Guest Post: A Reader Provides His Recipe for Weight Loss

His name is Brian Abernathy and a few weeks ago he reached out to let me know what has worked for him with his weight. And while I'm not suggesting everyone follow his plan (there's no one right way, and what's right for one, is no doubt wrong for another), I thought it was thoughtful, well written, realistic, and very much in line with my philosophy, and so I asked him if he'd mind if I shared.

Yoni,

First, thank you for your reasonable approach to weight loss and for pointing the finger at the dismal food environment we’ve created. I’ve been following your blog for a few years now and I thought I would give you a brief account of my recent weight loss of which a lot of credit goes to your simple approach, though I haven’t read your book (sorry). I have been dieting or exercising for weight loss for probably 25 years all to no avail until this year. I’ve gone from about 155-160 (at 5’9”) when I graduated high school in 1985 to a high of 215 lbs. at the end of 2013. As of today I’m at 178 lbs and still working at it (37 lbs total loss).

I think part of the problem was that I wanted society to change my eating environment for me or perhaps for there to be a way to eat as much of some kind of esoteric diet (Ornish, vegan, paleo, etc.) as I wanted and still lose weight. I came to the realization that two things had to happen:

1. I needed to take charge of my weight loss because the food environment was unlikely to change.
2. I needed something that was guaranteed to work and would be simple.

I’m fairly well read on the literature so I took your advice along with some others and just started. My plan was simple:

• Set a fixed calorie amount per day – in my case 1,800 and try to get about 100-150g of protein per day. Fat and carbs could vary (I didn’t track them). I had tried 1,600 before and it was way too low and 2,000 didn’t give me fast enough results to keep me motivated.
• Write down and weigh all the food I was eating – the good, the bad and the ugly. This is really not that hard – takes a few minutes a day at most now. Early on, I realized I had eaten 3000-3500 calories some days and the scary thing was how easy that is to do if you don’t pay attention. If I wasn’t sure about a food’s calorie count, like at restaurants, I would just estimate and try to be close – don’t get trapped into being perfect. The food log ended up being the most critical part of the weight loss – I can’t emphasize this enough.
• DO NOT have a weight loss goal or a date to have lost the weight – too easy to fail. Better approach is to remember than not quitting is the only way not to fail.
• Focus on systematically meeting my calorie/protein goal DAILY – the rest will take care of itself.
• Eat any kind of food – nothing is off limits. However, I quickly figured out that whole foods are just more filling than processed ones. Really, I’m not pious about this at all, but the reality is that an 8 oz chicken breast, 6 oz. of boiled golden potatoes with salt & pepper and a couple of cups of broccoli with a pat of butter is so much more filling than a large milkshake for the same calories.
• Eat cake at parties, pie at Thanksgiving, ribs on the 4th of July, etc. without guilt.
• Don’t use setbacks to quit – get back on track and keep working at it even if your weight goes the wrong direction for a few days.
• Don’t get trapped into being perfect.
• Exercise daily for fitness and not for calories – I focused on getting faster in my running and lifting more weight.

While losing I also decided to write down lessons learned and follow them (here they are so far):

• Always look at the menu and decide what to eat BEFORE having a drink - drinking lowers my inhibitions and I go off the rails with my eating
• Write down the meal and calories before eating it – then go to town and enjoy!
• Eat whole foods because they are bulky and fill me up more than refined ones
• Alcohol takes up calories I would rather be eating
• Eat lots of vegetables – they are stupidly low calorie and fill you up
• Meatless days are very hard on a low calorie diet for me.
• Starches like potatoes, rice & pasta seem to have too many calories for how little I enjoy them – replace with veggies I like or more protein.
• Prepare my lunch the night before – I never regret this small chore
• Rolled oats are cheap, low calorie, high protein, fast to cook and I don’t seem to tire of them for breakfast – cinnamon, applesauce, walnuts, brown sugar – lots of ways to mix them up.
• Controlling your food intake by cooking at home is HUGE – very hard to manage calories while eating out regularly
• You can eat healthy and low calorie at practically any restaurant – it’s just not always easy to do
• Don’t let yourself get too hungry or you go off the rails – an apple is usually enough to take the edge off.
• Man up! - you have to be a leader and stay in your own frame – don’t let other people influence you to eat the way they eat even though it doesn’t fit your lifestyle
• Your family will start to follow your lead – my wife weighs the food now before she cooks it!

I started out using an app on my phone and tried various ones (Fitday, MyFitnessPal, etc.) but I eventually went a more Luddite route. After a few months of logging foods, I figured out that I don’t eat 1000’s of different foods and I could just put them in a spreadsheet and print them out and keep them in my notebook. It’s four pages and includes calories for common recipes we use too (lentil soup, ragu sauce, balsamic dressing, etc.). I use the notebook to log workouts, food, etc. and I really like the portability of the notebook over my phone. Unlike some other people I try not to be tethered to a cell phone and I can throw my notebook around, sweat on it and it never needs charging.

YMMV.

Regards,

Brian Abernathy
Upstate NY

Why You're Better Off With Froot Loops Than Special K Granola

Because spoon for spoon Froot Loops contains 20% less sugar and roughly 1/3 the calories as Special K granola.

Yet here's betting the health halo of the words, "Granola", the claims, "Made with Whole Grains", "Low-Fat", and "Source of Fibre and Vitamin D", along with the weight-focused branding of "Special K", leads many to think this high calorie sugar bomb is a great, weight-safe, healthful meal or snack.

If you're going to have a dessert cereal, best you know it's a treat and not think it's a health food.

Guest Post: Obesity, Cancer, and Mental Health. What Links Them All?

Today's guest post comes from Dr. Sandro Demaio - a rising public health champion. When he asked me if I'd write something for him, I jumped at the chance to ask him to write something for me!

There's been a lot of discussion about obesity. Whether or not it's a disease (as it is in the USA now). How this label would positively or negatively influence action taken by society and governments in addressing this large and growing burden.

This conversation is important, but I have noticed very often it ends with confusion. Questions around why we begin talking about obesity - and end discussing mental health, cancer, heart disease or diabetes. To make hings even more confusing, the term 'Non-Communicable Diseases' might even be mentioned.

So what is the link between all of these diseases, and why can we not have a discussion about obesity, without talking about a range of seemingly unrelated ailments?

Well the reality is that all these diseases are actually highly interrelated. Obesity, diabetes, heart disease, cancers, lung diseases and mental illness (all combined are called Non-Communicable Diseases, or NCDs) largely share the same drivers or "risk factors". Things like an unhealthy diet, using tobacco, drinking alcohol and not getting enough exercise are all related to, or direct drivers of obesity and diseases like diabetes and some cancers. What's more confusing though, is that obesity itself puts us at higher risk for diabetes and some cancers, as does diabetes for heart diseases - for example.

Taking a step back though, the overlap becomes even more apparent. Because at a time when as much as two-thirds of many countries are overweight or obese (and obesity is rapidly rising in even the poorest nations), this is not an issue that comes down to 'stupid individuals making poor choices'. The reason we have a poor diet, or smoke, or don't get enough exercise - is largely due to the built environment around us, the ubiquitous nature of junk-food and alcohol advertising, the way our cities are designed, the structuring of our food system, the subsidies that make unhealthy foods cheap, the over-focus of treatment at the expense of prevention in our health systems, the lack of integrated health education in schools and so on...

These are the structural and social determinants of health, and disease.

Let's just look at food for a moment - which is a leading risk factor for disease worldwide with poor diet driving obesity, diabetes, heart disease, some cancers and more. We can say that people eat poor diets because of poor choices, but I don't really buy this. Do we really make informed, un-coerced decisions on what we eat? We buy that chocolate bar because it's delicious, but also because we are bombarded with advertising which makes us want it. They use psychologists and behavioural studies to develop the right flavour, size and packaging. They place it at the check-out because they know we will impulse buy it - that is, we never really wanted it. The sugar in that bar is cheap because our governments (more so in the USA nd Europe) subsidises the cost of sugar production and having eaten the bars as a child due to clever marketing specifically pointed at young people, we associate chocolate with happy memories.

My point is that in a nation where 2 in 3 of us are overweight or obese, something much bigger is going on that simply 'stupid people making poor choices'.

My other point is that whilst we might think of these diseases as separated outcomes, they actually have common root causes, risk factors and social determminants. Many of them far beyond the health sector.

Some biting food for thought.

TheFace

In the month of October, NCDFREE is running a campaign called The Face of NCDs. Here are some crowd-sourced reflections on the overlaps between these diseases, from people like you around the world.

"The idea of NCDs as a result of broader social engineering, rather than from the intentions of individuals, is something that needs to be more widespread. Too much of our approach to conditions like diabetes, pulmonary disease, and heart attacks blames the sufferer when we should be looking to the societal and economic determinants of health. When two thirds of Australians are overweight, there have to be larger forces at work than the personal failings of patients." - Oscar, Australia

“How ironic is it that man created antibiotics and medicines that keep us alive, but also created societal structures, alcohol, cigarettes and processed foods that are killing us? We need to realize that NCDs are problems of the way we constructed our societies and that there is a way out.” - Signe, Denmark

"In more and more countries being overweight or obese is the norm. Its the most shocking sign that our food system is simply failing. It’s going to take concerted effort from governments, the food industry and the public to make the changes needed to tackle this problem. Failure to do so will have catastrophic consequences for humanity.” - Henry, Denmark

"Coming from the US and living in Denmark has shown me the massive influence that political and public infrastructures have on health-related behavior. It can be argued that an unhealthy lifestyle is simply a matter of individual choice, but when roads are designed for automobiles rather than bicycles or when cheap, highly processed foods are available in excess rather than moderation, the odds are stacked up against you from the start.” - Hillary, USA

"Major sporting events often talk about leaving a legacy to inspire the youth of today to live a more physically active lifestyle. However these same events, which are watched by billions around the world, are sponsored by leading food and drinks companies which are contributing to the current global epidemic of obesity and type 2 diabetes. Is this the legacy we really want to leave?”- Jack, Denmark

For more stories, head to www.thefaceofncds.org today.

Dr Alessandro Demaio trained and worked as a medical doctor in Melbourne, Australia. While working as a doctor at The Alfred Hospital, he completed a Masters in Public Health including field-work in Cambodia. In 2010, Alessandro relocated to Denmark and completed a PhD fellowship in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases.

In 2013 Dr Demaio co-founded NCDFREE, a global social movement against NCDs – reaching more than 1.5 million people in its first year. His team convened two international launches and has made 4 short advocacy films; two in collaboration with the World Health Organization.

Currently, he holds a Postdoctoral Fellowship at Harvard Medical School and continues a part-time role as Assistant Professor at the Copenhagen School of Global Health. He also serves on the Advisory Board of the EAT: Stockholm Food Forum.

Saturday Stories: Viola Vanclief, Environments, Ebola x 2, and Marathons

Viola Vanclief

Garrett Therolf in the LA Times tells the haunting story of Viola Vanclief's too short life.

Brad Stulberg in The Harvard Public Health Review makes the case for levee building over swimming lessons in behaviour change.

Josephus Weeks, the nephew of Ebola victim Thomas Eric Duncan, with a must read story in The Dallas News on why his uncle's death might have been preventable.

Frank Bruni in The New York Times on how Ebola has highlighted our messed up health priorities and asks, among other things, if you've had your flu shot?

Alex Hutchinson in Runner's World with an amazing example of why the Internet's a great place to write, with his incredibly presented piece on what it's going to take to run a sub 2 hour marathon.

[And if you don't follow me on Facebook or Twitter, here's my piece this week from US News and World Report where I make the case for "Guerrilla Nutrition."]

Dear Kitten, About that Dog

Today's Funny Friday video has Ze Frank lending his comedic styling to a cat food commercial. It's fantastic.

Have a great weekend!

What Actually Reading that Fast vs. Slow Weight Loss Study Taught Me

I imagine this one will be all over the news today, and superficially I can certainly see why - a new study reportedly proves that if you lose weight fast or slow, 3 years later, regardless of the speed you lost your weight, you'll have gained back the same amount. This of course flies in the face of the advice that slow and steady wins the weight loss race.

Read the actual paper and the story becomes far less exciting.

In brief, study participants were randomized to either lose weight quickly with an all-liquid meal replacement shake program (Optifast), or to lose weight slowly using that same Optifast shake to replace one to two meals daily. Once a target weight loss of 15% was reached all patients who got there were then instructed to follow Australia's national dietary guidelines and to see a dietitian once every 3 months for the next 3 years.

Over that same 3 year period, everyone, regardless of whether they lost weight with Optifast quickly, or lost weight with Optifast slowly, regained the same amount of weight when following Australia’s national dietary guidelines – guidelines not even remotely designed for weight management or satiety (15% protein, 30% fat, 55-60% carbs) - while being provided with very little in the way of ongoing support.

Put another way, being prescribed a weight loss program that involves zero changes to lifestyle (aside from drinking shakes in place of meals), and then once weight is lost quickly or slowly, being told to follow a diet not designed in any way shape or form for weight management while receiving infrequent ongoing support, is clearly equally ineffective.

The fact that weight lost comes back when the intervention you undertook to lose the weight is stopped is anything but surprising, and yet that is precisely what was done with both the rapid losers and the slow losers. That there was no difference in their rate of regain speaks more to the authors' failure of recognizing obesity as a chronic condition, which like any chronic condition, returns once treatment is stopped, than it does to the speed participants lost weight using weight loss interventions that they were explicitly instructed to stop once their weight was lost.

The more weight you'd like to permanently lose, the more of your life you'll need to permanently change. All this study proves is that temporary changes lead to only temporary results and that what matters to your longterm success isn't the speed with which you lose your weight, but whether you lose your weight with a lifestyle that you enjoy enough to sustain.

The New York Times, Ebola, and "Immune Boosters"

While we may tell ourselves we live in a time of enlightenment, when it comes to our health, one walk through a pharmacy or health food store's aisles of Dr. Oz-esque nonsense and nostrums, and it's easy to see we're certainly not all the way there yet.

And while I fully expect the likes of both tabloid television and tabloid journalism to ascribe super powers to supplements without the requirement of super proof of those same powers, for some reason (naiveté I'm guessing) I wouldn't have expected the same from the New York Times. And yet...

Yesterday I clicked on a link to a story in the Times that detailed a reporter's experiences travelling from Liberia to New York in this new context of Ebola. When I got to this sentence, had I been drinking coffee I might have spit it out,

"I carried a blue canvas handbag crammed with wallet, laptop, two cellphones, passport, change of clothing, bleach wipes, and two Ziploc bags full of the malaria pills and immune boosters I had been taking for the two weeks I had been covering the Ebola outbreak".

Immune boosters?

To date, there are no products that I'm aware of that have been found to have a direct connection between their ingestion and heightened immunity. Sure, there are some theoretical connections (probiotics for instance), but nothing that would make me not scratch my head about the New York Times' journalist (and her editor) who felt that including a casual mention of "immune boosters" as if they were, akin to malaria pills, real and obvious things to pack (and take), in an article about Ebola, during a time of knee jerk medical paranoia, was in the public's best interest.

Why? Well beyond the responsibility a credible newspaper has in providing the public with fact and not fiction, there may be risk to those pharmacy shelf/health food store products that purport to boost immunity, because if they actually did, they would likely cause harm. Mark Crislip of Science Based Medicine explains this succinctly,

"If you really, truly, could boost your immune system, you would almost certainly increase your risk for thrombotic events."

The reason there would be risk is that a genuinely boosted immune system is pro-inflammatory which in turn would increase your risk of thrombotic events (like strokes, heart attacks, blood clots, and embolisms).

That a New York Times reporter is not only comfortable purchasing and taking products purported to "boost" her immune system, let alone casually including a mention of them in her article (and having that casual inclusion get past her editor), is a true testament to us needing far more regulation when it comes to our aisles of nonsense.

The Recipe for the Perfect Family Meal

Yesterday a fascinating new study published in Pediatrics. Researchers studied the video recordings of 120 families' meals for over a week to try to tease out what family meal factors were most associated with overweight and obesity in children. Not only were where the meals taking place studied, but also who was there, how long they lasted, and then what sort of interpersonal relationships were seen at the table (both between parents, between parents and kids, and between kids themselves).

Before I get to the results it goes without saying that these results can't distinguish between cause and effect - meaning that it's unclear if the relationships described by the study, if adopted, would in fact prevent weight gain (or lead to loss). That said, given how easy and straightforward many are, I thought it would be worthwhile to publish a simple recipe for healthful family meals based on the study's findings.

The Perfect Family Meal

1. Takes place in the kitchen
2. Lasts for 18 minutes or longer
3. Has at least one (or ideally both) parents present
4. Is consumed alongside attentive, warm and supportive conversation
5. Includes a positive discussion of the foods involved (not a discussion in terms of weight or good/bad, but rather such things as where the food came from, what it might be like to grow it, other meals that might be enjoyable from similar/same ingredients, etc.)

and while not found to be significant in the study I'd still add:

       6.  No screens (TV, phones, or other).

Saturday Stories: Pink, a Backpack, Ebola, Glucola, and Home Cooking

The Chicago Tribune's Barbara Brotman on why some women with breast cancer dread the pink month of October.

A harrowing story in the New Yorker by Jennifer Gonnerman on a boy, a stolen backpack, and 3 years of his life.

A great piece of investigative journalism by a team from the Washington Post on the failures that have allowed for Ebola's rapid spread.

Dr. Jen Gunter delivers the Food Babe's most recent idiocy surrounding Glucola and OGTT testing.

Emily Landau in Flare (with some quotes from me) on the baby steps she's taken towards home cooking and the difference they've made in her life.

And here's the segment I did with CTV's The Social this week on sleep, sleep trackers, sleep aids, and sleep issues.

Also, if you're in Ottawa, here are the details on the free public lecture I'm delivering this coming Thursday October 16th at 7:00pm at Centrepointe Theatre for Ottawa Public Health (book signing following the lecture) - tickets are limited so register (freely) today!

RUN! (And Don't Play with Ouija Boards)

I honestly think if I had been the subject of this week's Funny Friday video I'd need a new pair of pants.

Have a great weekend!

From the "Not the Onion" and "How Can This Not Be a Joke" File

The Aberdeen Health Foundation in Nova Scotia is celebrating the $4,925 they raised by hosting a McHappy Day at McDonald's (a multi-year fundraising tradition) and this year is using that money to help fund the purchase of a specialized bariatric chair for use in the Aberdeen Hospital.

Here's hoping that next year they don't sell cigarettes to help fund a new respirator.

(For newer readers, here's a piece I wrote on why we need to put an end to this sort of fundraising, and if anyone is interested in non-junk food fundraising, here are some recommendations from CSPI, which while specific to schools, are in many ways applicable to hospitals and health foundations (and certainly are so when we're talking about raising a grand total of $4,925)

Community Races Shouldn't Promote Unhealthy Eating Practices

This past weekend my family and I continued our longstanding tradition of participating in CIBC's Run for the Cure (not to be confused with Komen's - a different beast altogether, though also in support of breast cancer research). We love it because it's a very accessible race for kids with lots of excitement, huge crowds with fun costumes, and a 1km option for little legs. Participating and learning about the race helps my children to learn about charity, community spirit, fundraising, and active living.

But it also teaches them that doing a teeny tiny bit of exercise warrants being fed, as the food tent is just steps from the finish line and loudspeakers (and food) beckon their visitations.

The fact of the matter is that neither a 1km nor a 5km run require any refuelling whatsoever as our bodies have more than sufficient supplies of fuel to get us through such short durations and distances. The myth that exercise warrants or deserves a food reward is part of our broken societal approach to food as a whole and may well be a contributor to the fact that despite the laws of thermodynamics suggesting they should do otherwise, exercise only interventions meant to address weight tend to fail miserably in part because we've been taught (and do) to eat "because we exercised".

And what of the food in the food tent? Well no doubt in large part due to our ridiculous national Food Guide that still lists juice as a fruit serving, there were post-breakfast (the race began at 9:30am) large cans of juice containing nearly 200 calories and 10 teaspoons of free sugar. There were also 260 calorie bagels with an additional 1.5 teaspoons of free sugar, bananas, and if you were lucky enough to get there first and were so inclined, they also had a few bottles of water (compare and contrast the bottled water availability to the boxes of juice cans in the photo up above that I took from the end of the table).

Of course this isn't unique to the Run for the Cure, but true of most short duration/distance community races (both charitable and not) that I've run. Given the organizations involved are deeply invested in improving health, either through charity or through fitness, their food offerings are an unwelcome contradiction of their aims.

Is The World's Best Sleep Tracker a Simple Notepad?

Later this afternoon I'll be appearing on CTV's The Social to talk sleep, and part of our chat will be about sleep tracking technology.

Preparing for the show I was provided with two trackers to test drive. One from Beddit, and one from Fitbit.

The Beddit tracker, a thin strip of high-tech sensors that you adhere to your mattress, chats via Bluetooth with your phone and records heart rate, respiration and sleep time. Below is a typical night of mine's Beddit readout:

While it was definitely cool data, where Beddit struggled was in figuring out when I was tossing and turning. Fitbit, a sleep tracker/accelerometer that I wore on my wrist, did that well as it recorded every my arm moved.

As you can see from the Fitbit readout, I'm quite a restless sleeper, but frankly some nights I feel much more rested than others irrespective how much I tossed and turned.

And that's where both of these sleep trackers are lacking as there's no amount of technology that would be able to tell a tracker how sleep subjectively feels.

And that's where a notepad shines. Instead of concerning yourself with respiration, heart rate, or movement, concern yourself with how your sleep felt, and using a notepad beside your bed (or a notepad app on your smartphone), when you wake up each morning, rate your sleep on a scale of 1 to 10, where 10's are mornings you feel terrifically well rested, and 1's are mornings you feel tired and a mess. Combine those numbers with information such as how much caffeine or alcohol you consumed (and when you consumed it - both interfere with sleep), your room's temperature, darkness and noise levels, whether or not you used a screen (phone, laptop, TV) before bedtime, what time you went to bed, whether or not you exercised, whether you used a sleep aid, etc. and suddenly you'll have a low-cost, low-tech tool that will allow you to somewhat objectively figure out what matters to your sleep. For instance happily I learned that cutting out both coffee and alcohol from my life doesn't in fact improve my perceived quality of sleep (meaning I don't have to cut them out), but that my room's temperature is best on the colder side if I want to feel rested.

Gadgets are great, but sometimes old-school is the best way to go.

How About a Front-of-Package Health Claim Extension to Canada's Added Sugar Plan?

Was in the supermarket yesterday, and while wandering through the cereal aisle I had a thought.

If Health Canada moves ahead with added (or free) sugar nutrition fact panel labelling, could that information also be used to dictate which products are, and which products aren't, allowed to make nutrition and health claims on the fronts of their packages?

Preferentially, I'm for the removal of all front-of-package health claims, but given I can't see that ever happening, wonder if there might be a compromise where products with non-natural trans-fats, or some predetermined amount of free sugars, would be forbidden from using their front of package real estate to try to coax busy shoppers into thinking they're making a good (or less bad) choice.

Froot Loops should not be allowed to infer they're healthful no matter how much vitamin D might be added to them.

Saturday Stories: 10,000 Hours, Free Cookies, the NFL, and Assumptions

David Z. Hambrick, Fernanda Ferreira, and John M. Henderson in Slate take on Gladwell's 10,000 hour rule with their piece on practice not making perfect.

Lois Beckett with a somewhat terrifying piece in ProPublica on how much personal information people were willing to give up in return for a yummy cookie.

Sally Jenkins in the Washington Post with an incredibly hard hitting editorial (pun intended) on how the NFL needs to be treated like the coal industry.

Robert Pearl in Forbes with HIV as a backdrop explains why assumptions are unwise in medicine (and life in general).

[And if you don't follow me on Twitter or Facebook, here's my weekly piece in US News and World Report - this week, more on the science of why The Biggest Loser folks are likely to struggle to keep their lost weight off.]

The Best Lightbulb Commercial Ever Made

If you know of one better and funnier than today's Funny Friday video from GE, please post it in the comments.

Have a great weekend!

PepsiCo Plans to Carbonate Granola Bars?!

According to Food Navigator, PepsiCo has recently filed a patent for making snack products that contain "carbonated 'fizzy' candy" What's "carbonated candy"? According to PepsiCo's quote in the Food Navigator piece,

"Carbonated candy typically consists of tiny sugar crystals containing highly pressurized carbon dioxide"

And when those crystals mix with saliva, they reportedly fizz (think pop-rocks).

Here's betting that when they inevitably do carbonate granola bars, the words "carbonated candy" won't appear on the no doubt health-washed front-of-package nonsense usually festooned on the fronts of Quaker's (a PepsiCo company) granola bar packaging.

LOVE This New Boston Program, But It's Not Going to Prevent or Treat Obesity

It's called "Prescribe-a-Bike" and I love everything about it except one thing.

I love that it has MDs prescribing exercise to patients.

I love that it helps to provide affordable transportation to low income Bostonians (with an MD's Rx the normally $85 bike share membership cost is dropped to $5 and a free helmet is provided).

I love that it will improve the health of its riders.

I don't love the fact that Boston Medical Center President and CEO Kate Walsh promoted the program by suggesting the bike share will help to combat obesity as you'll no sooner out-ride your fork than out-run it, and perpetuating the myth that you can forestalls both individual and societal efforts at targeting our godawful diets.

Just Because it Came from a Supermarket Doesn't Mean it's not Takeout

A short post.

You know those counters in the supermarket where you can buy prepared meals?

Well I've met quite a few folks over the years who believe because supermarket meals are prepared in an actual supermarket that somehow they're healthier than restaurant meals.

Sad to tell them (and you), that take-out's take-out, no matter where it's made. And chances are those supposedly healthier supermarket offerings are just as salty, sugary, and calorific as anything you'd buy in a restaurant.

Guest Post: Can a Food Charity Reject Food Industry Funding and Fundraising?

Today's guest post comes from Nourish Nova Scotia's Executive Director Margo Riebe-Butt. Nourish is a non-profit organization that supports nourishment and food literacy programs in school communities, and Margo reached out to me a little ways back to let me know how Nourish was set up from the get-go not to rely on food industry dollars and to overtly reject junk food fundraising and that it did so by way of governance. A good read for all health organizations and I've no doubt that were you to want a copy of Nourish' complete policies and procedures that Margo would be happy to oblige.

Dear Dr. Freedhoff,

It’s kind of you to understand the struggles charities face when trying to fund important programs and organizational operations through various fundraising activities, and I applaud you for calling out those that ought to know better. Charities are under constant pressure in an extremely competitive environment to get the almighty donor dollar. It appears in this day and age anything goes when it comes to bringing much needed funds—even if it runs counter to the cause. But does it have to be that way?

At Nourish Nova Scotia, we don’t believe this needs to be the case. We believe there is a different way, and we’re living that reality today. We will not accept money from Big Food!

We are people who believe that real food is the food your grandmother would recognize—minimally processed and wholesome. We are nutritionists, home economists, educators and parents who care deeply about the future of Nova Scotia. We are members of our communities who know that eating real food helps keep people, communities and our economy healthier.

At Nourish we know that well-nourished kids have better health and education outcomes. We work to support nutrition programs in schools to help achieve this. Our goal is to support the nutritional well-being of children and youth and to build their food knowledge and skills so they can feed themselves well into a healthy future. Right now we support 366 breakfast programs in Nova Scotia, and we have dreams of building on this foundational program to support school gardens, farm to school initiatives, lunch, snack and cooking skill programs. Our dreams are tempered by reality, and the reality is the need for money in order to do what we need to do.

Learning from the experiences of other agencies we realized in the early days that we could not follow the well-worn path by accepting money, partnership and sponsorship incongruent with our mission, while still remaining true to our purpose for being. We had to be brave, innovative and make bold decisions not to enter into partnerships that would compromise our integrity and more importantly, the health of those we serve. We decided to take the time to formulate an internal fund development/gift acceptance policy to guide our actions and decisions. It’s a comprehensive policy, and in the interest of brevity, I’ll share only pieces pertinent to charitable fundraising in this email.

Nourish Fund Development Policies and Procedures

Purpose of Policy

In order to achieve Nourish’s vision that all Nova Scotia children and youth are well nourished to live, learn and play, individual citizens as well as the public, private and corporate sectors need to be engaged. Nourish inspires support by maintaining the highest ethical standards in all its actions, demonstrating wise stewardship of its resources and employing equitable and transparent processes to this end.

Nourish Nova Scotia believes integrity is paramount in fulfilling its vision mission and purpose. Its intention at all times is to put the nutritional health and well-being of Nova Scotia’s children and youth first. Therefore its financial responsibilities will always be balanced against its social responsibilities. To that end, Nourish chooses its partnerships thoughtfully and carefully, in order to protect its brand and, most importantly, the children and youth that it serves.

The second of eight principles states:

2. Nourish will seek to form meaningful relationships with individuals organizations and corporations that share our vision.*

This principle is further defined:

* Given the complexity of the food system, Nourish has made a conscious decision not to seek or enter into partnership with food industry. Exceptions to this decision may occur at some point in the future but involve only those that grow, produce, harvest and promote, what in our expert opinion constitutes real, whole-foods. Whole-foods contribute to the healthy development of children and youth and the good food environment we wish to co-create with generations of Nova Scotians. A careful and stringent review process will be followed to assess any such partnerships prior to any decision to partner.

We also gave thought to our organizational structure, and how that effects decision making, most notably at the board level. We’ve all had experiences on boards where well-meaning volunteers bring their own fundraising ideas to the table. Board dynamics may be such that these ideas-which often run counter to the charity’s purpose, are accepted anyway. To that end we have developed a community engagement model structure that brings new volunteers and potential board members into the organization on one of four leadership teams. It is here that the bulk of the work for the organization is conceived and actualized. Volunteers have the opportunity to become orientated to the purpose and mandate of the organization over the course of a year or more, ahead of the opportunity to be nominated to the board of directors.

We were very intentional in developing these policies and structures after we became incorporated and before we became a full-fledged charity. It was difficult to invest so much time and effort on policy development at the front-end of building a new charity. Because of our backgrounds and experiences we knew how imperative these foundational documents would be to the strength and integrity of our organization, and how these investments would serve us well down the road. If you would like more information on how our organizational structure helps to keep volunteers focused on our purpose, I would be happy to share.

We face the same financial challenges as all of our charitable colleagues. We are proud to differentiate ourselves by taking the road less traveled and keeping the children and youth we serve at the centre of our work.

Like you, we believe every health charity should be focused on wellness, and not fundraising by selling illness.

In the sage words of Kermit the Frog….."It’s not easy being green.”

Margo

Margo Riebe-Butt, RD
Executive Director, Nourish Nova Scotia

Like us on FaceBook or follow us on Twitter

Saturday Stories: Smoke Jumpers, Genetic Testing, and Tomatoes

Glenn Hodges in National Geographic covering Russian smoke jumpers.

Denise Grady and Andrew Pollack in the New York Times do a great job of covering the slippery slope of genetic testing.

Daniel Gritzer on Serious Eats explains why there's nothing wrong with refrigerating your tomatoes.

Puppies!

Today's Funny Friday documents the marriage between a GoPro camera and a bunch of adorable puppies!

Have a great weekend!

Big Beverage Pledges to Take Credit For Pre-Existing Consumer Trends

I imagine you've heard of "the big announcement" from Big Beverage, but in case you didn't, a few days ago, on stage at the Clinton Global Initiative Annual Meeting, The Coca-Cola Company, Dr Pepper Snapple Group, PepsiCo and the American Beverage Association, together pledged to reduce beverage calories consumed per person nationally by 20 percent by 2025.

And it would seem much of the world has swallowed it.

All Big Beverage is actually doing is pledging to take credit for the decade from now outcome of the rapidly shifting and growing consumer sentiment that has already led to a marked reduction in sugar-sweetened beverage sales - a reduction that's likely to accelerate as the World Health Organization's recommendation that added sugar be capped at 6 teaspoons daily is formally accepted, as nutrition fact panel reform that specifically calls out added sugar goes live, and as the science fingering excess free sugar consumption as a bad plan continues to accumulate. In fact given the growing groundswell against free sugar, I'd be genuinely surprised if sugar sweetened beverage sales don't go down by more than 20% over the coming decade.

This is all just smoke and mirrors. Hitching themselves to the already rapidly decreasing consumer interest in their products is a brilliant move that will likely help Big Beverage to forestall soda taxes and legislation by allowing them to pretend that they're part of the solution.

What sorts of consumer campaigns would convince me that Big Beverage really did want to drive down their own profits (which of course they legally can't because of their fiduciary responsibility to their shareholders) and change American's beverage choices?

Campaigns telling consumers that they should immediately and dramatically minimize their consumption of soda, that switching to artificially sweetened beverages is only a shift to a lesser evil and that their consumption too should be minimized, and that tap water is hugely preferable to bottled water as bottled water is an entirely unnecessary and expensive environmental blight. We might also see food industry pledges not just to make smaller sizes, but to stop selling larger ones, slashes to advertising budgets, and a commitment to immediately stop using Santa Claus, polar bears, teen idols, and sport and entertainment industry celebrities and stars to hawk their products.

Anything less than the above is just lip service and I for one can't wait for the day (and it'll come), when society stops listening to the food industry's wholly explicable, and ultimately unhelpful, self-serving machinations and starts treating them as the non-evil, profit-driven corporations that they are who by definition must place profits and self-preservation ahead of public health.

Another Meta-Analysis Confirms that Kids Can't Outrun Their Forks

Wouldn't it be great if childhood obesity could be tackled with PE classes and after-school sports?

Unfortunately believing or wanting something to be true doesn't make it so and study after study looking at the impact of activity levels on children's weights demonstrate that while incredibly good for their health, exercising doesn't tip the needle on the kids' scales.

Well add this meta-analysis to the mix. Published in Preventive Medicine the authors pulled randomized controlled trials of 6 months or longer in duration that looked at the impact physical activity interventions had on body mass index, blood pressure, total cholesterol and triglycerides. In total there were 11 such trials that together included 10,748 children.

The results were pretty clear. 6 month or longer physical activity interventions weren't associated with reductions in BMI, but they may have a positive impact on the kids' blood pressures and triglycerides.

Yes, I know I'm a broken record, but for the record, weight is lost in kitchens, health is gained in gyms.

Book Review: 100 Days of Real Food (Guest Post)

Today's post is a guest post cookbook review from our office's fantastic RD Rob Lazzinnaro.

100 Days of Real Food

Full disclosure: I was provided a free copy of Lisa Leake's 100 Days of Real Food by Dr.Freedhoff to review, and I have no ties to the author.

I tend to review all cookbooks with two guidelines:

1. Are the recipes attainable, nutritious, and is nutrition information provided.
2. If the cookbook has nutrition tips (which many do these days) is the information accurate and would I be comfortable recommending it as a registered dietitian.

Let’s start with praise. Overall this is an excellent book with a great message and some excellent recipes. Its central message is one we all still desperately need to hear, which is to cook more, eat more whole foods, and rely on highly processed foods less.

The message is stated clearly from the book’s get-go - we eat too many highly refined and ultra-processed products. Why is that significant? In depth, eating more processed food often means consuming portions deceptively high in calories, ingredients that are proven harmful to our health (trans fats), and foods that are often devoid of essential nutrients.

Leake’s definition of what REAL food is:

• "Whole food that typically has only one ingredient…
• “Packaged foods made with no more than five unrefined ingredients. (based on Michael Pollan’s food rules).
• Dairy products like whole milk, unsweetened yogurt, eggs, and cheese.
• Breads and crackers that are 100 percent whole grain.
• Wild-caught seafood
• Locally and humanely raised pastured meat products like chicken, pork, beef, and lamb
• Dried fruits, nuts and seeds
• Naturally made sweeteners including honey and maple syrup
• More a product of nature than a “product of industry”. "

The Meal Planning Tips and Recipes Section; Chapters 4-5 & Part Two:

The book shines in its practical “how to” managment tips, and particularly in the chapters Getting Your Family On Board” and “Food Budget Tips and Meal Plans. The last half of the book includes the 100 recipes, and the majority are enticing, and more importantly, not intimidating . Without question most parents will especially enjoy the lunch box recipe ideas for kids. With respect to nutrition within the recipes, Leake is not a believer in counting calories or macronutrients, but I am, so I put some of her most indulgent recipes to the test.

If you had a serving of the Quinoa and Sausage Stuffed Peppers on pg. 242 you would consume:

~455 Calories/18g Protein/400mg Sodium/5g Fibre

Pair it with a serving of Spinach Salad with Warm Bacon Dressing on pg. 214 you would consume an additional:

~347 Calories/16g Protein/591mg Sodium/2g Fibre

Essentially, what that means is that the book’s most indulgent meal would be ~800 Calories. The rest of the recipes tend be much less caloric and fall somewhere between 200-300 calories per serving. For me this hammers home two points.

1. When you cook at home from whole ingredients the majority of your meals will naturally fall within a reasonable calorie range and consequently tracking calories isn’t as necessary as it would be were you to be assembling boxes and hitting restaurants rather than cooking.
2. Not all meals are created equal and just because they are cooked from scratch some meals will still fall into the eat less often category and so if your recipe sounds indulgent, it may be worth crunching the numbers.

The Nutritional Information Sections, Chapters 1-3:

There is some very solid advice in these sections ranging from what are whole grains, healthy oils/fats, label reading, not aiming for perfection and the problem with added sugar which Leake covers succinctly,

“The problem with sugar is honestly not sugar itself, but the quantity in which it’s being consumed”

Unfortunately, Leake’s solid nutritional advice is at times followed up by non-evidence based statements. As many in the real food (whole food) movement are, Leake seems guided in part by natural fallacy - the belief that only something “natural/real” necessitates healthy and good; everything else is a compromise. I worry that this false construct and focus may lead some to ultimately struggle as not everyone has the budget, access or interest to cook the majority of their food, let alone do so with organic, grass fed, and speciality ingredients. I can’t help but wonder whether some of the fierce attacks on home cooking of late by journalists and bloggers as being elitist, aren’t bolstered some by recommendations that in a sense, put too many rules on home cooking.

At the end of the day this is a great resource for those looking to eat and cook with more whole foods; keeping in mind that it is perfectly fine if you choose to cook/bake with white flour once in a while ;)

If you'd like a copy, here's an Amazon Associates link to pick one up.

More on Why The Biggest Loser Contestants Are Doomed To Fail

I've written a great deal about The Biggest Loser.

I've covered the fact that according to previous contestants the vast majority gain their weight back, I've covered the metabolic slow down that occurs consequent to the show, I've covered the cruelty of the show's inclusion of children, I've covered how watching the show actively discourages viewers from exercising, and I've covered the ethics of being a physician involved in its production.

Today I'll leave you with this tidbit.

In a study published early online last week in the journal Obesity, when compared with matched gastric bypass patients, following their respective losses, contestants on The Biggest Loser had 5x less circulating leptin in their bloodstreams.

Leptin, in case you aren't aware, is one of the body's primary satiety (fullness) hormones.

With 5x less circulating leptin, and metabolisms that are slowed down twice as much as their gastric bypass counterparts', it's no small wonder the majority of The Biggest Loser's contestants are reported to have gained their weights back as it's tough to be a metabolic slug and be hungry.

Saturday Stories: Farmaceuticals, Sustainable Seafood, and Vegetative States

Here's Brian Grow, P.J. Huffstutter, and Michael Erman with an impressive Reuters special investigation on the abuse of antibiotics on farms.

Here's Nathanael Johnson on the potential of sustainable seafood.

And lastly here's Maclean's Kate Lunau with a fascinating story involving Alfred Hitchcock and a not persistent vegetative state.

The World's Most Awesome Don't Walk Signal!

Today's Funny Friday is both awesome and reportedly extremely effective.

Don't walk. Dance!

Have a great weekend.

Why Did Toronto Mayoral Candidate John Tory Shoot A Pringles Commerical?

On the down side, clearly junk food is so normalized that John Tory, the front runner in Toronto's mayoral race, didn't have any issue shooting a Pringles commercial in the name of his campaign. And I think it'd be fair to say too that the ad's existence also means that the food environment isn't anywhere near Tory's radar.

On the up side, at least he doesn't smoke crack.

(Tory comes in at 1:06, just after the appearance by David Zimmer, Ontario's Minister of Aboriginal Affairs)

Food Banks Canada Now Teaming Up With 7-11 To Sell Slurpees!?

I do get it. Charities feel they need to take whatever monies they can get.

But given I've never seen a co-branded cigarette sale to raise money for this, that, or the other, clearly there are lines drawn that charities don't cross in their cross promotional activities.

As I mentioned over on US News and World Report, charities, especially those tied to public health, given diet and weight related illnesses are North America's primary causes of preventable death, should be on the front lines of actively working to decrease the number of opportunities for junk food's consumption.

And could there be any "food" junkier than a Slurpee?

Fundraising by selling illness isn’t in anyone’s best interest, and health charities of all folks, ought to know that without being told.

Did You Know that Coca-Cola Basically Owns Emory University?

I'm rarely speechless.

I was close yesterday though.

It was yesterday that I learned of a long-standing Emory University tradition. Apparently, unabashedly, and transparently, in part no doubt consequent to the $105 million endowment provided to Emory by a former Coca-Cola CEO, and in part no doubt due to the reported fact that 16% of Emory's $6.3 billion endowment fund is made up of Coca-Cola stock (down from 63% in 1998 and 47% in 2002), all first year Emory University students are brought together as they start school to toast their futures with a Coca-Cola beverage.

And just as Coca-Cola notes in their own coverage of this marketing scheme tradition (highlighting mine),

""To our rebirth!”—three words, two memories, and a new Coke connection that will forever live in their hearts and minds."

It'll be interesting to see what Emory chooses to do about their Coca-Cola ties over time. I'm guessing history will eventually see them as rather unwise.

And to round things off, here are some videos from Coca-Cola Emory University:

Guest Post: The Pharmacist Who Refuses to Sell Soft Drinks

Last week the media was abuzz with reports of a pharmacist from Nova Scotia who had elected, despite the financial disincentive, to stop selling soda and other sugar sweetened beverages in his pharmacy. His name is Graham MacKenzie and his pharmacy, Stone's Pharmasave in Baddeck, Nova Scotia, is a testament to doing the right thing. Huge kudos to Mr. MacKenzie. Wish there were more like him. Here's what he did and why in his own words:

Roughly six months ago I started serious consideration after repeated studies that came out documenting the bad effects of sugared drinks. The consideration was whether or not to continue selling the sugared beverages in my pharmacy, Stone’s Pharmasave in Baddeck, Nova Scotia. The reasons to drop this category were simple. The consumption of just one of these beverages daily was proven to cause adverse metabolic traits including metabolic syndrome, which is a cluster of symptoms including high cholesterol, diabetes, abdominal obesity and high blood pressure. In our nutraceutical consultations we often stress the importance of nutrition in overall wellbeing and improvement of health related issues. Having a customer leave the store by walking past the pop and juice coolers on their way out after that talk made zero sense.

Customers would ask me if there was a safe level of consumption. The best way I could explain it is if you hold out your hands and I pour marbles into them - it is relatively easy to catch all of them without dropping any at first. The marbles represent insults to your body: either sugar, pesticide, herbicide, fertilizer, heavy metal, radiation, processed food, poor nutrient consumption, air pollution and so on. At first you are young and you have no issues, later on as you get older, more and more marbles fill your hands and eventually you drop one, or two. This is the tipping point where your body now expresses disease or injury. Sugar is a big part of this contribution.

So, I sent out a press release on September 11, 2014, which can be found here: Nova Scotia pharmacy stops selling soft drinks and other sugary beverages

We pulled the pin before we opened that morning by removing all juices, soda, sport drinks and vitamin water from the store. I figured all would be quiet for the most part, a few blank stares a couple of frowns and that would be it. We have been overwhelmed by the positive response on all of our social media channels. People are now alerted to the effects of sugar and how much sugar themselves and their families have been consuming. They have become more aware that it is better to eat the food rather than drink the juice. For example, eating an apple gives you fiber, which slows the glucose absorption, plus you don’t get as much juice. They now know that by consuming one or two of these beverages daily, they have the same chance of increased diabetes risk as a smoker does. By raising awareness, people now ask what high fructose corn syrup is and why it is particularly important to avoid this dangerous visceral fat absorbing sugar.

My overall goal was to raise awareness of the adverse health effects of drinking soft drinks and sugary beverages. At some point, disease prevention needs to become part of our world-class medicine we have available to us. Treating patients symptom by symptom is too much of a downstream activity to really act in our favour. I want to promote healthy living for my customers and I think this was a step in the right direction. Perhaps it was nothing more than a symbolic moral gesture to spark an educational thought not only among my customers, but those globally. In a television interview in the pharmacy the following day, with camera rolling and the interviewer present, one of our biggest pop buyers walked in for his regular case of soda. When he found out there was none sold there anymore he turned to the empty cooler, then looked at the water filled cooler next to it and picked up two bottles of water. “These are better for me anyway I guess!”, as he purchased them and went on his way out the door.

Overall, it has been a great week. For my customers and me.

Graham MacKenzie graduated from St.F.X.U. In Antigonish, Nova Scotia, Canada in 1989 (BSc chem) and Dalhousie U College of Pharmacy in Halifax, NS in 1993. He went to Stone's Drug Store in Baddeck, NS at that time. In 2001 he purchased the store and renovated it inside and out to include a compounding lab and new dispensary. He has developed a one on one Nutraceutical Consultations, developed a 40 minute Healthy Grocery Shopping Tour and continues to actively educate on alternative and conventional therapies to his patients and globally. He actively blogs on his website, www.stonespharmasave.com, and you can follow him on Twitter.

Saturday Stories: 23andMe, Red Delicious Apples, and Turtle CPR

Julia Belluz on Vox.com with a great story on the unintended consequences of home genetic testing.

Sarah Yager at The Atlantic on the awful reign of the red delicious apple.

And on Slate, here's David Steen on what it's like and why he gave mouth-to-mouth to a turtle.

[And if you don't follow me on Facebook or Twitter, here's my US News and World Report column that explains why sandwiches, eggs and roasted chickens aren't elitist or unrealistic]

True Facts About Marsupials

Today's Funny Friday is from Ze Frank. I need not say any more.

Have a great weekend!

Health Canada So Sure of Self, It Sets Policy Before Scientific Review?

In case you're wondering what we're up against here in Canada when it comes to public health and Health Canada, this story sums it up pretty well (and is applicable to many government health agencies the world over).

Carly Weeks, one of Canada's foremost health reporters, published a story a ways back on how the Canadian Medical Association, the Childhood Obesity Foundation, the Canadian Institute for Health Research and the Libin Cardiovascular Institute of Alberta, have all added their voices in demanding that Health Canada change it's lame, industry appeasing, sugar policy. For whatever reason, I only just read this Valentine's Day piece yesterday.

In it, Weeks quoted Norm Campbell, the CIHR Canadian Chair in Hypertension Prevention and Control as stating,

"We’re talking about the leading risk for death and disability and [the federal government is] doing nothing.”

Next up she quoted former Canadian Medical Association President Louis Hugo Francescutti,

"At the end of the day, I think we know what we need to do. We don’t need any more studies, but we need to develop a fairly robust national strategy."

And she also snagged this quote from Tom Warshawski, pediatrician and chair of the Childhood Obesity Foundation,

"I think Health Canada is not really doing their job. They look for industry to self-regulate.”

And while those quotes are damning in and of themselves, they weren't what really caught my eye. It was this.

Weeks lead the piece off noting that the increased concern from public health groups stemmed in part from a recent study published in JAMA that concluded folks whose diets included 25% or more calories from added sugars were found to be 3x more likely to develop heart disease.

Well Weeks got Health Canada on the phone and here's what she reported they said (highlighting mine),

"On Friday, a spokesman for Health Minister Rona Ambrose said the department will review the JAMA study, but ruled out setting limits on sugar added to food or adopting consumption guidelines."

And with that one line that Health Canada spokesperson, unless it was a slip of the tongue, made clear that Health Canada makes decisions in advance of, and potentially despite, the science.

Such a shame for the health of Canadians.

Food Banks Canada Demonstrates the Folly of Working with the Food Industry

Yesterday's story showed how the Heart and Stroke Foundation's divorce from the food industry finally allowed them to speak their mind.

Today's story's not like that.

Today's story is about Food Banks Canada and their partnership with "Breakfast Cereal Canada" (a food industry organization) who for a measly $25,000 bought Food Bank Canada's imprimatur and endorsement for their new, "What's in the Bowl" hurray for breakfast cereal promotion.

Want to guess what What's in the Bowl has to say about the fact that in many cases breakfast cereals are just bowls of pulverized white flour sprinkled with sugar?

"When you consider sugar consumption, it’s important to look at the total amount of sugar in your diet from all sources. In the case of cereal, it’s worth noting that studies have found that less than five percent of the total daily sugar in Canadian diets typically comes from cereal – and that includes the pre-sweetened varieties. At the same time cereal often provides fibre and important vitamins and minerals, including iron, zinc, B vitamins – and the research shows that without adequate intake of these nutrients at breakfast, most people don’t make up for the shortfall later in the day."

Really, you have to love that 5% number. It's a per capita number and consequently it's useless in terms of describing the total daily sugar cereal provides to actual consumers of cereal given not everyone eats cereal for breakfast and perhaps as many as 1/3 of the population don't eat breakfast at all. The only reason to use a per capita number here is to make the number seem much lower than it actually is for cereal eaters.

The campaign has even purchased the services of consulting RD Lydia Knorr who added her two cents on sugar in breakfast cereals in the press release,

"As a dietitian, it makes me happy to hear that consumers are taking factors such as sugar and additives in their foods seriously and want to know more. But what many people don't realize is that cereals can provide more iron, folic acid, zinc, B vitamins and fibre than other conventional breakfast choice."

Gotta love those magic nutrients that make everything else in the bowl a-ok. Krave, Cinnamon Toast Crunch and Honeycombs for everyone! And hey, can someone please fortify alcohol with vitamins for us adults?

Ugh.

Canada's Heart and Stroke Foundation Issues World Leading Sugar Statement!

Huge kudos to Canada's Heart and Stroke Foundation.

For years I've pointed out that public-private partnerships with the food industry necessitate watered down public health messages so as not to offend the industry partner's products or positions. With this in mind, my hope had been that in unchaining themselves from their food and restaurant industry partnered Health Check program, Canada's Heart and Stroke Foundation (HSF) would suddenly be free to take on a leadership role in the area of food and public health - and if today's news is any measure, the HSF is doing just that and is positioning itself to be Canada's voice of dietary reason, and a world leader in health charity driven public health advocacy.

Today's news has to do with their release of their new position statement, "Sugar, Heart Disease and Stroke", which is as hard hitting as any I've read, and runs in line with the World Health Organization's recommendation to limit added sugars to between 5-10% of daily calories. I vastly prefer the HSF's use here of the term "free sugar" rather than "added sugar", as free also covers sugars freed from their fruity origins and would include juices and products made with juice/fruit concentrates and purees.

The position statement goes on to provide a slew of recommendations, most of which simply could not have been made while the HSF wore the yoke of their public-private Health Check partnership. Here are just a smattering:

For Consumers:

• Limiting restaurant meals out
• Limiting processed foods
• A call to return to cooking from fresh, whole, ingredients

For the Federal Government:

• Adopting the HSF's proposed sugar thresholds
• Restricting marketing of all foods and beverages to children
• Taxing sugar sweetened beverages and using funds generated therein to subsidize fruits and vegetables
• Avoiding public health partnerships with producers and suppliers of foods high in free sugars

For Provincial Governments:

• Taxing sugar sweetened beverages and using funds generated therein to subsidize fruits and vegetables.
• Adopting a Bloomberg style large cup ban (if you want to drink a litre of Coke, you'll still be able to, you'll just need to buy two cups)!

For Municipal Governments, Regional Health Authorities, Workplaces and Schoolboards

• Adopting a Bloomberg style large cup ban in food service outlets
• Banning sugar-loaded beverages in recreation centres, hospitals and schools
• Ensuring potable drinking water made more readily available in parks and public facilities
• Creating zoning laws to prevent the establishment of fast food outlets and convenience stores within walking distance of schools
• Banning the practice of junk food fundraising.

The only thing missing from these recommendations (though it's certainly implied), is a direct call to action for the overhaul of Canada's 2007 Food Guide and with it the Guide's inclusion of free sugar limits, and the removal of the Guide's inane recommendation that half a cup of sugar water with vitamins (juice) is a fruit serving equivalent.

Whether or not you agree with the HSF's recommendations, one thing's incredibly clear, the HSF is no longer the food industry's partner - and that news is tremendous for Canadians as it's amazing how forceful and broad-sweeping public health organizations' recommendations can be when there's no worry about upsetting industry partners.

[I also must add, while reading this position piece and in it the HSF's clear, unadulterated by industry voice, I couldn't help but wonder what sort of forces Dietitians of Canada and the American Academy of Nutrition and Dietetics could be were they to divorce themselves from their throngs of food industry partners, for as it stands now, they're both rather toothless and certainly not describable as drivers of change or true champions of health.]