Dietitians of Canada Eschew Nutrition Month, Launch Dairy Funded Milk Month Instead

Today's guest post comes from our office's RD Mark McGill who has a few things to say about nutrition month here in Canada.

He was rather horrified to receive his marketing materials for the month given what he felt to be a rather blatant bias. Interestingly, last week 3 other RDs approached me to ask if I would write about what seems to have become "Milk Month".

Here's Mark's take (oh, and you can follow him on Twitter too):

At the Udder of Big Dairy

Every February, since I’ve been a Dietitians of Canada (DC) member, I’ve received a triangular shaped cardboard poster-box in the mail. It acts a tangible reminder that Nutrition Month (March) is just around the corner. And while the theme varies each year (for 2012: Get the Real Deal on Your Meal: Dietitians Bust Food and Nutrition Myths), the primary goal has been a constant: to educate Canadians on what healthy eating is all about and that their best source for obtaining this information is from a Registered Dietitian. It’s something that Dietitians of Canada works hard to promote and rightfully so as that’s their purpose. From our mission, vision and values which state in part to advance,

"the profession's unique body of knowledge of food and nutrition and that our dealings with colleagues, associates, clients and the public [are to be] based on credibility that relies on information from solid, scientific evidence and direct experience to support decision-making"

and that RDs do this with integrity to ensure we function with honesty, fairness, and objectivity to one of this year’s press released busted "myths",

"There is no difference between a dietitian and a nutritionist."

The answer, in part, states that a dietitian is your smart choice for credible advice on healthy eating.

I’m not going to discuss whether or not I agree with how the myths are answered as fellow RD Diana Chard has already taken care of that quite nicely. Instead, my focus is going to be on the blatant bias and conflict of interest that exists in the materials I was sent. These include a cover letter, a colour poster, two double-sided educational sheets for copy and distribution (one students grade 7 and up, one for adults).

The cover letter was signed by Isabelle Neiderer, RD and Director of Nutrition for Dairy Farmers of Canada (DFC). Since DFC are the National Sponsor for Nutrition Month 2012 (they’ve been a sponsor in previous years, as well), I guess the fact that her name is on it shouldn’t come as a huge surprise, or that she states that in addition to the materials I’ve been sent, I can order copies of a brochure entitled “What’s True? What’s Not? Get the Real Story about Milk Products” or that if I have any questions I can email nutrition@dairynutrition.ca. What would be a surprise is if the material in the package, the brochure or a reply from DFC is "honest, fair and objective" as per the statement on the DC website.

So what's inside?  Certainly not "honest, fair and objective".

First there is the student resource entitled "The Myth Buster" which has games and quizzes that aim to shed light on common nutrition myths. Of the 7 crossword puzzle clues, milk's featured in two, which perhaps isn't in and of itself terrible, but clue number 4 is probably worth highlighting,

"4. Chocolate milk has the same _________ as white milk",

where the "correct" answer is "nutrients". Never mind the 15.5 tsp of sugar and 360 calories per 500mL of 1% chocolate milk I suppose.

More amazing though is this statement found at the bottom of that Myth Buster page, entitled, "We're Brilliant,

"Humans may be the only adult mammals that drink the milk of another species. Eating nutrient dense milk products have helped humans survive and thrive all over the world!"

where the answers listed for you consideration are,

"True",

"Very True",

and

"The Truest"

Well just because we can doesn’t mean we should, and while the risks to milk consumption probably aren't particularly high, there is certainly a real body of research that links milk consumption to ovarian cancers and more aggressive forms of prostate cancer, while its benefits to osteoporosis prevention, at least according to the Nurse's Health Study, appear to be non-existent (If you're interested, here's Harvard's take on the subject). And chocolate milk? I think Dr. Freedhoff's covered that pretty well in the past.

Next comes a word scramble. The first question of the word scramble has you sort out the words fattening, yogurt, healthy and less. When finished you get a statement saying it’s a myth that milk products are fattening and that eating them has been associated with a healthy body weight and less body fat. Last time I checked, consuming calorie-dense, higher sugar products (chocolate milk, fruit-on-the-bottom yogurts) contributes to the opposite, and that the data on milk and body weight is at best described as weak, preliminary and under powered, and at worst described as the product of a conflicted researcher who has patented the claim that milk helps with weight loss.

Oh, and hey, how does that answer contrast with this statement,

"Sorry! There is no food that burns fat or makes you lose weight more quickly."

Where's that statement from? Dietitian's of Canada's Nutrition Month 2012 Myth #13.

The adult sheet (entitled "Mythmania") is also awash with dairy goodness.

From the section entitled "Milky Madness" which addresses myths such as "milk causes mucous" to the inclusion of dairy in all three included recipes, milk is featured quite prominently. How prominently? Well the handout is meant to present just a smattering of the myths from Milk Month, oops, I mean Nutrition Month's Dietitians of Canada press release. What's telling is the fact that while the Dietitians of Canada's lists 39 myths, only 3 of which involve milk, the handout I've been given by Dietitians of Canada to provide to my adult patients includes 10 myths, 5 of which feature milk.

Finally, there's the poster I've been given to hang up in my office. If you squint your eyes and look hard, you'll find a few sources of protein that aren't dairy. They're up in the top right corner. That's where you'll find the entirety of your non-dairy based protein choices (nuts, beans, meats, and fish). What won't be hard to find? Milk. The giant glass of white milk splashing in the centre, the flavoured yogurts, the 3 huge hunks of cheese, and of course the chocolate milk. There's also a QR code that you can scan. It's also on all of the handouts I'm supposed to be giving my patients. Wanna guess what image you'll see when you get there?

If you'd like to have a peek at the materials yourself, they're all available for download here.

Suffice to say that I have not and will not be using any of these materials and encourage other DC members to do the same. Doing so goes against the principles that as DC members, we are supposed to stand for. If we truly want to be viewed as authoritative voices it is imperative that our messages this month be unbiased and trustworthy. Both of which are impossible given the large corporate influence that currently exists.

The Canadian Government Thinks Dietitians are Useless!

Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2008.

Or so it might seem.

Do you work for the Canadian Government? If you do, perhaps you'd like to call your HR department and ask them why it is that the federal government's health care insurance plans don't cover the services of a registered dietitian and while I can't speak for all provinces, neither does the plan for the Province of Ontario's government workers.

That sure seems a bit incongruent doesn't it?

After all, we know that the government worked closely with the Dietitians of Canada in the creation of the Food Guide and putting aside my various condemnations of the Guide's non-evidence based recommendations, doesn't it strike you as odd that while the government might feel dietitians are valuable contributors to counsel Health Canada on nutrition that they don't insist their insurers pay for individual dietetic consultations for their employees?

It's also odd given that the Canadian Government is well aware of the perils of obesity and the role of a healthy diet in the prevention of chronic disease.

David Butler Jones, Canada's Chief Public Health Officer has been heard to state that,

"with the rapid increase in obesity in young people, that this generation currently in childhood will be the first ever to experience poorer health than their parents"

and that,

"by increasing their levels of physical activity, improving eating habits and achieving healthy weights, Canadians can help ensure good health and prevent many chronic diseases, including some cancers, type 2 diabetes, cardiovascular disease and stroke."

Tony Clement, our former Minister of Health has stated,

"More than ever, Canadians understand the consequences of an unhealthy diet. We know that a bad diet and no exercise can lead to serious conditions such as obesity, diabetes, heart disease, and certain types of cancer."

And it's not as if the government's insurance plan doesn't cover complementary health care and paramedical services. Both the federal and the province of Ontario's plans cover psychologists, optometrists, chiropractors, chiropodists, audiologists and naturopaths. I'm told they even shell out for homeopathic consultations, a highly contentious practice desperately lacking in evidence-based results covered elegantly in the Guardian by Dr. Ben Goldacre and with mirth yesterday regarding its use in obesity treatment by Dr. J. on Calorie Lab.

If you'd like to complain to our current Minister of Health Leona Aglukkaq feel free to click on her name to send her office an email.

If you're looking to email David Butler-Jones, while according to his website the Chief Public Health Officer "welcomes your comments and suggestions", his office's website doesn't provide an email address to which to address them. Instead they provide a fill in the blank form to fill out and Dr. Butler-Jones' snail mail contacts. I was however able to find his phone number in the Government directory and so if you'd like to call him to discuss this just buzz (613)954-8524 or fax him at(613)954-8529.

If you work for the Canadian government, please share this post with your colleagues.

Anyone out there up for a petition?

UPDATE: A kind reader has informed me that really the person in charge of these type of decisions is Mr. Vic Toews from the Treasury Board. If you'd like to email Vic Toews simply click his name.

[Originally posted January 9th, 2008]

Eat Wise: Dietitians of Canada's new Online Venture. Helpful, Harmful, or Ho-Hum?

So last week I received an email from the Dietitians of Canada promoting their latest venture. It's called "Eat Wise" and it's basically an online searchable database of nutrition fact panels.

So what's it for?

According to the press release it's to,

"make it easier for Canadians to get the nutrition facts on the foods they eat",

and Mary Sue Waisman, the PR and Communications manager of Dietitians of Canada was quoted as saying,

"Whether it’s a fresh apple, apple juice or frozen apple pie, you can get the information you need with just a few ‘clicks’ to help you make informed food choices."

So I decided to put Mary's quote and the site to the test.

Here's what the site taught me regarding fresh apples, apple juice and frozen apple pie (click on the image to enlarge if you'd like):

So what did the site teach me to help inform my food choices?

Fresh apples? Hmm, they really don't contain much of anything, not even vitamins, and wow, they're a lot fewer calories than I thought.

Apple juice? Well a serving apparently is nearly 2 cups, but not quite 2 cups. Gotta remember not to pour that last 27ml.

Apple pie? Great source of iron.

What didn't I learn?

I didn't learn that diets rich in fruits and vegetables have been shown to protect against a myriad of chronic disease, and that apples, given their water content and low energy density, are great in terms of volume based satiety, and that even though they may not be superstars in terms of the meager selection of nutrients Eat Wise scored, their consumption has been linked to health. Nor did I learn that the majority of apples are nearly double the size (and calories) of the "serving" reported by Eat Wise.

I didn't learn that the American Academy of Pediatrics and the Canadian Pediatric Society recommend kids younger than 8 have no more than 125ml of juice daily and that drop per drop juice has as many calories and as much sugar as Coca Cola.

I also didn't learn whether or not that apple pie was a large piece or a small piece, or whether compared with other apple pies or home made, it was a good, bad or neutral choice. Interestingly, when I clicked on other apple pies to try to figure that out, serving sizes varied from 164g to 100g, to 156g making actual comparisons quite challenging.

Lastly, while I learned what percentage of my daily recommended value the ten nutritional determinants of food scored provided, glaringly absent was a daily recommended sugar allotment to put that rather important ingredient in perspective.

I think the Eat Wise site is ho-hum, bordering on harmful.

It promotes pure nutritionism and sadly also misinforms by allowing industry based and/or seemingly random portions to be evaluated.

The notion that food is the sum total of its nutrients flies in the face of the fact that virtually everything we understand to be true about the impact of diet on the prevention of chronic disease comes from patterns of whole food consumption, not nutrients.

At the end of this day, I can't imagine who'd find value in this site. If you want pure nutrition data, check out Nutrition Data, where rather than 10 nutritional determinants, they score dozens.

Of course, if you want to know if you're making healthier processed food choices, I'd just stop right there.

Sure it's worth looking at the backs of your packages and getting the least bad options you'll enjoy, but easier still not to worry about nutrients and instead focus on something magical for health - the transformation of raw ingredients. It's called cooking, and it's the very definition of eating wise, and I don't the that the Dietitians of Canada, or anyone else, should be creating products or programs that may lead people to believe that they can do it with boxes.

An exciting new Canadian dietetics initiative!

And we've got to find ways to get it more attention!

It's called "The Ryerson Declaration" and it stems from the 2009 Ryerson University workshop, Beyond Nutritionism: Rescuing Dietetics through Critical Dialogue and according to the Dietitians of Canada Practice Blog, the Ryerson workshop gave birth to a new focus in dietetics that attendees referred to as, "Critical Dietetics".

Unlike nutritionism, the aim of Critical Dietetics is to answer tough questions utilizing critical appraisal and an evidence based approach. Questions such as,

"What counts as “knowing” in dietetic practice? How do we, as nutrition professionals, come to know what we don’t know? How does the evidenced-based culture of dietetics give voice? Where does dietetic culture render silence? What is it that we have already accomplished as a profession? In what ways do we continue to evolve? How can we further build upon the rich roots of our profession? What do we envision for the future of our profession?"

The Ryerson Declaration then is a manifesto of sorts calling for change whereby,

"It invites constructive dialogue and challenges us to discuss, debate, and rethink what we know and how we know it. It is a generative and collective effort which understands that strength comes from diversity and debate."

It's this type of thinking that may see dietetics rise from the realm of belief based nutritionism to evidence based science and allow for debates with passion, but not anger, and end the current state of affairs where people take disagreements personally and emotionally rather than with thoughtful critical appraisal.

The post on the DC site is getting very little play. I know quite a few Canadian RDs read this blog - I hope you all take the time to pop over there read all about it and hopefully sign onto the declaration.

[Hat tip to blogging friend, Canadian RD and gastronomic explorer Vincci who linked to the declaration on her blog yesterday]

Conflicts of interest in professional dietetics

According to my friends over at Fooducate, at this week's American Dietetic Association (ADA) conference there was a talk regarding whether or not we can trust industry sponsored nutrition research. The reason that's in question is because sadly right now there are no guidelines in place to help expose conflict of interest in dietetics. It was the absence of such guidelines which led Marion Nestle in 2001 to write a fascinating journal article about how food company sponsorship impacts on the profession's credibility. Ultimately it led Marion to resign her ADA membership. According to Fooducate,the lecture was not a popular one at the ADA conference and was very poorly attended.

Of course it's not just research articles that demonstrate conflicts and bias, we can see non-evidence based industry bias in a far more dangerous place - the mainstream media.

Case in point?

Yesterday there was a CBC report about an Ipsos-Reid survey which according to the CBC was, "conducted on behalf of Dietitians of Canada" (DC). What the CBC article later reported was that the survey was cosponsored by the Dairy Farmers of Canada. The DC and Dairy Farmers of Canada joint press release on the survey drew these 4 conclusions (highlighting is mine, not theirs):

"1. Consumption of all four food groups is far below recommended levels;

2. A significant number of Canadian adults had not consumed any milk and alternatives or any vegetables and fruit on the day prior to the survey.

3. Many Canadian adults report they have barriers to healthy eating.

4. A majority of Canadian adults are not aware of the many health benefits of milk and alternatives and vegetables and fruit including their role in reducing the risk of some cancers, hypertension and other chronic diseases.

5. When made aware of these important health benefits, Canadians report they are motivated to increase their intake of foods from these food groups."

Well last week we covered how milk doesn't appear to actually have a benefit on hypertension and that calcium supplementation alone impacted on cancer risk while dairy might in fact up the risk of prostate cancer and given milk's failure in preventing osteoporotic fracture and in weight loss, I'm not sure what magic milk is meant to do.

Looking at the actual survey the bias is obvious. The only specific questions regarding choices and healthfulness have to do with either "dairy and alternatives" or "fruits and vegetables" and of the 5 conclusions of the press release, 3 directly relate back to dairy (2, 4 & 5). Absent was information regarding the health benefits of whole grains, nuts, legumes or fish.

The thing is I get it. I fully understand why the Dairy Farmers crafted the survey - it was designed to report that Canadians don't drink enough milk; that there are umpteen-million magical "benefits" to milk consumption; that milk's as healthy and important as fruit and vegetables; and that if we just teach people more about unbelievably healthy milk they'll drink more of it, but the question I've got is why do you think the Dietitians of Canada decided to lend their name and credibility to a survey that ignored multiple food groups and is basically a milk advertisement?

Unfortunately the media certainly treated it like more than simply a milk ad and they ran with it prominently featuring DC's involvement. Had the poll simply been one from the Dairy Farmers of Canada I imagine the coverage of the report, if any, would likely have been very different. As well in this case, the media also oiled the slippery slope of corporate dietetic collaboration by failing to identify quoting dietitian Kathy Furgala's corporate allegiances referring to her instead as a "Toronto-based dietitian". Frankly it was in fact Kathy's quote from the CBC story that got me riled up enough to write this post and explore the survey in the first place. She was quoted as saying,

"For people who say, 'I don't want to worry about the food groups,' just look at your plate, and see if you can't throw in one veggie or some cheese"

Yup, the two most important things you could ever add to your plate if you don't want to "worry about the food groups" - a single vegetable or of course, some cheese.

I'm not sure what's worse. DC signing off on a milk ad disguised as a national eating survey, a dietitian who would give the advice that all your plate needs for your meal to be healthy is one lonely vegetable or a hunk of cheese, or a reporter who chooses to identify that dietitian as a "Toronto area dietitian" while omitting the fact that she's in fact a nutrition educator for the Dairy Farmers of Canada in an article whose focus is on increasing dairy based on the results of a survey paid for by the Dairy Farmers of Canada.

[Oh, and in case you noticed - the survey found that "consumption of all 4 food groups is far below recommended levels". Strange in a country where over 65% are already overweight or obese. Could it be that the recommended levels recommend too much? Tune in tomorrow for more discussion.]

Nestle, M. (2007). Food company sponsorship of nutrition research and professional activities: a conflict of interest? Public Health Nutrition, 4 (05) DOI: 10.1079/PHN2001253

Breaking News: Dietitians of Canada Support Calories on Menus

This just out. A Dietitians of Canada (DC) press release that provides their explicit support for posting of calories on menus in restaurants!

Regular readers will remember a few weeks back when I posted my concern that DC was actually going to come out against mandatory restaurants menu labeling. They had sent out a loaded questionnaire that reported they had their own concerns and then a spokesperson came out and suggested that putting calories on menus might cause Canadians who were reading them to misinterpret them as some sort of taste-o-meter reading and aim for more of them.

All I can say is kudos to DC for finding the right path on this issue and thank you to all of my dietitian and non-dietitian readers who wrote DC with their concerns.

[Hat tip to dietitian, author and columnist Rosie Schwartz and her Twittering (@rosieschwartz) of the press release]

My CBC interview regarding menu and newspaper calories

Thanks to the crew over at CBC Ottawa Morning for being so kind, courteous and engaging.

For those who might have missed the interview, here it is:

Dietitians of Canada hits bottom, digs

Wow, I'm almost speechless, but don't worry, only almost.

Yesterday Don Butler from the Citizen called me about my post regarding Dietitians of Canada's non-support of mandatory calorie labeling.

When he interviewed me he asked me what I thought DC was worried about.

I told him I didn't know but that common arguments include a mistaken belief that posting calories will cause a sudden outbreak of anorexia; that calories are not the only nutritional determinant of food; and that restaurants may have a tough time making calculations (not true for chain restaurants where uniformity of meals is integral in their success and where calorie counts already exist).

I was way out to lunch.

Nope, apparently the Dietitians of Canada are worried that,

"If a person looks at food that way, would they be more likely to make a higher-calorie choice because they think it's going to taste better?"

Oh and also that people aren't going to understand how to use the information,

"If you just post calories on the menu, how well can consumers use that information? That's a question we have."

So basically it seems that Dietitians of Canada are concerned that Canadians are nutritional morons and that they're going to believe menu posted calories are in fact some sort of new fangled taste-score and consequently choose foods with higher numbers because they think that food is likely to be "more tastier".

As I mentioned yesterday, if I were a Canadian Dietitian, I'd be absolutely mortified.

Dietitians of Canada opposed to calories on menus?

Calories on menus.

I would have thought it's pretty much a no-brainer for any one who cared about nutrition and heath. I mean who could possibly have a problem with providing consumers with information that might help them make better dietary decisions? The information isn't meant to be judgemental. It's not meant to teach people that calories are bad any more than price tags are meant to teach people that dollars are bad. It's just there to help allow consumers to actually make informed choices.

So who's come out vocally in favour of calorie labeling?

The list grows daily and among many others includes:

American Association of Retired Persons

American Cancer Society

American Diabetes Association

American Dietetic Association

American Heart Association

American Medical Association

American Public Health Association

Canadian Obesity Network

Canadian Society for Exercise Physiology

Canadian Teachers' Federation

Canadian Women's Health Network

Centre for Science in the Public Interest

Heart and Stroke Foundation

Institute of Medicine

National Eating Disorder Information Centre

Newfoundland and Labrador Medical Association

Ontario Medical Association

Ontario Society of Nutrition Professionals in Public
Health

Rudd Center for Food Policy and Obesity

Society for Nutrition Education

United States Food and Drug Administration's Obesity Working group

World Health Organization

So who else wants calories on menus?

The public. Polls have consistently placed public support of mandatory calories posting on menus at around 80%.

Who else?

The food industry. Recently in the United States the National Restaurant Association has joined hands with lawmakers to support the passing of a federal bill that would mandate chain restaurants post menu board calories in every single chain restaurant across their country.

So who doesn't want calories on menus?

The Dietitians of Canada.

Yup, that's right, the Dietitians of Canada upon review of Ontario's Bill 156, a bill designed to force chain restaurants in Canada to publish calories on menu boards, decided to send out an email to its members to ask their opinions. You might be thinking that clearly here I'm out to lunch, that there's nothing wrong with DC gathering members' opinions, and you'd be right, assuming that the email simply asked for opinions. But the email didn't simply do that though. No, instead the email primed members' opinions by stating that DC was "concerned" regarding providing Canadians with information about the single most important nutritional determinant of food - calories,

"To: DC Members

Posting of caloric information on menu boards or through a tag attached to individual food items is being proposed through a bill introduced in the Ontario legislature by Frances Gelinas, MPP and NDP Critic for Health. The proposed bill would apply to foodservice operations with annual revenues greater than $5 million, and non-compliance would be fined. The bill also proposes limits on artificial trans fats.

Dietitians of Canada is concerned that there is limited evidence to support a move to posting energy content of foods on restaurant menu boards as a means of influencing consumers to make positive changes in their food selection at this point of purchase. We are interested in identifying your views on this issue as well as identifying relevant evidence to support your views.

Your input will help shape the DC response to this issue. Please take a few moments to complete this brief survey.

The survey should take no more than 5 - 10 minutes to complete. Your response by April 17 is appreciated.

Thank you
Posted by
Linda Dietrich, Regional Executive Director Central and Southern Ontario"

So just to put this in perspective - nutrition advocacy and professional organizations (including the American Dietetic Association - the DC's American counterpart) support mandatory menu labeling, medical organizations support mandatory menu labeling, non-profit health groups support mandatory menu labeling, the public supports menu labeling, even Big Food supports mandatory menu labeling and the Dietitians of Canada have concerns?

What could they possibly be concerned about? They talk of a lack of evidence, but yet there's ample evidence that menu board calories are both an important need and a great idea. But really, even if there wasn't yet ample evidence, what possible reason could DC have to deny Canadians the ability to make more thoughtful dietary decisions by ensuring restaurants provide them with more information? Does DC feel that the calorie section on nutrition facts panels should be removed as well?

Dietitians out there? Do you have any thoughts as to what the Dietitians of Canada might be afraid of and why they seem to be having more difficulty assessing the evidence base than even the food industry?

[If you want your voices heard and you didn't happen to notice the email above, feel free to write to Linda Dietrich and let her know how you feel about the need for menu board labeling by clicking here.]

UPDATE: Thanks to RD who in the comments posted the results of the incredibly skewed survey (meaning if you prime your members by telling them the organization "has concerns" go figure people aren't going to support the concern in question).

So unbelievably only 47% of Canadian dietitians who participated in the survey felt that posting calorie information on menus is an effective means of public education and modifying food choices.

Even more unbelievably only 71% of Canadian dietitians who participated in the survey felt that trans-fats should be banned.

If I were a Canadian dietitian, I'd be absolutely mortified.

Dietitians of Canada Officially, Formally and Happily Sell Out

According to their vision statement, the Dietitians of Canada purports itself to be,

"the voice of the profession"

I think they forgot to mention they're also quite comfortable being the mouthpiece of Big Food.

While I recognize that physician groups aren't immune from conflict of interest (primarily stemming from Big Pharma), I know as a physician I'd be fairly uncomfortable to land on the Canadian Medical Association's website and find advertising there from drug companies.

Imagine my surprise when learning that the "Members only" section of the Dietitians of Canada (DoC) website does in fact have Big Food advertisements as evidenced in the screen captures below (click them to open them in a large window) where the first shills for President's Choice Blue Menu products and the second for eggs:



Apparently if you keep refreshing the page, new ads pop up.

But let's put internet advertising aside, we can chalk that up to poor judgment, (UPDATE - Poor judgment shared by the Canadian Medical Association where I also found some internet drug ads) I mean after all, it's not like it's a clinical practice guideline or a resource manual for the profession.

Ummmm, about the DoC professional resource manuals....

After a bit more sniffing on their website I came across this link to the Dietitians of Canada 2001 National Nutrition Month Resource Manual for Dietitians (I realize it's 2008, but this is still featured prominently on the DoC website and is one of many Fact Sheets explicitly endorsed and implicitly steered by Big Food).

Read through it and you'll find it was sponsored (paid for) by the Canadian Sugar Institute, the Canadian Egg Marketing Agency, the Dairy Bureau of Canada and Kraft. Ominously the Canadian Sugar Institute was referred to as an "internal sponsor" while eggs, dairy and Kraft were merely, "official sponsors".

Think the sponsors were just silent spectators?

Then how come there's giant pictures of dairy products throughout; 3 pages on encouraging Canadians to drink more milk (replete with a section on getting the lactose intolerants to drink milk too); and two pages devoted to encouraging Canadians to eat more eggs?

There's also messaging that sugar is a carbohydrate just like fruit and this great quobesity,

"With the exception of dental caries, there is no evidence to show that sugar causes health problems. There is no specific limit or recommendation to reduce the amount of sugar we are currently eating."

Did the Dietitians of Canada really just steer their members as the "voice of their profession" to educate the public that sugar doesn't contribute to health problems and that you can eat as much of it as you want and not worry?

Looking at the 2008 Nutrition Month page that details some information about sponsors, DoC spells out who'll they'll happily take money from:

"Food products and Manufacturers", "Food Retailers".

No real limitations there either - basically if you makes or sell a food that can conceivably fit in Canada's Food Guide, you're welcome to play.

Marion Nestle, world-renowned nutrition expert (don't believe me, click here and check out her rather ridiculous C.V.) on her wonderful blog What to Eat details the equivalent practice within the American Dietetic Association (ADA). Here's a recent excerpt with her call to action for her fellow ADA members (feel free to mentally swap DoC for ADA),

"Respected ADA colleagues: as long as your organization partners with makers of food and beverage products, its opinions about diet and health will never be believed independent (translation: based on science not politics) and neither will yours. Consider the ADA’s Nutrition Fact Sheets, for example, each with its very own corporate sponsor (scroll down to the lower right hand corner of the second page to see who paid for the Facts). Is the goal of ADA really the same as the goal of the sponsors–to sell the sponsor’s food products? Is this a good way to get important scientific messages to the public? ADA members: how about doing something about this!"

Now I know that I have many Canadian readers who are registered dietitians. What do you think about the involvement of the food industry with DoC?

[Hat tip to a concerned dietitian who threw the screen caps my way]

EATracker, your new Weight GAIN Weapon

Every once and a while I get a phone call at my office asking if I can help someone gain weight. Now that I've found the Dietitians of Canada's new EATracker site, I've got somewhere to send them.

Now I can't say that this is an entirely unbiased review of EATracker given that the site was created by the Dietitians of Canada - an organization that has come out in strong support of a Food Guide with nutritionally indefensible positions like advocating chocolate milk to children, refined carbohydrates and red meat to all, the inclusion of juice as a fruit, and the limitation rather than the elimination of trans-fats.

That said, I was hopeful that at the very least EATracker would succeed where Health Canada failed - Calories.

Before I get to the Calories, let's start with the site itself. It's slow - painfully, frustratingly, dysfunctionally slow, but perhaps that's just growing pains.

It's laid out into 5 sections:

1. Select a Day - an easily navigable calendar that lets you scroll through your entries
2. Eating Diary - this is your food journal area.
3. Activity Diary - this is your exercise journal area.
4. Daily Assessment - their summary pages
5. My History - where you'll find out how close the Food Guide you're eating.

The eating diary is truly terrible.

The food database is incomplete and challenging. For instance if you want to enter a banana you won't find one under banana. Instead you have to search for bananas plural. For the day that I tried to enter, I was unable to find egg whites or scotch and given that there's no means to enter your own food items, they got dropped off my list.

I was also disappointed to find that the only way to adjust your portions is through Canada's Food Guide serving sizes - apparently there are no in betweens and no means to account for things accurately like simply inputting an exact weight or measure, and therefore if you don't buy and eat your food in Canada's Food Guide servings, there is no accurate means to account for your intake.

You can also forget about adding in anything from a restaurant. No Tim Horton's, no Swiss Chalet, no McDonald's, no restaurant information at all - this despite the clear availability of chain restaurant Calorie information and the Dietitians of Canada explicit knowledge that Canadians eat out a lot.

The activity diary works easily enough, you search for your activity and then enter the number of minutes that you participated.

It's in the daily assessment where the weight gain magic begins, as it's in the daily assessment where they provide you with their, "Energy (Calorie) Feedback"

Firstly I'll point out that despite clearly having a food database somewhere, EATracker only displays the total amount of Calories it estimates you've consumed for the day, not the itemized breakdown by food, thereby preventing you from learning from your choices.

Where it really falls apart is when EATracker estimates how many Calories you should be consuming each day.

EATracker told me that I should be eating 2,900 Calories daily based off my age, weight, height and reported activity levels. I generally eat in the neighbourhood of 2,200-2,400 Calories. Were I to eat 2,900 Calories daily I'd gain roughly 1lb weekly.

I was at work when I was playing with this and so I grabbed some patients from the hall and had them complete the EATracker demographic collection and activity diary so as to see what it told them to consume.

Patient number 1 is in her early 40s, 5'5", weighs 148lbs and is a runner. She's currently consuming 1,600 Calories daily and in so doing has lost nearly 50lbs this past year. She's still losing weight, albeit at a slow rate. EATracker told her to consume 2,700 Calories daily - an amount that would have her gain back the weight that she lost in roughly 6 months at an initial rate of close to 2lbs weekly.

Patient number 2 is in her early 50s, 5'3", weighs 128lbs and is also a runner. She's currently consuming 1,600 Calories and in so doing has lost 30lbs. She's been maintaining her weight loss now for more than 6 months. EATracker told her to consumer 2,160 Calories daily - an amount that would lead her to gain roughly 1lb per week.

So what does all this mean?

If you want to gain weight, if you want to ignore careful weights and measures, if you want to forget about the fact that most Canadians eat out multiple times per week, if you want to adhere to a nutritionally flawed Food Guide, then by all means use EATracker.

I don't understand the notion of putting out such a subpar product. There are fabulous, free food diaries out there. Sparkpeople is great. It's customizable in terms of weights and measures, allows you to input your own foods, and includes restaurants in its database. Why release a product that's clearly less expansive, less user friendly, less customizable and more misleading than the ones that already exist?

The release of EATracker is analogous to a pharmaceutical company releasing a drug for blood pressure that's not even remotely as good as the ones already on the market. Frankly in the free market, that would never happen which is why to me, EATracker, heavily promoted on Health Canada's Food Guide website, looks like a collusion between Dietitians of Canada and Health Canada to promote our substandard Food Guide. I would be shocked to learn that Health Canada, and therefore you and me, didn't foot the bill for the creation of this useless tool.

I grade it an F.