Badvertising: Jimmy D's French Toast Griddlers sure sound like villains to me.

Didn't Batman and Robin fight French Toast Griddlers?

These dastardly turkey sausages sandwiched between pieces of French toast epitomize the very essence of what I see as Frankenfood - highly processed muck slapped together that eliminate the need for cooking and beautify lowest common denominator nutrition.

So what's in 'em?

54 different ingredients culminating in an admittedly it could be worse 1/3 of your child's total daily recommended sodium intake.

The bigger problem here?

Buying into the notion, and in so doing, teaching your kids food comes from boxes and that cooking's for suckers.

How difficult is it to actually make an egg sandwich?

Badvertising: The Special K Challenge shows Kellogg's true obesity colours.

Well given what Kellogg's suggests will happen if you lose weight with the almost painfully stupid Special K challenge (just eat small amounts of cereal instead of substantive food and low and behold you'll lose weight) it would seem Kellogg's doesn't think too much of folks who are obese.

Taking an antonymous look at their ad yields something like this:

If you've got weight to lose you're probably a sad, anxious, dull, drab, meek, boring, timid, angry, cowardly, pessimistic, insecure, weak willed, lazy, stuck, indecisive, slob.

Gee Kellogg's, you guys really are special.

Badvertising: V8 V-Fusion tries to fuse your brain cells.

Really V8?

You're really trying to suggest that that V8 V-Fusion with 120 calories and more than 6 teaspoons of sugar and 0g of fibre per glass along with a bunch of Vitamin C is the equivalent of eating a half a cup of broccoli and half a cup of blackberries?

Funny thing.

That half cup of both broccoli and blackberries? Well together they'd contain only 46 calories, and they'd also contain 5g of fibre and only 1 teaspoon of sugar. They'd also contain all of the phytonutrients lost during juice processing and their sheer volume will help make you feel full.

You can't drink your fruit and vegetables!

Badvertising: Great job on your homework, here's a pie?

Saw this gem in a parenting magazine.

Bribe your kids to do their homework with pies.

This particular pie?

At 370 calories it's got as many as nearly a litre of Coca Cola. It's also got just shy of 6 teaspoons of sugar and get this, 650mg of sodium - almost double the sodium of two orders of large fries at McDonald's.

Perhaps if the mom in the photo had done her own homework growing up she'd know just how terrifically awful the product she's just served her daughter is and moreover perhaps she'd have learned better parenting skills than bribery to raise her children.

(Oh, and by the way, it's Badvertising week!)

Saturday Stories

Yale and Nuval's Dr. David Katz dissects the new 2010 American Dietary Guidelines, while Food Fight's Melanie Warner mercilessly translates them.

Mark Bittman talks food policy manifesto in the New York Times.

Arya covers a recent study that revealed new MDs aren't interested in talking lifestyle change.

Travis warms my confirmations biases with his piece that calls for an end to linking inactivity and obesity.

A brilliant VW commercial

You can watch it on Funny Friday or during the Super Bowl.

Your choice.

Have a great weekend!

Why I still think breakfast's part of weight management.

Much ado has been made of a recent study that suggested that eating large breakfasts added to total daily calorie counts with pretty much all coverage suggesting that folks trying to lose weight should think twice about having it, or more specifically, how much of it.

The study, published in advance of print in Nutrition Journal, monitored the dietary intake of 280 obese and 100 normal weight subjects for 10-14 days. Researchers were interested in total daily energy intake as a function of total daily breakfast calories.

Right off the bat this was a strange study as it would seem that virtually all of the subjects were eating 3 meals and 2 snacks daily - a pattern of eating that is not one I see regularly. Of the literally thousands of patients whose eating patterns I've explored, I'd venture a guess that 3 meals and between meals snacks were a regular and consistent pattern in no more than 10% of them. Of course this study was conducted in Germany and my practice population is Canadian, so perhaps this concern is unfounded in that perhaps Germans are great snackers and don't skip meals.

Ultimately the study concluded that in both normal weight and obese individuals who are weight stable, higher breakfast calories resulted in higher total daily calories.

The problem I have is that there are far more variables than simply breakfast that determine total daily satiety and satiety has a great deal of bearing on total daily intake as hunger will impact dietary quantity and choice. Other things that matter a great deal? Macronutrient distribution, timing of meals and snacks, sports nutrition and minimums of calories per meals and snack.

Folks reporting on this study have basically been telling people that if they want to lose weight, they should just eat less for breakfast. Of course telling someone to simply take what they're currently eating and eat less (for breakfast) falls into that nonsensical, oversimplified, nightmare on ELMM (eat less, move more) street scenario whose value and worth we all know too well. Moreover, according to news reports on the study, the primary driver of higher calories for breakfast was bread, which if refined, ain't going to help satiety much either and therefore perhaps it's not surprising that high breakfast calories led to great total weights as loading up on bread for breakfast will certainly impact total calories, but might not impact satiety and consequently not impact on rest of day eating patterns.

So is breakfast importance in weight management? Well 78% of the National Weight Control Registry eat breakfast daily. For those who aren't familiar, registrants have lost on average 67lbs and kept them off for over 5.5 years. They're great at managing their weight and while that number very clearly states that 22% of registrants don't eat breakfast daily, that the vast majority does speaks directly to breakfast's importance to most folks' long term strategies.

So while an interesting result and one perhaps worthy of further study in a population that's actually trying to lose weight, the fact that normal weight or obese individuals who have had stable weights for at least a year, eat more total daily calories on days they have larger breakfasts, doesn't change the fact that my recommendation for folks trying to lose weight is for breakfasts of at least 300 calories (though certainly >500 calories is probably overkill), consumed within 30-60 minutes of waking and containing a good source of protein, followed by well organized meals and snacks throughout the remainder of the day.

Schusdziarra, V., Hausmann, M., Wittke, C., Mittermeier, J., Kellner, M., Naumann, A., Wagenpfeil, S., & Erdmann, J. (2011). Impact of breakfast on daily energy intake - an analysis of absolute versus relative breakfast calories Nutrition Journal, 10 (1) DOI: 10.1186/1475-2891-10-5

Village on a Diet Episode 5 Recap: My last recap?

This show sure doesn't seem to be changing.

5 hours in and ultimately we're faced with a show that's reinforcing many of the worst stereotypes of obesity and weight loss. That obesity's a disease of laziness. That the obese are ignorant. That treatment involves massive amounts of exercise. That healthy eating must include esoteric health food and always, always, always exclude dietary vices. That weight management is about suffering and that if someone's not successful with weight management, it's because they're weak willed.

One of the most telling parts of this week's episode? Trainer Garfield is waxing on about how every week there are less folks involved in his challenges and then concludes that the town is failing him. I guess it didn't occur to him that perhaps he's failing the town.

Another? They had psychologist Adele Fox talk hypnosis for smoking cessation. Never you mind that the Cochrane meta-analysis of randomized trials shows hypnotherapy for smoking cessation is no better than no treatment on 6 month quit rates - let's tell all of Canada it's a great plan.

You want more? How about the completely disrespectful, looking a mile down his nose chef who walked into the 30 year old single mom's restaurant shop and basically told her she was failing Taylor when really all she was doing was putting food on the table for her children? His condescension literally drove her out of town.

It's pretty clear by now, this show isn't about best evidence or best practice, it's about best TV.

It's too bad too.

Sure, the townsfolk are going to lose their ton, but losing a few pounds per person's not particularly difficult and no doubt some folks will have been so strict as to lose whole piles. As the show's taught both viewers and Taylorites, all you need to do to lose weight is suffer. Of course there aren't too many folks out there who are willing, regardless of how much weight they might lose, to suffer forever, which is why folks who lose weight through suffering invariably gain it back when the scale stops whispering sweet nothings in their ears. Ultimately folks who lose weight suffering tend to go back to the lives they lived before they lost, which while not conducive to weight loss, were at least lives they enjoyed.

How amazing would it have been to have a show that broke the classic reality TV weight loss mould? Where the obese were treated compassionately. Where weights were explored from individual environmental, medical and psychological perspectives. Where treatment consisted more of education and empowerment about nutrition, energy balance and exercise than punishment. Where realistic goals were set and bolstered. Where the means to satiety were taught and cultivated. Where it was about nurturing realistic but still less than perfect lifestyles because striving for perfection is a recipe for failure.

Such a show would truly have the potential to positively impact a nation and a genre, not just a small town.

So no more recaps from me. Maybe I'll do a series recap down the road, but unless there's major change to the format, I'm not sure there's much left for me to say.

2011 Weighty Matters Annual Report on the Heart and Stroke Foundation

Coincident with the publication of this blog post the media's likely awash with news stories about the Heart and Stroke Foundation's 2011 Annual report on Canadians' health.

Guess what? It's not so good, and as with each and every Heart and Stroke Foundation annual report there are a myriad calls to action.

Noticeably absent of course?

Calls to action for the Heart and Stroke Foundation.

To that end I publish my Weighty Matters Annual Report on the Heart and Stroke Foundation. You'll notice it's pretty darn similar to last year's because, well, they haven't made any formative changes to their own shortcomings.

Makes me wonder - why does the Heart and Stroke Foundation expect folks and governments to clean up their houses when they're so clearly unwilling to clean up their own?

To the Heart and Stroke Foundation:

1. Rebuild the Health Check Program.

- Actually have the Heart and Stroke Foundation's Health Check program adopt the Heart and Stroke Foundation's own recommendation for a daily maximal intake of 1,500mg of sodium and adjust the program's criteria to bring them in line with the Canadian Stroke Network and Blood Pressure Canada's recommendation that maximal per serving sodium be 200mg.

- Create more than just a yes or no seal of approval so that foods with check marks can actually be compared to one another as there are often far healthier choices to be made even within comparable Health Check'ed products themselves.

- Evaluate all of the foods in the marketplace so that foods healthier but not a party to health check can be identified by consumers.

- Eliminate Health Check products made with refined grains (whether they're "enriched" or not).

- Eliminate beverages from the program. People should not be encouraged to drink their calories.

- Eliminate Health Check products where sugar is added as fruit juice concentrate or puree and in so doing recognize that sugar is sugar.

- Eliminate Health Check products containing processed meats and in so doing fall in line with organizations like the Canadian Cancer Society and current evidence based nutrition.

- Expand Health Check's nutrient criteria to include the literally dozens of nutritional determinants of health its current iteration ignores (right now the majority of Health Check categories only evaluate 3-4 nutritional criteria in awarding the seal).

- Eliminate restaurants from Health Check. The Heart and Stroke Foundation should be encouraging Canadians to eat out less and cook with whole foods more rather than enabling Canadians to eat out and feel a false security about their choices. "Less bad" is in fact still "bad".

2. Acknowledge the existence and importance of calories.

- Immediately add a robust energy expenditure online calculator and caloric education and guidance section to the Heart and Stroke Healthy Weight Action Plan which currently has only the most rudimentary caloric guidance.

- Add calories as a criteria to be considered for every product category in Health Check.

- Never again release any type of tool or report having to do with obesity without explicitly including and discussing calories.

3. Call for a revision to Canada's Food Guide

- The Heart and Stroke Foundation should call upon the federal government to immediately revise Canada's Food Guide reinforcing the Canadian Medical Association's call to have the Guide revised every 3-5 years to incorporate advances in our understanding of the impact of dietary choices on health.

4. Buy a mirror

Before criticizing federal and provincial governments, before chastising the public about their need to be more concerned about their determinants of health, the Heart and Stroke Foundation should take a good long look at themselves in the mirror. What might they see?

- Health Check'ed Slush Puppies.

- Health Check'ed vegetable juice with nearly a 3rd of their own daily recommended sodium maximum.

- A front-of-package labeling program that thinks 3-4 nutritional determinants of food are all that matter.

- Partnerships with Boston Pizza that lead to the sale of heart shaped pizzas on Valentines day (a practice akin to a lung association having a day where they promote cigarette sales in 7-11s where part of the proceeds of smoke sales would go to them) and the distribution of fast food coupons to children who fund raise for the Heart and Stroke Foundation.

- Dietitians that rather than promote home cooking would rather give up the fight altogether and instead encourage weekly school pizza days with "healthier" fast food pizzas - akin to a respirologist encouraging light cigarettes because people are already smoking.

- Reports on childhood obesity that don't mention the word calorie even once.

For such a proud and supposedly stalwart organization these glaring shortcomings besmirch their good name.

[For those wondering, Village on a Diet recap will be tomorrow]

Ending public-private partnerships between Big Food and Health

Sorry for the late post, the embargo lifted at noon.

Today's edition of the Canadian Medical Association Journal contains an editorial the I co-authored with Paul Hebert. In it we argue that partnerships between food conglomerates and health organizations should be avoided.

The risk is straightforward. Partnerships by definition serve to benefit both parties. For the health organizations the benefits involve some combination of money, resources and exposure. For the food industry the benefits include sales, brand image improvements (which in turn translates into sales) and spin which may serve to help deflect criticism or further political needs.

The increase in sales is problematic in that more often than not, the brands that partner with health organizations are the very brands whose images or products may be considered unhealthy. Moreover, the consumption of more food, even more healthy food, won't help with our obesity problem.

The usual Big Food suspects involved in such partnerships most often include purveyors of sugared soda, sweets, savory snacks and fast food. While arguments can be made that the funding they provide is helpful and at times may further the needs, aims or research of health organizations, it does so at the expense of those very health organizations serving as inadvertent pitchmen to help sell products that run contrary to their public health aims.

Some argue that since all private partnerships (meaning not just partnerships with Big Food) have their warts (things like environmental concerns, fair trade policies, child labour issues, etc.), that the call to action should be for health organizations to abandon all private partnerships. While there may be some merit to that argument it's important to explain the Big Food distinction in that partnership with them involves corporations whose products themselves contribute to the very burdens their partnered health organizations are striving to combat.

We all need to stop relying on the food industry. As individuals we need to renew the art of cooking from scratch with whole, healthful ingredients and stop kidding ourselves that reheating, stirring, and mixing count as home made meals. As health organizations we need to find new and novel means to raise funds and awareness. And while divestment may not be fair or easy, given our dire circumstances, can we really continue to afford not to?

These partnerships do not exist in a vacuum. Diet and weight related illnesses have become the number one preventable cause of death in North America. Health organizations need to divest themselves from Big Food partnerships lest they contribute unwittingly to that burden.

You'll find the full text of our editorial online at the Canadian Medical Association Journal]

Yoni Freedhoff, & Paul Hebert (2011). Partnerships between health organizations and the food industry risk derailing public health nutrition CMAJ

Come back at noon (EST)

That's when today's real post goes live.

How come? Well noon's when the embargo lifts on my most recent co-authored editorial in the CMAJ.

The subject?

Public-private partnerships.

Stay tuned!

Saturday Stories

Busy week - not much reading.

Appetite for Profit's Michele Simon explains why she thinks Happy Meals are illegal.

Peter from Obesity Panacea tackles new research on 100 calorie packs.

NPR on how bacon's a "gateway meat".

Cats on a treadmill

Today's Funny Friday video answers the age old question, "do cats like treadmills?".

Have a great weekend!

Cats on a Treadmill - watch more funny videos

Seriously, what the hell is wrong with the Heart and Stroke Foundation?

I know I'm beating a dead horse here, but I can't help it.

Yesterday morning I was flipping through my various RSS feeds and I came across the latest post on the Heart and Stroke Foundation's Health Check blog. It written by Devon Peart, a registered dietitian who also has a Masters in Community Nutrition. In the post Devon applauds Domino's for making a "healthy" pizza to offer kids as part of their school pizza days. Moreover she quite literally challenges Canadian pizza producers to make a Health Check approved pizza to serve to kids in schools for what Devon calls,

"a welcome change from routine for many school children"

And she ends the post with, "Let's hope they take up the challenge!"

So I guess you should forget about the fact that childhood obesity rates are still rising and that kids as young as 6 are now developing type 2 diabetes. Forget too that every school food reform policy ever written feels school pizza days are anathema to healthy school food. You'd better also forget about the fact that our societal shift from actually cooking to the normalization of fast and restaurant food is stoking the rise in obesity and chronic disease and that food dollars spent outside the home have risen from the low 30s to nearing 60% since the 1970s. Not to mention that you should forget about the fact that the Heart and Stroke Foundation, as a for-health organization, should be bending over backwards to encourage home cooking, discourage processed foods, and all in all help to protect our children from the purveyors of fast food.

Why should you forget all of those things?

Because if you don't forget them how else are you to explain that here we have a registered dietitian with a Masters in Community Nutrition, supporting school pizza days as, "welcome changes from routine", explicitly inviting Canadian pizza makers to apply for a Heart and Stroke Foundation Health Check which the pizza folk would then use to help to dupe school children into thinking that store bought pizza is a healthy, good for them, Heart and Stroke Foundation approved, at least weekly meal.

Mind boggling, horrifying, and heartbreaking.

McMaster University sells out to McDonald's

Today's ill advised Big Food partnership comes from McMaster University's Athletics Department where they've sold out their various Marauders, to McDonald's.

Though it's not clear from the press release how much McDonald's ponied up, their contribution's bought them, "presenter status" rights which means from now on the players of the games in multiple sports are going to be presented at the end of each game as the, "Big Macs of the Game".

But that's not all.

In what I'm sure has Hamilton's McDonald's owners salivating, their partnership with McMaster has also bought them the ability to influence youth in that McDonald's will now be running the Catholic Youth Organization "Small Fries Games", which will see community youth mingle with Marauder players during which time they will undoubtedly be bombarded with McDonald's advertising and coupons in events that by their nature will link McDonald's brand with fun, happiness and health.

Great job McMaster. Way to be socially responsible.

[Anonymous hat tip to a now quite disgruntled McMaster alumnus]

Village on a Diet episode 4 recap: Unrealistic expectations

So could anything make a show that continually and falsely suggests to Canadians that exercising till you throw up is how best to lose weight any less helpful?

Yup.

And we get it this week when the show starts off with the person who thinks it's, "pathetic" that she's only lost 5lbs, another who's upset she's only lost 2bs, another who can't see her 12lb loss, and a dad who thinks his young son's a failure and should be busting his hump 24/7 because he's only lost 9lbs.

Never mind that to lose faster than 1-3lbs per week pretty much necessitates non-sustainable approaches, this show's all about the non-sustainable, and while Dr. Zentner puts the dad in his place in her office, and later tries to make Jamie feel better about her 12lb loss, it doesn't seem as if she sat down the show's producers. Oh, and don't bother discussing energy balance with viewers - better just to think as the show suggests for most of the episode, that the town's just not working out hard enough.

But that's not all. Today we also get taught that healthy eating has to include ingredients that I'd bet the vast, vast majority of Canadians aren't familiar with, nor interested in. Think that's going to inspire viewers to want to change what they're eating? Think perhaps it would have been more helpful to explore healthy eating that didn't include tofu and quinoa?

Oh, and their registered dietitian's given a new nickname by British accent voice over guy - "calorie cop". Way to inspire Canadians to consider seeing dietitians.

But it's probably just TV. You know if I had to wager, I'd bet that in the town the Taylorites got far better treatment, advice and help than what viewers have been shown.

So why are Canadians getting the short end of the Village on a Diet stick?

I want to share part of a comment from last week's recap.

"These programs are popular as they are designed to produce a sense of unearned superiority in the audience, with pat,over simplistic solutions presented as the answer to complex problems (see eat less,move more)."

I don't disagree.

It's interesting too, each week in the comments a few folks will tell me the show's inspirational, that I shouldn't rush to judgment, that great changes are taking place.

So let me ask you - would it be inspirational to watch a show about depression where people simply yelled at you to, "pull yourself up from your bootstraps"? Would you judge a show on stock market investing as lacking if the only formative advice they aired was, "buy low, sell high"? Would you consider a show teaching a family how to hold their breath as proof the family will be able to hold it forever?

I wish I could be applauding this show. I wish that each and every week I commented about how wonderfully the show tackled another facet of the struggle against obesity.

Ultimately I wish that it was a show that focused on education, not entertainment.

There's always Season 2.

A cold Ottawa morning!

For those of us in cold climates, an easy recipe to impress children?

1. Boil water
2. Open back door
3. Throw water into -30C air

The UK Advertising Standards Agency finds juice to be non-nutritious.

Well not exactly, but bear with me.

You see last week the UK's watchdog Advertising Standards Agency ruled that Coca Cola's Vitaminwater advertisements stating their beverage was "delicious and nutritious" were misleading because,

"Because Vitaminwater contained about a quarter of a consumers GDA for sugar as well as the added vitamins, we considered that the description of Vitaminwater as ‘nutritious’ was misleading."

So what's about a quarter of a consumer's GDA for sugar? 4-5 teaspoons.

What else has 4-5 teaspoons per glass?

Orange juice, apple juice and pretty much any other fruit juice. Some, like grape juice, have even more.

Of course there'll be those who argue that the sugar in the Vitaminwater is "added" sugar, but me? Sugar water's sugar water, whether the sugar was added by God or by machines is inconsequential. Think of it this way. If you took pure spring water and added to it 5 teaspoons of sugar and exactly the same amount of vitamins and minerals as you'd find in orange juice then for all intents and purposes nutritionally the beverage would just be orange juice. So if the UK Advertising Standards Agency is unhappy with Vitaminwater, I think they also ought to be unhappy with juice.

Drink water.

Eat fruit.

[via Nutraingredients]

Saturday Stories

I Came to Run crushes the Special K challenge.

Harriet Hall from Science Based Medicine and her take on Gary Taubes' Why We Get Fat.

Travis on Obesity Panacea wonders if fear and disgust will help people lose weight.

Dr. Oz hits rock bottom and digs, digs digs.

Arya Sharma takes a post away from me and does a better job than I would have explaining how the recent inactivity statistics from Canada prove that obesity ain't about exercise.

How much fish do you eat while exercising?

Today's Funny Friday demonstrates how even the animal kingdom is taught to overcompensate calorically with fitness.

Have a great weekend!



[Hat tip to loyal blog reader Jocelyne]

What's in your kid's lunch bag?

Amazingly, despite the very basic fact that the food we provide our children is quite literally their bodies' building blocks, it would appear as if we're building our kids out of sugar and salt.

Researchers over in the UK wanted to get a better look at packed lunches and so they undertook at cross-sectional survey that had 1,294 8-9 year old kids from 89 different British public schools work with researchers on a tool called the, "Lunch Box Evaluation Questionnaire".

The results weren't heartwarming.

Sandwiches were the most commonly packed foods and were most unfortunately followed by candy, savory snacks and sweetened drinks. The food least eaten? Fruit. Most eaten? Candy.

Only 5.1% of packed lunches met what the study referred to as a "healthy standard" which consisted of, "a sandwich with protein filling (or alternative starchy and protein food), some vegetables, fruit, and a dairy product". 40% had both a confection and a savory snack (candies or cookies and chips). The average number of added teaspoons of sugar/lunch? 10.

Those sure don't sound like ideal building blocks.

Evans, C., Greenwood, D., Thomas, J., & Cade, J. (2010). A cross-sectional survey of children's packed lunches in the UK: food- and nutrient-based results Journal of Epidemiology & Community Health, 64 (11), 977-983 DOI: 10.1136/jech.2008.085977

[Hat tip to my friend and colleague Sara Kirk]

Starbucks' "Trenta" - the caloric equivalent of more than half a gallon of Coke!

Ok, I'm not a math maven, but here's what I figure.

Their new "Trenta" size is 7oz more than their Venti.

Based off the caloric information for a Venti, if you order a, "Trenta 2% iced peppermint white chocolate mocha with whip", you'll be hauling in 904 calories.

What else has 904 calories?

2.2L of Coca Cola.

[Anyone out there still think mandatory calorie menu labeling's a bad idea?]

(image via the National Post)

Village on a Diet episode 3 recap: Nobody yelled!

This week on a Village on a Diet....

Food wise they're finally weighing in, and just like with fitness, it's food boot camp. Apparently you have to give up everything that's bad for you. Nothing about moderation, calorie awareness/consideration. Nope, instead Chef Jonathan, hands out bags of fresh vegetables and then later in the show has participants show up at a community centre to learn how to cook with them. During the cooking segment the CBC impresses upon us that they want Canada to think Taylor's a community of rubes. Chef Jonathan holds up some fennel, asks the room full of folks if anyone knows what it is, and the CBC then cuts to a few very confused faces and pipes in the sounds of crickets chirping.

So other than being given a bag of vegetables and standing in a gym sized room while a chef cooked up front did Taylorites learn anything about healthy eating, healthy cooking, or the interaction between food and weight? Well they learned about "portion control". No discussion of calories, just the same old, "servings" that confuse everyone and help no one. Energy density (calories per gram) makes servings a rather useless measure as identically sized servings of foods with different energy densities will clearly impact differently on weight. They might have even learned other things, but there wasn't much time in the roughly 25 seconds they gave to dietitian Maria Thomas. Later in the show trainer Garfield encouraged Taylorites to eat frequently.

Lastly Chef Jonathan heads over to the pizza restaurant and asks the owner to change her pizzas and at least this week, she seems on board with the proposed changes (though I sure wish they'd have done a nutritional breakdown of the recipe they used).

All in all, a fairly uneventful episode.

I've got a few nagging questions about the show.

What percentage of the Village is involved? If it's a village of 1,300 folks and if overweight and obesity are in the 70% range, that'd be 910 eligible townsfolk. Given that there's 2,000lbs in a metric ton, that'd mean each of those folks would have to lose 2.19lbs in 3 months if all were involved. As blog reader Martin Collis very rightly points out, the Hawthorne Effect ought to cover that and much, much more alone - and that's something which in my mind should obligate the CBC to make an unannounced return to Taylor 6 months or a year after filming to see how the town's doing without them.

Why did the CBC decide to make the townsfolk seem more stranded and helpless than they are? According to a comment left on Dr. Sharma's blog, the closest grocery store is 12 minutes away from Taylor - hardly far. The same commentator also noted that the walking trail VOAD suggested was never utilized is used plenty. It doesn't take isolation or a lack of facilities to struggle with weight - Canadians struggle with it everywhere. Why the pretence?

Most importantly, what is the CBC's ultimate aim with VOAD? If it's to inspire people to try to improve their fitness, I think they'd be far better off promoting SMART goal setting than boot camps. If it's to help people manage their weight, they've got to put more of a focus on food and also more of a focus on the "whys" of excess calorie consumption. Ideally I'd love to see VOAD explore eating patterns and help to educate Canadians. Explore macronutrients and educate Canadians about the importance of protein and the challenges of refined carbohydrates. Explore the examples parents set for their children. Explore the difficulties of finding time to make home cooked meals when working long hours or not even knowing how to cook. Explore the umpteen dozen myths about food and weight and take advantage of their gigantic soap box to help bust them.

What do you think the CBC's aim is with VOAD? Is it spectacle or support?

Anyone in Ottawa wanna punch me? Train with me free for a month.

First some background.

Growing up I was a disaster romantically. Looking back it seems like either I was pining after someone who wasn't interested, or I was in the midst of some sitcom-esque, disastrous relationship with me playing a markedly overly dramatic, hapless suitor.

1993 was pretty typical. Crash and burn relationship, me thinking the world was ending and comforting myself by embracing my misery. I needed an outlet. At a Passover seder my cousin Amelia chatted with me about a new martial art she was taking. It was called Gorindo and she described it as spiritual, non-aggressive, a fantastic workout and a lot of fun.

I decided to give it a go and I trained right through medical school until I moved to Ottawa.

My sensei, Claudio Iedwab, is from Argentina. He's one of those lucky folks who in many ways has retained the enthusiasm of childhood and he's always got a mischievous gleam in his eye.

As a martial artist, Claudio's exemplary. In addition to his 6th dan in Gorindo, Claudio is also a 5th dan in Moo Duk Kwan Taekwondo, a 5th dan in Jujitsu, 3rd dan in Shotokan Karate-do and was once the South American Taekwondo Champion. He created Gorindo in response to what he felt was a North American overemphasis on the "martial", rather than the "art", and its name means five ring art. The five rings of Gorindo include Taekwondo (Moo Duk Kwan), Karate-do (Shotokan), Ju Jutsu, Savate (a French foot-boxing style) and Yoga.

Mentally for me Gorindo was a godsend. It helped to clear my head, improve my mood and helped me to focus during some difficult times. Physically it was also a godsend as by means of incredibly varied workouts, my chronic back pain disappeared. It has also helped me a great deal with my balance, flexibility, focus and coordination.

Thankfully, after moving to Ottawa I met my wonderful wife and as the best man at my wedding put it, he knew she was the one for me as there was no drama. Sadly, after moving to Ottawa, my Gorindo stopped. I tried to find a dojo I liked here, but every one I auditioned seemed to me to be either too aggressive, or too business-like for me to feel comfortable.

Two years ago I decided I'd try to track down Claudio just to say hi and I was thrilled to find out he was living in the Gatineau. He didn't have a dojo anymore - was working more on his other projects, but was still available for private teaching. I jumped on the chance to have him come and teach me privately and for nearly 2 years he'd come by my office twice a week to train. I think our training together relit his teaching bug and about a year ago he started to look for a location to open an Ottawa Gorindo dojo.

Finally last fall he found an old homestead that had been converted to office space that was just a few short minutes from my office. He calls it his, "candy box" and truly, it's a very special space. He's spent a few months working the kinks out of the new place and come this New Year, he's ready to start promoting it to the general public and I asked him if I could blog about it on his behalf.

So here's the scoop. If you're a blog reader and you're interested in trying something that for me was without exaggeration life changing, or if you've been looking for the opportunity to punch or kick me, Claudio's offered to extend to my readers a free month of training - no strings attached.

Pop in before February during class hours at 6 Deakin Street (Prince of Wales and West Hunt Club right near the Met church), or contact Claudio via email or give him a call - say you've come from Weighty Matters and away you go. There you'll have a chance to meet Claudio, his wife and 3rd dan Roxanne, and potentially you'll get your shot to get your shot at me.

Remember, this offer expires in February - and given that you've truly got nothing to lose and perhaps something wonderful to gain, why not take Claudio up on it?

Saturday Stories

Mark Hyman wants us all to celebrate home cooked meals (great piece).

Watch my friends over at CBC Marketplace during their season premiere - Big Gym Ripoff.

If you followed all of Jen Melo's healthy eating rules, you'd be doing just fine.

Science Based Medicine's Mark Crislip takes on cranberry juice for urinary tract infections. My favourite quote?

"If you collect individual cow pies into a larger pile, it does not transmogrify into gold."

My blackberry's not working!

Today's Funny Friday?

Some British humour.

Have a great weekend!



[Hat tip to loyal blog reader Martin Collis!]

Coca Cola's spins arms length relationships into "corporate social responsibility"

I'm guessing that not to many people have had the chance to read Coca Cola's 2009-2010 corporate social responsibility report.

It's quite the feel good tome and it covers all the wonderful things Coca Cola has done for the world - from improving our health to saving the earth, and while undoubtedly Coca Cola will strive to make a positive impact on the world, it will only do so when and where such efforts are able to translate into more sales. This isn't in my mind evil behaviour, it's just the nature of being a public company - ultimately it's all about shareholder equity - if Coca Cola spends money recklessly on do-good efforts without returns on investments, the shareholders have a case to sue.

So reading through the report I came across the section on Corporate Responsibility and Sustainability. According to Coca Cola, by virtue of the 2010 Olympics they,

"engaged stakeholders at all levels, particularly those related to healthy active living and the environment."

Sounds pretty great, no?

So who'd they engage?

Well according to the report among others they "engaged": the College of Family Physicians of Canada, the Canadian Obesity Network, the Ontario Medical Association, the Alberta Medical Association, the BC Medical Association and the Canadian Medical Association.

I was curious what "engaged" meant so I contacted my friends and colleagues at both the Ontario Medical Association and the Canadian Obesity Network.

Did they have sit downs with Coca Cola?

Nope.

Did they advise them about anything health related?

Nope.

Did they review their corporate social responsibility plans?

Nope.

So what the heck did they do that landed them as bragging trophies for Coca Cola?

Well apparently they provided the Olympic Torch Relay committee with names of members for consideration of inclusion in the relay.

The same Olympic Torch Relay sponsored by Coca Cola.

That's the "engagement".

Oh, and in case you were wondering why Coca Cola wanted to sponsor the relay/Olympics?

ParticipACTION's Kelly Murumets explains their partnership with Coca Cola

ParticipACTION's Kelly Murumets accepting her Live Positively Award from Coca Cola's Nikos Koumettis

I've blogged about it many times before, but recently the Ottawa Citizen's Joanne Laucius decided to tackle the oxymoron that is the ParticipACTION/Coca-Cola partnership.

The deal Coca Cola made with ParticpACTION is worth $5,000,000 over 5 years. Hardly a huge amount of money to be partnered up with one of the most recognizable and well respected brands in Canada. In fact I'd venture that companies would have been lined up out the door trying to attach themselves to ParticipACTION's heritage brand coattails.

But apparently ParticipACTION was picky. They didn't want to partner with just anybody, they wanted to partner with Coca Cola. ParticipACTION's President and Coca Cola award recipient Kelly Murumets calls Coca Cola, "a responsible, effective partner". Never mind the fact that improving Coca-Cola's brand image will help to sell sugar sweetened beverages - a causal factor in childhood obesity. Never mind the fact that Coca-Cola and ParticipACTION's recent co-branded advertising campaign purposely misdirects people about calories. Coca-Cola knows what kids want (sugar-sweetened beverages?) and so they're the perfect partner?

How so Kelly?

"If we had partnered with an insurance company, we would not get kids' attention and get commitment to behaviour change"

Why not? Doesn't ParticipACTION have the brand awareness necessary to make advertising headway?

According to Laucius' article, ParticipACTION's own partnership strategy document spells out what's in it for Coke,

"an effective partnership will leverage and extend each partner's assets (and partnerships) will further your own mission, but will also offer a return on investment for your partner organization."

So while ParticipACTION is as unlikely to impact on childhood obesity rates this time around as last (during the original 30 year reign of ParticipACTION childhood obesity rates rose by nearly 300%), one thing they'll certainly be able to do. They'll be able to offer Coca-Cola a return on their investment.

Translation?

ParticipACTION will help Coca Cola sell more Coke.

Village on a Diet Episode 2 recap: ELMM St. revisited

So has the Nightmare on ELMM street continued (Dr. Sharma's moniker - ELMM = eat less, more more)?

Sigh.

Notable this week?

Personal trainer Mike Veinot walks into a gym class of kids stating for the camera he wants to teach kids that exercise can be fun and then proceeds to work them out so hard that one asks if she can "die now" while other seems to be collapsing in piles of sweat. Super fun.

Dietitian Maria Thomas is almost given the opportunity to teach Canadians that when you serve yourself from large jars you'll serve yourself far more than if the jar were simply smaller, but instead that wound up on the cutting room floor (no doubt that's where she went with the actual family), only to return to the scene with this piece of sage advice from British voice-over guy, "the couple can start by eating less".

Maria then tells a couple and viewers that a "serving" of steak is 2.5 ounces (75grams). Really? While I realize our Food Guide states a "serving" of meat is 75grams there's not a person out there, let alone a person who is accustomed to steaks at least 4x that size, who's going to be satisfied eating such a small amount and to suggest that they should be just fits Dr. Sharma's Nightmare on ELMM street - "eat less, move more" weight loss is simple, stupid.

Psychologist Adele Fox, on air for all of a minute or so, has the thrust of whatever it is she actually told Taylor boiled down to her telling residents to put their forks down and take sips of water between bites.

British accented voice-over guy states, "everyone's in such bad shape they're going to have to ramp up their exercise if they're going to reach their weight loss goals in three months".

There was also some good.

Mike Veinot gave a great workout to young Jonathan who's been bullied because of his weight (whether it helps his weight or not, I'm keeping my fingers crossed his work with Mike improves his confidence)

The townsfolk helped to motivate Jamie to complete a difficult physical challenge.

Now I recognize that there's no doubt that small-stepped sustainable lifestyle change doesn't always make for good television. As commentators on both my and Arya's blogs have noted, yelling at people to exercise and deriding them for their weights and perpetuating the stereotype of obesity being a disease of willpower makes for far more entertaining television than talking about food, and this episode with a focus on further "butt kicking" and folks who are filmed being repulsed by vegetables doesn't do much to bust those stereotypes.

But how much should ratings and "entertainment" matter to the CBC? Shouldn't the CBC be held up to a different standard than NBC (the home of The Biggest Loser)? After all, the CBC is funded by us, the taxpayers, and consequently entertainment value need not be their foremost consideration.

There's also no doubt the CBC could make this program great. It's clear that the producers of Village on a Diet are quite talented and were they to set their minds to it, I'm certain they could make thoughtful lifestyle change and environmental overhaul great TV. By means of example, you don't even need to leave the network. Not sure who out there saw it, but Jay Wortman's and the CBC's My Big Fat Diet which followed Jay and his work with Alert Bay, BC where he put that community on a low-carb diet that saw them losing weight and improving their biochemistries, was wonderful and didn't rely on ridiculous and inconsequential in the long run physical challenges.

Dr. Brian Goldman of White Coat, Black Art fame and a man whose public health advocacy efforts I greatly admire, suggests that I and others are missing an important point,

"As a nation, we have let the obesity crisis creep up on us like those unwanted kilos. Sometimes, you need shock therapy to grab peoples' attention. Shows like Village on a Diet do just that."

And while I don't disagree with the notion of shock being useful, suggesting that Village on a Diet thus far has been a wise and laudable shock treatment is more than a stretch. Shocking people by perpetuating disparaging stereotypes about obesity isn't a great plan for the nation. Nor do I think that the celebration and publication of one of the primary things that needs to change - the notion that weight is an individual problem that's caused by laziness and cured primarily through exercise - as the means to solve the problem is a good one either.

I know that the CBC reads my blog, and I hope that the ongoing discussion, both here and in the comments, will help to shape the next season of Village on a Diet, because I don't think the CBC set out to perpetuate harmful stereotypes, I think they truly set out to do what they thought was best and were they able to turn this around, I think they'd be doing Canadians a tremendous service.

Looking forward to next week's apparently food focused episode.

Book review: Gary Taubes' Why We Get Fat

It's rare that I've had the occasion to read a book whose premises I agree with (that we eat way too many carbs, that they in turn impact on our weights, and that weight-wise exercise isn't much to write home about), but whose arguments make me cringe. Gary Taubes' Why We Get Fat met that billing.

Let me start out by stating that I'm quite low-carb friendly and that I readily agree that science has proven that saturated fat has been wrongly demonized by the medical establishment for decades, including somewhat by me when I co-wrote my book in 2006/7 (a guy's allowed to learn, and it was in this spirit that I approached reading Taubes' book). Furthermore, I also agree that carbohydrates, more specifically the refined highly processed ones, contribute dramatically to both obesity and chronic disease and their reduction may well have a role to play in most folks' weight management efforts, and that a myopic view of dietary fat as causal to chronic disease and obesity has likely in and of itself, by means of a consequent dietary shift to carbohydrates, contributed dramatically to the rise in the societal prevalence of chronic disease and obesity.

All that said, I found Why We Get Fat to be an extremely difficult read. Not because the writing wasn't engaging. On the contrary, Taubes is an excellent writer. I found the book difficult to read because for reasons I can't understand, Taubes seems to have decided to abandon journalistic and scientific integrity in place of observational data, straw men and logical fallacy.

Taubes' manifesto is straight forward. Carbohydrates make us fat and they do so independently of the first law of thermodynamics. Forget about calories, you can eat as many or as few of those as you'd like, ultimately weight is purely about carbohydrates.

Why We Get Fat's observational data comes hard and heavy right out of the gates. Taubes posits that because there have been examples throughout history of impoverished peoples with high rates of obesity that the concept of a toxic environment (cheap calories and minimal exercise) being causal to our modern day weight woes must be false. Does Taubes really think that obesity has a singular cause? That there's only one pathway to weight gain? That because he can find obese impoverished people the environment's not involved? Apparently he does.

Straw men and logical fallacy? Try this one on for size. He tackles an observation made by Williams and Wood, researchers who'd studied exercise and weight. They found that even marathon runners tend to gain weight over time and suggested that in order to avoid that gain they'd have to run further each and every year. Taubes extrapolates to suggest that any middle aged runner wanting to stay lean will have to run half marathons five days a week to resist weight gain. Sounds ridiculous, right? He then concludes on that basis the calories-in/calories-out hypothesis couldn't possibly be true. But couldn't calories in and out still matter in these runners? Don't our lives change as we get older - less time, more disposable income, more responsibilities - all things that may cause increased reliance on both convenience and celebratory calories. And doesn't metabolism naturally slow as we age due to age-related sarcopenia - wouldn't that also lead a person to steadily gain weight even if all other things (intake and exercise based output) remained constant? Or couldn't the runners consistently be consuming more calories than they burn as a consequence of either exercise-induced hunger or overcompensated reward based intake, and that coupled with natural aging's effect on metabolism causes ever increasing weight gain in the absence of changing calories in or calories out?

Next Taubes' tackles the classic 20 calorie a day mismatch leading to 2 pounds of weight gain a year (roughly the average gain per year of North American adults) and then presents it literally which of course appears ludicrous and ridiculous. Are 3 extra chips a day causing you to gain weight? Of course not. Therefore according to Taubes' next straw man, calories in and calories out can't be causal for weight. Forget about the fact that calories can come in clumps. 3,500 calories in extra Christmas time treats doesn't sound to me to be too off the mark and those alone would take care of 175 of Taubes' 20 calorie days. Tack on a couple of birthday celebrations, a vacation and a visit or two to a Chinese buffet and we're more than done.

Next comes cows. Taubes shows us pictures of two cows. One an Aberdeen Angus - fatty and delicious looking. The other a Jersey milk cow - lean and chewy looking. He then goes on to state that it's not possible that breeders have simply manipulated genes to make the Aberdeen cow hungry and the Jersey cow active. Instead Taubes argues that genetic breeding has impacted on these cows partitioning of fat (one to flesh and one to milk production). While I don't disagree with him, his conclusion that their genes don't determine how many calories the animals consume, but rather what their bodies do with those calories doesn't in any way support or refute the notion of calories in or calories out. A quick Google image search had me staring at some pretty hefty Jersey cows and some Anguses with very visible rib cages, and I'm fairly confident that were female Angus cows given hormones and milked daily, they'd also have big full udders. Could it be that cows do in fact behave both according to the laws of thermodynamics and also according to their genetic makeups? That's where my money'd be in Vegas.

Taubes' own cognitive dissonance appears mid book and it led me to be briefly more hopeful. Taubes was going on about the first law of thermodynamics (TFLOT) (that energy can neither be created nor destroyed - the cornerstone of the calories in/out hypothesis of weight). He actually seemed to agree with TFLOT but then tried to suggest that talking about "overeating" is not the same thing as talking about "energy" and that the important question to ask is, "WHY",

"Why do we take in more energy than we expend? Why do we overeat? Why do we get fatter?"

I agree, those are tremendously important questions and moreover I agree that macronutrient distributions (one's daily dietary spread of carbs, fats and proteins) for many folks likely play a big role in those whys.

Sadly Taubes takes a strange road to walk in following up on those whys. Taubes rages against the calories-in/calorie-out hypothesis stating that one would be, "hard-pressed to find (a concept) more damaging". He states the calorie concept has done, "incalculable harm", that it has fueled the obesity as a function of sloth and lack of willpower that lays blame squarely on each obese person's ample shoulders.

I wholly disagree with him. It's not the concept that's done so much harm, it's the misuse of the concept, its oversimplification and its grossly unfair, individualized, blame-based application. The danger and the harm lies solely with the failure of society and medicine to ask why are people consuming so many more calories - a failure Taubes so rightly pointed out just a few pages prior.

Amazingly, despite his embrace of the concept that different bodies do different things with the calories presented to them (as evidenced by his discussion of the fat partitioning of cows), next he comes at the reader with this painful series of questions,

"It's the environment we live in that makes us fat, we're being told, not just our weakness of will. Then why don't lean people get fat in this toxic environment? Is the answer only willpower?

Could Taubes possibly be suggesting that genetic variation only impacts upon fat distribution and that it's silent in terms of dietary choices, inclination towards activity, non-exercise induced thermogenesis, the thermic effect of food, resting energy expenditures, etc? Does Taubes truly consider us all to represent a single genetic and metabolic lineage that should see us all uniformly responding the same way to a specific environment?

Taubes next talks of differences in fat distributions seen between men and women to support his assertion that the amount of fat is "exquisitely" regulated. To me all it suggests is that distribution is regulated. Then Taubes launches into a discussion of wild animals and points to the fact that hippos and whales don't get diabetes and "never get obese" as further proof for his theories. He states that no matter how abundant their food supply, wild animals will maintain a stable weight and never become obese. Really? Do we track the weights of wild animals? Is there an animal NHANES database on squirrels, frogs and crows, or is Taubes, a man who purports to be a "firm believer in science" really just relying on his own observational assessments of animals and at the same time extrapolating wild animals to be useful to this discussion as small little human models appropriate for comparisons? Even putting aside a lack of actual data to support his thesis, even were it to be true that animals never become obese, could it not also possibly be the case that wild animals, most of who don't have very good health care plans, don't have the luxury of living long enough or healthfully enough to maintain gains in weight and that disease and early death help keep their weights down?

And what of human "wild animals". Up until a hundred years or so ago, obesity was a rarity for free-living humans as well, and I don't think Taubes will dispute the fact that genes tend not to change dramatically in just 3 generations. Clearly something else is at play - but for Taubes it's not excess consumption of calories that make us fat. Instead he believes carbs make us fat independently of thermodynamics, and in turn our fat itself drives us to overeat.

To support his point Taubes continues to lean on anthropomorphizations and frighteningly non-scientific comparisons with other species. He talks of elephants and blue whales eating huge amounts because they're huge. He talks of mice that are bred to be obese who when starved to death, still have more adipose tissue at autopsy, but to me all that proves is the notion that the distribution of calories is regulated by the body, not that calories don't count. Then he suggests that marathon runners run not because they choose to, or that they want to embrace what they see as a healthy lifestyle, but rather because their muscle tissue is regulated to take up more calories and they're literally driven unconsciously to burn off those calories by, "a very powerful impulse to be physically active". Who cares that there's no evidence to suggest that's true - that sound awesome. The reason I'm not a marathon runner is that my actual body isn't forcing me to lace up my shoes. And here I thought it was because I don't have much free time. But wait a second, I'm pretty damn lean and my diet's in the neighbourhood of 45-50% carbs, how can that be if carbs make people fat independently of energy consumption? But forget about me, I'm a case study of one. Forget too about the thousands of folks in the National Weight Control Registry who manage to control their calories and maintain their weights on low-fat (and hence high carb) diets. Forget too about the multiple studies that have looked at isocaloric restriction and haven't found significant differences between different dietary macronutrient distributions. No, instead I think it'd be fair given Taubes' penchant for observational data for you to do a quick observational exercise of your own. Think for a moment about all your leanest friends and relations. Are they marathon runners, obsessive exercisers or hard-core low-carb dieters? Perhaps some are, but I'm willing to wager, the vast majority aren't. What's up with them? How do they (and I) fit into Taubes' hypothesis?

And then there are simple non-truths. At one point Taubes states,

"You don't get fat because your metabolism slows, your metabolism slows because you're getting fat."

But as anyone who measures resting energy expenditures knows, metabolism actually rises as one gains weight due to the very simple fact that the more of a person there is, the more calories that person burns, and that significant weight loss almost invariably results in significant decreases in resting energy expenditures. Perhaps Taubes is referring to the individual who stays the same weight but loses muscle in place of fat - but of course as a seasoned writer, he knows that's not how readers will interpret his statement.

So what's the cause of everything according to Taubes? Oh yeah, carbs. In fact he states that the reason any diet works isn't because of caloric restriction, but rather it's due to carb restriction, with the corollary also being true - weight gain's not a consequence of caloric intake, but rather carb intake. Tell that to Twinkie Diet guy Mark Haub who lost 34% of his body weight eating 1,800 controlled, processed carby, junk food calories a day purchased from convenience stores.

To hammer his point home Taubes ignores the fact that correlation doesn't prove causality and talks of how it was during the 60s and 70s that doctors stopped believing in the low-carb route to weight management and how this coincided with the obesity epidemic as a means to prove his thesis. Of course nothing else has changed since the 60s or 70s to promote weight gain has it? I mean the world's exactly the same as back then, isn't it? Same number of restaurants, same dollars spent outside the home on food, same time spent preparing home cooked meals, same number of food commercials, same fast paced electronically tethered existence, same portion sizes, same number of available foods in the grocery store, same cost per calorie of food, same everything, right? No? You think that some or all of those things and dozens more might impact on weight? Me too.

Next he launches into antique medical textbooks and their takes on low-carb diets as proof of his manifesto. Does the fact that antique medical texts through until the mid 19th century recommend phlebotomy to treat asthma, cancer and pneumonia mean that we should start practicing it again?

Taubes next argument centres around the suggestion that carbs were not evolutionarily a part of our natural diet and that consequently we did not adapt to high carbohydrate diets. While I don't disagree with the suggestion, unlike Taubes I can't make the stretch that the foods we became adapted to eating during the millennia that our life expectancies were in our 30s and 40s necessarily have a bearing on our health and long lifespans today. He points to indigenous peoples of the world and comments on how when they kill an animal they eat, "virtually all" of its fat as proof that's a wise way to live and that fat's healthy for us, and while there's no doubt that the data on fat suggest it's not particularly scary, the fact that hunger-gatherers try to make the most out of every meal they catch doesn't impress me much to prove anything other than hunting's tough. Further to his discussion of evolutionary dietary adaptations he notes of our modern refined sugars and carbohydrates,

"That a diet would be healthier without them seems manifestly obvious."

And here I thought scientists were supposed to rely on evidence, not what seems obvious to draw conclusions. Sadly what seems, "manifestly obvious" isn't always a good or true idea as was evidenced by our reliance on the logic of the obvious in recommending decades of hormone replacement therapy to postmenopausal women.

Next up is his discussion of the Maasai tribesmen who he reports don't have cancer, heart disease or obesity and traditionally were very-low carb eaters. Of course they were also nomads who wandered and hunted all day long with life expectancies of 42 years for men and 45 for women - hardly a lifestyle or lifespan we should aspire towards and certainly potential explanations in and of themselves for the Maasai's lack of heart disease and cancer - both diseases tightly associated with age and at least partially preventable by means of exercise.

So how does Taubes' explain the impact of carbs on weight? Amazingly he states,

"We know the laws of physics have nothing to do with it."

Ultimately he embraces the notion that carbs make you fat regardless of the calories in/out hypothesis, rather than discuss such possibilities as carbs making you fat by having a lesser impact on satiety. Mid book I had hoped this was where he was going, but sadly, for reasons that are backed up by observation, inference, logical fallacy and straw men, apparently he's decided that living creatures are magical beings that live independently of the laws of physics and thermodynamics.

Taubes doesn't just rely on non-scientific argument, he also appears to be comfortable in ascribing his beliefs to other people and to omitting facts when its convenient. In discussing the World Cancer Research Fund's Food, Nutrition, Physical Activity and Cancer Report that concluded obesity and cancer were tightly linked he calmly states,

"If the expert authors of the report had paid attention to the science of fat accumulation ... they would have concluded the obvious: that the same carbohydrates that make us fat are the ones that ultimately cause these cancers"

Yeah, I'm sure none of these folks know anything about the physiology of fat. On omission - there's no doubt that Taubes knows that between 5-10lbs of weight are lost on a low-carb diet due to the mobilization of the water stored with glycogen, yet when discussing the A TO Z Weight Loss study, he doesn't bother to mention that the 9lbs lost in the first 3 months of the study almost certainly included a significant percentage from the water lost due to the participants' adherence to ketogenic carb limitations and that some of their regain as they added carbs back in was also likely just water weight.

Finally Taubes talks of the individuals who have cut their carbs down to nothing and still can't lose weight. He quotes Wolfgang Lutz, an Austrian low-carb practitioner from the 50s as stating that those patients must have "reached a point of no return". Makes sense to Taubes because he doesn't believe that the laws of physics apply to people and therefore it wouldn't be consequential to him (or presumably Lutz) if perhaps those folks were simply consuming too many fat and protein based calories.

Why We Get Fat is certainly a book that will appeal to the masses as it pseudo-scientifically preaches that carbs are a magic food and that if you eat almost none of them - the diet he recommends includes 20 grams (less than an ounce) a day - you'll magically lose weight. Perhaps more appealingly, Taubes and Why We Get Fat also preach that you can eat as much fat and protein and you want and you'll never gain. Of course that's pretty much identical to the original Atkins' diet, and virtually all of the diets that Taubes himself references. You think that maybe, were it that easy the world would already be skinny? That low-carb would have continued its huge surge from the early 2000s (or the mid 1800s)? Why didn't it? Not because it doesn't work as for many folks it does - by means of folks on low-carb diets naturally eating, wait for it, smaller numbers of daily calories because they're not as hungry. No, ultimately I think that low-carb diets didn't continue to surge because most folks don't want to adhere to them as by their very definition they meet the classic definition of a "diet" - blind restriction and deprivation - things most folks don't want to live with for a lifetime.

At the end of the day Why We Get Fat's likely fate is to serve as the book for the next century's Taubes to point at, just as Taubes pointed at Banting's, in discussing how science has overlooked the horrors of carbs. Nothing new to see here, it's just another magic diet book.

The question that bothered me most throughout the book wasn't about carbs or thermodynamics, but rather why has Taubes chosen to argue his points like he's a Grade 9 student writing a high school science project rather than a well respected, scientific journalist? Some have suggested it's simply to sell books and have acerbically changed his name to Gary Taube$. I don't know, I think he was probably already doing pretty well for himself before this book was published. Perhaps the best explanation for why Taubes seems to have abandoned thoughtful journalism in place of this mess is his comment near the end of the book,

"One problem here is that when people, experts or not, decide to review the evidence on an issue dear to their hearts (me included), they tend to see what they want to see. This is human nature, but it doesn't lead to trustworthy conclusions."

Well said, and readers of this book, are best advised not to forget it.