Holiday Gift Guide Edition

Full disclosure: Each of the items I'm mentioning today I purchased myself, use regularly, and love. I was not asked or paid by anyone to provide these reviews. You should know too, that if you use the links to purchase them on Amazon, I will receive a small commission (at no extra cost to you).

The Cookbook: Jerusalem, by Yotam Ottolenghi

This past summer I had the incredible fortune to spend two weeks travelling through Israel in celebration of my oldest daughter's bat-mitzvah. If you've never been to Israel, then you probably don't realize that the food there is incredible. Jerusalem, Yotam Ottolenghi's tribute to Israeli cooking, is both beautiful to read and to explore. While we've cooked a good percentage of its meals, with all being incredible, it was only after I returned from Israel that I found what for me is its truest gem. It's Ottolenghi's take on shakshuka.

For those who don't know, shakshuka is an Israeli comfort food. Often consumed for brunch, it's equally adept at serving as a dinner time meal and at its simplest is peppers and tomatoes stewed with a hot middle eastern spice paste, finished by poaching eggs directly in the mixture, and then eaten with crusty white bread.

When we were in Israel, one of the restaurants I needed to eat at was called, "Shakshukia" and the only thing they serve there is shakshuka. It was incredible. And when we got home, and I cooked Ottolenghi's version, it was almost a dead ringer (when made with Ottolenghi's pilpelchuma (which I'd recommend making with Ancho rather than Pasilla peppers and also doing a quadruple batch and then freezing, in 1/8 of a cup measures, the extra which will allow you to make shakshuka with at most 10 minutes of prep time)).

If you do make it, know that you can keep it vegetarian by cooking it as is, or you can, like I learned to do at Shakshukia, add some grilled merguez sausage to it.

Click here to buy for US readers, or click here to buy for Canadian readers.

The Surprisingly Awesome Kitchen Gadget: A Vacuum Sealer

Though it might not seem exciting, I can't tell you how much I love our vacuum sealer. We bought it this year to use in conjunction with the sous-vide setup I received for my birthday, and honestly, I think I've used it every single day since.

Of course its primary function for us is to freshly seal cooked meals (we batch cook so we always have lunch options and quick dinner options at the ready), and because it does so with a vacuum, the foods stay fresh for far longer than if you were to use (like we used to) Ziplock freezer bags. I have read in some places that you can save a great deal of money using a food saver, both in terms of the ability to buy meats on sale and freeze them without worrying about freezer burn, and also in terms of the heat-sealed bags being cheaper than Ziplocks - but I haven't done the math. What I do know though is that a vacuum sealer is more than that, and for chip-aholics like me, it's a great way to reduce my temptation to eat more. What I mean is that heat based vacuum sealers will also re-seal bags of chips (and rice, and spices, etc.). Doing so not only stops me from going back for seconds, it also keeps the chips as fresh as they day they were opened.

If you do buy one, or even if you use Ziplocks, another tip I've got is once sealed, smooth out the contents of the bags so that they're as thin and as flat as you can make them. That way they'll take up far less room in your freezer, and they'll thaw that much more quickly. The link below is to a Foodsaver version, I bought the one from the US link because it's cheaper and I didn't want fancy bells and whistles (and it's been great), but I couldn't find the same one for sale on Amazon Canada.

Because the prices vary regularly, and because there are many makes and models, make sure you hunt around on Amazon before choosing one, and you might also consider buying some discount bulk no-name vacuum sealing bags - so far they've worked well for us.

Click here to buy for US readers, or here to buy for Canadian readers.

The Incredibly Useful Kitchen Gadget: The Instant Pot Pressure Cooker

We bought ours a few years ago and we're using it more and more often and not just for speedier rice, beans, and quinoa. Don't worry about the space it takes up as the Instant Pot actually replaces a whole pile of devices in your kitchen as it is at once a pressure cooker, rice cooker, steamer, slow cooker, and even can be used as a saute pan. The online Instant Pot communities on both Facebook and Reddit are incredibly helpful, and recipe wise, Serious Eats has a pile as well.

Lately we've been using our Instant Pot to take a shortcut with Ottolenghi's shakshuka (using a can of San Marzano tomatoes and then a 45 minute high pressure run through the Instant Pot as opposed to the long simmer recommended by Shakshukia's chef and owner) - a shortcut inspired by this recipe for an almost as good all-day red sauce for pasta. The one thing we have yet to try is the yogurt making feature which I hear is easy and great.

These Instant Pots go on sale regularly, and there are many models, so once again, have a hunt around on Amazon before buying.

Click here to buy for US readers, or here to buy for Canadian readers

The Home Barista: The Breville BES870XL Barista Espresso

I bought this for my wife for her birthday 3 years ago and we've both used it virtually every single day since. Though it's definitely not describable as inexpensive (generally it runs around $500-$600), if over time it precludes your need to buy espressos, cappuccinos, americanos, or lattes at an expensive coffee shop, you may make some of your money back. For us, because we buy green coffee beans in bulk and roast them ourselves, I'm guessing a fancy coffee costs us somewhere on the order of $0.40 each. Multiply their savings over the at least 730 cups we pull a year and that argument about paying for itself probably holds water.

That aside, this thing is an absolute workhorse and it allows for tremendous customization of grind (the built in grinder works great), tamp, and temperature which in turn yields coffee shop worthy cuppas. It's also incredibly speedy. From turning it on, to a double espresso in my hand in just over a minute (and this includes the time it takes for the machine to heat, the beans to grind, me to tamp, and the pour).

Click here to buy for US readers, or here to buy for Canadian readers.

For other ideas, feel free to have a peek at my last year's gift guide which also includes the simple, relatively inexpensive coffee roaster we've been using for the past 4 years now.

Saturday Stories: Post-Truthism, Anti-Semitism, And At Least 2 More Hate Filled Isms.

Photo Source: Nick Solari, Michael Vadon CC BY-SA 2.0 / Mario Santor, Georges Biard CC BY-SA 3.0

The inimitable Margaret Sullivan in The Washington Post on the post-truth world of the Trump presidency.

Alana Newhouse in Tablet with an incredible piece on anti-Semitism in America.

Tiffany Martínez, in her online journal, covers how the word "Hence" highlighted at least 2 more hateful biases currently in America.

Are There People More Dysfunctional Than Infomercial Befores?

It's hard to pick a favourite moron in today's Funny Friday, but if I had to vote, it'd be the guy cracking eggs.

Have a great weekend!

Guest Post: Skim Milk Makes Kids Fat. Or Does It?

Today's guest post comes from my friend and colleague Dr. Dan Flanders and it's about a topic that has in fact received a fair bit of attention over the past few years - full fat vs. skimmed fat milk and the proposed impact which you choose might have on your child's weight. If you're looking for Dan, you can usually find him on Twitter.

Last week, Target Kids!, a distinguished group of Toronto pediatric researchers, published a study on the relationship between the types of milk that young children drink and their weights. They demonstrated, quite convincingl,y that young children who routinely drink fattier milk (e.g. 3.25% whole milk) tended to be leaner than those who drank lower fat milk (e.g. skim or 1%). Likewise, children with overweight and obesity, were found by them tend towards drinking lower-fat milk than children who were leaner.

The authors suggested, as a possible explanation for these findings, that low fat milk doesn't satiate children very well and therefore probably leads to the eating of excess calories and consequently, the additional weight. Higher-fat milk drinkers, they proposed, feel fuller, and for longer, and are therefore less likely to overeat.

One can imagine how compelling this explanation might seem in light of our current international childhood obesity concerns. So is this the simple intervention we need to cure childhood obesity!? Probably not.

Consider, for example, what a sensible and caring parent of an underweight young child might do to help them to gain. As both a pediatrician and as a father of an underweight child, my first instincts and steps were to increase the fat content of my son’s milk. In fact it is common practice in the medical community for doctors and other allied health professionals to recommend switching to fattier milk as a means to encourage weight gain for young, slow-to-gain children.

Likewise, it is extremely common for parents of children who have excess weight to attempt reducing their children’s caloric intake by serving them lower-fat milk. And again, this is a practice that health professionals regularly recommend to help to “prevent childhood obesity”.

Coming back to this new study, in my opinion, the directionality is wrong, I think it highly unlikely that drinking fattier milk is causing leanness in children and that drinking low or no-fat milk is causing obesity. Rather, I would bet that the milk type that young children are drinking is probably being chosen by their parents as a consequence of their kids’ weight status’: fattier milk for the children who are lean and lower-fat milk for the ones who are heavy.

Effectively, this study shows a correlation, not a causal relationship, and its findings are just as (or perhaps more) likely to reflect sensible parenting decisions than the discovery of a new intervention to reduce childhood obesity.

So why write about this study? Well, in a word … The Media.

There can be an interesting and sometimes dangerous intersection between science and the media. As consumers and parents, we are eager to make good, health-promoting decisions for our children and families. When it comes to health and nutrition, these decisions ought to be properly informed by the process and outcomes of scientific inquiry, and be published in peer-reviewed scientific journals. But most of us are not scientifically minded enough to read, digest, and critically appraise peer-reviewed publications directly from the source, and so we turn to the media for help.

The media - broadcasters, journalists, health bloggers - play the important role of consuming, interpreting, and packaging science discoveries in a way that is digestible to mainstream consumers. Unfortunately, the media too often botch their coverage of important science discoveries by spinning stories to feed flashy and controversial narratives thereby, they hope, driving higher consumer subscriptions and ad revenues. Left in the dust is their mandate to responsibly inform consumers.

Using this milk study as an example: a fair and responsible way to cover this story might be to write some version of the following:

A correlation has been found between the type of milk that young children drink and their weight status. The study was unable to determine whether the type of milk consumed caused changes in body size or whether existing body size influenced the type of milk consumed. Future studies are needed to establish any causal connection.

Instead, here’s but a sampling of irresponsible headlines cranked out by some well-respected news publishers in response to this study:

• Which milk is healthiest for kids? New study suggests it isn't skim
• Full-fat milk leads to leaner children, says study
• Children who drink full-fat milk end up slimmer than those on skimmed
• Children who drink full fat milk are SKINNIER because it stops them from snacking

I am concerned that parents, wanting to do what's best for their children, have been misled by these headlines. Not only does this type of reporting send a statistically inaccurate message, but there is a real chance that these headlines will change (or have changed) parents’ family nutrition decisions with the risk of actually making things worse for their children.

I am even more concerned that this sampling of misleading health journalism is but a spit in the ocean; reckless health reporting is routine and commonplace. As a global community we must demand better from our journalism communities.

Dr. Daniel Flanders is a Toronto pediatrician and founder/owner of Kindercare Pediatrics. He has a special interest in pediatric nutrition and childhood obesity. Dr. Flanders completed his medical education at McGill University in Montreal and the University of Toronto’s Hospital for Sick Children. He is on staff at the North York General Hospital and is an adjunct lecturer at the University of Toronto’s Department of Pediatrics, Faculty of Medicine.

Can School Based Rummage Sales Put The Boot To Junk Food Fundraising

Right now our garage is literally filled with boxes of outgrown toys and kid related paraphernalia. Our plan had been to donate it all to one charity or another, but what if it could be put to use to help fund our kids' schools?

Thanks to the forward thinking of 13 year old Belle Pan, that might be possible one day soon.

The daughter of an entrepreneur, Pan developed iRummage - an online and app based infrastructure to allow schools to host year long rummage sales where the items for sale, and their listings, come from the schools' families. What else will this app do? According to Pan,

"We're going to train 100,000 ten year old CEOs. Raise money for schools? Check. Provide business education for kids? Check. All I'm asking of you is your old couch".

Awesome!

Here's hoping iRummage finds the funding it needs to launch, and that we continue to see innovations and ideas like Pan's push school junk food, bake sales, and fast food fundraising to the curb.

Saturday Stories: Cancer, Locked Wards, and 1984

Hugely powerful piece by an oncology nurse who herself gets diagnosed with cancer and her apology to her patients for not understanding them before.

Haunting story from Taylor Elizabeth Eldridge in The New Yorker on her 17 days spent on a locked psychiatric ward.

And Andrew Simmons in The Atlantic on teaching kids about George Orwell's 1984 in 2016

Even Bears Are Better Dancers Than I Am

Sadly I was not blessed with any dancing genes.

Today's Funny Friday bears were.

Have a great weekend!

Why Are Dairy Farmers' "Dairy Educators" Invited To Teach Our Kids?

"What the hell is a Dairy Farmers of Ontario 'Dairy Educator' and why are they allowed to speak to my kids?"

That was the question posed to me by the reader who sent in this video.

Apparently it was shown to his Grade 4 student in school by a 'Dairy Educator' who clearly was invited by that kid's school to teach kids about "The Miracle of Milk" (that's literally the title of the video).

The claims in the video?

Milk contributes to (all direct quotes):

• Strong bones and teeth
• Strong muscles
• Energy
• Healthy blood and a healthy nervous system
• Help prevent diseases like cancer
• Healthy brain development

The video goes on to talk about how many servings kids should have, with the majority of kids in the video drinking from almost comically large glasses, and of course it features both chocolate milk and ice cream.

The video and the 'education' are part of a larger 'curriculum' offered to Ontario's schools.



The claims made by the video, and presumably amplified by the 'educator', certainly aren't those approved by the Canadian Food Inspection Agency, nor is milk miraculous.

So as far as what Dairy Farmer of Ontario Dairy Educators are - well they're marketers. But as to why they're being invited in to schools to market a product dishonestly to trusting children, I haven't a clue.

Some Reflections After 3,000 (!) Blog Posts (And A Personal Request)

After 3,000 blog posts, 43,000 tweets, apparently of late, I'm a cyberbully.

So was the conclusion of the two "Keto Dudes" who felt that me tweeting my thoughts about what I saw as Dr. Jason Fung's fat shaming was bullying behaviour. Never mind that I didn't mention him by name in my original tweets, or that I refused repeatedly to name him when asked afterwards, or that when he later outed himself and was questioned about his tweet by Julia Belluz he confirmed his intent and shamed another marginalized group by explaining to her that the opinions of experts with obesity on obesity are as worth listening to as the opinions of the homeless on finance.

The Dudes also provided some decontextualized tweets of mine as their proof of my bullying using this tweet launched at Dr. Oz in response to his continued anti-science, magic weight loss, predation promotions, this tweet sent to a local radio station whose morning show host had told listeners that he thought the government added mind control agents to vaccines and encouraged people not to get them, this tweet inspired by the Women's World cover I was standing in front of at checkout that had Dr. Oz' unflinching smile promoting "Metabolism Boosting Detox Diet Soup" with the promise of losing "30lbs in weeks", and this tweet, directed at a "functional" physician with an online store front to sell his cleanses and detoxes that among other things promise the desperate they'll be, "tonifying and rejuvenating" for their "entire adrenal systems".

I'd send each of them again.

But these tweets aside, to be sure there are definitely those I've sent, and blog posts I've written, that if given the chance, I'd do differently. Some because my opinions have changed. Some because the science has evolved. And some because, especially in the early days of my blogging and social media, I was too aggressive or arrogant. And yes, a few times over these past 11 years, 3,000 posts, 43,000 tweets, and 2,000,000 words, I've definitely gone too far. For those times, I'll point out that I'm human, fallible, and sorry.

All told, I'm proud of this blog. I started it as an outlet - both for my thoughts and for writing as a whole (I was an English major before switching into genetics), and I was writing it regularly long before anybody was reading it. And then, through a combination of the magic of the Internet and good luck, people took notice. Through it, and over 14,000,000 visits later, I've been able to affect real change - like when this blog post led Disney to, within 48 hours of its posting (and subsequent media swirl), to shutter an Epcot based ride that would have furthered fat-shaming of kids, or how being pathologically attached to Twitter, helped to expose Coca-Cola's cynical promotion of "energy balance".

My agenda is easy to describe - I enjoy writing and believe that through it, I am able to advocate for better health far beyond my office's four walls. No one pays me to write anything, and I refuse to host advertisements. In the blog, as I did in those tweets up above, I call things as I see them. I don't expect people to always agree with me, and certainly if you're hoping that I'll never write something that you find to be upsetting or wrong, eventually I'm sure I'll disappoint you. The good news of course is that you can always stop reading, or if you're so inclined, just as the Keto Dudes did, write about it - the Internet's everyone's canvas to share their opinions.

And now the ask.

While this blog will always remain free to read and free from advertising, if you've enjoyed it and found it to be valuable or entertaining, please donate to my Movember fundraising and my absolutely ridiculous lipterpillar.

Not a Snapchat filter

With this 3,000th post ask I'm hoping to raise $3,000 for men's health. Contrary to what some believe, Movember is not a prostate cancer charity, and though some of its funds do go to prostate cancer research and treatment, Movemeber funds multiple men's health initiatives including those involving mental health, suicide, body image, eating disorders, testicular cancer, and more. Regarding prostate cancer, I was pleased to see that Movember encourages patients to speak with their physicians about the value (or lack thereof) of PSA screening, rather than suggesting it's a good idea for one and all.

For me the ask is personal. My father was diagnosed with prostate cancer back when I was in medical school, and soon I'll need to start wrestling with whether or not with that strong family history, I should walk the slippery slope of testing. My oldest cousin - we lost him to substance abuse.

Every dollar counts, no donation is too small, and if you want, you can make your donation anonymously.

Donating is easy. Just click here and give! And of course, Movember is a registered charity, so all donations are fully tax deductible.

So here's to another 3,000 blog posts, and thanks for reading.

(Oh, and keto folks who might be reading this, please know that there's nothing stopping you from being pro-keto/IF, anti-CICO, and at the same time, anti-fat shaming)

Saturday Stories: Afghan Girl, Alt-Right, and Poisoned Words

Max Bearak in The Washington Post chronicles the sad story of National Geographic's iconic "Afghan Girl".

David Frum in The Atlantic on how censoring the alt-right is the wrong way to deal with their hate and growing influence.

Liel Leibovitz in Commentary explains why history demands that you should treat every poisoned Trump word as a promise.

Patton Oswald Says The Election's Over and It's Time to Choke It Down

Pretty much.

Today's Funny Friday, so good, though it's not all that funny now is it?

Have a great weekend!

The Two Easiest Lifestyle Tweaks To Improve Your Blood Sugar

In my practice I see loads of patients who have diabetes, and loads more of patients on their ways there.

No doubt many of those patients do, or will, take medication to control their blood sugars, but there's also no doubt that attention to diet and exercise can, in many cases, either preclude the need for medication, or reduce the medication needed.

While I've written before about the challenges that reality throws at intensive behavioural changes geared towards health, there are two easy, accessible, tips that evidence suggests can have a real impact on your blood sugar.

1. Take short, post-meal, walks: A study published in the December 2016 issue of Diabetologia compares the impact of 10 minute post-meal walks on blood sugar levels. According to their findings, those short walks led to post-walk decreases in blood sugar of 22%. And while walking after each and every meal may not be doable for everyone, it's not all or nothing. Simply put, if blood sugar's a concern, anytime you're able, here's a great incentive to add a few steps to your day.

2. Eat your carbs last: A study published in Diabetes Care last year explored the impact of food order on post-meal blood sugar. The thinking is that eating proteins, fats, and fibrous vegetables first, slows down the speed with which the body absorbs the meal's carbohydrates. Though it was just a small study, the results were heartening. After eating identical meals, but where subjects were instructed to either eat the carbohydrate portion of their meals first (in this meal's case it was orange juice and ciabatta bread), or last, blood sugar levels were monitored. And when eating their carbs last, their blood sugar levels were 29% lower after the first half hour, 37% lower after one hour, and 17% lower after two hours.

While it's important to bare in mind that these were both small studies, given that they carry zero risk, and that they're both quick and easy, there's certainly no harm done employing them.

(and here's hoping someone's studying the impact a combination of these two simple interventions might have)

Ontario & Quebec Schools - A Food Industry Partnership You Should Explore

They're called Green Apple Grants and they're a program run by the Metro supermarket chain.

The $1,000 grants are available to every public and private elementary and high school in Ontario and Quebec and the grant applications are due by December 31st.

The grants are for projects designed to increase students' consumption of fresh fruits and vegetables. Schools can apply for up to two grants and past projects in other schools have included the establishment of school gardens, cooking classes, revamping school cafeteria options, hiring RDs or chefs to give workshops, and many more.

As to who can apply, anyone affiliated with the school (principal, teacher, professional advisors, nurses, etc.) can submit an idea with the principal’s approval.

The program has allocated $500,000 for Ontario schools, and $1,000,000 for Québec schools.

For more information and application instructions, have a tour of the Green Apple School Programs page here (and if you're in Québec make sure to hit the change province button).

Saturday Stories: Post-Election Edition

Of the hundreds of post-election stories out there, here are some that resonated with me.

Michael Schur has his Twitter based election post-mortem compiled in Paste.

Lindy West in The New York Times with her version of what happened on election day.

James Hamblin in The Atlantic on health care under Trump.

Mark Joseph Stern in Slate on why as a gay Jew in Trump's America he's afraid for his life.

Paul Krugman in The New York Times and his "thoughts for the horrified"

Russian dissident and journalist Masha Gessen in The New York Review of Books with her rules for surviving an autocracy

Never Rake Leaves Around Panda Cubs

Today's Funny Friday was probably a lot less funny for the zookeeper.

Have a great weekend!

There Are Thin Bodies Too

I was surprised a few weeks ago to learn that a joint advertising campaign between the Toronto Ballet and the Toronto Transit Commission was deemed controversial and criticized as promoting

"unrealistic and highly regimented bodies as some sort of an ideal of ‘beauty."

The campaign, titled, "We Move You", features members of the Toronto Ballet in poses in and around Toronto's subway stations, street cars, buses, and trains.

There's no denying of course the dancers are very lean, and don't look like you or me.

But the campaign isn't tied in any way to self worth, beauty, or health.

It's a campaign highlighting the incredible athleticism and grace of ballet dancers, along with the fact that subways literally move people.

Though I definitely agree with the critic's statement that

“We can’t deny that there is a lot of body-based discrimination that happens … within our moves around the city”,

isn't the suggestion that the bodies depicted in these pictures are somehow wrong or unhealthy a form of body-based discrimination?

While I'm clearly not shy to call out fat shaming, I just don't think this is that. There are thin bodies too.

The Canadian Armed Forces Need Help On Obesity

Today's anonymous guest post is a letter I received a few weeks ago from a member of Canada's armed forces who wanted to fill me in on how obesity is being handled with our soldiers. The letter speaks to the fact that doctors and dietitians are not uniformly trained or capable of providing helpful, or thoughtful, advice, and that despite all evidence to the contrary, that the way to deal with obesity is at once simple and easy.

Good Morning Dr. Freedhoff,

Please let me start by thanking you for your efforts on promoting bariatric health (I own your book and subscribe to your blog).

It took me some time to work up the courage to write you on the issue surrounding obesity in the Canadian Armed Forces (CAF) as we are not meant to air our dirty laundry in public. However, I thought you might be interested in some of the recent media attention surrounding obesity in the CAF and how the issue is dealt with in our organization.

First, please note that I am obese. I weigh approximately 230lbs and am 5’7". I am active (running, cycling) and do not have any issues meeting the minimum fitness standards in the CAF. I would describe myself as someone who is carrying extra fat (read not a body builder).

This article (along with a couple of variants) have been getting media attention inside my organization of late and the issue of obesity is something that the organization wants to address (adding weight and waist circumference measurements to our fitness testing routine, introducing incentives to motivate members to improve their fitness scoring, and general fitness promotion). The article discuses more stringent fitness standards for a deployment when, in fact, the battle fitness test is a more specific assessment (marching with a “heavy” pack, fireman’s carry, etc.).

I was provided with some advice on how to lose weight from the CAF health services organization:

• Establish a starting weight (i.e. 230 lbs), and by the next week aim to be at 229. If by the next week I am not at 229, do not eat until I am. Repeat as required until I achieve goal weight (Medical Officer)
• Restrict calories (especially carbohydrates) in the evening (Medical Officer)
• After reviewing my food log (that didn’t contain ice cream) I was advised to reduce caloric intake by eating a bowl of ice cream each night instead of a full pint (Dietitian).

Needless to say, there is a negative connotation with being obese in the CAF. It is my opinion that the organization could find better ways to support its members in their efforts. As an example, at my most recent medical appointment I was happy to find that I had lost 15lbs over the past year (largely due to increased activity) but I was told that it was probably just water, not fat and that there was much more work to do to reduce my BMI to a healthy level.

As someone who is struggling to improve my fitness/health, it is fairly obvious that my organization does not understand the complexity of the issue they are trying to address. I appreciate your efforts to promote bariatric health and to advocate for obese/overweight people.

Here's hoping that over time, the military, and everyone else, starts to wrap their heads around the straightforward fact that scales (or BMIs) don't measure the presence or absence of health, and that the truism of "eat less, move more" is no more helpful to obesity than "buy low, sell high" is to wealth.

Saturday Stories: Performance Enhancement, Slow Cookers, and Scientific Training

Picture by J. Kenji Lopez-Alt

Brad Stulberg in The Science of Us on the only performance enhancing supplement truly proven to work.

J. Kenji Lopez-Alt in Serious Eats on why slow cookers sit on the low rung of flavour.

Nick Tumminello in Shredded by Science tackles what he sees as the top 10 arguments against science based training and nutrition.

Candidate For World's Greatest Dog Owner

Even if you're not a dog person, it's impossible not to love today's Funny Friday video.

Have a great weekend!

New Brunswick Says Slush Puppies Provide "Maximum Nutritional Value"

Need proof that 5-10 years is too long to wait for improved nutrition guidelines from Health Canada?

That photo up above is from New Brunswick's George Street Middle School's cafeteria's Facebook page. They're highlighting the fact that they've recently installed this Slush Puppie machine for their students.

Slush Puppies, for those who aren't clear, are non-carbonated, vitamin fortified, juice concentrates, poured over ice.

Each glass of Slush Puppie Plus contains 7 teaspoons of free sugars - more than the World Health Organization and Canada's Heart and Stroke Foundation recommends as a total daily limit for kids.

This led one concerned parent to write to George Street Middle School's cafeteria to express her concern.

The response she received in reply?

It spelled out that the vitamin fortified liquid candy machine that the school installed was not only not cause for concern, but rather was a drink that was defined by New Brunswick's Healthier Foods and Nutrition in Public Schools Policy 711 as being of Maximum Nutritional Value which

"indicates foods that are a good or excellent source of important nutrients and are low in fat, sugar and/or salt. These foods are considered nutrient dense relative to the energy they provide. These foods should be offered on a daily basis and comprise the majority of foods/beverages served in schools."

And it's not just a New Brunswick inanity by the way. When writing this blog post I noticed that Slush Puppie Plus is making the rounds in US schools as well where it is reported to meet the “Alliance for a Healthier Generation” Guidelines for 100% Juice in Elementary, Middle and High Schools.

And no, just in case you were wondering, this isn't The Onion.

Why Will It Take Health Canada 5-10 Years to Clean Up Nutrition?

Image Source

In case you missed it, last week the Honourable Dr. Jane Philpott, Canada's Minister of Health, announced that changes were afoot to nutrition in Canada.

On the menu?

• A much needed revision for Canada's Food Guide
• A ban on the advertising of food to children
• A front-of-package labeling program designed to help consumers better navigate the grocery store
• A ban on trans-fats (something promised by a former Minister of Health back in 2007)
• A nutrition facts panel that included information on added sugars

None of this is surprising - both from an evidence based perspective, and from a mandate perspective, as in his mandate letter to Dr. Philpott, Prime Minister Justin Trudeau made it clear, these were matters he wanted addressed calling for,

"introducing new restrictions on the commercial marketing of unhealthy food and beverages to children, similar to those now in place in Quebec; bringing in tougher regulations to eliminate trans fats and to reduce salt in processed foods, similar to those in the United States; and improving food labels to give more information on added sugars and artificial dyes in processed foods."

What is surprising though is the announced timeline of 5-10 years to implement.

I can't wrap my head around that.

While clearly change doesn't happen overnight, I can't come up with a plausible explanation for why Canadians will be forced to wait for up to a full decade for these changes as:

• The last Food Guide revision took just over 3 years once the prior Guide's assessment had been completed (where we are now with 2007's Guide).
• Québec has successfully managed an ad ban to kids for the past 36 years.
• Established Front-of-package programs abound and as evidenced by their own marketing campaigns and product reformulations, industry is able to quickly change their packaging to suit their needs (or requirements).
• Health Canada's own trans-fat task force, an industry inclusive task force, provided us with their blueprint for trans-fat's regulated reduction a decade ago.
• The road to added sugar labelling is already well paved by the FDA in the United States.

It's also worth noting that in Canada, a government's mandate's duration is four years and as of this Friday, the first of them is done.

Having had the pleasure and honour of meeting with Dr. Philpott in the past, I am very comfortable stating my belief that if she were able, these changes would occur far faster than the timeline she's laid out. Which leads me to assert, admittedly without proof, that the food industry lobby in Canada is far more influential than anyone would believe.

[For more on this, definitely have a peek at the award winning journalist Holly Doan's terrific CPAC piece on this government's mandate regarding obesity (disclosure - I'm in it). To watch the video when you get to the link, click the language button below the video to get it rolling as clicking the arrow doesn't do it]

Saturday Stories: Men Behaving Horribly Edition

Image Source

Michelle Hamilton in Runners World on running while female.

Dorothy Beal in Active with an open letter to men from female runners.

Roxane Gay in Glamour on how to handle street harassment.

I Would So Vote For Gerald

Today's Funny Friday is perhaps the best campaign advertisement ever.

Vote for Gerald!

Have a great weekend!

How To Learn To Stop Worrying and Start Loving Halloween

(This post first published October 24th, 2013)

It's coming.

And I'm not really all that worried. At least not about Halloween night.

The fact is food's not simply fuel, and like it or not, Halloween and candy are part of the very fabric of North American culture and to suggest that kids shouldn't enjoy candy on Halloween isn't an approach I would support.

That said, Halloween sure isn't pretty. On average every Halloween sized candy contains in the order of 2 teaspoons of sugar and the calories of 2 Oreo cookies and I'd bet most Halloween eves there are more kids consuming 10 or more Halloween treats than less - 20 teaspoons of sugar and the calories of more than half an entire package of Oreos (there are 36 cookies in a package of Oreos).

So what's a health conscious parent to do?

Use Halloween as a teachable moment. After all, it's not Halloween day that's the real problem, the real problem are the other 364 days of Halloween where we as a society have very unwisely decided to reward, pacify and entertain kids with junk food or candy (see my piece on the 365 days of Halloween here). So what can be taught on Halloween?

Well firstly I think you can chat some about added sugar (and/or calories), and those rule of thumb figures up above provide easily visualized metrics for kids and parents alike.

Secondly it allows for a discussion around "thoughtful reduction". Ask them how many candies they think they'll need to enjoy Halloween? Remember, the goal is the healthiest life that can be enjoyed, and that goes for kids too, and consequently the smallest amount of candy that a kid is going to need to enjoy Halloween is likely a larger amount than a plain old boring Thursday. In my house the kids have decided upon 3 pieces - so our kids come home, they dump their sacks, and rather than just eat randomly from a massive pile they hunt out the 3 treats they think would be the most awesome and then take their time enjoying them.

The rest?

Well it goes into the cupboard and gets metered out at a rate of around a candy a day....but strangely....and I'm not entirely sure how this happens, maybe it's cupboard goblins, but after the kids go to sleep the piles seem to shrink more quickly than math would predict. I've also heard of some families donating candy to a local mission or homeless shelter, and others who grab glue guns and make a Halloween candy collage.

A few years ago we discovered that the Switch Witch' territory had expanded to include Ottawa. Like her sister the Tooth Fairy, the Switch Witch, on Halloween, flies around looking for piles of candy to "switch" for toys in an attempt to keep kids' teeth free from cavities for her sister. The joy and excitement on my kids' faces when they came downstairs on November 1st that first Switch Witch year was something to behold.

And if you do happen upon our home, we haven't given out candy since 2006 and we haven't been egged either. You can buy Halloween coloured play-doh packs at Costco, Halloween glow sticks, stickers or temporary tattoos at the dollar store (glow sticks seem to be the biggest hit in our neighbourhood), or if your community is enlightened, you might even be able to pick up free swim or skate passes for your local arena (they run about 50 cents per so if you're in a very busy neighbourhood this can get pricey).

[Here's me chatting about the subject with CBC Toronto's Matt Galloway]

Are Conflicts of Interest In Nutrition Less Worrisome?

Today's guest post comes from public health ethicist Daniel Goldberg. It has to do with conflicts of interest in nutrition. I've found it fascinating to watch otherwise evidence based individuals suggest that conflicts of interest in nutrition don't matter. That somehow, unlike the risks proven to exist with conflicts in medicine - where highly paid physicians have been shown to be influenced by cheap lunches and plastic pens - that the suggestion that conflicts in nutrition might influence opinions, research, attitudes, and more, is ridiculous. It's not.

The Academy of Nutrition and Dietetics ("AND") recently held its annual meeting. According to registered dietitian Andy Bellatti (and others), during her opening talk, the President of the AND, Lucille Beseler, opined on the rising concerns over financial conflicts of interest among nutritionists and dietitians:

"I'm not so weak-minded that I would make a decision on receiving a pen."

In the course of researching, writing, and teaching about conflicts of interest among health professionals for over a decade, what I have come to marvel at the most is the apparent ease with which leading health professionals insist on a kind of willful ignorance regarding the cognitive science underlying concerns over COIs. This is amazing to me because of the irony: members of professions presumably dedicated to basing their practice on the best evidence proceed to engage concerns over COI with almost no awareness whatsoever of what the best evidence actually suggests regarding the impact of conflicts of interest on human behavior.

This is why, in December of 2015, I published a small chart with explanation in BMJ entitled "COI Bingo." I grew so exasperated with the same tired justifications for financial COIs that I categorized the standard responses into a Bingo chart (up above)

Reasonable people of good conscience can, of course, disagree on whether the behavior of partiality that occurs in the presence of COIs are morally justified, and on the appropriate remedies, if any, for such behavior. But the argument should proceed with all stakeholders fully aware of what the cognitive science actually suggests regarding the impact of COIs on health professional behavior.

What does that evidence show? Beyond a shadow of a doubt, gifts almost certainly do influence health professionals' behavior, at least in the aggregate. Not only have we documented this finding itself ad nauseum, we also have powerful causal explanations that elucidate the mechanisms by which even gifts of de minimis value influence health professional behavior. Virtually all human societies exchange gifts -- they promote social cohesion and are therefore a critical adaptive mechanism. One of the ways gifts accomplish such cohesion is because they tend to automatically, unconsciously create a desire to reciprocate on the part of the recipient.

Commercial industries are well-aware of this phenomenon, which is why they provide such gifts. The gift exchange also cements the relationship with industry, which that in which commercial industry is most interested. The tighter the relationship that exists between commercial industries and health professionals, the more likely it is in the broad run of cases that behavior of partiality will occur. COIs have to be understood iteratively -- the existence of a financial COI does not imply that bad behavior will necessarily take place in any given case. But over the long run of cases, the existence of financial COIs makes shenanigans much more likely -- a conclusion which is -- again -- extremely well-documented in both experimental and uncontrolled (i.e., real-life) conditions.

That these kinds of gifts "work" in the health professions to serve the interests of the "donor" is therefore beyond dispute. Moreover, some of the more darkly amusing findings in the COI literature document our own immunity bias: while we imagine ourselves much less likely to be influenced by pens and mugs, we have serious concerns that the professional sitting next to us may have their judgment clouded if they accept gifts from commercial industry:

Steinman, Shlipak & McPhee 2001

Maybe any given health provider will indeed remain entirely uninfluenced by deep entanglements with commercial industry. But the evidence establishes beyond all doubt that the odds are forever not in your favor.

Ultimately, far too many stakeholders seem willing to wade into the fray with a perfect, almost studied indifference to the significant evidence base regarding COIs. This is itself an ethical problem -- mistakes themselves are not ipso facto morally blameworthy -- but mistakes made because health professionals did not bother to examine an available evidence base and ground their practice in that evidence come much closer to moral failure.

Daniel S. Goldberg is a faculty member in the Center for Bioethics & Humanities at the University of Colorado Anschutz Medical Campus. He is trained as an attorney, a historian, and a public health ethicist.

Saturday Stories: Illness Metaphors, Tramadol, and Solitude

Louise Kinross in The Walrus on how serious illness should never be framed as a battle, especially not for children.

Justin Scheck in The Wall Street Journal on the damage being done by Tramodol in the developing world.

Donald Hall in The New Yorker with his beautifully written first person account of solitude.

I Never Knew You Could Eat Shoelaces Either

Today's Funny Friday involves Jimmy Kimmel, $14 shoes, and some people who really love Kanye.

Watching it I couldn't help but consider it in the context of this election. Blind faith is one powerful drug.

Have a great weekend!

What Is It About Cows That Makes The Word "Heifer" An Insult?

On Monday I wrote about how no one seemed to notice or care about the use of the term "heifer" as an insult in a story that went viral on Facebook.

That led to a whole pile of hoopla which, putting aside some of the more unhinged outrage and misrepresentation, ultimately boiled down to: that the term might not have been meant as a weight related slur, and/or that the flight attendant on its receiving end wasn't fat, and/or that really, who cares, she was upset and so it was justified.

Despite the fact that I've never seen or heard the term heifer used for purposes other than fat shaming (see for example the usage I'm accustomed to here and here from past also gone viral stories), and that all the various urban dictionaries and definitions online state that heifer is a pejorative term for a woman with obesity, it's of course possible that in this circumstance it wasn't meant as a weight related insult but rather as a general slur, and that heifer has become a term that some use in place of "bitch".

Which in turn speaks to the point I was making which is that we're so accustomed and innured to weight related insults, jokes, and judgement, that derisive terms with clear relationships to appearance and weight have become entrenched and even defended as being acceptable parts of our general vocabulary and vernacular regardless of whether or not they're marginalizing to an undeniably and regularly discriminated against population.

And where exactly do people think the pejorative part of the term comes? Is there something else obvious and well known about cows, besides their size and seeming laziness, to serve the general public as the word heifer or cow's driver of scorn?

Heifer or cow, wielded as an insult, regardless of intent, furthers the gluttonous, stubborn, lazy, narrative of obesity, and so yes, I'm going to continue to call it out, and that me doing so apparently upsets people, speaks directly to why doing so is worthwhile.

Black Doctor Recounts Blatant Racism, Spreads Blatant Weight Bias

By now you've probably already heard the story about Dr. Tamika Cross. She's a 4th year medical resident at the University of Texas Health Science Centre and she was on a flight when she tried to answer an overhead ask for an onboard physician to tend to an in-flight medical emergency. Instead of her help being welcomed, she was dismissed by some combination of racism and sexism as the flight crew would not believe that she, a black woman, was a physician.

She wrote up her undeniably awful experience on Facebook and the post went viral and at least at the time of me writing this, has been shared over 45,000 times, has received over 130,000 reactions, and has inspired the awesome #WhataDoctorLooksLike hashtag on Twitter.

The story was picked up by dozens of media outlets including The Washington Post, The New York Times, The Guardian, but missing in all of their coverage was the term Dr. Cross used to describe the flight attendant.

She called her a heifer.

Weight bias is a real social justice issue. Briefly, weight bias has proven medical and psychological consequences, it has been shown to reduce a person's earning potential, affect their hiring and advancement opportunities, and restricts their academic advancement (click the link if you don't believe me). Weight bias is also now the number one cause of schoolyard bullying.

Consider for a moment this same story but instead of stating,

"Then this heifer has the nerve to ask for my input on what to do next about 10 mins later",

Dr. Cross had said,

"Then this kike has the nerve to ask",

or

"this chink",

or

"this wop".

Would the story have had the same pickup? Or would the story have even been picked up at all?

I have yet to read a single piece about Dr. Cross' blatantly racist treatment mention her use of the term heifer which in turn speaks to just how normal and acceptable weight bias is. Moreover, that a person who was blatantly judged on the basis of her appearance, who notes in her own post that blatant discrimination on any grounds is "not right", calmly wields a derogatory appearance based slur as if it's no big deal, shows just how far society still has to go on this very real issue.

Racism and sexism are inexcusable. Weight bias should be too.

[For more on the realities of weight bias, please consider a tour around the Rudd Centre's Weight Bias and Stigma page]

Saturday Stories: Rape Silence, Chemical Weapons, and ICU Delirium

Lauren McKeon in Toronto Life on her 15 years of silence when it came to her 3 rapes.

The Associated Press with a terrifying story of how $3,000 buys a person a deadly chemical weapon that could kill thousands.

Usha Lee McFarling in Stat on ICU delirium (I've seen it, it's awful)

Watch This To See If You're An "Entitled Testosterone Monster"

Today's Funny Friday, where Samantha Bee covers the Billy Bush Trump tapes and more, isn't safe for work or watching around young kids. And that's an amazing statement given it's a story, albeit by a late night comic host, about an actual presidential candidate. No doubt it's more horrifying than funny, but do watch it - she's awesome.

Have a great weekend.

If Health Canada Won't List Free Sugars, These Frustrated Researchers Will

Today's guest post comes from PhD candidate and RD Jodi Bernstein. The post covers her, and her supervisor Dr. Mary L'Abbe, the University of Toronto's Earle W. McHenry Professor and Chair Department of Nutritional Sciences', continued push for Health Canada to require free sugars to be included on Canada's nutrition fact panels.

The World Health Organization recommends that we limit free sugar intakes to a maximum 10% of calories a day. But there are many factors that hinder our ability to abide by these guidelines, far more than support it. First of all, it’s pretty difficult to picture what 10% of calories looks like. Sure I can tell you that for the average adult it’s about 50g or 12 teaspoons, but would that really help you all that much? Most of the free sugar we eat is coming from inside candies and sweets, cereal, beverages, and baked goods, so we can’t easily see how much free sugar is in the food. To abide by the World Health Organization’s recommendations, free sugar needs it to be included on the nutrition facts table.

The United States is planning to include the amount of added sugar (similar to free sugar) on their food label. But here in Canada, the latest proposal to change the nutrition label did not include free sugar on the label. In fact, we discussed the importance of including added sugar on Canada’s nutrition label in a previous blog post on Weighty Matters.

But in the meantime, we weren’t about to just sit around and wait. In light of this difficult predicament we took it upon ourselves to calculate the free sugar content of over 15,000 Canadian packaged foods and beverages, published it for open-access use, and found some interesting results along the way. Using the University of Toronto’s Food Label database, which has nutritional and ingredient information, we calculated the amount of free sugar in each product using a 6-step algorithm tailored for just this purpose. Here’s what we found:

1. A lot of foods have free sugar in them. Sixty-five percent to be exact. That means its probably harder to find a packaged food that doesn’t contain free sugars, although the proportion was a lot lower in certain food groups like vegetables, nuts and seeds, dairy products and cereals and grains and highest in desserts, sugars and sweets, and bakery products.
2. Free sugar accounts for 62% of total sugar. Although this was much higher for sweets, bakery products, desserts, and beverages and much lower for fruits and vegetables.
3. There is a wide range of free sugar in a food category. This means two things: 1) when choosing a product, there may be a similar one that has less free sugar available; and 2) successful reformulation is possible. Having similar items, some with less free sugar, acts as proof showing that, yes, this food can be made with less free sugar and consumers will still buy it!
4. There are 152 ways to say “free sugar” in the Ingredient List. It’s no wonder free sugar is considered a “hidden” source of calories. For instance, ‘table sugar’ was listed 40+ ways including all dehydrated, dried, granulated, concentrated, refined, coarse, evaporated, solid, powdered, and liquid variants of cane juice, sugar, and sucrose.
5. 1/5 of total calories come from free sugar. Of course this ranged between food groups, with the highest at 70% of calories coming from free sugar in beverages. Consuming foods that have more than 10% of calories from free sugar increases the likelihood of exceeding dietary recommendations.

We are hopeful that these results will support of interventions and policies (including labelling free sugar on the nutrition label!) to limit excess free sugar consumption. The detailed information we provided in this study can be used as a benchmark to monitor changes in free sugar contents overtime, identify areas and targets to focus reformulation efforts, direct educational messages, and can be linked to national nutrition surveys to evaluate free sugar consumption and monitor associated health outcomes.

Jodi Bernstein is a Registered Dietitian and has a Master’s in Public Health, specializing in community nutrition. She is currently a PhD Candidate in the Department of Nutritional Sciences at the University of Toronto. Her thesis focuses on sugars in the Canadian food environment.

Most recently, Jodi has developed an algorithm to estimate the free sugars contents of Canadian food and beverages. Results have since been used to populate One Sweet App, a mobile app that allows users to track their free sugars intakes and compare this to guidelines from the World Health Organization.

Dr. Mary L’Abbé is the Earle W. McHenry Professor and Chair of the Department of Nutritional Sciences, Faculty of Medicine, at the University of Toronto, where she leads a research group on Food and Nutrition Policy for Population Health. Dr. L’Abbé is an expert in public health nutrition, nutrition policy, and food and nutrition regulations, with a long career in in mineral nutrition research. Her research examines the nutritional quality of the Canadian food supply, food intake patterns, and consumer research on food choices related to obesity and chronic disease.

Dr. L’Abbé a member of several committees of the WHO including the Nutrition Guidance Expert Advisory Group on Diet and Health and the Global Coordinating Mechanism for NCDs; the former which recently released the WHO Guidelines on Sugars. Dr. L’Abbé was co-chair of the Canadian Trans Fat Task Force, led the Trans Fat Monitoring Program and served as Chair and vice-Chair of the Canadian Sodium Working Group. Before joining the University of Toronto, Dr. L’Abbe was Director, Bureau of Nutritional Sciences at Health Canada. Dr. L’Abbé holds a PhD in nutrition from McGill University and has authored over 180 peer-reviewed scientific publications, book chapters and government reports.

New Canadian Senate Bill Calls For a Ban on Marketing Food to Kids

It's shocking that we allow anything to be advertised to young children, but its doubly shocking we allow "food" to be advertised to them. I put the word food in scare quotes because frankly given what's generally advertised to children, calling it food is generous. Sure it's technically consumable, but it's far from healthy fare. Here in Canada, and the world around, the foods advertised to children (and adults too I might add) are unsurprisingly dominated by the food industry's profit drivers - ultra-processed foods laden with salt, sugar, and/or fat, because it's not the food industry's job to promote healthy eating, it's the food industry's job to profit.

The thing is, times have changed. Whereas when I watched the Kool Aid Man crash through walls during commercials running through Saturday morning cartoons, today's kids are watching far more sophisticated commercials running nearly 24/7 on multiple media platforms. Worse, the kids who are watching today's advertising are developing chronic, non-communicable, diet-related diseases that when I went to medical school were only found in adults.

And don't kid yourself into thinking that marketing doesn't matter. While there are some who like to suggest that kids are, or with brief teaching can be made, media literate and that presumably the food industry is simply wasting literally billions of dollars on marketing that's just window dressing, the evidence states otherwise. Children who see advertisements are more likely to prefer branded foods, especially those high in sugars and fats, and that those advertisements lead kids to eat more of them. , and more food in general (including foods not being advertised). And in a study published recently, researchers suggested that food marketing to kids may alter the psychological and neurobiologic mechanisms of children's food decisions leading the researchers to state,

"Food commercials may prompt children to consider their liking and wanting of specific food items, irrespective of the lack of any health benefits. This increased emphasis on taste may make it even more difficult for relevant caregivers to encourage healthy food choices."

So with all of that in mind I can't tell you how pleased I am that The Honourable Nancy Greene Raine has introduced a bill in Canada's Senate that if passed would prohibit marketing of all food and beverages to children under the age of 13.

There really aren't any arguments to support the food industry's current advertising practices. Capitulating to the food industry by supporting the current status quo isn't about freedom of speech. Freedom of speech shouldn't extend to preying on our most precious, and vulnerable population.

Please consider voicing your support by clicking here and signing up to encourage your MP to support this bill.

Saturday Stories: Distracted Learning, Learning, and Bullshit Learning

Joelle Renstrom in Aeon on whether connected and distracted kids actually manage to learn anything.

John Taylor, also in Aeon, on whether modern day schooling teaches kids anything other than how to pass tests.

Julia Belluz in Vox on how to teach kids to be bullshit detectors.

Sometimes You Just Need a Little Silly to Start Your Day

And if that's you today, here's Joaquin Phoenix' forehead.

Just watch it.

Have a great weekend!

There's No Hydration Emergency, and Soda's Liquid Candy

Branding matters.

For soda makers, that their product's base is water means they can market or deflect around hydration and thirst.

But there is no hydration emergency.

If the body says drink, definitely do so, and water of course is your best bet.

Yet the world around has a bad habit of making it seem all the more complicated. Recently the New York Times wrote about "surprising ways" to stay hydrated. It covered the new "hydration index" study funded by the European Hydration Institute (EHI). The index ranks drinks according to their hydration abilities. Among other findings it reported that regular soda is as hydrating as water.

The EHI might be fairly described as the Global Energy Balance Network of hydration as it was founded by Coca-Cola at a cost of just over $7 million USD, and the study's lead author, a prior consultant and speaker for Coca-Cola, is the chairman of the EHI's scientific advisory board and the vice-chair of the EHI's board of trustees.

College Humor recently put out a great debunking of the hydration emergency. Have a peek!



All this to say that soda benefits from the hydration emergency message as it healthwashes their product in a way that leads people to think of soda as something more than just liquid candy.

So yes, definitely drink if you're thirsty, but drink water, not candy.

FitBits Aren't Supposed to Make You Lose Weight

It's been all over the news these past few weeks, a recent study reported that not only didn't wearing a FitBit as part of a weight loss program lead to increased weight loss, it led to decreased weight loss.

Does it really matter one way or the other?

The question that matters is whether or not FitBits led wearers to exercise more, not whether it led anyone to lose weight.

According to that same 2 year study, the answer to whether or not FitBit users moved more was no.

That's both disappointing and not particularly surprising. It's disappointing because moving more can markedly improve health and quality of life at any weight. It's not particularly surprising because no one has yet figured out how to affect a population based sustained increase in physical activity.

No doubt there are specific individuals who are motivated by their trackers and do in fact sustain long term changes to behaviour, but once again here we have an outcome that speaks against the ongoing singular focus of personal responsibility as the means to improve healthy living.

If we want people to move more we need to find ways to make doing so easier, more fun, and/or more valuable. Simply telling them to move more, or apparently showing them how little or how much they move, isn't going to be enough in and of itself.

[UPDATE: The study though did have a major limitation in that it used a now obsolete wearable. It's possible that the results with newer wearables would differ. Here's Aaron Coleman's coverage of same. Thanks to @Chimbo23 for pointing me to it.]

Saturday Stories: 2 Great Reads

David Samuels in Tablet with Shimon Peres' last interview. The world, not just Israel, has lost a giant.

Susan Schneider Williams in Neurology with a heart-wrenching first person account of her husband Robin Williams' descent into Lewy body dementia.

[And if you don't follow me on Facebook or Twitter, here's the piece I published this week in US News and World Report on how you should check your privilege before you talk about personal responsibility and healthy living]