Thursday, September 14, 2017

Canadians, Please Step Away From The Chip Wagons

My office's local chip wagon (for Americans, think of a food truck, but where fries are their dedicated specialty) is a case study as to why trans-fats need to be regulated out of the food supply.

Walking by the truck with Dr. Aric Sudicky we noticed outside of it, were empty fryer oil buckets. The buckets were a perfect size to brine a turkey and so I asked if I could have one. Kindly, the chip wagon folks said, "sure".

When we saw its trans-fat content our jaws dropped.

It contained 1.9g of trans-fat in every 9.2g of deep fryer shortening.

A quick spin online found us an article that reported that 17.1% of the weight of a french fry came from its absorbed frying oil.

A purchase of a large fries, a kitchen scale, and a smidgen of math later and it turns out that there are a staggering 20.5g of trans-fat in a large serving of our chip wagon's fries.

Here's the video we shot to help put all of this in perspective.



Non-naturally occurring trans-fats, according to the head of Health Canada's trans-fat task force (and everyone really), are a toxin unsafe in any amount, and 20.5g? Well that's the equivalent amount found in 11.4 teaspoons of the most trans-fat laden stick margarine we could find in the supermarket, the No Frills No Name All Vegetable Shortening which according to its package packed 3.5g of trans fat into every 2 teaspoons.

Now Health Canada had promised back in 2007 to regulate trans-fat out of the food supply if voluntary measures failed, and despite those measures' epic failure, for inexplicable reasons, regulation never happened.

The good news though is that I have it on good authority that Health Canada will be moving imminently on the trans-fat file. Given people have literally died waiting for them, their announcement can't come too soon.

[Interesting short side note: When looking up the margarine's trans-fat content online (I was looking for better photos than the one that had been shared with me), I found that No Frills' No Name All Vegetable Shortening was reported to only contain 0.1g of trans-fat per 2 teaspoons (as opposed to the actual label's reported 3.5).

Seemed really odd until I also noticed, in a very faint and difficult to read font (that's it in the hard to read light grey at the bottom) the line,
"The values stated are approximate and may not be fully representational of this products (sic) vitamins, minerals, and ingredients"
. Um...WTF?]

[And lastly, huge thanks to Dr. Aric Sudicky who shot and edited the video. Aric is a resident finishing up his last year of training and is spending the month with me. You can follow Aric on Twitter, and he's much more active on Instagram than me (I'm old).]

Monday, September 11, 2017

Unbelievable Grade One Snack List Highlights Unhealthy Social Norms

Thanks to nutritional biochemist Dr. Dylan MacKay (following him on Twitter is well worth it) for sharing the handout his 6 year old daughter's school sent home to parents to provide them with examples of peanut free snacks that their kids could bring.

The list is unbelievable. In part it's difficult to believe that a school would suggest these options, but more, it's difficult to believe that whoever put this together didn't take a minute to pause and consider what they were writing.

That they didn't doesn't speak to their lack of intellect, competence, or caring, but rather speaks to just how normal it has become to rely on ultra-processed junk to feed our children. Plainly put, people tend not to question or scrutinize social norms.

Here's the list transcribed
Cookies and Crackers

Dare: Wagon wheels, Bear paws, Vinta crackers, Grissol breads
Christie: If no peanut/nut warning on pkg then safe. Chips Ahoy, Oreos, Animal Crackers, Ritz, Stoned Wheat Thins, Triscuit, Premium Plus
Peek Freans: Shortbread, Creme-Filled, Digestive Cookies
Kellogg's: Rice Krispie squares (except for peanut type), Nutri-grain bars, Pop Tarts, Special K bars
President's Choice: Various cookies and crackers, Granola bars, Rice Crispie squares, animal crackers, fruit snacks
Pepperidge Farms: Goldfish crackers (various flavors)
Betty Crocker/General Mills: Fruit snacks, fruit roll-up, Dunkaroos

Chips

Old Dutch: All flavors, popcorn twists, pretzels, taco chips
Frito/Lays: All flavors, tortilla, taco chips, cheezies
Pringles: All flavors
Hawkins: Cheezies

Yogurt: Most yogurts are safe except those that contain Muesli

Puddings: Jello, Magic moments, Superstore brands are all safe, Fruit cups and applesauces

Candy/Chocolates

Dare Candy: all Dare candy made in a peanut/nut free facility
Wonka Candy: Sweet tarts, Nerds, Gobstoppers
Hershey's: *some products have peanut free symbol, Twizzlers, Nibs, Tootsie rolls, Kisses (read label for safe flavors), treat size bars
Nestle: Aero, Kit Kat, Coffee Crisp, Mirage, Mint Aero, Smarties, also treat size bars (seasonal or special shaped (heart, or ball) treats may not be safe)
Effem: *Mars bars with peanut free symbol, Skittles
Trebor-Allan: Various candy, Laces, Big foot, Hot lips, Lollipops
Vadeboncoeur: #peanut free symbol. Variety of chocolates
And then, as an afterthought, outside the main list iat the very bottom of the page, is this non-highlighted single line,
"Fruits and Vegetables are healthy choices and are also peanut free"
Hopefully, moving forward, the school will utilize the revised version that Dylan mocked up for them, and if your kid's school sends you a similar list, free free to share it with them as well.



Saturday, September 09, 2017

Saturday Stories: Flinging Feces, Undermining Health, And Science Sense

From the BBC comes a byline free story about feces flinging that though not even remotely deep, scientific, important, or fascinating, is just too golden not to share.

Rob Moodie, in The Conversation, covers what he refers to as the seven tactics unhealthy industries use to undermine public health policies.

Cornelia Dean, in Undark, with a terrific excerpt from her book, Making Sense of Science

Thursday, September 07, 2017

Ask The Wrong Question, Get The Wrong Answer, Risk Public Health

An example of a Kompan 'Supernova'
Saw a recent study in the International Journal of Obesity. The study, The effect of increasing risk and challenge in the school playground on physical activity and weight in children: a cluster randomised controlled trial (PLAY), set to measure the impact of school playground redesigns aimed at encouraging "imaginative and independent free play" on Grade 1-8 students' weight, waist circumferences, BMI z-scores, and their accelerometer measured activity intensity and duration.

All the schools involved in the intervention arm made substantial changes to their playgrounds which sound so fantastic that here's the paper's description,
"All eight intervention schools made substantial changes to their school play spaces, which promoted greater risk and challenge through building new areas (hills and tunnels), adding more dynamic equipment (for example, a Kompan ‘Supernova’ that requires co-ordination and teamwork to use), or via relaxing the rules (letting children ride their bicycles or scooters on school grounds, allowing children to climb trees or play outside in the rain). Children were able to engage more with natural elements, create imaginative play opportunities with loose parts (carrying tree stumps around to form a spaceship or a jumping game where the ground cannot be touched) or long grass (places to hide, roll around in, throw mown grass at each other). Some schools also ensured greater equity in access for all ages, or made different aspects of the playground more attractive"
The results weren't shocking.

The installation of awesome sounding playgrounds and relaxing playground rules wasn't shown to have any effect on kids' weights, waists, or BMI z-scores.

I say the results aren't surprising because why would anyone expect, even with a best case scenario, that an increase in schoolyard imaginative or challenging play could change kids' weights or waists? How many minutes messing around on a Koman Supernova would it take a young child to burn 100 calories more than they would lazily moving and resting in a plain lot? If I were a betting man, my vote would be in the neighbourhood 2-3 hours, or more than a week's worth of recess. But that's not a fair way to consider those calories given that those 100 calories aren't likely to be above and beyond the calories those same kids would have burned if they were engaged in less imaginative or challenging play.

As to activity, at least according to the kids' accelerometers, there wasn't an increase, though I'm fairly sure that they're unable to measure imagination.

What didn't the study measure? Physical literacy, fun, or happiness.

Honestly I can't understand why this study was conducted, at least in the context of the kids' weights and such. There's no mechanism by which anyone could reasonably expect fancier playground equipment to lead to significant weight change, but now that the study's out there, I wonder if it'll serve to discourage schools from undertaking awesome playground remodels of their own? I sure hope not. They sound great.

Tuesday, September 05, 2017

UK Gov's ParkLives Kids' Exercise Partnership Markets Coca-Cola

ParkLives is a joint project between Coca-Cola and the British government that aims to promote free physical fitness activities at local UK parks.

At least that's what's in it for the British government.

What's in it for Coca-Cola?

Well of course they can spin it as strong corporate social responsibility which helps their claim that they're on team health and in so doing provide themselves with ammunition to possibly forestall or block industry unfriendly legislation.

But there's more.

There's marketing.

A recent study set out to look at the ParkLives project through the lens of advertising.

The study analyzed two weeks worth of #ParkLives tweets during two separate weeks. The first week was during a week of school vacation (where the marketing might be expected to be thicker and the events more frequent), while the second was during the school year, but spanning National Fitness Day.

Every identified tweet was then coded for category of content (marketing or otherwise)

Over the two weeks of collection, 318 tweets containing 216 images were identified, and of those, 57% included a Coca-Cola logo (usually on banners or staff shirts).

The authors note that the exposure to Coca-Cola branding is perhaps more powerful here in that with ParkLives, Coca-Cola is associated with fun, healthy, family activities.

The authors' take on all of this?
"ParkLives is indicative of a CSR project that aims to create a health halo around a brand and influence wider socio-ecological factors by guiding public discourse and directing opinion on the determinants of public health issues away from corporate influence and toward individual responsibility"
Partnerships, by definition, benefit both involved parties. Perhaps governments shouldn't be helping out in the business of marketing the world's largest liquid candy brand.

Wednesday, August 30, 2017

Could Health Canada's Future Front-of-Package Stoplights Reform Deceptive Claims?

So on Monday I blogged about how there are plenty of foods of dubious nutritional quality with fronts-of-package claims that while legal, are deceptive.

Looking ahead, there is the chance that Health Canada will be implementing a national front-of-package food labeling program which in turn would highlight products' higher than desired nutrient contents (perhaps by way of stoplights for instance).

So here's my straightforward suggestion.

Regardless of the system implemented, if a product's ingredients score it a front-of-package warning from Health Canada, that product's packaging should be legally prohibited from including any front-of-package health claims or inferences (where inferences for example would be a package of Froot Loops shouting out to its inclusion of whole grains or Vitamin D, but without an actual functional health claim).

Though imperfect, this simple step might help tilt the playing field ever so slightly away from the food industry's current unfair advantage.

Monday, August 28, 2017

The Canadian Food Inspection Agency Asks For Examples of Deceptive Food Labels

Saw this tweet from the CFIA and so I decided to take a supermarket field trip and found plenty of what I would describe as deceptive food labels.

5 teaspoons of sugar per bar along with 210 calories 
31% more sugar cup per cup than Froot Loops
By weight, this product is 48% sugar
Cookie for cookie more than double the sugar of an Oreo
Drop for drop more sugar and calories than Coca-Cola
With 2.75tsp of sugar per "Twist", contains the sugar of 2.3 actual Twizzlers
Each popsicle contains the sodium found in 93/100ths of one single grain of table salt (along with 2 teaspoons of sugar)

But here's the problem, none of the products' labels above break any Canadian packaging laws, and if the labelling laws themselves explicitly permit deceptive labels, consumers don't stand a chance.

Why have a system where the onus is on the consumer to study the products' nutrition fact panels to determine if their healthy front of package claims are supported?

Saturday, August 26, 2017

Saturday Stories: Anne Frank Center, Post-Truth America, and Front Lawn Farming

Before you share that next clever Anne Frank Center for Mutual Respect zinger, please read Albert Eisenberg in National Review on how the center is a disgrace to Anne Frank's name and memory, and Emma Green in The Atlantic, with her detailed history of the center.

Kurt Anderson in the Atlantic with a great but depressing longread on how America has lost its collective mind.

Arielle Dollinger, in the New York Times, on the rise of front lawn farmers.

[And for those who don't follow me on Twitter or Facebook, I've decided to try to resurrect my Weighty Mutters podcast. You can find it on Anchor, iTunes, and Google Play]

Wednesday, August 23, 2017

PSA: Scales Measure Gravity, Not Health, Happiness, Success, or Effort

Just a periodic reminder that scales measure the gravitational pull of the earth at a given moment in time - nothing else.

Scales don't measure the presence or absence of health.

Scales don't measure happiness.

Scales don't measure success.

And scales don't measure effort.

Too many people believe scales measure things other than gravity, and for some, those beliefs lead them to abandon their best efforts.

If you're ever curious about how you're doing, consider the fact that the answer to that question has to do with the doing.

Are you cooking more frequently? Minimizing your liquid calories? Decreasing your restaurant reliance? Not drinking to excess? Cultivating sleep? Exercising as much and as often as you can reasonably enjoy? Keeping a food diary of some sort?

The answer to those questions (and of course that list isn't exhaustive, nor will all questions apply to all people) are how you're doing.

Please don't confuse what you weigh with how you're doing. Though there's often overlap, they're definitely not one in the same.

Monday, August 21, 2017

UC Davis Now Marketing HealBe Calorie Counting Indiegogo Scam

Do you remember HealBe?

They're the Russian company that raised over $1 million on Indiegogo in 2014 for a wearable that was supposed to track, just by your wearing it, how many calories you consumed.

They've been rightly pilloried for years by Pando Daily including a delicious quote from ZDogg on their technology who described it as
"some straight Ghostbusters, Peter Venkman bullshit"
Plainly put, the device hasn't delivered on its promises to magically measure the calories you consume, though it does deliver something - money into the pockets of its owners who don't seem to have any scruples about selling to a desperate population a device that hasn't been proven to work (review from Engadget here).

And if you don't believe me about the proof, the quote that HealBe's co-founder Stanislav Povolotsky gave Pando Daily's James Robinson succinctly sums it up,
"Proof, yeah… that is a tough piece for us."
And proof shouldn't be hard to come by. Controlled feeding for even just a few days while wearing the GoBe wearable and poof, if validated, a goldmine, not only for the investors, but for obesity researchers and the public the world over.

That 3 years after launch they're still nowhere, without a single peer reviewed publication, speaks volumes.

And with that all said, I just can't wrap my head around the fact that just a few months ago, researchers at the University of California Davis, entered into a 5 year agreement with HealBe to study their device.

Now I know what's in it for HealBe. Marketing.

As to what's in it for UC Davis?

There I'm at a loss.

Saturday, August 19, 2017

Saturday Stories: Charlottesville, Charlottesville, and Charlottesville

United States of America, 2017
Emma Green in The Atlantic, on why Charlottesville marchers were obsessed with Jews.

Alan Zimmerman, president of Congregation Beth Israel in Charlottesville, VA, in Reform Judaism, recounts his experiences during the march.

And if you haven't yet spent the time to watch VICE's short Charlottesville documentary, please do.



Thursday, August 17, 2017

Who Will Be The First To Sue A Fertility Treatment Centre For Weight Discrimination?

Did you know that women are regularly denied service from fertility clinics simply because of their weights?

I've met dozens of women struggling to conceive, who though healthy, exceeded a BMI threshold (usually in the neighbourhood of 35), and consequently were denied the opportunity to undergo fertility treatments and start a family.

I remember one who recounted how the fertility doctor who saw her suggested that perhaps God didn't want her to have a child (because she was unable to lose weight), but generally the reasons they're provided tend to focus on safety to them or to their future baby.

It's always struck me as arbitrary and biased as there are other conditions that confer risk that aren't exclusionary, and so I was thrilled to read a recent paper taking on the arguments in Human Reproduction Open. The paper, It is not justified to reject fertility treatment based on obesity, in my mind lays a basic groundwork for a future lawsuit.

It explains how though the risks of hypertensive disorders, gestational diabetes and caesarean sections are indeed higher in pregnancies of women with obesity, suggesting that this is a justification for withholding fertility treatment is dramatically weakened when considering that fertility treatments are not withheld from women with diabetes who in turn are at higher risks of developing hypertensive disorders, stillbirths and premature labour.

Similarly, when addressing the risks to the child - congenital malformations, premature birth with related morbidity, macrosomia and shoulder dystocia, future obesity, and a higher risk of metabolic syndrome - the authors note that children of women with diabetes also have increased risks of congenital anomalies, macrosomia and shoulder dystocia, and premature birth with related morbidity.

In speaking with an obstetrician friend, they pointed out that what's genuinely required (and unfortunately often absent or weak) is a frank discussion with the patient with obesity about the risks of the pregnancy - which indeed are real - but that denial of treatment simply on the basis of weight, is not justifiable. At worst it's conscious weight bias, at best, unconscious. Either way, it's ugly.

Monday, August 14, 2017

Dear Reporters, The Cure For Obesity Is Unlikely To Be For Sale On Indiegogo

Last week a reporter contacted me looking for a quote.

She was doing a story on a $449 weight-loss product that is being sold on Indiegogo.

Briefly, the device reportedly works by stimulating the vestibular nerve, which, according to the people selling it, triggers the body to reduce fat storage, and all with just one hour of wear per day!

Of course there's this proviso (emphasis mine),
"Used in conjunction with a healthy diet and regular exercise the average user should notice a significant difference in body fat percentage."
Does the product have peer reviewed studies proving it works?

Of course not.

But it does have an unpublished preprint hosted freely online featuring a 6 person treatment group, only half of who completed the treatments.

The preprint also features a 3 person control group who somehow managed to post an 8.6% increase in truncal fat and a 6% increase in total body fat during the study's short 4 month period.

And it includes the authors' assertion that neither group changed their diet and exercise habits - this despite the fact that the authors didn't track their subjects' diet and exercise habits, and also despite the fact that the control group gained a significant amount of fat in a very short period of time.

After looking at all of this, I politely declined the reporter's request for an interview, as a story at this point on this product, even with a dissenting voice in it, is not simply premature, it's unethical. It's unethical not simply because it further perpetuates the narrative that magic, quick, and easy exists in regard to weight management, but because as is evidenced by the product's Indiegogo page, a story, any story, on this already for sale evidence-free product will be used by its manufacturers to market it to a desperate, constantly preyed upon population (who at the time of this post's writing, have already given this product's promoters $728,463 USD)

Now I realize that reporters are busy, and many don't have the background to pick apart studies, but I'd like to propose that the simple rule of,
"Don't cover medical devices being sold on Indiegogo or Kickstarter as a means to magically treat anything"
is probably a safe one, and one that I wish went without saying.

Thursday, August 10, 2017

The Strange New Reason Why You Shouldn't Drink Sugar With Your Meals

Granted, it's a small study, but its results were interesting.

The study, Postprandial energy metabolism and substrate oxidation in response to the inclusion of a sugar- or non-nutritive sweetened beverage with meals differing in protein content, looked at the impact sugar sweetened beverages had on the appetite suppression benefits of higher protein meals.

The authors note that,
"increasing dietary protein while maintaining energy intake produces a greater and more prolonged thermic effect and greater total energy expenditure",
that protein,
"potentially increases fat oxidation by up to 50%,"
that
"decreasing protein consumption may stimulate an increase in energy intake in an attempt to maintain a constant absolute intake of dietary protein",
and that,
"a 1.5%E decrease in dietary protein intake increases energy intake from carbohydrates and fats by 14%, perhaps in an attempt to increase protein intake from less protein-rich food sources (and point out that) in a 4-day in-patient ad libitum crossover feeding trial, a 5%E decrease in dietary protein intake produced a 12% increase in total energy intake"
So the authors were curious whether or not the inclusion of a sugary beverage would change the impact that a high protein meal had on consumption, appetite, and fat oxidation, and to explore, they studied those variables in 27 adults (without obesity) on two separate occasions in a direct (room) calorimeter after the consumption of a sugar-sweetened beverage or a non-nutritive sweetened beverage along with meals that varied in protein composition (15% vs. 30%).

The authors found, as expected (and certainly in line with the experiences I've seen among thousands of patients), that meals with higher protein content decreased hunger, increased fullness, and decreased the desire for fatty/salty/savory foods (sweet desires weren't affected).

The authors also found that when consumed along with a higher protein meal, sugar sweetened beverages increased the desire for fatty/salty/savory foods, and simultaneously decreased diet induced thermogenesis (the energy spent on processing/storing food), and fat oxidation (which the authors postulate may lead to a greater tendency of the body to store fat).

All this to say, treating sugar sweetened beverages (including juice) like the liquid candy that they are, and consuming them as treats, in the smallest quantities you need to be happily satisfied, rather than drinking them along with your meals, is probably a good plan.

Tuesday, August 08, 2017

The Canadian Cancer Society Wants You To Drink Sugar And Eat At Chipotle

A few years ago I pointed out the hypocrisy of the Canadian Cancer Society encouraging people to eat Domino's pizza in the name of fundraising.

I noted that sure, fast food pizza here and there isn't going to kill you or give you cancer, but that there's little doubt that one of the major drivers of our society's struggles with diet and weight related illnesses is the normalization of fast and junky foods as regular, everyday parts of our lives.

My belief is that this normalized culture of convenience is in part encouraged by the cause-washed use of candy and junk food for fundraising - a practice which may have been inconsequential (and rare) 60 years ago, but superimposed on our health issues today, is just plain wrong (and constant). And it's especially wrong when adopted by health organizations whose cause, like that of the the Canadian Cancer Society, is itself impacted by low quality diets.

So this year's Canadian Cancer Society junk food partners are Chipotle, PepsiCo, and the Dole Food Company.

The Canadian Cancer Society's partnership with Chipotle sees them encouraging a trip to the giant fast food burrito maker in the name of 50% of a single day's sales, while their partnership with PepsiCo and Dole come from one of their flagship events - the Run For The Cure - where PepsiCo and Dole serve as the Run's, "National Official Suppliers". As such, at the finish line of the short 5km fundraising run (which of course isn't of a distance long enough to worry about any fuel or hydration needs), PepsiCo and Dole will be there to market hand out the beverages that the Run For The Cure website notes provide participants, year after year, with "delicious refreshment".

Of course they'll also provide participants with piles of sugar given that Dole Sparklers, a "real fruit beverage", pack 4 teaspoons of free sugar per can, while Real Tea's offerings can pack up to a whopping 12 per bottle depending on flavour.

It's a good thing then I guess that the Run For The Cure is on October 1st rather than September 30th given that in September the Canadian Cancer Society's fundraising effort is a much more appropriate Sugar Free September initiative

And as the Canadian Cancer Society is explicitly aware, fruit drinks and sweetened tea, are common sources of free and added sugars in our diets.

One of the other reasons why these partnerships are so unwise is the way they're utilized by the junk food partner. For instance Dole's gone ahead and leveraged their partnership for in store sales of their sugar water by using it to cause-wash their products directly.

Given that the last time around the Canadian Cancer Society reported they were incredibly proud of their partnership with Dominos, I imagine this time will be no different.

Not sure pride is the emotion I'd recommend when reflecting on their comfort with junk food fundraising.

Saturday, August 05, 2017

Thursday, August 03, 2017

Will Weighing Yourself Daily Really Help You Lose Weight?

There are no shortage of people and stories who'll report that one of the easiest things you can do to help yourself lose weight is to weigh yourself daily.

And there are plenty of journal articles too, like this one which came out just last week, that concluded,
"these data extend the possibility that daily self-weighing may be important for prevention of unwanted weight gain"
The problem with the majority of these studies however, is that they're not randomized trials designed to compare the intervention of weighing oneself daily to not, but rather they're either longitudinal studies, or retrospective studies, that look at weight loss and whether or not there's an association with daily weighing.

That matters a great deal because it certainly might follow, and this would be consistent with the experiences I've observed in working with thousands and thousands of patients, that when people know they're struggling with their diets and lifestyle changes, they avoid stepping on the scale, and therefore my bet would be that daily weighing is simply a marker for people who are doing well with their efforts.

So have there been randomized controlled trials of daily weighing on weight loss?

Surprisingly, I could only find one that isolated daily weighing as the primary weight loss intervention. It was a study which randomized 183 adults with obesity to weigh themselves daily, or not, and both groups were given weight loss advice that was known to be ineffective. That last bit is important if you're trying to suss out whether or not daily weighing itself provides benefit.

The authors' conclusion?
"As an intervention for weight loss, instruction to weigh daily is ineffective. Unlike other studies, there was no evidence that greater frequency of self-weighing is associated with greater weight loss."
I also wonder about whether or not daily weighing might lead to increased recidivism? Though I couldn't find any studies that looked at daily weighing and its association with patient dropout, given that day to day weight fluctuations are normal, and that weight loss (and life as a whole) isn't often a straight, consistent, line, I worry that those weighing themselves daily will provide themselves with more opportunities to be discouraged and hence, more likely to quit their intentional weight loss efforts in frustration.

In our clinic we recommend our patients weigh themselves weekly, on Wednesday mornings, naked, after pee, before breakfast, with the rationale being it's important to ensure weight gains, if they're occurring, are noted, because if you're off course, it's easy to gain a great deal of weight in a short period of time and avoiding the scale because you know things aren't going well might lead you to gain more than you would have were you aware of your trend.

Tuesday, August 01, 2017

How Is Reading with Ronald (McDonald) Still A Thing?

There's no denying there's a fair bit of grey to the black and white world of corporate sponsorship and public private partnerships, but the Reading With Ronald program probably doesn't fall into that category.

Simply put, Reading With Ronald sees public libraries inviting Ronald McDonald to read to kindergarteners.

Publicly funded institutions that by definition are trusted by children shouldn't be used to market anything, let along junk food, to children.

That these events occur doesn't speak so much to incompetence though, they speak to how normal it is in society today for us to pretend that corporate interests in events like these are altruistic, and not just marketing.

Saturday, July 29, 2017

Saturday Stories: What The Health, Carboholics, and Righteous Hatred

Ginny Messina, the Vegan RD, in Vegan.com, reviews the film What The Health and its "junk science".

Stephan Guyenet, on his own blog, responds to Gary Taubes' recent NYTs piece on "carboholics", and offers up a different, more science-pinned, narrative.

Jamie Palmer in Fathom, with an unflinching piece on the Left and the Israeli-Palestinian conflict: The path to righteous hatred.

Wednesday, July 26, 2017

Should You Buy The World's First DNA Based Weight Loss App?

This week saw the release of embodyDNA a, "DNA based weight loss app".

According to the press release, for the low, low, price of just $188.99, to work alongside your new food diary, you can order a saliva kit to have your DNA analyzed and then you'll receive results telling you to do such things as reduce your sugary drinks, limit your calories, avoid empty calorie foods, get plenty of sleep, and include protein in your diet.

Or, alternatively, you could not spend $188.99 and you could do those same things.

Doesn't seem like a tough call to me.

While the notion of personalized DNA based recommendations is exciting, paying $188.99 for a test that'll tell you things you already know to be a good plan is about as far along as the science has gone.

So let me save you your hard earned cash and give you some straight forward advice:
  • Keep a food diary
  • Reduce restaurant and ultra-processed meals
  • Cook meals made with fresh whole ingredients and eat them free from distractions
  • Include protein with all of your meals and snacks
  • Minimize all caloric beverages (especially sugar sweetened beverages and alcohol)
  • Cultivate good sleeps and good friends
  • Don't smoke
  • Exercise as much and as often as you can enjoy
Do those things and you can safely, and possibly forever, ignore the latest hype.

Monday, July 24, 2017

Guest Post: A Lawyer Weighs In On Canada's Proposed Kid Ad Ban

Early last week there was a surprising piece in Blacklock's Reporter that suggested that Canada may be reconsidering its plans to ban the advertising of junk food to children (an election piece of Prime Minister Trudeau's and part of Health Minister Philpott's mandate letter). After seeing it, I contacted Canadian public health lawyer Jacob Shelley and asked him if he'd be so kind as to share his legal thoughts. He kindly agreed.
Restricting food and beverage marketing to children has long been identified as a necessary public health strategy to reduce diet-related chronic diseases, including obesity. It is a strategy endorsed by the World Health Organization and has been the focus of the Stop Marketing to Kids Coalition in Canada over the past few years (the Coalition has called for the implementation of its Ottawa Principles, which bans food advertising to youth and children under 16). Not surprisingly, there was considerable excitement in the public health community when Prime Minister Justin Trudeau identified “introducing new restrictions on the commercial marketing of unhealthy food and beverages to children, similar to those now in place in Quebec” as a top priority for protecting public health in his Minister of Health Mandate Letter.

Québec’s Consumer Protection Act prohibits, with some exceptions, all commercial advertising to children under thirteen years of age (s. 248). In 1989 the Supreme Court of Canada upheld the Québec ban as a constitutionally valid limitation on the freedom of expression, protected by section 2(b) of the Charter of Rights and Freedoms in the seminal case of Irwin Toy v Québec.

In Canada, expression is considered a “fundamental freedom”, and because of its importance, the courts have consistently held that section 2(b) requires a large and liberal interpretation. Commercial speech, which includes advertising, is among the types of expression that the Charter seeks to protect. The courts have held that commercial expression serves an important public interest, one that goes beyond its economic value, because it allows consumers to make informed choices. Even so, the government can impose restrictions on expression. A limitation on the freedom of expression can be justified if the government is able to demonstrate that it is reasonable, an assessment based on the Oakes test.

This is what occurred in Irwin Toy, where a majority of the Supreme Court found that the Québec ban was justified, even though it infringed on the freedom of expression. The Court was particularly concerned about the vulnerability of children to advertising. It held: “the evidence sustains the reasonableness of the legislature's conclusion that a ban on commercial advertising directed to children was the minimal impairment of free expression consistent with the pressing and substantial goal of protecting children against manipulation through such advertising.”

Since Irwin Toy, the Supreme Court has upheld other bans on commercial speech, most notably, commercial speech related to tobacco products. In Canada v JTI-MacDonald, the Court unanimously held that the restrictions placed on tobacco advertising and marketing were justified restrictions on the freedom of speech. Of particular note, the Court held, “when commercial expression is used for the purpose of inducing people to engage in harmful and addictive behaviour, its value becomes tenuous” (para 47).

Through Irwin Toy and JTI-MacDonald, the Canadian jurisprudence clearly establishes that (i) children are vulnerable and need to be protected from manipulative advertising and (ii) commercial expression that induces harmful behaviour(s) has tenuous value. It would seem apparent, then, that restricting advertising to unhealthy food products to children – the strategy the government appears to have adopted – is relatively low-hanging fruit. After all, the government could do more, as Irwin Toy involved restricting all advertising directed to children. While there may be some details to iron out – such as what age should the ban use and determining what constitutes unhealthy foods – the overall strategy seems to be in accordance with Canadian law.

Thus it was surprising to read that Health Canada may be backing away from meaningful restrictions on food advertising to children out of fear of industry lawsuits (note: this has not been confirmed or reported elsewhere).

UPDATE: Health Canada was kind enough to tweet a response after this article was posted. What is there to be afraid of, exactly? Certainly industry lawsuits were expected the moment PM Trudeau penned his mandate letter. It would be unrealistic to expect the food industry to accept any governmental oversight of advertising to children – kids are big business, after all, and restricting food advertising to children will have a discernable impact on the industry’s bottom line. The industry is not interested in any regulation.

To avoid regulatory interference, the industry has created its own self-regulatory framework that it frequently touts. It includes the Broadcast Code for Advertising to Children and the Canadian Children’s Food & Beverage Advertising Initiative (this is in addition to individual corporate promises). Such frameworks are often considered to be largely ineffective, lacking transparency and accountability. Recent research suggests that advertising of unhealthy foods to children has increased in recent years. Self-regulation, simply put, isn’t working.

If the industry does initiate a lawsuit, we can be sure that it will cloak its claim in Charter language, but this should not be mistaken as interest in protecting Canadian’s freedom of expression. Rather, it seeks an unbridled free market, one that allows it to continue to target vulnerable children in order to increase profits.

When PM Trudeau announced Canada would impose restrictions on the marketing of unhealthy foods and beverages to children, the world noticed. Canada now has the opportunity to become a global leader when it comes to restricting marketing to kids. It would be a shame if the fear of industry push-back impeded current efforts, especially when the courts have already made it abundantly clear that children are more important than commercial expression.

Have your say: Health Canada is currently seeking feedback on its approach to restricting marketing unhealthy food and beverages to children, and you can do so by visiting here.

Jacob Shelley is an Assistant Professor with the Faculty of Law and the School of Health Studies in the Faculty of Health Sciences at Western University. His primary area of research is the role of law in promoting public health and preventing chronic disease, with a focus on diet-related chronic diseases. Follow him on Twitter here.

Saturday, July 22, 2017

Saturday Stories: Sham Surgeries, Plastic Mice Penises, and Gooplandia

Christie Aschwanden in Five Thirty Eight discusses the powers of sham surgery.

Ed Yong in The Atlantic with a story that begins with a plastic mouse penis.

Beth Skwarecki in Lifehacker details her strange trip to Gooplandia.

Wednesday, July 19, 2017

On Respecting Reality And Moving Forward

As anyone who has ever suddenly lost a loved one will tell you, there's a great deal of processing to be had to comprehend what's happened.

Having just come back from a hiking trip with my father in Italy's breathtaking Dolomites (we'd booked long before my mother's death and yes, that's a photo from our trip up above), and having had now 5 weeks to try to wrap my head around what seems still at times an impossibility, I'm feeling like it's time to get back at things.

Not sure I'll be fully up to speed for a while, but I'm at the point where I feel that I have enough mental real-estate to start writing again.

I didn't before. Our realities often precludes our best intentions, and it's important to respect that.

My newly darker reality before was such that my best efforts in life excluded all sorts of behaviours. From more regular exercising, to healthier eating, to more moderated drinking, to being more engaged with my loved ones, to writing this blog, and to so much more.

Spending time kicking yourself because you've fallen down will not likely accelerate your ability to get back up, and no doubt life ensures that at times, we all fall down.

The most important question to ask yourself when life isn't going according to plan or when your deck of cards is ugly is, "what can I do today that will help even a little"?

Truthfully, some days the answer may be little to nothing at all.

One day though, there'll be something more formative to do. And today (well yesterday really), mine was to type this out.

Our best efforts in life are dynamic, but that doesn't mean that they're not our bests, and the fact that our bests during difficult times might not be all that impressive when measured against our bests during easy times, doesn't make them any less worthy of pride.

Monday, June 19, 2017

One Last Tribute To My Trailblazing Mother Helen Freedhoff

The last week was an incredibly difficult one with our family reeling from the sudden and unexpected death of my mother.

During the course of the week I reached out to Hilda Bastian as I felt that as a fellow trailblazer for women in STEM, she might be interested in my mother's career.

After reading about her, Hilda offered a nearly unbelievable kindness - over the course of her own weekend, Hilda put together a Wikipedia entry for my mother (click here to read it) which I was able to share with my father before having to leave Toronto.

Through his many tears also came, "how lovely, how lovely", and "what a tribute!"

Were my mother still alive, an incredibly modest and private person, she'd have been embarrassed (maybe even mad at me for indirectly facilitating) and might have asked that the entry be removed, but since she's unable to complain, and as I and her family is intensely proud of her accomplishments, consider my sharing them my last opportunity as her son to shake her tree a bit (please also find our eulogies below).

With the shiva over I will slowly be returning to social media and blogging. Will be returning to Twitter and Facebook first, and blogging a touch later. With Jewish mourning, the first 30 days have a special significance and so I'm thinking I'll start blogging again (aside from this post of course) once they're complete part way through July.

[My deep and heartfelt thanks to Hilda for her compassionate kindness and generosity in putting my mother's Wikipedia page together.]



Monday, June 12, 2017

Remembering My Mother (And Why I Won't Be Around As Much For a While)

Dr. Helen Freedhoff January 9th, 1940 - June 10th, 2017
My mother was her own force of nature, and tragically, wholly unexpectedly, and thankfully without suffering, she died on Saturday. To say our family is in shock is an understatement. My mother lived life on her own terms, both for the better, and at times for the worse, but there was never an instant in my life where I didn't know how fiercely she loved me, nor where I didn't love her back.

A theoretical physicist who received her PhD from the University of Toronto she was a trailblazer for women in science. Her work in science is baffling to me. I read the titles of her papers, and while I understand some words here or there, they might as well be written in a foreign language - one of her students told me that this paper is one of which she was especially proud. She once explained to me how it was she went about choosing what to study. The gist was that she would look at experimental results that people could not explain, and then if she thought that the solution would be mathematically elegant, she'd get to work. And while I may not be telling that story perfectly accurately, that's how I remember it anyhow. We've no doubt, that had it not been for mandatory retirement (she missed its abolition by 2 years), she'd have still been teaching.

It was my mother who taught me, again for better or for worse, to always speak my mind and not to be shy, even with criticism. Below is the obituary we're placing in the papers - and I thought I'd share it here as well and let it fly out into the ether. Love you Ma, can't believe you're gone, and will always be proud to be your son.


Helen (Henchy) Sarah Freedhoff (nee Goodman)

Passed away suddenly on Saturday June 10, at the cottage she loved in Muskoka at the age of 77.

She was predeceased by her parents Sholom and Ethel Goodman (Kohl)

She will be dearly missed by her husband Stephen of 57 years, her daughter Michal (Michael Van Leeuwen), her son Yoni (Stacey Segal), her brother David Goodman, her grandchildren, Rena, Zahava, Talia, Sammy, Leah, Vivienne, and Yael who adored their Omi, and many nieces and nephews. Sister-in-law of Judith and Aubrey Golden,Sylvia Goodman (late brother Irving), and Doba Goodman.

Helen was born in Toronto and excelled in the sciences, having graduated from the University of Toronto with the highest marks and was awarded the Governor General’s Gold medal. She went on to obtain a PH.D in physics and was appointed an assistant professor at York University in 1967. At the time of her appointment, she believed she may have been the only woman in Canada teaching at the university level in her field.

She took a keen interest in her students and was responsible for many of them under her guidance continuing their careers in science. She was soft spoken, a voracious reader, had taken up piano again upon retirement, was an expert ken-ken solver, a weekly yoga practitioner, and maintained a meticulous household

Funeral service at Benjamin’s Park Memorial Chapel 1:30 Monday June 12.

Shiva at 38 Alexandra Wood. Morning services daily at 7:45 a.m. Evening services at 8:45 p.m. Shiva will conclude Sunday morning, June 18.

Donations in memory can be made to Associated Hebrew Schools, Ethel and Sholom Goodman Fund, (416) 494-7666

Saturday, June 10, 2017

Saturday Stories: War Photography, White Washing, and Cancer

Photo by Nancy Borowick from her piece in NPR
Marie Brenner, in Vanity Fair back in 2014, with an amazing piece on World War II photographer Robert Capa.

Julie Lenarz in The Tower on the whitewashing of Linda Sarsour.

Nancy Borowick in NPR with her poignant and beautiful piece on her parents as they were both dying of cancer.

Friday, June 09, 2017

Former Mexican President Vicente Fox Is All Kinds of Hilarious

Honestly, today's Funny Friday bit, with Fox lecturing Trump about the wall, is just genius.

Don't miss it.

Have a great weekend!



Thursday, June 08, 2017

Canadian Nutrition Society Calls 13 Daily Teaspoons of Added Sugar "Moderate"

To be fair, it wasn't the Canadian Nutrition Society (CNS) directly who told attendees of their recent annual scientific conference that consuming 13 daily teaspoons of added sugar represented a "moderate" amount, it was the handout they stuffed into all their conference swag bags that did.

That handout, available here, had this to say,
"In 2004 Canadian consumption of added sugars was about 11% of daily energy intake (53g or 13 tsp per day), according to an analysis of dietary intake data from the Canadian Community Health Survey. Average intake ranged from 9.9% of energy in adults aged 19 and above to 14.1% of energy in adolescents aged 9-18 years. This is generally considered to be a moderate amount"
Given it was authored by The Canadian Sugar Institute, it's wholly understandable that they're not lining up with the World Health Organization or Canada's Heart and Stroke Foundation in considering 12 teaspoons of added sugars per day a daily maximum, and 6 teaspoons of sugar per day a better goal. Less understandable though for the CNS.

According to the CNS, their aim is to,
"foster the next generation of skilled nutritionists, thereby building a better and healthier future for all Canadians"
I struggle to see how providing the food industry with the ability to influence and directly access the next generation of nutritionists would fit within that mandate.

(Thanks to the dietetic student attendee who sent me the handout, and for the record, I feel the same way about medical organizations providing pharma with the opportunity to stuff medical conferences' swag bags with their marketing materials)

Monday, June 05, 2017

Definitely Don't Take Your Kids To See Red Shoes And The Seven Dwarfs

Via Tess Holiday on Twitter
Want to know how socially acceptable weight bias is?

There's a movie coming out, for children, about, what if Snow White were fat?

The trailer highlights the apparently hilarious horror.



The pervasiveness of weight bias in children's movies, TV shows, and books is a near constant.

Can you imagine how you'd feel if you were a little girl with obesity and you saw this poster (let alone the movie)? Or if you were a schoolyard bully that hadn't yet started targeting kids for their weights (weight by the way is the number one target of bullies by a long shot).

It's horrifying that weight bias is so normalized that a movie studio signed off on this. Hopefully, with awareness, ticket sales will be sufficiently bad and the outcry sufficiently loud, so as to dissuade future such projects.

Saturday, June 03, 2017

Saturday Stories: Opioid Origins, Trump Loneliness, and the Confederacy.

By Infrogmation of New Orleans - Own work, CC BY-SA 4.0, Link
Pamela Leung, Erin Macdonald, Irfan Dhalla and David Juurlink in New England Journal of Medicine expose the 1980 letter to the editor that may be responsible for today's epidemic of opioid addiction.

Rebecca Solnit in Literary Hub with an amazing piece of writing on the loneliness of Donald Trump.

New Orleans' Mayor Mitch Landrieu in The Atlantic with the speech he gave to explain why his city's confederate monuments had to come down.

Friday, June 02, 2017

This Commercial Almost Makes Me Want To Watch Shark Week

But not quite.

That said, today's Funny Friday video is a gem for those of us old enough to be Seal fans.

Have a great weekend!