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.

You're a bad parent if you don't feed your kids chocolate

That's my take on Kinder's new, "Have you played today" campaign".

The gist of the campaign?

Treats are an important part of parenting and so to be better parents you've got to make sure you give them treats, more specifically - Kinder chocolates.

Now it's true the chocolates are smaller than regular Kinder chocolates, but that's not really the point. The point is here's a campaign with an incredibly unique marketing pitch. Forget probiotics, omega-3 and fibre. Here we've got chocolate being pitched as a parenting tool; a pitch that suggests that you're a bad parent if you don't give them Kinder eggs.

How does it do that?

By recruiting experts to push their message.

Experts? What expert in their right mind would agree to pitch chocolate to children under the banner of good parenting?

Two in fact. Registered Dietitian Mary Bamford and child Psychologist Dr. Anthony Volk.

So what did they have to say?

When I read Mary's piece entitled, "Treating with Food: What's Okay", I learned that Mary advocates giving children 10-15% of their total daily calories in treat form and that doing so would, get this, teach them about portion control,

"For younger children, allowing around 100 calories per day as a treat allows you to teach the importance of portion control. Older children and female teens are allowed 150 to 200 calories per day and 200 to 400 calories per day for active teen boys."

More strikingly I learned that Mary doesn't seem to be aware of treats other than food as not once does she suggest that such treats exist. She also advises parents not to stress about giving their children chocolate every day because,

"The Kinder Survey reveals that 91% of dietitians agree that parents should feel comfortable including chocolate in their children’s diets on a periodic basis."

I suppose "daily" is technically "periodic". Gee thanks Mary for the sage advice of parents' own hands providing 10% of their children's daily calories as treats and backing that up with a spun-by-you statistic that clearly did not apply to the daily provision of the caloric equivalent of 1 can of Coca Cola for toddlers and small children, 2 cans of Coca Cola to teen girls and 4 cans of Coca Cola daily to teen boys

(I use Coca Cola as an example because Mary has also worked for them suggesting that sugared soda availability helps teach about choice and that it's fine for 10% of your child's daily caloric intake to come from sugar lest they become apparently sugar-crazy teenagers,

"If parents don't expose kids to things in our culture, they're going to go crazy in their teens and so really teaching them reasonable choices is a good way to go so getting 10 per cent of your calories from added sugars is quite reasonable")

And the child psychologist, what about him? He had a lot to say - 4 pieces in total. In his article, "Why Treat" he explains that giving your kids Kinder chocolate every day will:

1. Encourage sharing between children, promoting patience, fairness, and social skills.


2. Teach patience and perseverance.


3. Reward positive behaviour.


4. Encourage play.


5. Help build positive parent-child relationships.

To his credit, unlike Mary Bamford he does suggest and support the provision of varied treats but overall hammers home this message,

"Did you know that treats of all kinds – from a special shared experience to a simple chocolate bar – can be used to help build those positive parent-child relationships? In fact, when used as part of overall positive parenting practices, treats can:

• Show children that their parent is concerned about making them happy, and willing to do things that make them happy.
• Set a positive mood to make a child more receptive to what a parent has to say.
• Foster positive interactions between parents and children.

Giving and receiving treats – shared moments of joy – can help to build strong parent-child relationships."

To be clear, it's not as if my wife and I never use food treats with our own children - we surely do but certainly not every day. More importantly our food treats are never given as rewards like Kinder's purchased experts suggest. Why not? Because it's thought that rewarding with food treats (called instrumental feeding) encourages and teaches children to eat for a myriad of cues and may further their risk of eating more than they need, which is probably why in guidelines on the treatment and prevention of childhood obesity rewarding with food is explicitly cautioned against.

So when do we use food treats? Pretty much on a just because/sometimes food basis and we certainly don't link them with the completion of any activity or eating behaviour. We do however treat regularly. Treats may be "special time" with mom or dad, telling them how proud we are of them, how much we love them, warm hugs, favourite activities, etc.

Now I can only hold out hope that Dr. Volk and Mary simply didn't think their involvement with Kinder through, and certainly from Dr. Volk's quote in Sarah Schmidt's article published yesterday in the Vancouver Sun, I wonder whether or not he really understands how Big Food works its magic,

"I think we live in a consumer society, and it’s very refreshing to see companies taking interest in the welfare of children that they’re marketing to. You have to buy things for children, so for a company who wants to sell to children, I think it’s very responsible that they actually try to get experts on board"

Dr. Volk, Kinder's job is to sell chocolate. They used you to do that. Nothing refreshing about it.

[I had seen the campaign months ago but didn't look carefully enough at it. Thanks to Sarah Schmidt from Canwest for forcing me to take a closer look.]

Thoughtful elementary students ignored in quest for healthier cafeteria.

This is not a happy story.

So roughly two weeks ago I received a series of emails from kids in a Canadian elementary school. The emails were sent to Health Canada as well as their school trustee, local papers and television as well as me (thanks kids!). The emails were quite straightforward.

You see the kids were concerned that the food being sold to them in their school cafeteria did not reflect the food they were taught to eat in class.

Here's a sampling of some of their concerns,

"I think that it is not fair that you guys talk about healthy things and then you put junk food in our school's cafeteria. There is no healthy food in our cafeteria, but only deep fried garbage food."

"We learned form our classes that we should not eat junk food too often, but I have to eat from the cafeteria because my mother works too much and has no time to cook for me. So, I want healthy foods served to me in my school."

"I don't find it sensible to learn repetitively in science and phys.ed class about healthy food choices and be served the exact opposite in our school cafeterias."

"I do not want to have angina or a heart attack in my early 20s because of the junk food in my school cafeteria. I do not have a variety to choose from. Many of this foods that are being served in my school's cafeteria are extremely unhealthy for us, so I want better and healthier choices in our cafeteria."

"We had study in our science textbook that we have to eat healthy, but our school cafeteria sells junk food to us. So what's the point for studying health and eat heathy, when the bell rings and all we can buy is unhealthy food?"

"I would REALLY appreciate if the cafeterias stops selling fried food, and sell some more healthy food like salad, which can actually HELP us grow, not destroy us."

"My school cafeteria and food dispenser machines offer DEEP FRIED French fries, baked pizza, DEEP FRIED burgers, DEEP FRIED potato chips, DEEP FRIED apple pies, DEEP FRIED beef patties, candy, cookies, muffins, and sodas. Help us help ourselves. What can you do for us? Is there any hope to see healthy food in schools?"

Great stuff right? Very valid concerns by real kids facing a real problem.

So what did the school do to these young activists? I was curious myself so I decided to follow up with the kids and ask them what happened.

Apparently the kids were given a private lecture where they were chastised, intimidated and shamed for what they'd done. They were told they were irresponsible for sending letters outside of the school; that their letters might cause the folks in the cafeteria to lose their jobs; and they were told that what they did was wrong. Here's one kid's words,

"We were reprimanded, even though they told us that we weren't in trouble. They were just "disappointed and upset" because we had not told them about this. We were very intimidated, and felt like we were being looked down upon, for having our opinions."

How sad is that? As if the school itself doesn't know what it's serving. Clearly the school was aware of what was being served and had they themselves cared the students would have already had healthy fare to choose from. And what kind of a lesson did the school just teach them - that they shouldn't question authority? That they shouldn't stand up for the causes they believe in?

School cafeterias certainly need to change, hopefully there will be more students like these elementary students who are willing to stand up and demand good nutrition.

Shame on everyone who gave those kids a hard time. As educators, you should know better. You not only owe those kids a healthy cafeteria, you owe them an apology.

Ottawa Citizen Nutrition Watch - Saturday Edition

I've noticed that there are often Saturday recipes as well.

Here are the nutritional breakdowns for today's two recipes:

Braised Beef Ribs with Pomegranate Jus:
(per serving): 447 calories, 10g saturated fat, 838mg sodium, 21g total carbs.

Cretons:
(Not sure how to break this down - makes 2 pounds but is spread. Here's the breakdown for the entire recipe and if anyone makes it, email me and tell me how many cups it made and I can break it down by teaspoon): 3,793 calories, 105g saturated fat, 7,937mg sodium, 137g total carbs.

[All recipes calculated using Mastercook 9.0. Today it took roughly 1.5 minutes per recipe]

By 2025 American kids to be too obese to ride hoverboards?

Oh ONN, how I love you Onion News Network.

Today for Funny Friday watch and hear how Obama's vision for America changed after he visited a neighbourhood Denny's.

[Fair warning - some occasional yet very foul language makes this NSFW or young ears]

Have a great weekend!

Ottawa Citizen Nutrition Watch Week 4 - Progress?

So yesterday I sent a letter to the Citizen and this time I expanded the list of folks to include the Citizen's Editor-in-Chief Gerry Nott along with their publisher James Orban and their VP of Reader Sales and Service Paul Sarkozy. If you're not sure what I'm talking about, here's the letter which will help to explain,

Dear Mr. Orban,

My name is Yoni Freedhoff and I’m a Citizen subscriber here in Ottawa. I’m also a physician with a focused practice that deals with weight and nutrition. Advocacy is something I feel very strongly about and wish that more physicians and professionals would use their voices to help improve the life of their fellow Canadians. My advocacy efforts tend to focus on what I know best – nutrition.

In April I was invited by the Ontario Medical Association to help them with their launch of an initiative to have calories legislated to be posted on chain restaurant menu boards and in school cafeterias. The Citizen, in their editorial on the matter (April 10th) did not support the initiative stating that legislation would not be necessary if consumers simply mounted an “ask before you order” campaign. Soon afterwards I noticed that in the Citizen’s Food section the published recipes lacked nutritional information and I wrote a letter to the editor asking that in the spirit of the “ask before you order” campaign suggested by the editorial board for posting of menu board calories, that I was asking the Citizen to publish nutritional information for its readers.

Nothing came of that letter and so I decided to in fact go ahead and mount the campaign the editorial board suggested.

First though I’d like to explain why. It’s not to vilify specific recipes or nutrients. Certainly life should include indulgent meals from time to time, but it is about providing a level playing field to help your readers make their own decisions as to whether or not the recipes meet their needs nutritionally. The fact is there are tens of thousands of Citizen readers for whom nutritional information would be beneficial. Readers with diabetes, hypertension, obesity, kidney disease and those who simply are concerned about their nutritional health. In fact I’d go further and state that even individuals who don’t currently feel nutritional information to be important, when faced with actual numbers, might well utilize them in their decision making. In publishing this information the Citizen would be doing a great service to its readers and providing the newspaper with a value added that could be promoted both in terms of Thursday sales and in terms of the Citizen’s caring for its readers.

Three weeks ago I emailed Ron Eade with these suggestions and he kindly informed me that it wasn’t his decision to make and that instead I should contact Wendy Warburton as he was concerned regarding the cost involved. I did email Wendy and let her know that the cost would be negligible or even free as the internet has free resources to analyze recipes' nutritional content and there are programs such as the one I use that cost less than $20.

I never heard back from her.

The next week I emailed Ron privately and let him know that I was going to offer to do the work for the Citizen for free. I offered that were the Citizen to provide me with the recipes 24hrs. prior to the copy deadline that I would personally take the time to calculate calories, saturated fat, sodium and total carbs for each and every one. Ron emailed me back to let me know that he’d pass the request on up and again, I haven’t heard a peep.

The campaign to have nutritional information published in the Citizen is slowly permeating local social networks. I blog about it weekly on my blog Weighty Matters and it’s been picked up by at least two other local bloggers and multiple local Twitter users and while I’m not suggesting that the Citizen must simply acquiesce to the request I’m surprised, especially given the uniform support expressed by folks commenting on the initiative, that to date the Citizen has simply chosen to ignore it. While I can’t imagine what it would be perhaps the Citizen has a reason why they would not want to take me up on my offer to provide them with free work that would serve to both enhance their content and empower their readers and I’m writing to you today in the hopes that you, or any of the other folks I’ve included on this email, might be able to provide me with some insight as to the decision making over there at the Citizen.

Yours sincerely,
Yoni Freedhoff

So the good news?

Gerry Nott, the Editor-in-Chief wrote me back to tell me it was the first he'd heard of my concerns and offer and that he'd bring it up with Wendy on her return from vacation on June 22.

I realize you may have sent emails already, but perhaps you could drop Mr. Nott a line (and included in the email will be Wendy Warburton) and let him know how you feel about the matter. Please email them by clicking here and please consider doing so even if you've already emailed in the past (you can even cut and paste your old email from your sent messages folder).

I know this subject has started to be cross-posted on various blogs and Twitter accounts (thanks!) - please consider reposting again or for the first time.

Remember, it was the Citizen's editorial board in their piece on posting calories on menus who suggested that legislation isn't necessary to get restaurants to post calories but rather that consumer demand would do the trick. Let's see if they were right with regards to their own paper. Please consumers - make some demands.

Here's the breakdown for this week's batch of three lonely Citizen recipes (The fact that this week's recipes are supposed to be geared towards diabetics certainly highlights the need for posted nutritionals as many diabetics utilize nutritional information to help manage their treatments):

Basil Lamb Chops
(per serving with low sodium V8 and no added salt): 362 calories, 13g saturated fat, 77mg sodium, 3g total carbs (add in the regular V8 and salt and sodium rises to 551mg per serving)

Bar-B-Q Chicken/Foil Pack
(per serving assuming 4): 274 calories, 3g saturated fat, 553mg sodium, 16g total carbohydrates.

Bar-B-Q Sauce for Diabetics
(per tablespoon): 10 calories, trace fat, 146mg sodium, 3g total carbs.

[All recipes calculated using Mastercook 9.0. Today it took roughly 3 minutes per recipe]

Jamie Oliver's at it again!

You've heard of Jamie Oliver, right?

He's the British chef who single handedly changed his nation's school meals, who's hired street kids and turned them into world class chefs, who's tried to use social networking to teach entire towns to cook.

Now he's trying to create healthy kids' meals at hotels.

Lord knows healthy kid meals are tough to come by on the road. Usually all you'll see are staples such as chicken fingers and fries, grilled cheese and fries, hot dogs and fries, macaroni and cheese and maybe a pizza.

Well Jamie's now partnered up with Sweden's Scandic Hotels to revamp their nutritional fare and he's starting with the kids.

Good on you Jamie. Hopefully it's a trend that other hotels will jump on.

[Hat tip to Lorne, BMI's director of operations]

What the American Beverage Association and Philip Morris have in common.

There was a letter to the editor in yesterday's New York Times. The letter was written by Ms. Susan K. Neely, the President of the American Beverage Association. According to their website the ABA`s members,

"market hundreds of brands, flavors and packages, including regular and diet soft drinks, bottled water and water beverages, 100-percent juice and juice drinks, sports drinks, energy drinks and ready-to-drink teas."

Susan was writing in response to an editorial where the New York Times called on the imposition of an excise tax on sugary beverages given their clear cut linkage to obesity and their dearth of health benefits.

Those madmen!

In any case, Susan was understandably upset. You see Susan represents many of the beverages upon which such a tax would impact. So what did Sally do? She followed the Big Tobacco Playbook. If you'd like to read the playbook have a gander at Kelly Brownell and Kenneth Warner's recent paper, The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food? in which the authors spell out how Big Tobacco's spin machine set out to delay the inevitable taxation and vilification of their product and then draw comparisons with Big Food.

According to Brownell and Warner if Big Food plays by Big Tobacco's rules these are the plays we'll be seeing (with excerpts from Sally's letter italicized throughout):

Focus on personal responsibility as the cause of the nation’s unhealthy diet.

Raise fears that government action usurps personal freedom.

"There are better initiatives to tackle obesity than discriminatory taxes."

Vilify critics with totalitarian language, characterizing them as the food police, leaders of a nanny state, and even “food fascists,” and accuse them of desiring to strip people of their civil liberties.

Criticize studies that hurt industry as “junk science.”

"As policy makers seek ways to finance health care reform, we encourage them to seek broad-based, equitable solutions based on science, economic realities and common sense."

Emphasize physical activity over diet.

"Balancing calories consumed with those expended through physical activity is the critical factor in preventing obesity."

State there are no good or bad foods; hence no food or food type (soft drinks, fast foods, etc.) should be targeted for change.

"Scientists agree that there is no single cause of obesity, and there will be no single solution. In fact, a recent study published in The New England Journal of Medicine reaffirms that calories are calories, regardless of their source. "

Plant doubt when concerns are raised about the industry.

Not bad Sally. You hit 4 of 7 plays in only 159 words!

Thanks to the refreshments industry in both Canada and the US for providing such easy fodder for blogs.

Oh and Brownell and Warner, you guys rock.

Kelly D. Brownell, & Kenneth E. Warner (2009). Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food? The Milbank Quarterly, 87 (1), 259-294 PMID: 19298423

Media chastised for not enough fatism?

View Larger Map

Nope, it's not happening in Bizarro-world, but certainly you'd never see this in North America!

It's an article from a Dubai newspaper detailing the "flaying" of their media for not doing enough to dispel the

"deep-rooted misconceptions about excessive weight being an indicator of good health"

by the combined forces of their Ministry of Health and UNICEF.

Contrast that with North America and Europe where you'd be hard pressed to find a non-negative portrayal of obesity in the press or elsewhere. In fact just this past year alone the press has managed to "link" obesity with global warming, rising fuel prices and contagion (the message being don't hang out with fat folks or you're liable to get fat too).

I wonder what Dubai would make of the recent paper published last month in Obesity authored by Rebecca Puhl and Chelsea Howard who cover the stigma associated with obesity. Sadly their paper clocks in at a meaty 24 pages and covers the negative bias seen in:

Health Care Settings (including doctors, nurses, dietitians, medical students, and fitness trainers).

Educational Settings

Interpersonal Relationships

Entertainment Media

News Media

Advertisers

And then they cover the unfortunately devastating impact this has on the obese.

If I can give Dubai some words of advice - be careful what you wish for.

One monkey, no cup.

Forgive the reference in the title (and if you don't know the reference, consider yourself lucky) and forgive the toilet humour. What can I say, I'm a simple man.

Today's Funny Friday proves why it's always handy to have a camcorder when visiting the monkey cages.

Have a great weekend!



[Hat tip to Lorne our Director of Operations at BMI]

Help get nutritional information into the Ottawa Citizen!

Unfortunately it seems this may become a recurrent Thursday topic.

A few weeks agoI blogged about how I had written a letter to the editor of the Ottawa Citizen asking that they publish nutritional information for its Food Section recipes.

It didn't get published.

I then wrote Ron Eade, the Citizen's Food Editor with the same request and he informed me that it was a budgetary issue and suggested I contact Wendy Warburton the person in charge of making the decision to spend the $16.99 it would cost to buy the software to analyze the recipes.

And so I did.

She didn't write me back.

So I'm at it again.

The issue here is simple. There are tens of thousands of Citizen readers for whom nutritional information would be beneficial. Readers with diabetes, hypertension, obesity, kidney disease and those who simply are concerned about their nutritional health. Those individuals would greatly benefit from having the Citizen publish nutritional information along with their recipes and frankly it's dead simple and dirt cheap to provide it.

How dead simple and dirt cheap?

It can't get any easier than this:

If the Citizen provides ME with their recipes 24hours before their copy deadlines I will personally take the time to calculate the nutritional information for each and every Food Section recipe they print.

So what say you Ron and Wendy?

Zero cost, zero effort.

Feel free to email Ron and Wendy by clicking here.

If you're a local blogger or Twitter'er please repost. If you're not into blogging and such, just email this to your friends. Perhaps we can make enough noise to affect change for as you may recall, the Citizen's editorial board in their piece on posting calories on menus suggested that legislation isn't necessary to get restaurants to post calories but rather than consumer demand would do the trick. Please consumers - make some demands.

Until I hear back from them I guess you'll have to tune in here for breakdowns.

Here's the breakdown for this week's batch of Citizen recipes:

Saucy Spinach-Dressed Baked Spuds
(per serving assuming 1/16 teaspoon of salt per): 449 calories, 10g saturated fat, 826mg sodium, 25g total carbs [A lot of salt and calories for a side dish and even if you leave out the salt altogether sodium only goes down to 692mg per].

Smoked Pork Tenderloin with Blueberry Glaze
(per serving if you serve 6 and use 1/8 teaspoon salt to taste spread over the entire recipe): 487 calories, 817mg sodium (can easily trim this to 487mg by using light soy sauce and not adding salt to taste), 4g saturated fat, 53g total carbohydrates.

Grilled Brats in Beer
(per serving): 482 calories, 9g saturated fat, 832mg sodium, 31g total carbohydrates [This one will really vary dependent on your bun and bratwurst. I would take the numbers here as low estimates and figure they could easily double depending on what you buy - read your labels!]

To-Die-For Decadent Burgers
(per burger with NO fixings): 776 calories, 29g saturated fat, 592mg sodium, 22g total carbs [Obviously these numbers will climb with the fixings.]

Roast Rack of Lamb
(per serving with no salt to taste): 1,501 calories, 54g saturated fat, 871mg sodium, 34g total carbs.

Sweet and Sour Cucumber Salad
(per serving): 36 calories, trace saturated fat, 98mg sodium, 7g total carbs.

Tube Steaks (Hotdogs) with Pickled Onions
(per serving not including ketchup or mustard): 554 calories, 13g saturated fat, 2,219mg sodium, 42g total carbs [Really, are hot dogs worth more than a day's worth of sodium? Your call of course].

[All recipes calculated using Mastercook 9.0. Today it took roughly 4.5 minutes per recipe]

Flying Pig Served at Australian McDonald's?

Not unless you think the photo above is helpful.

To summarize, apparently McDonald's Australia is pushing for the mandatory posting of calories in fast food restaurants and their submission has received very positive play both in the news and the blogosphere.

So what exactly is going on? Click here and you can read Peter Bush's, the CEO of McDonald's Australia's submission to the Australian's Parliament's Standing Committee on Health and Ageing's inquiry into obesity in Australia.

To quote from the submission,

"McDonald's Australia calls for the Federal Government to introduce mandatory nutrition labelling for quick service restaurants."

Sounds good right? Pig droppings falling from the sky good right?

Um, not so much.

Let's read the next line,

"By nutrition labeling we are referring to the Nutrition Information Panel"

What's a nutrition information panel?

It's a poster on the side wall of a restaurant that has lots of small print that no one reads or in some cases, a trayliner or a panel on the food itself (as in the photo above). That's a far cry from menuboard calories and according to a recent study I blogged about out of Yale, something that virtually no one ever bothers to look at.

Sorry folks, nothing to see here - just a pig wearing fake fairy wings.

Refreshments Canada President playing from Big Tobacco's playbook

There was a letter to the editor in yesterday's Edmonton Journal. The letter was written by Mr. Justin Sherwood, the President of Refreshments Canada. According to their website Refreshments Canada,

"represents more than 30 brands of beverages including bottled waters, juices and carbonated soft drinks, all of which have a place in a healthy, balanced lifestyle and offer consumers choice and variety."

Justin was writing in response to a column written by Dr. Louis Francescutti (an ER doc and the President of the Alberta Public Health Association) who called for government regulations to ban trans fats, regulate advertising targeting children and remove harmful foods (trans fats, high-sugar and high-fat foods, and low-nutrient foods) from school vending machines.

That madman!

In any case, Justin was understandably upset. You see Justin represents many of the beverages that Dr. Francescutti's plan would see leave the schools. So what did Justin do? He proved Dr. Francescutti's point that Big Food is playing by Big Tobacco's playbook. If you'd like to read the playbook have a gander at Kelly Brownell and Kenneth Warner's recent paper, The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food? in which the authors spell out how Big Tobacco's spin machine set out to delay the inevitable taxation and vilification of their product and then draw comparisons with Big Food.

According to Brownell and Warner if Big Food plays by Big Tobacco's rules these are the plays we'll be seeing (with excerpts from Justin's letter italicized throughout):

Focus on personal responsibility as the cause of the nation’s unhealthy diet.

"Proper nutrition education at home and in the school system is the most effective way to teach young people to make choices in a healthy and balanced way"

Raise fears that government action usurps personal freedom.

"I am writing to express concern over the heavy-handed approach to the theme of this opinion article."

Vilify critics with totalitarian language, characterizing them as the food police, leaders of a nanny state, and even “food fascists,” and accuse them of desiring to strip people of their civil liberties.

"The author is obviously an experienced medical practitioner, but his misguided advice reflects his role as a civil and public servant, in that he insists on more government regulations to protect adults and children from making poor food choices."

Criticize studies that hurt industry as “junk science.”

Emphasize physical activity over diet.

State there are no good or bad foods; hence no food or food type
(soft drinks, fast foods, etc.) should be targeted for change.

"Obesity is a very complex issue which cannot be blamed on a single food or beverage group as the major cause."

Plant doubt when concerns are raised about the industry.

"Refreshments Canada members have been working closely with nutrition experts in the education system to ensure that healthy beverage choices, which are age appropriate, are presented in public schools across Canada."

Pretty impressive Justin - you hit almost all the plays and in only 225 words! No wonder you're the President of Refreshments Canada.

Justin, if you're reading this, I don't hate your products. I do believe in choice. I don't however believe in misleading the public, spinning the truth and doctoring the message.

Let's all hope that this time around the public is more savvy than during those bad old days of Big Tobacco.

Kelly D. Brownell, & Kenneth E. Warner (2009). Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food? The Milbank Quarterly, 87 (1), 259-294 PMID: 19298423

Hamilton-Wentworth Schoolboard Votes Calories In!

So in April I helped the Ontario Medical Association roll out their call for calories to be posted both on chain restaurant menus and in school cafeterias.

I'm please to report that Hamilton Wentworth district schoolboard voted last week 5-4 to require cafeterias to "prominently display calories" of all menu items by September!

Some of the dissenting members displayed common misconceptions about calories. Wes Hicks was quoted as stating,

"It's the quality of what you eat and it's what you do after you eat calories"

I suppose Wes thinks that exercise will burn off those calories and that if you choose healthy foods you needn't worry yourselves about calories.

Frankly I'd be surprised if all 4 of these misconceived arguments didn't rear their heads:

1. There's more to nutrition than simply calories (True. That said, I challenge everyone out there to tell me what nutritional determinant is more important at the end of the day than calories.)

2. We should be focusing on exercise, not food (False. Despite a ridiculous amount of attention, research and program development there has yet to be a school based public health intervention focused on exercise that has impacted upon weight).

3. Highlighting calories will promote eating disorders (False. There has never been a study to suggest that calorie awareness leads to eating disorders and further more I'd argue that taught properly kids should learn that there are in fact minimum numbers of calories per meal, snack and day that they should be seeking to both meet their nutritional needs and circumvent the influence of hunger).

4. It's too difficult to organize (False. Calculating calories is not particularly difficult and furthermore, given the large institutional contracts for food provision, something that certainly could be included in negotiating the next year's delivery).

Kudos to Hamilton-Wentworth for leading the way!

A new plan for economic recovery!

Another gem from the Onion News Network.

Here we have the nation's girlfriends' plan to end the recession.

Have a great weekend!

Help get nutritional information into the Ottawa Citizen!

Last week I blogged about how a number of weeks ago I wrote a letter to the editor of the Citizen asking that the Citizen publish nutritional information for its Food Section recipes. I included in my letter the calorie, sodium, fat and sugar counts for that week's recipes and pointed out that it took me all of 5 minutes to make the calculations. The letter never got published and so last week I calculated all the calories and asked readers to contact Ron Eade, the Citizen's Food Editor.

Ron kindly wrote me back and here's what he had to say,

"Dear Dr. Freedhoff,

We have in the past received requests for nutritional information in the Food section recipes, but we do not have the software to input the ingredient list to obtain this data. While we have in the past included nutritional information in recipes where it is provided by the originating source, sadly, most of our recipes from chefs, from the wire service(s), and books we consult do not include this. If it is a matter of buying the software, that is a decision for management at the Citizen who have budgetary authority.

Kind regards to you and your readers,

Ron Eade, Food editor."

I wrote Ron back and explained that the "budget" required for such a move would be either $0.00 (as there are sufficient tools online that freely help with calculations like Sparkpeople's recipe calculator and Calorie King if Sparkpeople's lacking an ingredient) or as low as $15.99 (the cost of Mastercook 9.0, the program I use at home to calculate calories). I then suggested that it would take a lucky intern all of 20 minutes maximum weekly to make the calculations.

So who has budgetary authority for a less than $20 purchase? According to Ron the person we should be writing to is Ms. Wendy Warburton.

Therefore if you're an Ottawa Citizen reader (or even if you're not), and you'd like to see calories, fat, sugars and sodium published alongside Citizen recipes please take a moment of time to email Wendy Warburton and let her know.

Remember, the information would not be meant for judgement but rather knowledge and it would benefit the tens of thousands of Citizen readers who may be dealing with obesity, heart disease, kidney disease or diabetes - all diseases where nutritional information can be very useful.

If you're a local blogger or Twitter'er please repost this blog. If you're not into blogging and such, just email this to your friends. Perhaps we can make enough noise to affect change for as you may recall, the Citizen's editorial board in their piece on posting calories on menus suggested that legislation isn't necessary to get restaurants to post calories but rather than consumer demand would do the trick. Please consumers - make some demands.

Here are this week's recipes:

Grilled Lamb with Summer Salad and Minted Couscous
(for entire recipe) 6888 calories, 209g saturated fat, 1474mg sodium, 216 total carbs - 72% of calories come from fat

Asparagus Wrapped in Pancetta with Citronette
(per serving assuming 1 teaspoon total salt) 152 calories, 2g saturated fat, 888mg sodium, 7g total carbs

Grilled Asparagus with Garlic
(per serving) 106 calories, 1g saturated fat, 354mg sodium, 3g total carbs - that's a lot of sodium for a small side dish

Flank Steak Fajita
(for entire recipe) 2824 calories, 18 grams sat fat, 4042mg sodium, 389g total carbs

Rhubarb Custard Bars
(per bar) 137 calories, 3g saturated fat, 84mg sodium, 21.5g total carbs

Bacon and Olive Apertif Cake
(per entire cake assuming 1/4 teaspoon salt) 2,153 calories, 43g saturated fat, 3,033mg sodium, 135g total carbs

Chef Andrew's Fig Anise Crackers
(per entire recipe) 4,940 calories, 25g saturated fat, 30,272mg sodium (GOOD LORD!), 739g total carbs.

Chef Andrew's Fig and Ginger Jam
(per entire recipe) 991 calories, no fat, 12mg sodium, 254g total carbs

[All recipes calculated using Mastercook 9.0. It took roughly 3 minutes per recipe]

Is Nestle's Good Start probiotic infant formula breaking the law and harming babies?

It sure looks that way to me.

You see Nestlé has a product line of infant formula entitled Nestle Good Start. Here's some stuff from their website:

"Protecting your baby's future. It's what every parent wants. And what every baby needs. Starting with the right nutrition. Introducing Nestlé® Good Start® Natural Cultures™."

What parent wouldn't want to "protect their baby's future".

So what's the issue here?

Well actually there's a bunch.

First let's go to the Canadian Food Inspection Agency. In their 2007 Letter to Industry: Requirements Related to Nutrition Information and Nutrition and Health Claims for Infant Formula they spell out a few things to folks like Nestlé,

"Comparing infant formula to breast milk, including comparisons of the levels of a nutrient in infant formula to the levels of the same nutrient in breast milk, is contrary to the message embodied in the Code".

and

"the infant formula industry is encouraged not to make a reference to breast milk on a label or advertising of infant formula, other than a statement regarding the superiority of breastfeeding"

Yet on Nestlé's site,

"Natural cultures are part of what gives breast milk its naturally protective qualities. And of the natural cultures found in breast-fed babies, one is by far the most prevalent - Bifidobacteria. That's why we added Bifidobacteria, which we call bifidus BL, to Good Start® Natural Cultures™. It's the first and only Infant Formula to contain it. Because we believe your baby deserves it."

and,

"Enhanced with Omega-3 (DHA) and Omega-6 (ARA) - two of many important nutrients also naturally found in breast milk - to help support your baby's normal brain, eye and nerve development right from the start."

and,

"There are only two places your newborn can get natural cultures. The first is you. The other is from Nestlé® Good Start® Natural Cultures™. "

Sure sounds like Nestlé's making the case that they've basically powdered breast milk!

But it gets worse.

Going back to the Canadian Food Inspection Agency document,

"The use of health claims on food labels and in advertising of foods including infant formulas is limited by the Food and Drugs Act. Although the Food and Drug Regulations currently allow five diet-related health claims on food labels, these are not permitted on foods for children under two years of age, including infant formulas. The dietary recommendations that lay the foundation for these claims are for adults and are not appropriate for infants and young children."

I guess Nestlé didn't get that memo as they promote their formula on their labeling and website as having the following health benefits,

"easier to digest",

"naturally protective",

"helps support babies’ normal brain, eye and nerve development",

"helps your baby build strong, healthy bones and teeth",

"crucial to his continued mental development"

"As good bacteria, Bifidobacteria can compete with unwelcome harmful bacteria in the gut by helping keep them from entering your little one's vulnerable body - providing added protection to help keep your baby healthy."

And it's about those harmful bacteria and your little one's vulnerable body where Nestlé's product can become potentially fatal.

You see there's this bacteria, Enterobacter sakazakii, it's been found to be a contaminant in infant formula. Sadly it has been known to cause sometimes fatal cases of meningitis (brain infections), sepsis (blood infections) and necrotizing enterocolitis (very bad intestinal infections) in infants. Consequently the World Health Organization in their Guidelines for the safe preparation, storage and handling of powdered infant formula recommend that with the specific aim of minimizing the risk of E. sakazakii infections, the water mixed with formula ought to be a minimum of 70 degrees Celsius (158 degrees Fahrenheit) and then be allowed to cool.

And what of Nestlé "Good Start"?

They explicitly advise consumers,


But of course given that E. sakazakii actually can contaminate the formula itself even if you use previously boiled water that has cooled to 40°C you'll still run the risk of not killing this opportunistic pathogen.

As Kim Sheeler, OB nurse and whistle blower asked me in her email pointing out Nestlé's egregious behaviour,

"I wonder if the parents who spend an extra $10 or more per container of powdered probiotic formula are willing to take the risk of having their baby exposed to E. sakazakii or Salmonella in exchange for the benefits of the probiotics, or is it that they are lulled into a false sense of security by the probiotic halo and think that any risk of a sakazakii or salmonella infection is minimized by the presence of probiotic cultures?"

Great questions Kim.

This isn't the first time Nestlé's come under the gun for their aggressive formula marketing as this article from the UK attests - that said, aggressive marketing is one thing, breaking the law and endangering children is quite another.

I'll be sending this post along to the consumer protection division of the Canadian Food Inspection Agency and to the Director of the Bureau of Nutritional Sciences at Health Canada. Perhaps they will be able to put a stop to what appears to me to be both a horrendous abuse of public trust and a potentially fatal product for infants.

Is your OJ filled with ethyl butyrate?

Probably, according to Toronto based author Alissa Hamilton.

She's recently finished writing an expose on the OJ industry entitled,

"Squeezed: What You Don't Know About Orange Juice"

and this past weekend the Toronto Star interviewed her about her findings.

Among them:

"Juice companies therefore hire flavour and fragrance companies, the same ones that make popular perfumes and colognes, to fabricate flavour packs to add back to their product to make it taste like orange juice."

"Most of the juice sold in North America contains flavour packs that have especially high concentrations of ethyl butyrate"

"Any product that has a 60-plus day shelf life and is available year-round has to be heavily processed. If you want a product that is fresh-squeezed or close to it, the "best before" date is a good gauge. Fresh-squeezed juice doesn't last for more than a couple of days"

She also wades into the marketing reporting that,

"the statement that appeared at the top of Tropicana's new and now discontinued carton: "squeezed from fresh oranges." (is) meaningless – one would hope the oranges were fresh when squeezed – the statement could easily be misread as "fresh squeezed" by all but the most discerning shoppers."

I'm excited to read her book - it's available for preorder from Amazon.ca for $24.89 (37% off) right now for shipping on or around the end of the month!

Oh - and Alissa, like me, recommends you eat your oranges, not drink them.

[Via Marion Nestle's Food Politics]

Health Canada Clueless on Probiotics

Now I can't claim I'm an expert on probiotics but Professor Gregor Reid sure can. Professor Reid is a Professor of Microbiology and Immunology at the University of Western Ontario, Director of the Canadian Research and Development Centre for Probiotics, and Assistant Director International at the Lawson Health Research Institute. According to his biography on Canada's Advanced Foods and Materials Network website he,

"holds 28 patents, has published over 300 per-reviewed papers and given over 380 talks in 38 countries. In 2001-2002, he was appointed Chair of United Nations - World Health Organization Expert Panel and Working Group on Probiotics. In 2006, he was appointed President of the International Scientific Association for Probiotics and Prebiotics"

Professor Reid is both a strong proponent of probiotics and of ensuring claims made by probiotic food manufacturers are in fact evidence based.

In February Health Canada published a product monograph on probiotics meant to,

"serve as a guide to industry for the preparation of Product Licence Applications (PLAs) for natural health product (NHP) market authorization of probiotics".

Last week the e-newsletter Nutra-Ingredients interviewed Professor Reid and asked for his thoughts on the monograph. Here are some choice bits of what he had to say,

"Health Canada has no expertise on its Expert Advisory Committee to assist with preparation of this Monograph, and I assume no consultation was made with anyone who actually knows anything about probiotics."

"They don't understand that unless you show that a product confers a health benefit on the host (which by itself requires a properly designed human study) then it should not be called probiotic. NHPD need only ask companies to show such documentation, refer to the FAO/WHO document and if they can't satisfy this, then they need to call their product something else,"

"Sadly, we have probiotic chocolate, bread, orange juice, certain dairy products and even an ice cream that has a flyer which mentions probiotics can prevent colon cancer (how much ice cream should I take every day to do this?). I am not questioning the quality of these products or that they might be beneficial, I just want to see some data on what they have been shown to do. Otherwise, we are fooling the consumer and/or not giving them sufficient information."

I guess here we have yet another example of why I call Health Canada, Happy Corporations.

So sad.

[FYI - Dr. Reid is a fan of Danone's yogurts Activia and Danactive both of which he believes Danone has sufficient scientific evidence to support their probiotic benefit claims.]

10 Things you don't know about orgasms!

Like for instance they can cure intractable hiccups.

Thanks to blog reader Sebastien who brought this video to my attention.

Not my typical Funny Friday as it's lengthy but well worth all 17:11.

Believe it or not it's a TED talk by author Mary Roach all about orgasms that will also teach you how to best arouse a female pig so as to encourage a larger litter.

Have a great weekend!



Roni Peleg, MD Aya Peleg, PHD (2000). Case report: Sexual intercourse as
potential treatment for intractable hiccups Canadian Family Physician, 46, 1631-1633 PMID: PMC2144777

Calories in the Ottawa Citizen Food Section Recipes

A number of weeks ago I joined the Ontario Medical Association in calling for legislation to force chain restaurants to post calories on menus.

The vast, vast majority of news pieces and editorials were strongly supportive however my local paper, the Ottawa Citizen, wasn't so enthralled with the idea.

In their editorial on the matter the Citizen made the case that while they felt indeed it would be useful that rather than legislate the matter that consumers should demand it and industry would respond.

In that spirit that week I wrote a letter to the editor of the Citizen "demanding" that the Citizen publish nutritional information for its Food Section recipes. I included in my letter the calorie, sodium, fat and sugar counts for that week's recipes and pointed out that it took me all of 5 minutes to make the calculations.

The letter didn't get published and still the recipes are count free.

Starting today I will endeavor to calculate the Citizen's Food Section calories but in return I'd like to ask a favour. If you find this information useful please click here to email Ron Eade, the Citizen's food editor, to request that the Citizen include this information in their newspaper. The information would not be meant for judgement but rather knowledge and it would benefit the tens of thousands of Citizen readers who may be dealing with obesity, heart disease, kidney disease or diabetes - all diseases where nutritional information can be very useful.

Ron, if you're reading this, I'd be very happy to sit down with you and show you how easy it is to calculate. We could even sit down over a smoked brisket.

So without further ado, this week's recipes:

Mixed-Grill Vegetable and Chick Pea Lasagna
(per entire dish) 3,356 calories, 4,569mg sodium, 172gr fat (33g saturated), 39.7g sugar
- Fairly high in both calories and sodium.

Blueberry Orange Muffins
(per muffin) 240 calories, 286mg sodium, 14.5g sugar, 3.1g saturated fat
- Not terrible for a muffin. Would be much less on all counts if you substituted Splenda (wholly or partially) for sugar and apple sauce for oil.

Whole Wheat Penne with Chicken, Wild Mushroom and Tomato Basil Pesto
(per serving) 446 calories, 106.4mg sodium, 2.8g saturated fat 0.4g sugar
- A winner! Especially given the 11 grams of healthy unsaturated fat in the recipe.

[BTW, Ron has a great blog Omnivore's Ottawa and is on Twitter as well!]

Antioxidant Immune Protecting Grape Juice

Twice the "antioxidant power" of orange juice - you don't say.

Um, what exactly is "antioxidant power" and how does it "protect" my immune system?

According to the advertisement it has to do with the "Oxygen Radical Absorbance Capacity".

Is that an established measure of healthfulness? Of course not. Has it been shown to "protect" immune systems? Of course not. Does that stop Welch's from making health claims to boost sales? Of course not.

You know what else Welch's grape juice has twice as much of compared with orange juice (and Coca Cola for that matter)? Calories and sugar.

Yeah, that's right.

And I don't think they protect your immune system.

A personal trainer for eating your vegetables?

I've got one.

It's my subscription to a local farm's community shared agriculture (CSA) opportunity.

Why? Because really I'm like everyone else. Sometimes it's difficult to motivate myself to exercise and sometimes it's difficult to motivate myself to eat healthier.

To that end this year my family subscribed to Bryson Farms' CSA program. It's fantastic. Yes, it's more expensive than buying vegetables in the supermarket, but when left to our own devices my wife and I certainly weren't the most adventurous vegetable consumers. Now, each week, we receive a large bag of vegetables. Some are familiar to us while some are not. Bottom line for us it's analagous to folks using personal trainers to insprie themselves to exercise except here instead of paying for it and exercising we're paying for it and eating it.

In so doing we're also supporting local agriculture, eating pesticide free produce and just in general eating a heck of a lot more vegetables than we used to.

[If you're in Ottawa and you're interested in Bryson Farms' CSA just head over to their website to learn about their various options.]

Does just thinking about exercise make your heart beat faster?

I certainly hope not because if a recent study holds true, if thinking about exercise causes your heart to race you're twice as likely to die of a sudden heart attack.

Of course it occurs to me that the folks whose hearts are likeliest to race at the thought of exercise would be those who are the least fit as they'll be worried about the prospect of exercising which in turn might cause their adrenaline to flow and their hearts to race.

So perhaps the results aren't so surprising - those who are the least fit are the most likely to suffer sudden heart attacks.

Bottom line? We should all do more exercise.

Jouven, X., Schwartz, P., Escolano, S., Straczek, C., Tafflet, M., Desnos, M., Empana, J., & Ducimetiere, P. (2009). Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population European Heart Journal DOI: 10.1093/eurheartj/ehp160

[via bookofjoe]

Health Canada does NOT advise you to stop taking Hydroxycut

By means of example as to just how pathetic Canada's natural health product laws and regulations are one needs to turn no further than the recent Hydroxycut recall.

In case you're unaware, on May 1st the FDA warned consumers to immediately stop taking 19 different Hydroxycut products due to adverse effects including liver failure and death.

So what happened in Canada?

On May 1st Health Canada issued a press release stating that they were looking into the issue.

Then on May 3rd they issued an advisory that does not in fact advise Canadians to stop taking Hydroxycut. Instead they have this generic line,

"Health Canada advises consumers not to use any unauthorized health products, as they may pose a risk to health. Authorized health products will bear either an eight-digit Drug Identification Number (DIN), a Natural Product Number (NPN), or a Homeopathic Medicine Number (DIN-HM) on the label."

Why such a non response? Because there is no Canadian mechanism or government body that oversees Hydroxycut products. Meaning that even though they're not "authorized", clearly there's nothing stopping companies like Iovate Health Sciences (the makers of Hydroxycut) to sell whatever they want, with whatever claims they want, in Canada. All that said, I still can't help but scratch my head at the fact that Health Canada still hasn't told Canadians to stop taking Hydroxycut. I wonder if they're worried about being sued by Iovate?

Hey here's a conundrum. What if the folks currently taking and buying Hydroxycut don't read Health Canada bulletins? What if one of those folks develops serious complications?

I'd recommend they sue our government for failing to provide even the smallest amount of due diligence on a drug that even the manufacturer has decided is deadly enough to voluntarily recall it.

Doesn't Health Canada have an obligation to review ALL products sold to Canadians purporting to affect their health?

Something tells me these guys are single.

Another week's gone. Great week though - I can't believe how much play the story on Health Canada fortifying junk food received!

Today's Funny Friday is another reminder of just how odd our world is.

Have a great weekend!



[Hat tip to loyal blog reader Annette!]

A Doctorate in Big Macs?

A little over a year ago I blogged about McDonald's in Britain being given the right to award advanced high school degrees to its workers.

Well the Bizarro world we live in just got a little more bizarro.

Apparently British McDonald's are set to start award McPhD's.

Yup, doctorates.

According to David Fairhurst, McDonald's "Chief People Officer" the awarding power proferred to it by Britain makes McDonald's, "a University in its own right".

Really, I couldn't make this stuff up.

Ottawa children needed for focus groups on food marketing!

A few days ago I was contacted by Bernie Gauthier, the CEO of Delta Media (a PR firm that helped our office out in our early days). His firm has become involved in a study being conducted by associate professor of communications and culture Dr. Charlene Elliott, funded by the Canadian Institute of Health Research, and ethically cleared by the University of Calgary.

Currently Bernie's firm is trying to find enough children for Ottawan focus groups. While the study is indeed looking at both healthy weight and overweight children, it's the overweight children that are required for this round of focus groups. Boy focus groups will occur on May 27th and girls on May 28th. The cutoff for inclusion is a BMI of 25 (BMI cutoff values differ for children - to calculate your child's BMI click here). They're looking for 6 boys and girls for each grade from 1-6.

Having worked with Bernie in the past I can tell you that the groups will be professionally run and organized.

If your child fits their needs and you've got the time, please consider contacting Bernie's team (information below) - who knows, maybe the work from this project will be the last straw that causes the government to ban advertising foods to children.

Here's some information from the study's consent form:

What is the purose of this study?
The purpose of this study is to examine child and parental responses to child-oriented food/food packaging so that researchers, nutritionists and policy makers have a more complete understanding of the current food environment, and its influence on children’s food choices, habits and nutrition. Understanding the consumption habits of children is necessary in order to create effective strategies (and policy) for promoting wholesome food habits and combating childhood obesity.

What Will I Be Asked To Do?
We are looking for children in grades 1-6 to participate in a one-hour focus group session, which will explore how they feel about the supermarket foods specifically targeted at them. During the session, the children will be asked questions and participate in activities that will help us to understand the appeal of these foods and to understand the evaluation of nutrition/nutrition claims from their point of view. The sessions will be digitally recorded for transcription. They will take place after school hours, and there will be a comfortable space for you to wait as your child participates.

Parents will also be invited to participate in a one-hour follow-up telephone interview to discuss how they make food purchasing decisions for their child—and to discuss some of the challenges of doing so. Children will receive an honorarium of $25 for participating in the focus groups and parents will receive a further $25 for completing the interview.

What Type of Personal Information Will Be Collected?
The focus groups and interviews will be audio recorded and transcribed. No names will be used in the analysis of any of the reports. The identity of all participants will remain completely confidential.

Are there Risks or Benefits if I Participate?
There are no risks associated with participating, and both you, and your child’s anonymity is ensured in the reporting of results by use of participant number.

I'm Interested. What should I do?

Call or email Nyree St. Denis at Vision Research to find out more:

nyree@visionresearch.ca

(613) 233-9191

Is "vicarious goal fulfillment" to blame for that order of French fries?

Here's a strange one.

We've talked about health halos before - if you think a food's healthy you're more likely to consume larger portions of it. Things like "low-fat" front-of-package claims and even restaurants (Subway) have been shown to have health halos that lead to less healthy consumption patterns.

This one has to be the strangest health halo yet. This one states that if there's salad on the menu you'll be more likely to order the fries.

In this study, when menu choices included healthier ones individuals were more likely to choose less healthy options than when the exact same menu was provided minus the healthy options. When salads were on the menu, fries were eaten more frequently, bacon-cheeseburgers when veggie burgers were available, chocolate covered Oreos when 100 calorie packs of Oreos were present etc. In fact there was not one menu in this study with which this phenomenon was not found to occur.

The researchers called the phenomenon, "vicarious goal fulfillment" whereby the mere ability of being able to meet their goal of eating healthier actually caused individuals to feel that they had already met their goal and therefore could order the less healthy, more indulgent option.

Wow - brains are crazy places.

Wilcox, K., Vallen, B., Block, L., & Fitzsimons, G. (2009). Vicarious Goal Fulfillment: When the Mere Presence of a Healthy Option Leads to an Ironically Indulgent Decision Journal of Consumer Research DOI: 10.1086/599219

Congratulations to the Canadian Obesity Network!

This past weekend I had the pleasure and honour of attending and presenting at the first national Canadian Obesity Network (CON) conference.

It was held in the Kananskis (at the foot of the Alberta Rockies) and I can honestly say that it was one of the loveliest conferences I've ever attended.

Many of the who's who of obesity in Canada were there and topics ranged from program development, to genetic determinants to public policy and perhaps the best part of the conference was the incredibly warm and close atmosphere that was generated by the 400 attendees.

The standout lecture for me was one by Dr. Alejandro (Alex) Jadad the Canada Research Chair in eHealth Innovation, Professor at the University of Toronto and Director of their Program in eHealth Innovation. His accomplishments are far too wide and varied to be included in this post but if you're interested click his name above to read about him on Wikipedia.

Alex spent an hour both entertaining and scolding the audience for letting technology pass us by leaving us pondering whether or not we ought to ask our patients for their email address while patients themselves set up sophisticated social networking sites that allow them to make up for our failings in providing them with sufficiently timely information and support. He also spent time chastising us for putting too much of our focus and energy on, "applying for grants, seeking promotions and giving ourselves awards" when instead we could be doing more to improve patient care in Canada.

Personally I think Alex's message was spot-on. There are tangible things that we could be doing to help improve patient care (not just with regards to obesity but in fact to medicine as a whole) and yet vastly disproportionate amounts of resources are being spent on basic science that while certainly noble, is not helping Canadians in any concrete way.

We were able to discuss this further after his talk when he and CON's communications director and mutually good friend of ours Brad Hussey and I closed the bar. We all agreed that frankly there are too many times when we've read newly published studies only to ponder, "So what?!" and without revealing our hand, by the end of the night, we had set in motion a plan of action to shake things up a bit in the research world (stay tuned).

Me? I was able to discuss regulating the weight loss industry. I discussed two options. The carrot and the stick.

The stick is formal regulations but I'm actually pushing for the carrot.

The carrot would involve an organization establishing an auditable set of inclusionary and exclusionary criteria designed to identify ethical and evidence based weight management programs.

Programs would then pay for their own audits annually and if deemed appropriate would be allowed to use a front-of-program logo on their websites and promotional materials. Governments, NGOs and allied health personnel would then be recruited to promote awareness of the logo and in so doing would help provide patients with a simple but powerful tool to help navigate the morass of the commercial weight loss industry.

My belief is that this is a job for CON.

Why CON?

In just 5 years CON has established itself as the Canadian authority on all matters obesity related; the Canadian Medical Association has called on Provincial, Territorial and municipal health authorities to work with CON on their obesity policies; and this type of an endeavour would help extend CON's recognition to the general public.

If you're interested I've managed to post my talk below (remember, email subscribers need to click the post's title to get back to the blog to view the videos).

Really kudos to CON and sincere thanks to everyone who was involved in putting together what turned out to be a fantastic conference.

If you missed it this year, don't miss 2011 in Montreal!









[Thanks to Brad Hussey - friend, CON communications director, and now too, videographer!]

World's Best Yoga Teacher

Today's a cross between Funny Friday and Feel Good Friday.

It's a brief video of an inspirational yoga class.

Have a great weekend!



[Hat tip to my friend and sensei Claudio Iedwab]