Saturday Stories: Lottery gaming, Nazi Looting, And Astral Weeks

Jason Fagone, in Highline, with an incredible story about math, and the folks who used it to successfully game the lottery.

Sophie Gilbert, in The Atlantic, with an inconvenient story about Nazi-looted art.

Jon Michaud, in The New Yorker, tells the story of the creation of my very favourite album of all time - Van Morrison's Astral Weeks.

Guest Post: RD Christine McPhail Reviews Greta Podleski's Terrific New Cookbook Yum and Yummer

Today's guest post comes from one of our office's wonderful RDs - Christine McPhail, who has been spending a bit of time with Greta Podleski's terrific new cookbook Yum and Yummer.

As a Dietitian, I see the difference it makes when families start cooking together and children begin to develop the important food skills that they will need as adults. I hear about children being more interested in trying new foods, helping in the kitchen, wanting to pick out recipes, and being proud of the foods they’ve made. These cooking experiences can help children learn about nutrition, balanced meals, and the importance of including a variety of foods. Our lives are busy and I do hear about food going on the back burner (see what I did there) but it shouldn’t have to. You can read Dr. Freedhoff’s past post Teaching Your Kids To Cook Is More Important Than Teaching Them To Play Soccer Or Hockey that provides strong rationale for families cooking together.

Adults in turn benefit from sharing their skills, having the opportunity to pass down their favourite recipes and traditions, and of course having more balanced and nutritious meals themselves. A great place to start is having your family go through cookbooks together and pick recipes they would be interested in making. One recipe book I can recommend is Yum & Yummer by Greta Podleski, a Canadian author and recipe developer, who you may know from her very popular Looneyspoons cookbooks, which she co-wrote with her sister Janet.

Here are a few reasons I liked Yum & Yummer:

• The introduction is worth a read. I really appreciated that Greta addressed that healthy eating means different things to different people and that we all could try to be less judgemental. Unless there is a true risk with an eating behaviour, which as a dietitian, I am trained to look out for, I believe it’s important that we respect one another’s food preferences and choices.
• There truly is a recipe for everyone in this book and Greta follows through with her mission to use common everyday ingredients and simple recipes. Recipes will signify if they are dairy-free, gluten-free, vegetarian etc. 60% of the recipes are vegetarian but she also has sections for fish, poultry, and red meat, soups and chilis, snacks, and desserts. Meatless meals are a great way to get your family to enjoy meat alternatives that not only provide protein but plenty of fiber as well. You’ll save some money in the process too!
• For people who are new to cooking, are nervous to try recipes, or learn better with visuals, each recipe has a photograph and a “how to” video that you can access just by scanning the QR code on the page with your phone. They show you exactly what to expect step by step, so you can feel confident developing new skills (you can take a look at them here).
• For those who like to know the nutrition information, each recipe shows calories, total fat, saturated fat, protein, carbohydrate (fiber and sugar included), cholesterol, and sodium. This way you can make an informed choice that works for you and your family’s needs.
• The recipe descriptions don’t go into detail of the “nutritional benefits” or labels foods as “good” or “bad”. Greta does include some great food prep tips and food facts that are helpful. This is important because we don’t want to label recipes as “good” or “bad” and we don’t want weight to be the main motivation when trying a new recipe, especially if children are reading along. We want to hear about the fresh ingredients, flavour and texture as well as the nutrition information, when we are choosing to make a recipe or not. At the end of the day, if you don’t enjoy it you won’t continue to eat it anyways.

With some quality time in the kitchen and eating meals together, your family can appreciate the benefit and taste of whole foods, cooking from scratch, and eating together as a family. If you are interested, you can purchase the book via Amazon.ca (where 92% of the 148 reviews (and counting) are 5 star) or any other online Canadian book retailer.

Christine McPhail MSc, RD is one of our Registered Dietitians at the Bariatric Medical Institute. Christine has worked in academic, clinical and public health nutrition settings and has been fortunate to have worked on projects relating to food sustainability, food security, food policy and politics, childhood nutrition, body image, and school nutrition programs. She believes in the power of connecting with your food from farm to table. She feels fortunate to share this passion with her clients, as she helps them strengthen their relationship with food and learn more about nutrition.

Nothing Good Can Ever Come From Weighing Your Child

(This post was first published on US News and World Report in November 2013)

I'm not suggesting your child should never get weighed – certainly I'd encourage annual weigh-ins with your child's pediatrician or family doctor to track growth curves – I just don't want you weighing your child.

Aside from determining whether or not your kid has outgrown their car seat, or what size uniform or sporting equipment they require, there are three main reasons for a parent to want to weigh them. The first would be a worry about a child not growing sufficiently – and herein I'd encourage you to defer to your child's doctor to determine whether or not worry is warranted.

But the second and third reasons are the ones that concern me. The second reason is a parent's belief that his or her child's weight is too high. The third reason is the second reason's corollary, where a parent might be weighing a child to see if the child has lost weight or to keep track of the rate of gain.

The thing is, scales don't measure anything other than weight. They don't measure the presence or absence of health; they don't measure whether a child is being fed a nutritious diet; they don't measure whether a child is regularly active; and they don't measure self-esteem. But they sure can take away self-esteem, can't they?

And while I haven't seen a study that proves it to be true, I'd be willing to wager that scale use in children has played a formative role in their development of mood disturbances and eating disorders over the years, as well as having had many negative impacts on their self-esteem, body images, and relationships with food.

Yes, childhood obesity is worrisome. And yes, if you're worried about your child's weight – especially if it's having a negative impact upon his or her health or quality of life – you might want to try to help. But weighing your child doesn't actually do anything. All weighing your child does is teach him or her that scales measure success, self-worth, and parental and personal pride – and that weight is all that matters.

You might think that tracking your child's weight loss on a scale may be motivating, but celebrating a loss on a scale is no less risky than shaming a gain; they're flip sides of the same coin – the coin that says scales measure success. And what happens if that child who is losing one day gains?

A child's actual weight doesn't really matter, at least not in any constructive, formative way. Ultimately, a child's weight is not something that is directly controllable. Weight's primary levers – eating behaviors and activity levels – have dozens, if not hundreds, of drivers and co-drivers, and many of them won't in fact be modifiable.

Genetics, peer groups, socio-economic status, coexisting medical conditions (both mental and physical and for both child and parent), food available at school and after-school activities, and many more factors all have a very real impact on weight, while none are particularly changeable. Moreover, weight management is a struggle for highly motivated, fully mature adults with various weight-related medical conditions. Should we really be expecting children to accomplish a task that eludes many grown-ups?

If you're worried about your child's weight, look to those weight-relatable behaviours that you might actually help to change instead of weighing your child. For example, consider the source, quality and quantity of their calories and of the meals you're providing them.

Look to your own examples for fitness, and cultivate active family outings. Review your home's screen-time rules, and certainly rid all bedrooms (again, including your own) of televisions (which has been shown to dramatically increase risk of obesity in children. Cut your cable (and hence, eliminate the constant food advertisements your children are exposed to), and ensure that your child's bedroom and habits are conducive to adequate sleep (as short sleep duration is also strongly associated with increased weight).

While it's true that there are things affecting your child's weight that you won't be able to change, it's also true that there are many things affecting their weight that fall within your parental discretion – and it's there where you should expend your energies. Importantly, do so without explicitly putting a focus on weight as the cause of your home's changes or the child as their sole target; instead, put the focus on improving the health of your family as a whole, with your changes affecting every member of the home, as the cultivation of healthy living behaviours provides benefits to everyone at every weight.

Bottom line: If you're concerned about your child's weight, don't rely on a number to tell you or your child how he or she is doing. Simply measuring their weight does nothing to helping you understand how it got there nor will it do anything to help it to go away, but it may make your children hate themselves just a little bit more each time you put them on that scale.

Saturday Stories: Lots Of Farrakhan/Anti-Semitism

First, Yair Rosenberg, in The Washington Post, with a great, short, and very balanced piece highlighting 5 myths about anti-Semitism.

Nylah Burton, in Forward, writing, "To My Black Brothers And Sisters: I’m Black And Jewish. Farrakhan Is Bad For Us All."

Yehuda Kurtzer, in Times of Israel, with a very thoughtful piece, On friends and Farrakhan: A plea to progressives

The Hunger Hormone Ghrelin May Be Another Reason To Eat Your Carbs Last

Preproghrelin: By own work - adapted from http://www.pdb.org/pdb/files/1p7x.pdb using PyMOL, Public Domain, Link

I've blogged in the past about how eating your carbs last may help reduce your blood sugar levels even 2 hours after your meal.

Well here's another reason why you might want to eat your carbs last - ghrelin.

Ghrelin is one of the body's primary hunger hormones. More ghrelin, more hunger (more on this though in a tiny bit).

Well, a small crossover study looking at the effect of food order on ghrelin levels found that eating carbs last led to a sustained suppression in ghrelin levels 3 hours later, while eating carbs first led to not only ghrelin levels returning to baseline at 3 hours, but also their slight rise (-11.45 ± 3.86% vs. +4.13 ± 4.38%; P = 0.003).

But that said, ghrelin is a surrogate end point for hunger and/or consumption.

Unfortunately, at least in this small study, subjective hunger wasn't different between conditions at any point, and consumption at later meals wasn't measured.

Looking forward to future research on this file, but given the ease of this intervention, I'd file it under maybe worth a try.

Hey @CR_UK, If Any Amount Of Guilt, Shame, Blame, Or Fear, Were Sufficient To Treat Obesity, It Wouldn't Exist

Thanks to Anthony Cox for sharing Sofie Hagen's reaction to CancerResearchUK's new awareness campaign.

The campaign, which is meant to let people know that there are strong associations between obesity and cancer (and some plausible biological mechanisms that would suggest some causality), though factual, is troubling.

Here's the thing.

By vilifying obesity directly, rather than focusing on the social determinants of health and the built environments that fuel our behaviours and weights, Cancer Research UK's campaign is simply contributing to fear and stigmatization. But if any amount of guilt, shame, blame, or fear were sufficient to treat obesity, obesity wouldn't exist.

And what's odder still is that Cancer Research UK seems to know that, at least partially, as their pinned video that highlights their campaign showing them telling people that obesity is a risk factor for cancer, they mention that they're asking the government to take action.

If Cancer Research UK wants to make a difference, given that there are no gold standard treatment programs (let alone programs covered by the NHS) that will reliably lead to sustained population based behaviour change/weight loss, and that the personal responsibility approach to treating obesity is a luxury that many people's lives preclude, and that the one thing people with obesity don't lack is constant messaging that tells them that there are risks to obesity, instead they could mount a campaign to educate doctors about how weight bias has been shown to lead physicians to screen their patients with obesity less frequently for various cancers (including colorectal, cervical, and breast), and to encourage those physicians to treat their patients with obesity the same as they treat all of their other patients.

[And lastly, content aside, it's also odd to see Cancer Research UK's lack of people first language with obesity. Does Cancer Research UK describe people who have cancer as being cancerous? If not, perhaps they should stop referring to people who have obesity as being obese.]

Saturday Stories: New England Journal Of Medicine Edition (Read Them Before They Go Behind Paywall)

Michael S. Weinstein, in The New England Journal of Medicine, recounts his experiences as a surgeon-patient with severe depression.

Audrey M. Provenzano, in The New England Journal of Medicine, describes how she overcame her fear of treating opioid use disorder.

Anupam B. Jena, and Andrew R. Olenski, B.S., in The New England Journal of Medicine, with their letter highlighting the reduction in firearm injuries during NRA annual conventions (and here's Vox' Julia Belluz with her coverage of same)

Maybe Stop With The Hot-Take Childhood Obesity Rate Trend Stories And Reports?

Or at the very least stop until we're actually as a society trying to do something about it? Because why would we expect it to change if we're not doing anything about it?

As to why stop? Well because despite not doing anything as a society, it seems to be changing....but not really the way you might expect.

Here's what coverage has looked like for the past 8 years

STABILIZE IN 2010

SLOWLY RISE IN 2012

FALL IN 2013

BARELY EXISTS IN 2014

LEVELLED OFF IN 2015

STILL RISING IN 2016

STOPPED RISING IN 2017

GETTING WORSE IN 2018

All this to say, these annual takes? They don't make sense both in terms of the outcomes (up, down, sideways, gone, up, down, etc.), but also not in the context of change. Changes tend to occur consequent to changes, and given there really aren't any initiatives going on in the US or Canada that one might expect to impact on childhood obesity rates, perhaps the coverage instead could be about our inaction as a society on this sad file, rather than whether there's been a tiny blip up, down, or sideways in some survey's reported incidence.

Yes, Calories Counted (Literally) In The Recent #DIETFITS, Low-Carb, Low-Fat, Shootout Study

(Credit goes to RD Daniel Schultz for finding this reference in his read of the DIETFITS study and for sharing it via his excellent Twitter thread of thoughts on same)

In case you somehow missed it (though that seems hard to imagine), last week saw the publication of the excellent DIETFITS study - a year long, randomized, controlled trial, that compared the effects of low-carb and low-fat diets, on weight loss and other metabolic outcomes.

Briefly (and if you want to read a detailed synthesis you can read this one over at Examine.com), DIETFITS found that over the course of a year, both low-fat and low-carb diets produced similar weight losses and had similar effects on various metabolic outcomes.

The coverage of the study was widespread, and integral to it was this notion that counting calories isn't necessary for weight-loss, or that it's less important than the foods consumed, in that this successful study's approach involved counselling participants to eat whole foods, be they low-carb or low-fat, while eschewing the rest. Put another way, according to the coverage, people were taught to monitor and care about the quality of their calories, not their quantity, and that this was sufficient to drive significant weight change regardless of whether the foods they consumed were low-carb, or low-fat.

That conclusion is problematic for two reasons.

First, there was no study arm that explicitly taught participants to carefully track their quantity of consumed calories with no emphasis on their quality. Such an arm would be important to conclude that quality of calories trumps quantity of calories for dieters.

But more importantly, and again, thanks to Daniel Schultz, it would seem that the bulk of participants were in fact counting calories as reported by the previously published DIETFITS study design and methods wherein it was reported,

"The most common dietary monitoring method used was the on-line MyFitnessPal tool"

And as anyone who has ever used MyFitnessPal (or any of the other app based trackers - some of which were also utilized by DIETFITS participants) knows, while yes they'll track what you're eating, their primary end-user feedback is calories. And so even if somehow participants did not know in advance that calories were a consideration in weight loss, MyFitnessPal use would have seen to it that they learned that fact very quickly.

You see, setting up a MyFitnessPal account requires the input of a number of different variables: Weight, height, goal weight, age, sex, and some demographics.

And once input, MyFitnessPal then lets you know how many calories you should be aiming at daily to hit your stated weight loss goal.

Finally, when you start entering foods, though macronutrients are also tracked, calories are MyFitnessPal's most prominent field whereby there's a running calorie tally at the top of your diary, along with their meal by meal breakdown.

So while participants may not have been provided with specific calorie goals by the researchers, they were recruited on the basis of being involved in a weight loss study, and without a doubt, they all knew, that when it comes to weight loss, calories do count, and the majority of them used an app that tracked their calories, provided them with a personalized daily calorie goal based on their desired losses, and reported those calories to them prominently every time the app was utilized. And it's difficult for me to imagine that information didn't affect participants' choices, and certainly is enough of a confounder so as to render the conclusion that counselling solely on dietary quality is sufficient to drive significant weight loss.

This doesn't diminish the study's actual findings, but when it comes to calories' quantity and quality, it would seem that there are those who want to promote the existence of a false dichotomy stating that only one or the other of those two variables count. Honestly, I come across it all the time. Angry folks who claim that when it comes to weight and/or health, calories don't matter at all and that what really matters is the quality or types of foods, or the folks who claim that the quality or types of foods don't matter at all, it just comes down to calories.

It's both of course.

The currency of weight is certainly calories, and while we all have our own unique internal fuel efficiencies when it comes to using or extracting energy from food or from our fat stores, at the end of the day, we still need a surplus of calories to gain, and a deficit of calories to lose.

But don't kid yourself - foods matter too. Choice of food matters in terms of health, but also in terms of how many calories our body expends in digestion, and more importantly, upon satiety, which in turn has a marked impact upon how many calories, and which foods, we choose to eat (and of course to health, but that's a whole different matter).

All this to say, the DIETFITS study is terrific, and speaks directly to my published confirmation bias that adherence to one's dietary strategies matter far more than the macronutrient breakdown of said strategy. It also speaks to my bias that when armed with information about both the quality and quantity of the calories we're consuming, and provided with ongoing attention and support, weight loss and improvements to various metabolic parameters are far from an impossibility.

Saturday Stories: World's Worst Roommate, Sobriety, and Sexual Harassment

William Brennan, in The New Yorker, with a surprising story about the world's worst roommate.

Edith Zimmerman, in Spiral Bound, detailing her first year sober.

Kayla Webley Adle, in Marie Claire, on sexual harassment in science.

McDonald's, But Not Your Child's Elementary School, Removes Chocolate Milk From Their Menu

Not sure if you caught this news release last week. It detailed McDonald's announcement that they'll be overhauling their standard Happy Meal offering in a bid to, "support families".

Part of that "support" (I'll come back to the word, I promise), is ensuring,

"at least 50 percent or more of the Happy Meals listed on menus (restaurant menu boards, primary ordering screen of kiosks and owned mobile ordering applications) in each market will meet McDonald's new Global Happy Meal Nutrition Criteria of less than or equal to 600 calories; 10 percent of calories from saturated fat; 650mg sodium; and 10 percent of calories from added sugar"

And to meet those goals cheeseburgers will only be available by special request, a kids; fry size (smaller than current small) will be developed, bottled water will be a featured beverage option, and chocolate milk will only be available by special request.

Though I'm certainly happy that McDonald's Happy Meals will generally be lower in calories and sugar, here's the rub. While the rollout of this initiative speaks to health, corporations never make changes that they think will hurt their bottom lines. This is not an indictment - corporations aren't social service organizations - their goals are profit driven, and McDonald's are no exception as evidenced by their press release's first line,

"Today, McDonald's (NYSE:MCD) announced an expanded commitment to families, supporting the company's long-term global growth plan by leveraging its reach to impact children's meals"

They hope that these changes will bring in more families more often for more meals at McDonald's, which is good for their investors, but probably not so much so for public health, even without chocolate milk.

But you know which organization's goals aren't profit driven? Your children's elementary schools', yet their chocolate milk programs continue with no end in sight, and not just for a sometimes treat, but daily. If you wouldn't serve kids who didn't eat fruit, daily pie, you might want to rethink their daily chocolate milk.

Motivation aside, it's odd to see McDonald's being more proactive than our kids' schools on this file.

Saturday Stories: Chile, Junk Food, and Opioids

Photo: Mike Mozart

Andrew Jacobs, in the New York Times, on Chile's world leading approach to junk food.

Priya Fielding-Singh, in the Las Times, on the sad reality that turn so many people towards junk food.

Benjamin Davies, in Forbes, reflects on the opioid crisis, both as a surgeon, and as a grieving friend.

PSA: Please Don't Joke About Sometimes Wishing You Had Anorexia

Given what I do for a living, it happens not infrequently that someone will joke with me about sometimes wishing they had anorexia or bulimia in the context of their struggles with weight management.

And while I can see where their unfortunate attempt at humour is coming from, it always leads me to have a gentle chat with them that contains these truths.

Lives are ripped apart by eating disorders. Families are devastated. People die.

Eating disorders aren't punchlines.

Some Evidence Canada's New Food Guide Will Care About Evidence

Though there's no white smoke signifying the publication of a new Food Guide billowing out of Health Canada's food directorate's chimney, there are some signs that when it's finally published, it may be evidence based.

Take for example this story.

It details the concerns of Conservative agriculture critic John Barlow and it contained some heartening quotes.

Here's my favourite,

"It is very clear…that Health Canada is going in a direction that is detrimental to our agriculture sector, detrimental to our food processors as well as our producers on the ground."

Now while I feel for any sector impacted by the future Guide's recommendations, that Health Canada is not actively capitulating to agricultural interests suggests that perhaps instead, it's sticking with science as its underpinning.

According to Barlow, his office has been flooded with concern from a broad range of agriculture groups who are nervous about Health Canada's new policy of not kowtowing to industry,

"I want to really stress this point. These letters are not only from the livestock industry or the dairy industry, there’s letters in here from grain growers, the horticulture associations — none of them want us as a government, in this food guide document, to be picking winners and losers. They all want to be successful."

While there may well be some disagreement among health professionals as to what truly constitutes a healthy diet, where there likely is no disagreement is the notion that the desires of various agricultural sectors to be "successful" doesn't factor in to dietary health at all.

And just as an odd aside, in the same article is a quote from Agriculture Minister Lawrence MacAulay who was asked to comment about agricultural concerns. His response?

"Without a question, what I want to see is Canadians make sure that they express their view on what’s presented and that’s why things are gazetted. My opinion — really, it’s Canadians opinion that really reflects what takes place on this and anything else that’s gazetted to make sure that is what they do want to have happen."

Here's hoping that's not how policy works in Canada, as while not bashing the public, I'm pretty sure Food Guides shouldn't be built on what Canadians' personal opinions about food happen to be.

So bring on the evidence, and for the matter, bring on the new Food Guide. Remind me again, why are we still waiting?

Saturday Stories: Gender Balance, One In 259, And Terminal Wisdom

Am somewhat pleased to report that after being inspired by this piece by Ed Yong in The Atlantic, on how he spent two years correcting the gender imbalance of his quoted sources, I went back over my last year of Saturday Story pieces to discover that 46% of the 292 stories I've shared were written by women.

Chika Stacy Oriuwa, the only black student in her medical school class of 259 at U of T, in Flare, on how in her white coat she is more black than ever.

Alastair McAlpine, in The Guardian, expounds on his viral tweets about the lessons he's learned from terminally ill children.

Have Diabetes And Motivated To Change Your Lifestyle? Virta (And Maybe #Keto) Could Be Right For You

A quick post regarding an exciting study that dropped today in the release of Virta Health's one year data on the impact their intensive lifestyle counselling, coupled with their ketotic diet, had on patients with type 2 diabetes.

The results were impressive.

Of the 262 patients who started the year long study, 83% finished, and of those their metabolic biomarkers and weight improved dramatically. On average their hemoglobin A1C (a long term measure of blood sugar) dropped from 7.6 to 6.3, type 2 diabetes medications other than metfromin dropped from 56.9% to 29.7%, and insulin was reduced or eliminated in 94% of subjects who started out on insulin, while sulfonylureas were eliminated entirely. Weight dropped an average of 30lbs. Insulin resistance as measured by HOMA-IR dropped by 55%, hs-CRP by 39%, and triglycerides by 24%. Though LDL did rise by 10%, HDL rose by 18% and apolipoprotein B was unchanged.

All this to say that if you have type 2 diabetes, and you're motivated to make lifestyle changes, Virta health's program definitely appears to be worth considering.

But there are some caveats.

Firstly the study looked at individuals who self-identified as wanting to affect lifestyle change, and so their comparison with "usual care", which consisted of individuals identified by their MDs as having diabetes and then being relegated to their local diabetes education program, may not be a fair one.

Secondly, the intervention was incredibly robust and intensive. That's not a knock. I think it's terrific. It included,

"continuous care through intensive, digitally-enabled support including telemedicine access to a medical provider (physician or nurse practitioner), health coaching, nutrition and behavior change education and individualized care plans, biometric feedback, and peer support via an online community"

And where behaviour change techniques taught included,

"education of natural consequences, shaping knowledge, goal setting, self-monitoring, feedback, monitoring and reinforcement from health coach and medical provider, self-belief, social support, relapse prevention, associations, and repetition"

Patients were provided a cellular connected body weight scale, a glucometer and ketometer, and a bp cuff. Patients were then given access to a web-based application to input data and where they received monitoring, education, and communication with their team.

Food wise participants reported daily hunger, cravings, energy, and mood by way of a Likert scale and health coaches worked with patients individually to adjust intake.

It is notable that daily protein intake was targeted to 1.5g/kg, and also that their weight losses had pretty much leveled off by year's end.

I bring up the robust intervention only in that I'm not aware of any prior interventions with other dietary strategies that would compare and therefore at this point it's difficult to divvy up what percentage of outcomes relate to the intensity and frequency of the intervention, and what percentage to their high protein, low-carb, ketotic diet.

The cost of Virta Health (if not covered by your insurer), is reported by them to be (I have no affiliation BTW) $400/month, but given the cost of diabetes medications and the outcomes reported herein, those costs may well be offset by your results.

Canada, Where Dr. Feelgood Beer Sales Are Banned, But Vitamin Water's Are Allowed

What's wrong with this picture?

Last month the Liquor Control Board of Ontario banned the sale of Dr. Feelgood IPA on the basis that the snake encircling the hops paddle, coupled with the prescriptive looking ℞ in the D℞., would implicitly lead consumers to believe that the beer was a health food.

Yet Vitamin Water's liquid candy sales are just dandy (including of course in stores frequented by children). And so too are the hundreds, if not thousands, of packaged foods that explicitly purport to confer health benefits, not to mention an entire industry of supplements that promise health miracles.

It is so disappointing that Canada continues to allow the food industry to dupe consumers with impunity.

(And for the record, and not just because I enjoy IPAs, I think the LCBO is overreaching here, while Health Canada and the CFIA don't bother lifting any fingers at all)

Saturday Stories: Dutch Famine, Cooking Classes, And "Clean" Labels

Carl Zimmer, in The New York Times, on the lasting effects of World War II famine on Dutch genes and health.

Lela Nargi, in NPR, on cooking classes as heart failure medicine.

Nadia Berenstein, in The New Food Economy, on "clean" food labels.

Fred Morin, One Of Canada's Most Celebrated Chefs, On Bringing Back Home Economics

Many years ago I had the pleasure of meeting Joe Beef's Fred Morin when we were on a panel together at the Trottier Symposium. Since then we've managed to keep in touch. If you don't know Fred, he's a wonderful, ribald (don't say I didn't warn you), irreverent, French Canadian who is passionate about food and cooking, whose restaurants are ranked among the world's best. Last week Fred contacted me last week wanting to write about home economics and of course, I said yes.

Lunch is a chore and dinner barely squeezed in between school, homework and whichever sport or instrument you practice vicariously thru your offspring. For much of us the saving grace is the anonymous, and all to easy drive thru. Pardon the pornographic and graphic reference but the drive thru is no different than the glory hole, the source and recipient remain nameless in this rapid exchange of sin.

You see, meals went rapidly from something you made to something you buy, quickly ingested this brilliantly engineered modern days ration pack even comes wrapped in easily discardable containers, because, why would you be reminded of your sins beyond your health and/or weight!

Cooking, like football is played by a few skilled professionals on weekly tv shows, but like football, played by less and less of us. A quest for complicated taste and showy presentations has led many to head the way of the drive thru, paralyzed at the very idea of cooking a dinner that wouldn’t live up to Gordon Ramsay’s standards.

It may sound as a betrayal to my craft to preach simple meals but it actually very well may be the gateway to actual and beneficial cooking. a routine menu simplifies the arduous chore of shopping and your time in the kitchen. Don’t fret; simplicity is not the antagonist to diversity, you can season and twist a dish as you wish!

Cooking was, un-rightfully so a gender specific chore, in school, the boys would have shop class and the girls, home economics, only my generation was fortunate enough to experience both, Between the time schools became co-ed, and the day they removed the stoves and sewing machines to make place for room fulls of Coco 3 computers.

The secrets of braising, the skills of chopping, peeling and searing are all but lost!

We may project our own likes and professions, and pretend our kids need more coding, chess, nutrition, and organic farming classes, perhaps as a trained chef and cookbook author I’m am a little guilty of that.

Not overloading their ever morphing frontal cortex with page loads of facts on nutrition is crucial. I may be sounding like I’m metaphorically wiping my boots on my gracious host’s best Persian rug by denying the need for nutritional education in schools, while a guest on his nutrition blog (ed note: I agree with Fred), it’s unnecessary to provide tools for obsessive calorie counting, more label reading and macro nutrients deciphering to a generation who already has a very conflicted relationship with the simple act of eating, in fact, most ingredients you would want to cook do not even have a nutritional label!

I don’t want my kids to learn how to blowtorch meringue or to make spherical ice for mocktails, not yet, instead I want them, their friends and class mates to grow up with a comprehension of cooking that will set them up for life, with the ability to perform daily culinary tasks, whether they choose grass fed pasture raised hormone free Angus steak or certified authentic Kobe massaged beef, it’s up to them to decide, later!

Fred (all in his words) co-owns Joe Beef, Liverpool House, Mon Lapin, and Vin Papillion restaurants in Montreal, and is the co-author of The Art of Living According to Joe Beef. He fathered three offspring that currently prevent him from living a second youth behind the stoves. He also wishes he had gone to College. He divides his time between being fat, becoming slim, being slim and becoming fat. He lives close enough to Montreal, to call it Montreal. And you can follow him on Twitter

Saturday Stories: Arctic Time Bombs, Arctic Zombie Viruses, And A Very Old Jawbone

Michaelleen Doucleff, in NPR, on the possibility of an Arctic ticking climate time bomb.

Michaelleen Doucleff, in NPR, on the possibility of Arctic zombie viruses.

Ed Yong, in The Atlantic, on the newest, oldest, human jawbone.

When Weight Loss Makes You Stupid

First published in US News and World Report in October 2016

There's no overstating society's desire to lose weight. For decades, the goal has placed in our top New Year's resolutions, fueled a $60-billion American weight-loss industry, served as the driver of hundreds of idiotic diets and is the sizzle behind multiple, recurring, prime-time television shows. Coupling those desires with the marketing of thin as beautiful and a world that judges people with obesity as lazy gluttons who serve as the butt of fat jokes even in cartoons for young children, it's no wonder people get excited when they lose weight. They also often get a bit stupid.

Weight loss is like the dark side of The Force. It's powerful, it's seductive – but it's also very dangerous. It's weight loss that leads people to feel comfortable peddling multilevel marketing schemes involving hyped-up meal replacements to their friends and relatives. It's weight loss that leads otherwise thoughtful people to believe that because they themselves have successfully managed to temporarily lose some weight, that their method of doing so is the one and only right way to lose – sometimes even to the point of writing long missives on why everyone else's strategies are wrong or misguided. And it's weight loss – or, more specifically, helping people to lose weight by way of one particular strategy – that leads physicians and other health care providers to write books that at times eschew reason and promote their singular personal practice as set in stone science, regardless of the actual science.

The hyperbole-fueled notion that there's only one right road to success may be unique to weight loss. It seems that for all other lifestyle-influenced self-help desires it's a given that there are different strokes for different folks. Be it sleep, mood, relationships, studying, fitness and more, people don't seem to put out confrontational screeds to explain why everyone else is doing it wrong. With weight loss, those screeds seem to be the norm.

Now, you should know that I too have a weight-loss agenda. It's fairly easy to describe. In a nutshell, I don't believe that there's one right diet to suit everyone. In my clinical practice, as well as in my book, I embrace the fact that there are dozens, if not hundreds, of factors that influence an individual's chances of long-term success. Low fat, low carb, keto, paleo, intermittent fasting, vegan, Mediterranean, meal replacement, whatever – there are success stories out there with each and every diet that exists.

While I've seen proof of this in my own clinical practice, you don't have to take my word for it. Instead, look no further than the National Weight Control Registry for evidence that, when it comes to successfully keeping weight off long term, everyone's different. The massive database established in the 1990s tracks why and how over 10,000 people have managed to keep an average loss of 67 pounds off for over five years. And there, as I've described, there isn't one answer.

The one thing successful dieters have in common is that they reduce their calories on their new diets and like their lives and diets enough while on it to sustain its adoption for good. So, while it's true that you might be able to lose more weight, or to lose weight faster, with one diet versus another, unless you keep living with it forever, that weight's coming back when you head back to the life and diet that you actually liked before you lost.

To put it even more succinctly: If you promote the notion that there's one right way to lose weight or live healthfully, you're part of the problem. The more weight you'd like to permanently lose, the more of your life you'll need to permanently change. And, when it comes to something as pleasurable as food, merely tolerable lives just aren't good enough. What's best for you is undoubtedly worst for someone else.

Check Your Privilege Before Talking About Health And Personal Responsibility

This was first published in September 2016 in US News and World Report.

I was sitting and chatting with a journalist this past weekend. She's hearteningly passionate about her work, and hers is a health beat. She wanted to know how she and the media as a whole might do better at helping the public adopt healthy habits in the name of improving obesity and other chronic diet and lifestyle responsive diseases.

I think my answer may have surprised her. "Not that there aren't ways the media could improve upon their reporting," I said, "but I'm not sure it really matters in that the folks who both read about healthy living and have lives that are appropriately and realistically conducive to change are an incredibly privileged and small subset of the population."

Spelling that out more succinctly here, personal responsibility-based healthy living efforts require privileges that the vast majority of people don't possess.

First, there's the privilege of time. Yes, we all share the same 24 hours a day, but there's little doubt that for some, the time required to intentionally exercise, shop for fresh, whole ingredients, prep foods and cook rightly play second fiddle to working long enough hours to pay for their and their family's necessities. There's also the time involved in caregiving responsibilities, which could include looking after children with special needs, aged parents or an ill spouse.

Second, there's the privilege of personal health. People with disabilities, chronic pain, severe fatigue and other conditions may find purposeful behaviour change to be literally too difficult or figuratively too low a priority, given their day-to-day pain and challenges. That latter bit brings us to the most commonly overlooked privilege: the privilege of life being settled enough to even consider personal responsibility-based healthy lifestyle change.

Even if a person has the time and personal health to allow a run at intentional behavior change, how high on the list of priorities do you think healthy living lies for someone whose children struggle with substance abuse, or whose debts are staggering, or whose spouse is hobbled with post-traumatic stress disorder? Or someone with any of those same issues who is also unemployed?

Working in Canada where health care is socialized and so too are the bulk of my office's programs, I have the fortune of being able to work with people from every socioeconomic strata, and I can tell you that though everyone possesses the theoretical ability to focus on healthy habits and lives, many people's realities make lifestyle reform a nearly impossible luxury.

The longer public health and public opinion focus their attentions on the personal-responsibility narrative of obesity and other chronic non-communicable diseases, the longer we'll wait to see population level changes. If any amount of desire, guilt or shame were sufficient to drive sustained change, we'd have been rid of the so-called lifestyle diseases decades ago. We're not going to swim our way out of this flood, as not everyone can afford swimming lessons, not everyone has the time for swimming lessons and even though knowing how to swim is an undeniably good thing to know how to do, not everyone is interested in taking swimming lessons.

While it's always wise to ensure swimming lessons are available and affordable, more important to a population is ensuring we build a levee. We need policies that will help make healthier lifestyles occur by default, or that make purposeful changes easier or more valuable. Whether those changes are sugar-sweetened beverage taxes, front-of-package health claim reforms, banning advertising that targets children, improved school food policies and programs, zoning laws affected where fast food and convenience stores are located and more, there are no shortage of options. Right now, we're facing a torrential current of calories, ultra-processed foods and a culture of convenience that considers the use of junk food to reward, pacify and entertain our kids and ourselves at every turn as entirely normal. It doesn't matter how strong a swimmer you might be, or how great available swimming lessons are. Swim against this powerful a current, and even the strongest swimmers tire.

Saturday Stories: Bad Feminist, Zioness, and, Less-Is-More

Margaret Atwood, in The Globe and Mail, wonders if she is a bad feminist.

Amanda Berman, in the Forward, on Zioness, her newly founded movement that's under attack by both the far right and the far left - for feminists who (gasp) believe that Jews too have a right to self-determination.

John Mandrola, in Medscape, with his masterful essay defending less-is-more in medicine.

Numbers Aren't Behaviours And They Can't Tell You How You're Doing

I know I've said this before, but it bears repeating. Whether they're pounds on a scale, seconds on a stopwatch, or grades in school, numbers are not behaviours.

If you're ever curious about how you're doing, those numbers aren't capable of telling you. Sure, the numbers to a degree reflect your efforts and choices, but they aren't in and of themselves those things.

Given what I do day in and day out, I see this most in regard to weight management.

And I tell people, day in and day out, that if they're curious about how they're doing, the answer to that question isn't how much they weigh, how much they've lost, how their clothing fits, how they feel physically, or how they feel mentally. Rather I tell them that if they want to know how they're doing, they have to reflect on what they're actually doing, and whether that's keeping a food diary, minimizing meals out, increasing cooking, securing sleep, reducing liquid calories, whatever their strategies, if they're cultivating consistent change, they're doing well.

That's true with school in terms of going to class, doing your homework, and studying.

It's also true of sports in terms of practice, strength training, consistency, etc.

All this to say, don't confuse numbers with behaviours, and if you're doing all the things, you're doing great, numbers be damned.

Farm To Cafeteria Canada Offering $10,000 Grants. Should Your School Apply? Details Here!

When I first heard about Farm to Cafeteria Canada grants I immediately asked if they wanted to write a guest post explaining how they work. Happily Carolyn Webb, the Coordinator of Sustain Ontario’s Edible Education Network, was able to do so.

Check out this quote from NorKam Senior Secondary in Kamploops, BC,

“This year at NorKam Senior Secondary in Kamloops, BC, our cafeteria class started a salad bar for a fresh, healthy addition to our regular lunch service. We began this semester by growing our own vegetables, herbs and microgreens in anticipation of improving our cafeteria’s menu selection, and quality and freshness of food.”

Would you like to see a similar quote from your school next year?

Or how about these?

“College Heights Secondary School in the Upper Grand District School Board (Ontario) has had a fantastic first year connecting our school to local food and farms, and launching a full salad bar as part of our cafeteria service.”

“The salad bar was a huge hit today. Local carrots, kale salad with Hollyhock dressing, 3 potato salads -a traditional, a wasabi & a vinaigrette; (our vegan option) Amazing nut & bean veggie burgers, baked Halibut with sea asparagus tartar, and barbequed teriyaki spring salmon. Phew! Student prepared, right down to the condiments. (Gid Galang Kuuyas Naay Secondary School, BC).

Farm to Cafeteria Canada is offering $10,000 grants that would allow elementary and secondary schools in British Columbia, Ontario, Quebec, and Newfoundland and Labrador to implement a Farm to School program that includes a salad bar meal service.

Farm to School brings healthy, local food into schools, and provide students with hands-on learning opportunities such as growing and cooking that foster food literacy and enable students to make healthy food choices, all while strengthening the local food system and enhancing school and community connectedness.

The Farm to School Movement is growing across Canada. Today more than 1,100 schools and campuses across Canada have identified that they are providing more than 775,000 students with an opportunity to experience Farm to School through school gardens, cooking programs, salad bars and other activities. These schools and campuses estimate they spend nearly $17.5 million annually on local foods. For more information about Farm to School’s growth in Canada check out Canada’s Farm to School map.

Evidence tells us that when Farm to School is offered in K-12 settings:

• Students eat more servings of fruits and vegetables (on average .99 - 1.3 more servings), consume less unhealthy foods and sodas, reduce screen time and increase physical activity.
• Students are willing to try new and healthy food, and choose healthier options in the school cafeteria and at home.
• More students plan and prepare meals at home and more young children ask their families to make healthier purchases.
• Students are more knowledgeable about their food and the food system.
• Students achieve enhanced overall academic achievement, including grades and test scores.
• Food service staff have increased morale and knowledge about local foods.
• Each new farm to school job contributes to the creation of 1.67 additional jobs.
• Up to $2.16 of economic activity is generated for every $1 spent.
• (This data has been drawn from “The Benefits of Farm to School” (2017), The US National Farm to School Network.)

Farm to Cafeteria Canada is proud to champion Canada’s National Farm to School movement and has established the Farm to School Salad Bar grant stream thanks to contributions from the Public Health Agency of Canada and the Whole Kids Foundation. The aim of these grants is to get more students and school communities engaged in growing, purchasing, harvesting, cooking, serving, learning about, and eating healthy local foods at school.

For more information about how to apply for our 2018 grant opportunity please visit the Farm to School Canada Grants 2018 page. Applications are due by March 31st, 2018.

For more stories of inspiration from our 2016 grantees visit our Farm to School Canada Grants 2016 page!

Carolyn Webb is the Coordinator of Sustain Ontario’s Edible Education Network, a network that brings together groups in Ontario that are connecting children and youth with healthy food systems. The Network’s mission is to better enable these groups to share resources, ideas, and experience, work together on advocacy, and facilitate efforts across the province to get children and youth eating, growing, cooking, celebrating, and learning about healthy, local and sustainably produced food.

Saturday Stories: Tonya Harding, Pizza Cinnamon Rolls, and Romantic Hunter-Gatherers

Taffy Brodesser-Akner, with just a gorgeous piece of writing in the New York Times, with her interview of Tonya Harding.

Geraldine DeRuiter, in Medium, describes her experiences making Mario Batali's sexual misconduct apology pizza cinnamon rolls.

William Buckner, in Quillette, on the romanticization of the hunter-gatherer.

Britain's Food Nannies Will No Longer Sell You 1.75L Bottles of Coca-Cola

Yup, you read that right - if you live in Britain, you might want to stock up on 1.75L bottles of Coca-Cola, as starting in March, you'll be forced to buy only 1.5L bottles.

And yet there's no outcry from the beverage industry.

You'd think there would be. After all, back when nanny Bloomberg tried to pass his cup size ban - the one that would have forced you to buy two 500ml cups if you wanted to drink the volume of a human stomach (1L) worth of soda at once, the beverage industry bought a full page advertisement in the New York Times to complain about it (that's it up above).

But what about Brits' rights to buy 1.75L bottles of liquid candy? Why no screaming about Britain's fun and freedom stealing nanny?

Because Britain's nanny is the beverage industry. You see Coca-Cola, consequent to Britain's new soda tax, wants to ensure people keep buying plenty of product, and to help ease the tax' sting, they're going to stop selling 1.75L bottles (which incur more tax) altogether.

So the next time you're tempted to shout about the nanny state when someone like Bloomberg proposes a new policy designed to encourage decreased consumption of junk food, remember, you already live in a nanny state.

The food industry is your nanny.

(originally posted in response to Philadelphia's similar plan)

Body Weight Set Points. Sociology, Or Physiology?

The notion that bodies possess a weight "set point" is deeply entrenched.

And regardless of the mechanism, what appears to be true is that people tend, following weight loss, to regain the weight they've lost, finding themselves right back where they'd started.

As to the mechanism, there are many theories (including a cool new one that was explored in mice which Dr. Sharma covered last week), but the one that I tend think carries the most weight is sociological, not physiological, in that when we give up on our temporary diet and lifestyle interventions, we revert back to the lives we had been living prior. Those lives, for better or for worse, are comfortable and automatic. They include our dietary likes and dislikes, our cooking skills, our life's responsibilities, the number of meals out we regularly eat on our own, with our families, and with our friends, our sleep patterns, our activity levels, our treats and indiscretions, and so much more.

They also include the same average number of daily calories that they always did.

So why would it be surprising that when we quit our diets and return to all of our normal patterns (and calories), that our weights tend to head back to where they started?

All this to say, aim for the healthiest life that you can actually enjoy, as if life's merely tolerable, you're less likely to stick with it.

Saturday Stories: Siddhartha Mukherjee², and a Tea Party Friendship

Siddhartha Mukherjee in The New Yorker, with his poignant and incredible piece about his father's death.

Siddhartha Mukherjee in The New York Times Magazine, with his description of what happens when a clinical trial fails.

Stephanie Mencimer, in Mother Jones, with her tribute to her late Tea Party friend.