually restrict your portion to those recommended by the Food Guide (and let me tell you, that's not a ton of meat), then in that single serving if you're a woman you'll be consuming 38% of your total daily recommended intake of fat and if you're a man 57%, this despite the fact that the Heart and Stroke Foundation also recommends that you avoid choosing any item containing more than 10% of your total dietary fat daily value.

So I've got a few questions here.

Firstly the obvious one, can I have some of what the folks over at the Heart and Stroke Foundation's Health Check are smoking because their world certainly seems much kinder and gentler than mine.

Secondly though, and this one's glaring. Even putting aside all of these astronomical numbers, can you explain to me why the Heart and Stroke Foundation has agreed to lend its good name to lean ground beef when extra-lean ground beef, with 41% less fat than lean ground beef, is readily available?

It make me wonder if that Marvel Comics bizarro code, "Us do opposite of all earthly things" is posted outside the Health Check offices.

[Though you should know, run those same equations with even extra-lean ground beef and the Heart and Stroke Foundation would still be giving its blessing for women to consume 22% of their total daily fat intake and men 33% from a single, approved, Health Check'ed portion, despite at the same time recommending not consuming more than 10% from any one choice]

Why Health Check Matters

Yes, that is an ad promoting the consumption of a burger, and yes, that is the Heart and Stroke Foundation's Health Check with it's small print disclaimer that always says,

"This is not an endorsement"

Interesting thing here is the fact that the Heart and Stroke Foundation not only know it's an endorsement they in fact brag about it.

Here's Heart and Stroke Foundation registered dietitian Carol Dombrow quoted in a press release from 2005 detailing the Health Check on ground beef for burgers,

"The Health Check symbol complements mandatory nutrition labelling, in a 2004 research study, sixty-five percent of consumers recognized the Health Check logo as meaning the food is 'nutritious', 'healthy', 'good for you' or 'approved by the Heart and Stroke Foundation.' Sixty-eight percent agreed with the statement: 'I can rely on Health Check to help me make healthy food choices."

And how about her views on burgers specifically?

"With ground beef burgers being one of the most popular meats in the summer months, having the Health Check symbol in place now helps consumers understand that lean and extra lean ground beef can be part of a healthy diet."

So in fact the Heart and Stroke Foundation markets their Health Check as something that let's consumers know that a food is "nutritious", "health", "good for you" and "approved by the Heart and Stroke Foundation". You might even say they market their Health Check as something product manufacturers can put on their foods to sell more of them....sort of like an, what's that word again, ENDORSEMENT.

In that same press release David Ryzebol, the vice-president of public affairs for a large Supermarket firm concurred,

"Given a choice, most of our customers would choose a Health Check labelled product over one that doesn't have that designation"

Now back to beef - so that World Cancer Research Fund Report just came out - maybe Carol and the Heart and Stroke Foundation didn't know that red meat wasn't good for you and now they're going to take back that Health Check.

I wouldn't bet on it.

Of course, were it to be true that this is the first they're hearing that red meat's not a healthy choice it would reflect not a lack of research as the most recent report merely summarized existing literature, it would instead reflect either a lack of understanding of the research, a lack of reading of the research or a lack of caring about the research.

Unfortunately, none of those are really heartwarming options.

What it comes down to is the following question, is recommending something because it's not as bad as alternatives in its class a good idea?

Certainly my thoughts when it comes to folks like the Heart and Stroke Foundation should be an unequivocal, "NO!"

To falsely promote slightly less unhealthy foods as being good for you is just bad medicine and given that the HSF themselves state consumers who see their Health Check think, "the food is 'nutritious', 'healthy', 'good for you' or 'approved by the Heart and Stroke Foundation", I think it's unethical to boot as the HSF knows that their check lulls consumers into thinking that the food is good for them, not that the food is less bad for them than others like it.

So anyone want to take bets on whether or not Health Check rescinds its endorsement of red meat? Can you guess what answer my money's on?

(Side questions for all of my non Heart and Stroke Foundation dietitian readers - do you encourage your patients to eat beef burgers and promote them as healthy choices?)

And speaking of money, stay tuned tomorrow when I discuss just how much money Health Check makes and how that's likely to influence both their recommendations and their ability to change them.

Why the Food Guide Matters Part II

Roughly a year ago when I was initially writing my Canada's Food Guide to Unhealthy Eating series, I had a post detailing why the food guide matters.

I noted that not for one second do I think that Canadians put the Food Guide on their fridges or lug the ridiculously over sized 6 page document with them to the Supermarkets but rather that the Food Guide becomes Canada's nutritional backdrop.

Last week provided a stunning example.

Last week the World Cancer Research Fund released their report Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective

The report is a brick. 517 pages long and it involved 9 independent teams of global scientists, hundreds of peer reviewers, 21 internationally renowned experts, and 5 years of time for them to review and analyze more than 7,000 large scale studies for the effects of diet on cancer.

Among their many conclusions was that red meat consumption is not very good for you. In fact they concluded that every 48 grams of processed meat consumed per day boosts the risk of colon cancer by 21 per cent and every 48 grams of red meat consumption beyond a weekly limit of 500grams increases colon cancer risk by 15 per cent.

Not surprisingly Big Meat was not happy with this report.

So who, or should I say what did they turn to for help to defend their product in their press release? Why Canada's Food Guide of course:

"Eating Well with Canada's Food Guide continues to recognize red meat in the diet. The Food Guide recommends 1 to 3 servings of Meat & Alternatives per day"

And in today's Edmonton Journal, a letter to the editor from the Beef Information Centre states,

"The Beef Information Centre has many resources that can help Canadians continue to make beef a part of a healthy eating pattern, in keeping with Canada's Food Guide."

Way to go Health Canada - once again, you've earned the moniker, Happy Corporations.

Oh, and still no word back from the Heart and Stroke Foundation.

Tomorrow will revisit the Heart and Stroke Foundation and their take on beef in explaining why Health Check matters.

Heart and Stroke's heart-on for refined white flour, ground beef and salt

Here's another example of why you shouldn't blindly trust the Heart and Stroke's Health Check to steer you to "healthy" choices.

Stouffer's meat lasagna!

Given it's new status as a Health Check'ed item that would mean that according to the Heart and Stroke's dietitians refined white flour + ground beef + almost a day's worth of sodium = super-duper healthy!

What? You think there's something not particularly healthy about refined white flours? Could it be their clear cut contribution to the development of metabolic syndrome and diabetes? Beef not good for you? Carcinogenic? Increases the risk of diabetes? Salt increase blood pressure? Increased blood pressure increases the risk of heart attacks and strokes?

You'd think that perhaps the dietitians of the Heart and Stroke Foundation would know these facts - after all, they're dietitians and they work for the Heart and Stroke Foundation and doubtlessly they should know all about the dietary contributions to heart disease and stroke, right?

Apparently not.

Stouffer's Meat Lasagna where the flour is "semolina wheat flour" (white, white, white), the beef is "cooked ground beef" (wanna bet it wasn't extra lean ground beef?), and the sodium content is 950mg, a short hop away from what a recent Heart and Stroke Foundation press release recommended as a total daily allowance of 1,260mg now has a Health Check.

I know, I know, it's probably better than non-health checked lasagnas, but to endorse an unhealthy option as healthy simply because it's healthier than some other options doesn't make it a healthy choice and certainly shouldn't buy it an explicit endorsement from the Heart and Stroke Foundation.

Stouffer's of course is milking it for all it's worth on the product's webpage,

"Look for the Health Check logo on STOUFFER'S meals – it's like shopping with a dietitian from the Heart and Stroke Foundation."

and

"Enjoy all the taste that’s made STOUFFER’S Lasagna the #1 selling lasagna in Canada for the past year – especially now it’s got the Health Check mark."

I can't really blame them, after all they paid the Heart and Stroke Foundation's Health Check good money to apparently sell out.

The Baconator

Heart attack waiting to happen.

6 strips of hickory smoked bacon, 1/2lb of beef, 2 slices of cheese, mayonnaise and a giant bun.

830 Calories, 50% of calories directly from fat, 2.5gr of trans fat and 1,920mg of sodium.

(Add a medium fries and a medium coke (a combo) and you're up to 1,470 calories, 71 grams of fat and 2,350mg of sodium.)

The Baconator

Thanks Wendy's.

The Heart and Stroke Foundation Health Check Stinks

So I opened up the parenting magazine that we've been getting for free since the birth of our latest daughter and I came across this ad from Big Beef telling me that the Heart and Stroke Foundation of Canada wants me to eat red meat.

So I asked myself, why? Why does the Heart and Stroke Foundation think so much of red meat that they've given it a "Health Check", their symbol meant to indicate a good for your health type option?

I'm not aware of any study that has demonstrated any significant health benefits with red meat consumption.

On the contrary, I'm aware of many studies that have demonstrated the dangers of red meat consumption - from breast cancer (in post-menopausal women, intake of just 60 grams per day increased their risk of breast cancer by 57%), to colon cancer (people who ate the most red meat were almost 40% more likely to develop colon cancer), and diabetes (for every increase in the number of daily servings of red meat there was a 26% increase in the risk of developing diabetes)

So I decided to try to find some studies that demonstrated benefits to the consumption of red meat. I searched Medline for roughly an hour and the only articles I could find had to do with helping young women get enough iron by consuming more red meat.

Is red meat the only source of iron? Nope. Folks can get iron by consuming iron rich foods (iron-fortified cereals, tofu and soy products, poultry, almonds, dates and prunes) along with Vitamin C to help absorption, cooking with iron skillets/cookware, and avoiding the combination of iron rich foods with those that block iron absorption like tea and coffee, high fibre meals and calcium supplements.

Or of course you could also simply go out and buy an iron supplement and take that.

Sometimes proponents of red meat will talk about zinc and vitamin B12. Indeed red meat's a fantastic source of both, but why would I want a source of zinc (also found in poultry, beans, nuts, whole grains and fortified cereals), and B12 (also found in poultry, eggs, mollusks, fish, and fortified cereals) that upped my risk of developing various cancers when I could get both from other sources or once again, go out and buy a supplement?

Going back to the Heart and Stroke Foundation, the only answers I have as to their recommendation we eat red meat are cynical ones. The nicest one I can come up with is that they figure folks are going to eat red meat anyhow so they might as well recommend that we eat the leanest cuts therein and in so doing avoid the processed meats that have been shown to worsen the risks of red meat consumption. The meanest ones have to do with them having their heads in the sand, bureaucratic quagmire, or tunnel-vision incompetence.

Health Canada of course wants folks to eat red meat. According to their atrocious Food Guide, they want post-menopausal women to consume up to 150 grams of it a day, thereby increasing their risk of breast cancer by more than 60%, their risk of colon cancer by 40% and their risk of developing diabetes by over 50%.

MMMmmmm super healthy. Way to go Health Canada!

For Health Canada I don't have a nice answer as to why they recommend we consume red meat. For them it's absolutely due to the combination of tunnel-vision incompetence with both political and industry pandering.

When Dr. Walter Willett saw our Food Guide, he had this to say,

"Canadian Guidelines make little distinction between consumption of red meat, beans, fish, and poultry. Although they advocate lean meat, this is only a small fraction of the red meat in the food supply and the guidelines are silent about usual cuts of meat and processed meats, which are a huge part of the North American diet. Thus, the Guidelines seem unbalanced; the evidence would suggest that red meat and particularly processed meats should be limited, and that a combination of fish, poultry, nuts, beans and soy, and occasionally lean meat be the primary protein sources."

(In case you don't remember, Dr. Willett has been the chair of nutrition at Harvard since 1991, is without a doubt the world's leading nutritional epidemiologist and is the second most cited scientist in the history of clinical medicine.)

The only reason I can think of to eat red meat is taste. I adore the taste of red meat, but not for one second do I try to kid myself that red meat is a healthy choice, I simply eat the smallest amount of it that I feel I need in my life in order to be happy.

Plainly and simply red meat is not a healthy choice. It should not have a "Health Check" from the Heart and Stroke Foundation and of course they should and do know better.

This will begin an ongoing series on unhealthy "Health Checks" from the Heart and Stroke Foundation - I will be keeping my eyes peeled for them in the Supermarket. Should anyone out them come across one that they wonder about, please send it my way.

Canada's New Food Guide - I give it a C+

So the glass half full version of this Food Guide is that it's a great deal better than the 1992 version.

Of course, the glass half empty will tell you(I guess I'm the half empty glass), that it's primarily because of how bad the 1992 version was to begin with.

So why don't we start with my crystal ball predictions?

I hit them all.

Indeed there's now a call to reduce salt intake, the words trans-fats do indeed appear a total of one time, it is in fact a slightly less ridiculous 6 pages long, it does indeed say, "Make at least half your grains whole", there is zero guidance on calories, no call to minimize red meat consumption, dairy is still a category unto itself and as far as Big Food goes - the launch of the Food Guide took place at a Loblaws Supermarket and was assisted by the Secretary of State for Agriculture, need I say more?

What did I miss that was good?

There is indeed a specific call to minimize junk food in our diets with Health Canada naming names as to what constitutes junk food

"foods and beverages high in calories, fat, sugar or salt (sodium) such as cakes and pastries, chocolate and candies, cookies and granola bars, doughnuts and muffins, ice cream and frozen desserts, french fries, potato chips, nachos and other salty snacks, alcohol, fruit flavoured drinks, soft drinks, sports and energy drinks, and sweetened hot or cold drinks."

There is a specific recommendation that we consume two servings of fish per week (a recommendation that if followed would likely do more for the prevention of cardiovascular disease than any other intervention in public health history)

They took away the picture of the T-bone that used to represent the meat group despite being made up of 11 portions of high fat red meat.

They included a single directive aimed at helping people control their appetite (Eat Breakfast).

That's it.

Unfortunately the what's still wrong section is quite lengthy.

Much to the delight of the beef industry, they still do not recommend limiting dietary consumption of red meat - this despite reams of evidence that state that diets higher in red meat increase an individual's risk of cardiovascular disease and various cancers.

Dairy is still featured prominently and now with the very explicit directive of consuming 2 glasses of milk daily. What kind of milk you ask? Well any kind whatsoever. Skim, 1% and 2% are listed on the Food Guide itself, but if you take the time to click their "My Food Guide" link they'll let you have whole milk, chocolate milk and even pudding (replete with plenty of sugar and often trans-fats)! Feel free to click on the picture below to see a snapshot of their site highlighting this inanity.

While there is a mention of trans-fat, the directive provided is "Limit Trans-fat", this despite the fact that Health Canada's own trans-fat task force calls for the elimination of trans-fat from our Food Supply. Would it have been so hard for Health Canada to recommend, "Minimize trans-fat" or better yet, "Avoid trans-fat"?

Juice is featured prominently as a fruit. The American Academy of Pediatrics and any expert on the planet in adult or childhood obesity will tell you that the minor nutritional benefits of juice pale in comparison to the harm brought by the Calories associated with its over consumption.

Calories clearly don't count for Health Canada. Let's say you're a healthy individual with a healthy weight and you pick this Food Guide up. Let's say you were never much of a milk drinker and did not go out of your way to choose healthy fats and you read the Food Guide and followed the explicit directions to "Have 500mls of milk every day for Vitamin D" using chocolate milk (38lbs a year worth of chocolate milk) and you added the "2-3 TBSP" of olive oil (35lbs a year of olive oil), but you didn't change anything else in your diet or track calories. In a year you could gain over 70lbs!

For those of you who might care about Calories, Shawna Hunt, BMI's registered dietitian, working directly from the new Food Guide calculated that a middle aged woman following this Food Guide to a tee would consume a minimum of 1,600 Calories and a maximum of around 3,000 Calories. If you want to see her quick calculations, click here.

Of course, her calculations assume pretty damn good compliance along with you weighing and measuring your portions. Since the vast majority of folks won't do that, and since the human eye has a terrible habit of underestimating what we're having, you'll likely get far more than Shawna's spreadsheets suggest.

They still insist on providing a minimum number of "Servings" despite the fact that their own research suggests that most Canadians consider a serving to be the amount of whatever food item they put on their plate rather than the weights and measures included with the Food Guide. By providing minimums and knowing that most Canadians don't take the time to weigh and measure foods they are absolutely begging for over consumption.

Bottom line, the big winners of this Food Guide are Canada's beef and dairy industries who with the Guide's release received a wonderful early Valentine's day present. The big losers of this Food Guide are the Canadian public who were once again reminded that politics and industry matter more to our government than their health and well being.

All Meat is Good, and Please Eat More of it!

According to the Ontario Cattleman's Association, the average Canadian consumes 51.6lbs of beef per year and Canadian beef production contributes over $20 billion to the Canadian economy annually. Well hold onto your lassos folks, if Health Canada has its way, 2007 may be a banner year!

Why is that might you ask?

Well, Health Canada has increased the recommended number of servings of meat and alternatives for all men over the age of 14, from 2-3 servings per day to 4 servings per day, and as far as they're concerned, all meat and meat alternatives are good choices.

I'll get into Health Canada's explanation for this increase in a moment, but first let's cover the question, are in fact all meat and meat alternatives equally healthy?

So what are we comparing? We're comparing beef, poultry, fish, seafood, soy, legumes and nuts.

Off the top of your head, do you think it's just as healthy to choose beef over fish or nuts?

I didn't think so.

Strange that Health Canada apparently does despite ample evidence proving that red meat simply is not as healthy a choice as other meat alternatives.

Red meat consumption has been shown to be linked with the development of breast cancer, diabetes, and colon cancer, and of course as discussed yesterday, the saturated fat in red meat is tightly linked with the development of heart disease.

Contrast that with data from fish (also covered in yesterday's post). Remember, using the Nurses Health Study, Dr. Walter Willett and colleagues have calculated that replacing just 5 percent of total calories currently consumed from saturated fat (primary sources in our diets are red meat and dairy) with unsaturated fats (like those found in fish and nuts) would reduce the risk of heart attack or death by about 40 percent. There's also been research showing that substituting fish in the diet specifically for red meat reduces bad cholesterol and that the omega-3 fatty acids in fish lower levels of LDL or bad cholesterol, help to prevent the increase in triglycerides in high carbohydrate based diets, reduce the development of irregular heartbeats (a major cause of sudden cardiac death) and reduce the tendency for clots to form in our arteries.

You should certainly contrast the negative outcomes of high red meat consumption with nuts as well, as several of the largest epidemiological studies of our time, the Adventist Study, the Iowa Women's Health Study and the Nurses' Health Study have shown a 30-50% lower risk of heart attacks or heart disease associated with eating nuts several times per week and that including nuts in our diet helps prevent type 2 diabetes.

Remember too, in terms of reducing saturated fats, there are none in beans and soy and far less in poultry than in beef (especially if you remove the skin of the bird).

Dr Willett, in his review of the draft Food Guide had this to say on Health Canada's Meat and Alternatives recommendations,

"the draft Canadian Guidelines make little distinction between consumption of red meat, beans, fish, and poultry. Although they advocate lean meat, this is only a small fraction of the red meat in the food supply and the guidelines are silent about usual cuts of meat and processed meats, which are a huge part of the North American diet. Thus, the Guidelines seem unbalanced; the evidence would suggest that red meat and particularly processed meats should be limited, and that a combination of fish, poultry, nuts, beans and soy, and occasionally lean meat be the primary protein sources."

So bottom line, does the draft Food Guide differentiate between meat and alternatives. Nope. Buried in the draft Guide is indeed a recommendation that we eat fish once a week and "add variety by choosing alternatives such as eggs, nuts, peanut butter, hummus, seeds and tofu", but on the main pictorial page the wording's different, the category's actually entitled "Meat & Alternatives" certainly highlighting the "Meat". The instructions provided are, "Include a variety of lean meat, poultry, fish, beans and other alternatives", meat again leading off what we're told to choose and then of course there's the picture of the big juicy T bone.

I need to comment here on the T-Bone. It's quite a remarkable picture to represent meat considering the fact that T-bones are certainly NOT lean cuts of meat. It's a downright ridiculous picture when you look underneath it and see that Health Canada suggests a serving is 50grams because the average T-bone weighs roughly a pound and therefore would make up 11 Food Guide servings.

I won't bother getting into the picture of the chicken drumstick with the skin left on.

And what's with the increased number of servings? Health Canada explains it by pointing out that they've reduced the serving size and therefore the increased number of servings, by weight, actually ends up reflecting a smaller total amount. They say this despite the fact that there is no research that would suggest we're eating too little in the way of meat, and ample evidence that would suggest we're eating too much.They also say this despite their own research that shows most Canadians don't know what a serving is and generally relate the amount they put on their plates to be a serving. Put meat on your plate four times a day and there's four servings.

So if Health Canada wants us to eat smaller servings, do they instruct us to weigh and measure our food? Nope. Instead they've instructed us to use half the size of our palms to measure out meat portions. Guess what, palms vary pretty dramatically in size. I'm a pretty average sized guy and when I estimated the weight of my palm in ground beef I ended up with twice as much meat as what Health Canada called a serving. When my wife tried this, and she has incredibly small hands, even her portion was 10% greater than what Health Canada was recommending. Also there's the fact that as far as I'm aware, butchers don't sell half-palm sized cuts of meat.

At the end of the day, there's no doubt that the evidence would support recommending we minimize red meat consumption and increase fish and alternatives' consumption, though I suppose a $20 billion dollar Canadian beef industry would want us to think otherwise.

Tomorrow: Eat Less Fruit and Vegetables - Amazingly that's part of Health Canada's new recommendations

Yesterday: All Fat is Bad - Fat phobia still runs rampant at Health Canada.

All Fat is Bad

At least that's what Health Canada has consistently told us.

Would you be surprised to learn that the type of fat in your diet is much more important than the amount of fat in your diet?

My guess is probably not - there's been a tremendous amount of very well publicized research that has proven that blindly following a low-fat diet doesn't seem to help with any particular health outcomes and that diets richer in healthy fats are, well, healthier.

You might however be surprised at how much the type of fat you choose in your diet affects your health.

Let's start with the bad fats, the saturated fats and the trans fats - there's no disputing the fact they're not good for you.

Starting with saturated fats, Dr. Ancel Keys back in 1956 with the Seven Countries Study (another very important epidemiological data base) was the first to show that countries with diets higher in saturated fats had higher levels of heart disease. In his studies however, the total amounts of fats in the diet were not linked with heart disease and the country with the highest amount of total fat, Crete, also had the lowest rate of heart disease. Perhaps this is why results of clinical trials looking at simple overall fat reduction are not terribly impressive.

In January of this year, a series of 3 articles came out in the Journal of the American Medical Association detailing the results of the largest dietary fat trial ever conducted. The study they were detailing was the Women's Health Initiative Controlled Dietary Modification Trial where 48,835 women were randomly assigned to a low-fat diet (less than 20% of calories from fat) or to a comparison group and were followed for over 8 years. The papers reported that low-fat diets did not lower the risks of colon cancer, breast cancer or heart disease.

On to trans-fats. Trans fats today constitute roughly 3-7 percent of the calories we consume from fat. Trans fats come from shortenings, fried foods and many commercially baked goods (goods that almost always also use refined flours).

Trans fats have been shown to raise bad cholesterol, raise triglycerides, lower good cholesterol and make our blood stickier increasing the risk of blood clots. Trans fats have also been shown to increase the process of inflammation in our body which in turn has been implicated in heart disease and diabetes and may well also be involved in other disease processes.

Using the Nurses Health Study again, Dr. Walter Willett and colleagues showed that women who ate the most trans fats (3% of total daily calories worth) were 50 percent more likely to develop heart disease over a 14 year period than those who ate the least. Conversely, women who ate the lowest amount of trans fats and the highest amount of healthy fats (we'll get to healthy fats in a moment), were 70 percent less likely to develop heart disease.

The Center for Science in the public interest estimates that removing trans fat from the food supply in North America will prevent between 11,000 and 30,000 deaths per year and save over $50 billion dollars in annual health care expenditures. Interestingly Dr. Willett in his book Eat, Drink and Be Healthy states that he feels these numbers are underestimations as CSPI's report did not take into account the potentially harmful effects trans fats have on diabetes risk.

In June 2006 Health Canada released the findings of their Trans Fat Task Force and made recommendations to our government for the elimination of trans fats from our food supply. Given the strength of the research as well as the degree of damage trans-fats cause, it's hard to fathom why our government is not acting on these recommendations.

Now onto the good fats. The good fats are the unsaturated fats. Monounsaturated fats are found in vegetable oils, avocados and nuts and polyunsaturated fats are found in whole grains and fatty fish. You've probably read a great many claims about these fats and if your eyes have been open you've been seeing food products touting how much of them they contain, especially with regards to omega-3s. Omega-3 fats are unsaturated fats and there are three types of them, ALA, DHA and EPA. ALA is the most common, it's found in a variety of vegetable oils, while EPA and DHA come mainly from fish.

Again using the Nurses Health Study and the Health Professionals Follow Up Study Dr. Walter Willett and colleagues have calculated that replacing just 5 percent of total calories currently consumed from saturated fat with unsaturated fat would reduce the risk of heart attack or death by about 40 percent. In contrast they also showed that replacing saturated fat with carbohydrates (like we're told to do by the Food Guide) showed much smaller reductions in risk.

To summarize the studies on omega-3 fatty acids, they lower levels of LDL or bad cholesterol, they help to prevent the increase in triglycerides in high carbohydrate based diets, they reduce the development of irregular heartbeats (a major cause of sudden cardiac death) and they reduce the tendency for clots to form in our arteries.

A famous study called the GISSI Prevention trial took more than 11,000 men and women who had survived a heart attack and randomly assigned them to taking either a placebo or a 1-gram capsule of omega-3s. At the end of 3 years, there were over 14 percent fewer deaths in the omega-3 group (sudden deaths cut by 50%) and fewer second heart attacks and strokes.

So now that you've heard how terrible trans-fats are for you and how healthy unsaturated fats are for you would you like to know what the draft Food Guide had to say on the matter?

Dr. Willett, on reviewing the draft Food Guide had this to say on the Guide's fat recommendations,

"Like the US Guidelines, the draft Canadian document is still fat phobic. There is suggestion to use a very limited amount of vegetable oils, but there are recommendations to reduce or avoid fat in general, when it really trans fat in partially hydrogenated foods that should be totally avoided and saturated fat that should be limited. The main message should be to replace trans and saturated fat with unsaturated fats."

The words trans fat do not appear even once in the draft Food Guide, this despite the ridiculously large amount of evidence pointing to the need for their elimination. Health Canada's own Trans-Fat Task Force report recommends we eliminate them from our diet and Health Canada's own labeling laws required trans-fat to be listed on our food labels. Why then don't they point us in the Food Guide to look for and steer clear of trans fats?

Regarding healthy fats, the words unsaturated fats do appear twice. There's a statement that tells use to use vegetable oils high in unsaturated fats "most of the time", and then there's a statement to aim for a small amount of unsaturated oils or soft margarine each day. There's no mention of the healthy fats found in fish and the only call to action on fish is buried on page 6 where it says consume fish once a week. There's also no recommendation to try to replace some of the saturated fats in our diet with unsaturated fats (remember, replace 5% of one with the other and the risk of heart attack and death goes down by 40%).

So just as with the data supporting the preferential consumption of whole grains over refined grains, the preferential consumption of unsaturated fat over saturated fat and the elimination of trans fats from our diets are as black and white as things get in medicine.

Unfortunately our Food Guide seems hopelessly mired in gray.

Tomorrow: All Meat is Good, and Please Eat More of it - Beef farmers rejoice, Health Canada recommends Canadians eat more beef and still doesn't tell us fish is a healthier choice.

Yesterday: Please Eat White Bread - Why Wonder Bread's more in touch with the evidence on whole wheat than Health Canada.