8 Year Anorexic's Mom Cites The Biggest Loser as Potential Contributor to Daughter's Illness

In 2008 The Cutting Edge did a documentary on Dana, an 8 year old anorexic and recently a friend on Facebook sent it my way.

In it they cover the rising rate of eating disorders among ever younger children where according to the show in Britain between just 2006 and 2008 the number of children under 10 admitted to hospitals with eating disorders rose by 50%.

Dana did well in treatment and was discharged home and in the wrap up interview her mother pondered the genesis of her daughter's struggles,

"I always feel it was just a few things that clicked together like a jigsaw.  One, she started watching this program called America's Biggest Losers, it's a weight loss challenge. I did see her watching it. I just didn't really consider it dangerous. I didn't you know, she's never been a kid that had even mentioned dieting. It just clicked into place. If you don't eat, you lose weight and watching this weight loss challenge program about how they're all trying to give up food, it was just a combination of things that happened together".

The documentary is frightening. The residential eating disorder treatment home's director had this to say on their increasing number of under 10 year old patients,

"I worry very much that we're so many younger and younger children. They are being robbed of their childhood these days. Children as young as 5 and 6 are sitting in the playground discussing the shape of their bodies, talking about the fat that they've got and the fat bits that they would rather not have. You can't underestimate how serious it is."

If you'd like to watch the documentary, click here or watch below, and please, don't let your children watch The Biggest Loser and better yet, don't watch it yourself:

Saturday Stories: Trolls, Cheerleading, Amazeballs and Guerrilla Gardening

The New York Times covers the science of internet trolls.

Tom Laskawy in Grist and a great open letter to Michele Obama explaining how being a cheerleader for the food industry isn't likely to help.

My friend and fellow MD blogger Bryan Chung with some awesome irreverence on the recent eat protein for muscles story (and that's his photo I ripped off up above).

Here's a bonus TED Talk (email subscribers you'll need to visit the blog to watch) from Ron Finley on guerrilla gardening (h/t to CHEO's Dr. Stasia Hadjiyannakis)



[And finally some extras from me. My weekly US News and World Report piece this week was on why I think baked chips are worse than fried, and here's a clip from the CBC with me ranting about the need to stop focusing on individuals and start changing the environment in the context of Ontario's recent Healthy Kids panel report]

True Facts About the Land Snail

This Funny Friday video appeals to the little boy in me who used to spend Saturday and Sunday mornings watching nature shows, and the big boy in me who's full of snark.

Have a great weekend!

(Email subscribers - visit the blog to watch)

How I Earned the Ontario Public Health Association the Threat of a Lawsuit

So as regular readers are aware last week I gave an invited talk to the Ontario Public Health Association at a Marketing to Children conference.

Part of my talk included a screen capture of a press release from Food & Consumer Products of Canada (FCPC) that highlighted the appointment of their Vice President, Food-Policy, Science & Regulatory Affairs, Phyllis Tanaka (that's the screen cap up above, and here's the link to the press release).

According to the Government of Ontario's Newsroom, members of the Healthy Kids Panel,

"are recognized leaders in their fields, possess a broad understanding of childhood obesity, and are connected to different sectors and communities including....consumer products"

According to the FCPC their organization serves as,

"the voice of more than 100 businesses in the consumer packaged goods industry."

and where they report the FCPC,

"promotes sound public policy, champions initiatives that increase productivity and profitable growth and helps to protect the safety and security of the consumer product supply through a commitment to scientific and supply chain excellence and industry best practices."

Among the corporations spoken for with the voice of the FCPC are PepsiCo, Mars, Frito Lay, Hershey's, Nestle, McCain - and the list goes on.

Now for those who don't know, the definition of a conflict of interest includes even the perception of there being the possibility of a conflict, and given that public health is not part of the mandate of the FCPC, it struck me that Ms. Tanaka's inclusion on the panel was in conflict with the panel's expressed aim. And because Ms. Tanaka was in the audience during my talk, rather than simply flash a photo of her in a press release on screen and have people whisper, I mentioned that she was present when I discussed how I felt the FCPC should never have had a voting seat at a table where the votes would impact on their members' products' sales. I also explicitly pointed out that my statement had nothing to do with Ms. Tanaka as a person, that I didn't know her personally, and that my expectation of any member of that panel would be to represent their professional interests and expertise. I also pointed out that when I testified in front of the panel itself the only person who was furiously taking notes was Ms. Tanaka and I speculated that perhaps it was because my concerns, if acted upon or championed by the panel would be of concern to the FCPC's member corporations.

Following my talk Ms. Tanaka corrected me and told me that I had mis-characterized her note taking and that note taking was her habit and she was doing so for her benefit and for the panel. I apologized for the mis-characterization and did not bother pointing out at the time that there were official secretaries present during my talk to the panel. I also asked Ms. Tanaka what would have happened had the panel come out with a recommendation that very negatively impacted upon an FCPC member's product - would that put her in hot water with her boss? She informed me that she was on the panel as an individual, and was not representing the FCPC there.

The interaction was cordial. No voices were raised. No names were called. Nor did I ever dispute or question the veracity of Ms. Tanaka's answers to me.

Yet the next day the OPHA was contacted by the FCPC's Senior Vice-President Derek Nighbor who was very upset that I mentioned Ms. Tanaka by name during my talk. He demanded that said slide (the one with the FCPC press release congratulating Ms. Tanaka's appointment to the panel - the press release that too names Ms. Tanaka) be redacted from my presentation, that a report be made to the OPHA's Board of Directors, and that a letter of apology be sent to the FCPC and Ms. Tanaka. He also threatened to send a letter of complaint to Health Minister Deb Matthews and to sue the OPHA - though he did not make it clear to the OPHA what grounds the lawsuit would cover. He did not however attend my talk, nor did he attempt to contact me with any of his concerns.

I'm writing this blog post to apologize to the OPHA. I'm sorry that me calmly and politely speaking my mind led them to have to expend their time and energy dealing with the FCPC.

I also reached out to the FCPC. Not to apologize as truly I don't feel that it was wrong of me to mention a perceived conflict of interest, nor do I feel I was at any point rude or disparaging of Ms. Tanaka, but rather to try to understand what had gone on from their perspective. You'll find below an unedited response from Mr. Nighbor which as is my convention, is presented without commentary from me.

I know that I had some blog readers at the talk. Would love their opinion as to whether or not my talk or our question and answer period afterwards was disrespectful, and if it was, I certainly would like to extend my apologies to Ms. Tanaka as disrespecting her was not my intent.

What was my intent?

My intent was to point out that Frito-Lay's and PepsiCo's interests should never have a vote or even a perceived representation at a public health table due to the clear conflicts of interests involved in the inclusion of food industry representatives in the creation of public health policy involving food. I'd further argue that the reaction of the FCPC to my talk and what strikes me as an attempt to intimidate the OPHA is a clear example of how the food industry and public health aren't on the same team and that were this really about what I said at the conference, it'd have been me receiving the angry phone call and the threats.

Hi Yoni,

Thanks for your note and the ability to clarify a few things.

Let me be very clear - in my conversation with Ms. Cheng, a formal suit was never threatened against the OPHA.

I merely called Ms. Cheng to state my concern about how you questioned Ms. Tanaka's role on the Healthy Kids Panel as part of your presentation at the OPHA event - and that the positioning of your attack could be perceived as slanderous.

Ms. Cheng unfortunately misplaced the context of that discussion in her letter which makes it quite misleading.

The point I raised with her was my disappointment that, at a public forum, you would use a photo of Ms. Tanaka and name her. To me, it was straight-up inappropriate and a personal attack - as thought a host of others who were there to see the presentation and called to tell me what happened after.

Furthermore, I think it's important that you understand - contrary to your suggestions - that Phyllis' role as part of the Ontario Healthy Kids Panel was treated by her with the utmost of confidence - and that was supported and respected by FCPC.

Phyllis and our organization took this commitment very seriously - so much so that FCPC and our member companies were not privy to any of the HKP discussions - nor the report before it was released to the general public.

Yoni, we will likely disagree on a host of issues, but for me it's about a fair and honest exchange about the issues.

Challenge away at some industry practices, debate the issues, let's in some cases simply agree to disagree - but the attacks against specific individuals should be left on the sidelines.

Many thanks for reaching out and do contact me directly if there's anything else.

Derek.

Why I Don't Support a Junk Food Advertising Ban for Children

Simple.

It's not enough.

It's not enough for a number of reasons.

Firstly it's not enough because why should anything be advertised to a population that has been shown to not be able to discern truth from advertising? If we're talking ethics, it's plainly unethical to allow advertising to target children. Period.

Secondly it's not enough because at least one recent study suggests the possibility that advertisements for food, any food, even healthy food like fruit, paradoxically lead children to increase consumption of calories and unhealthy dietary choices.

Thirdly it's not enough because there's no agreed upon definitions for what would constitute unhealthy food. In turn not calling for a total food advertising ban at best necessitates long and drawn out discussions to try to define unhealthy and at worst, simply paralyzes the process.

Lastly it's not enough because even if a definition of "unhealthy" is agreed upon, food manufacturers will take advantage of the new definition of "unhealthy" to make products that come in one squeak better than that - and then not only continue to market them, but to market them with their newly found health halo - because after all, if they're allowed to advertise them, consumers will automatically assume that they must be "healthy".

And I'm certainly not the only one who feels this way as evidenced by a wonderful paper coming from a whole boatload of Canadian friends and colleagues from across the country. Published just last week in the Journal of Public Health Policy (and freely accessible) is a paper entitled, Restricting marketing to children: Consensus on policy interventions to address obesity where their evidence based consensus opinions include the following stronger than the recent Health Kids Panel report's recommendations:

• A Canadian (federal) government-led national regulatory system prohibiting all commercial marketing of foods and beverages to children under 18 years of age, with exceptions for 'approved public health campaigns promoting healthy diets'

• That regulators set minimum standards, assure monitoring of compliance, and impose penalties for non-compliance.

Importantly they also define marketing in a realistically broad sense of the term,

"We recommend adoption of a broad definition of marketing that includes, but is not limited to, all media through which children are or can be targeted, such as ‘sponsorship, product placement, sales promotion, cross-promotions using celebrities, brand mascots, or characters popular with children, Websites, packaging, point-of-purchase displays, e-mails, and text messages, philanthropic activities tied to branding opportunities, and communication through ‘viral marketing’."

So while I was thrilled to see a call targeting advertising in Monday's Healthy Kids Panel report, it's not enough, and moreover, if enacted, would be almost certainly be ineffective and potentially even harmful.

And my bet is, the food industry representatives who were full voting members of that panel - I bet they didn't raise one peep of concern when a junk food advertising ban was suggested as it was the best possible advertising recommendation they could have hoped for. I'd go even further and bet that they were even vocal champions of it during the committee meetings.

Government! Next time, by all means let the food industry come to testify in front of the next such committee and ensure their concerns are heard, but for the love of god, next time, don't give them a vote.

Why Ontario's Healthy Active Kids Panel's Report is so Important and Heartening

If you're an Ontarian by now I'm sure you've heard a fair bit about Ontario's release yesterday of the recommendations made by our Healthy Kids Panel.

I'm not going to go into a point by point discussion and dissection. Overall the report's solid. It makes 23 recommendations and as I was warned in an off the record chat with one of the panel members this past weekend, they might not be my top 23 items, but as I told the panel member, that's not what matters. What matters is that they're not all fluff, and more importantly what matters is that many of them have their sights set very squarely on the environment.

This is not your average Eat Less, Move More report. Instead this is a report that recognizes that the world in which we're raising our kids pushes them into the open arms of food marketers, of piles of sugar, and of boatloads of calories. Kids aren't trying to gain weight, their parents aren't encouraging them to eat poorly - that's just our new default - our new normal.

While it's no doubt going to take more than 23 sandbags to build a levee, and while no doubt some of these 23 sandbags are merely beanbags, while others may have a few holes in them, what's so incredibly encouraging is that this is in fact a levee building report, and not the usual tripe about how we're going to manage a flood by teaching kids how to swim.

More from me on one of the 23 recommendations tomorrow and where I think it missed a crucial mark, but for today, kudos to the panel, and kudos to our Health Minister Deb Matthews for making childhood obesity prevention a priority, and with this panel's help, for rightly identifying that it's the world around our kids that's the problem, and that the kids indeed are alright.

Fingers crossed too that this report, unlike many of our federally funded reports, does in fact translate into action, and isn't simply tucked into a drawer somewhere.

How Does a Biggest Loser Teen Celebrate her Birthday?

Who knew, but according to Wikipedia we've associated birthdays with birthday cakes since as far back as ancient Rome, while archaeological digs have us celebrating with food for at least the past 12,000 years.

Food isn't just fuel. As a species we celebrate and comfort with food, and when we undertake efforts that deny food those roles in our lives, well those are called diets, and generally in the long run they fail. Human nature simply isn't built to suffer unnecessarily in perpetuity, and while thoughtfulness regarding dietary choice is certainly a requisite for a healthy life, being overly strict surely isn't thoughtful.

I've been highly critical of the inclusion of teens on this year's The Biggest Loser. My two main concerns can be boiled down to:

1) The teens are going to be taught that success requires a lifetime of sacrifice and suffering.

2) Being portrayed as lazy gluttons on prime time television, and being taught that if you just try hard and sacrifice enough you'll succeed, when coupled with the almost statistical certainty of regain in at least one, if not all the teens, puts them at huge risk of both increased future bullying, and tremendous damage to their own personal self worth and esteem.

Now the Biggest Loser has made it very clear - the kids are going to be treated more gently than the adult contestants, but of course the kids will be watching the show and are in fact being managed by the same team that the adults are - are they going to absorb the show's ultimate messaging - that weight is the only determinant of health and that there's no amount of suffering too great to get to some artificial number on a scale?

Sure looks that way.

One of the contestants, 16 year old Sunny, recently blogged about her seventeenth birthday in Seventeen magazine. Did she have cake? Well of course not, the show has taught her that she doesn't deserve cake if she wants to be "healthy". Instead her trainer, after an "exhausting workout", gave her, "a tiny, sweet mandarin orange with a birthday candle stuck into it" which according to Sunny, "was, hands-down, the best birthday cake I’ve ever tasted".

Honestly I wish Sunny and the other teens on the show all the luck and kindness in the world. I hope they prove my concerns to be entirely unfounded, me a blowhard idiot, and that their weight losses are permanent and their lives only blessed by their involvement with the show.

But I can't help but worry about the 17 year old girl who's been taught to think that birthday cakes are tangerines with candles in them.

Saturday Stories: Peanut Butter Felonies, Calcium & Vit D supplements, BPA, Cancer, and Death

Too many great stories this week so an extended edition!

Maryn McKenna and a fabulous piece in Wired on the recent peanut butter felonies - Shit, Just Ship It.

The delightful Marion Nestle shares her recent editorial on whether or not we should still be recommending Calcium and Vitamin D supplements.

Trevor Butterworth in Forbes interviews a world expert and non-industry funded expert on phthalates and other environmental chemicals on whether or not we've been told an evidence based truth regarding the risks of BPA

An anonymous woman shares the real life impact her cancer's diagnosis and treatment had upon her marital identity.

Propublica Health Reporter Charles Ornstein with an incredible and personal piece on the recent death of his mother Harriet.

[And in case you don't follow me on Twitter or Facebook, here's this week's US News and World Report column - how to fight back against your children's sugar and junk food pushers.]

Toddler Takes First Steps and Proves Things can Always Get Worse

Stay tuned to today's Funny Friday past what you think might be the punch line to get to the real punch line.

Have a great weekend!

(Email subscribers, head to the blog to watch)

Is the Food Industry Public Health's Best Target?

A little while back I published a blog post entitled, The Talk the Food Industry Couldn't Bear to Hear and included in it a presentation that ultimately concluded the only real obligation I felt the food industry had was not to blatantly lie to consumers, and that much of the blame for the food industry's questionable products and practices fell on us as a society for letting them get away with what ultimately amounts to slow motion murder. Thanks in large part to the folks over at Reddit, that video has now enjoyed nearly a quarter of a million views.

Well on Monday I gave what perhaps can be thought of as a sequel to the food industry talk.  I've called it, "What's Public Health To Do" and in it I make the case that public health needs to throw more stones. And I think that right now those stones are probably better thrown at our own glass houses than the food industry's reinforced bunkers in that I think there's plenty we need to work on in-house and presumably, we'll have a more willing audience.

In business it's said that it's far wiser to spend your resources retaining an existing customer than trying to woo new ones. Here our customers are the folks who are already sweating their life's blood promoting and protecting public health and frankly I'd expect they'll be far more open to change than the folks we seem to want to woo as new customers - the food industry - whose life's blood is spent promoting and protecting profit.

Whether it's improving food in our schools, hospitals and public health institutions, improving nutrition fact panels and front-of-package labeling laws and self directed programs, removing vending machines from sporting facilities, creating evidence based resources for communities that tell the truth about exercise not being an obesity panacea, fixing summer camp menus and weak school food policies, or combating weight bias in public health messaging, there's plenty for us folks who care about public health to do.

One person attending the talk took some issue with my recommendation to throw stones stating that wasn't how public health gets things done. While I appreciate where she was coming from I think we do need to speak up more, we need to have a loud and unified voice, and indeed not be shy to throw stones. I don't recommend we throw them at individuals, but rather at what we feel to be broken. Critically appraising existing programs, calling out inadequately designed interventions - that's not the same as criticizing people and frankly if those programs or interventions are easily defensible, the criticisms will be easily deflected. I'd argue that staying quiet in the face of things we know to be wrong or misguided, while perhaps the polite thing to do, is a failure of our seminal obligation to the public - to protect, promote and preserve their health.

For those who are interested, the talk's just under 15 minutes long.

[And just a quick note. In the talk, and previously on my blog I talk of how when I provided testimony to the Ontario Healthy Kids Panel the only person furiously scribbling notes was a food industry representative named Phyllis Tanaka. After my talk she informed me that I was mistaken, and that it's simply her habit to keep notes and that they were for herself personally and the panel, and not her representative food industry organization. Of course it's also my recollection that the panel had their own official secretary.]

Guest Post: More Facts on Fats

Last Saturday I linked to a story from Consumer Reports that highlighted the state of the evidence on fat. That story seemed to upset some folks and so I reached out to the article's authors, Kevin Lomangino, the editor of Clinical Nutrition Insight and asked him if he would be willing to expand on his piece and also to cover what the term, "state of the evidence" means as it would seem that some of the comments left that Saturday were left by folks who aren't familiar with the concept that rather than meaning "fact", it means this is what the data looks like today.

More Facts On Fats
Kevin Lomangino

Last week, Yoni linked to a Consumer Reports story called “Fat Facts and Fat Fiction” that some readers of this blog weren’t very happy with (scroll down to the comments for Yoni's post). This was no surprise, since dietary advice about fat is always controversial, and even experts disagree about what recommendations are supported by current evidence. As a contributor to the Consumer Reports piece (which was also extensively edited and reviewed by nutrition scientists), I thought I’d address some of the concerns raised in the comments and try to provide more detail and links to the evidence that we considered. Although I don’t harbor any illusions about changing people’s strongly held beliefs about food, I do believe that our recommendations are sound and were based on the best scientific evidence available. The following comments are my own opinion and haven’t been endorsed or reviewed by Consumer Reports.

Revisiting Saturated Fat

Is saturated fat bad for you? A growing number of people think that the answer to this question is no. But to my mind, this question can’t really be answered without first considering a second question: What are you comparing it with?

If you reduce your saturated fat intake, chances are very good that you’ll be replacing those calories with something else. And if that “something else” is refined carbohydrate, then evidence increasingly shows that you won’t improve your health and might be worse off. On the other hand, if you replace those saturated fat calories with unsaturated fat instead, then there’s consistent evidence that you may well reap some cardiovascular benefits from the change.

As noted in the Consumer Reports piece, a recent Cochrane Group meta-analysis, widely regarded as the “gold standard” in critical evaluation of medical evidence, found a 14% reduction in cardiovascular events across randomized controlled trials that involved reduction and/or replacement of saturated fat with unsaturated fat (including both mono and polyunsaturates). Another meta-analysis that looked specifically at studies replacing saturated fat with polyunsaturated fat (trials involving monounsaturated fat were excluded) found a 19% reduction in coronary heart disease events.

Admittedly, the reduction is not that big, which is something we tried to communicate by providing the absolute number of events that occurred in these studies (77 per 1000 people on a regular diet vs. 66 per 1000 on a reduced saturated fat diet in the Cochrane review). Still, the difference is substantial enough to provide meaningful benefits if large numbers of people carried out the recommendations.

These studies have limitations, of course, and some researchers say there’s not enough proof to conclude that replacing saturated fat with polyunsaturated fat is causally related to heart benefits. Then again, diet studies are hard to do and almost always yield messy evidence. It’s unlikely that better studies will be available any time soon to guide our thinking. Meanwhile, a variety of prestigious groups have looked at the evidence (see this and this), including epidemiologic and biomarker studies, and concluded that it all points to a benefit for replacing saturated fat with unsaturated fat. That’s a well-supported stance based on the current state of the evidence.

Benefits of Omega-6

Commenters also raised concerns about our endorsement of vegetable oils that are high in linoleic acid, an omega-6 polyunsaturated fatty acid. This reflects longstanding worries that high intakes of omega-6 are pro-inflammatory, and that increased intake may well lead to higher risk of cardiovascular disease and other adverse health outcomes.

As the article pointed out, this is an area where research is rapidly evolving and could quickly swing one way or the other based on new evidence. Nevertheless, studies conducted to date don’t show that we have much to worry about with linoleic acid. Despite theoretical concerns about inflammation, recent systematic reviews found no evidence that higher linoleic acid intake increases inflammatory biomarkers or their precursors. And as noted above, a meta-analysis of clinical trials showed cardiovascular benefits from replacing saturated fat with polyunsaturated oils. In these studies, participants replaced saturated fat primarily with oils rich in linoleic acid such as soybean oil, corn oil, and safflower oil.

As some researchers have pointed out, there may be a difference between studies that increased linoleic acid exclusively and those that also simultaneously increased intakes of omega-3 fatty acids such as alpha-linolenic acid, EPA, and DHA. They say that the increased intake of omega-3s in these studies may have negated the harmful effects of linoleic acid and obscured its risks. This view is supported by a recent analysis that unearthed old data from one of these studies – the Sydney Diet Heart Study, originally conducted in the 1960s – that replaced saturated fat exclusively with safflower oil, which is 75% linoleic acid and has no omega-3s. The authors reported a higher rate of death from cardiovascular disease in the safflower oil group compared with controls who consumed their usual diet (17.2% vs. 11%).

This study hadn’t yet been published at the time our Consumer Reports piece was released, and I think it will take some time before these results are fully digested. However, early reaction to the study has raised concerns about its validity – particularly the fact that the margarine consumed by participants in the safflower oil group apparently had considerable amounts of trans fat, which might have contributed to the cardiovascular harm seen in that group.

Personally, I wouldn’t fault anyone for being a little more cautious about safflower oil in the wake of these results. But it’s hard to see how the results implicate linoleic acid in general, as similar studies involving soybean oil, which is about 50% linoleic acid and has only a small amount of omega-3s (about 7%), have shown cardiovascular benefit. Also, you’d have to work very hard to obtain 15% of your daily energy from safflower oil as they did in this study. (The average intake of linoleic acid in the U.S. is currently 6.7%, less than half that level.) If you “choose a variety of plant-based oils, plus low-mercury fish such as salmon twice a week” as recommended by Consumer Reports, you can be confident of getting a good mix of unsaturated oils that are likely to be protective.

What About Hexane?

Lastly, some commenters expressed concern about hexane, an industrial solvent that is used to process many cooking oils, including soybean oil (as well as the defatted soy protein flakes that are used in veggie burgers and other soy foods). As we noted in the article, hexane is a neurotoxin, and testing has reported trace amounts residual hexane in soybean oil (about 10 parts per million). While that may sound disturbing, there’s really no evidence that such minute exposures pose any kind of health risk. Hexane has been shown to cause toxicity in places like shoe factories and furniture finishing shops, where workers were breathing in much higher amounts of hexane and absorbing it through their skin from rags. But these types of exposure are likely more hazardous than oral consumption, because they bypass the liver.

According to an EPA toxicological assessment, there has never been a study of oral exposure to hexane in humans, and very few studies in animals. John L. O’Donoghue, VMD, PhD, a toxicologist who was a coauthor on one of these rodent studies, told me that they had to give “very large quantities” of hexane before they observed any neurotoxic effects. How much are we talking about? This Slate article estimates you’d have to eat the equivalent of more than 1 million veggie burgers a day to approximate this level of exposure! O’Donoghue told me, “I don’t know of any reason to consider [hexane in cooking oil] a problem.” With that being said, I realize that we can’t definitively rule out adverse effects from chronic long-term exposure to small amounts of hexane, because the studies simply haven’t been done. And you may also wish to avoid hexane-processed oils for other reasons, such as worker safety and air pollution concerns. Still, in a world full of risks, hexane in cooking oil doesn’t rank as priority for personal health. You can avoid hexane by choosing expeller-pressed oils, but realize that these products will cost quite a bit more than hexane-processed oil, because the extraction process is much less efficient.

Take-Home Message

Why is fat so controversial? In my mind, it’s an example what Marion Nestle called the conflict between science- and belief-based perspectives. Many people believe that vegetable oils simply can’t be good for you, because they haven’t been a significant part of our diet for more than a few decades. They are much more comfortable eating the foods that we’ve always eaten, which more often than not will be animal-based and higher in saturated fat. It’s a valid view, but the science—at least for now—does not support this approach. The verdict could change if and when we get more high-quality research on this topic.

Meanwhile, the overall science-based message is not to worry too much about one specific food or nutrient. Where reasonable and feasible, replace butter and solid fats in your diet with a variety of plant oils such as olive, canola, soybean, and peanut. Eat fatty fish twice a week. Limit processed junk food that is usually rich in saturated fat and refined carbohydrate, and fill up most of your plate with fruits and vegetables instead.

Kevin Lomangino is editor of Clinical Nutrition Insight, a monthly evidence-based newsletter for physicians and dietitians, and a reviewer for HealthNewsReview.org. He tweets as @Klomangino.

The Heart and Stroke Foundation Is Once Again Giving Health Check to Cookies?

Back in January 2008 I blogged about the inanity of the Heart and Stroke Foundation's Health Check program awarding its check mark to cookies.

I pointed out that the Health Check logo when awarded to cookies deceives Canadians into thinking that Check'ed cookies are not only choices that shouldn't be limited but rather choices that are, according to their own market research,

"'nutritious', 'healthy', 'good for you' or 'approved by the Heart and Stroke Foundation.'"

Perhaps in response to some of the stink I'd been raising in July 2009 the Heart and Stroke Foundation announced,

"To remain consistent with the recommendations in Eating Well with Canada’s Food Guide, the Cookies category is being removed from the Health Check program. Effective immediately Health Check will not accept any new food item from the Cookies category to join the program"

At the time, I did in fact take them at their word (though I couldn't help but scratch my head on why it is they needed the Food Guide to suggest to them cookies shouldn't get Checks).

Perhaps I shouldn't have.

I saw this product in the supermarket the other day. It's Dole's Mixed Berry and Almond Bites and there's no mistaking that it's being promoted as a healthful choice. Its box shouts that it's made with all natural ingredients, that there are no artificial preservatives, that there are 2 grams of fibre per serving (clearly proving that Canadians don't know much about fibre given that 2g of fibre isn't all that exciting), it's part of their "Live Right" branding, and yes indeed, it sports the Heart and Stroke Foundation's Health Check logo.

Looking at the nutritional breakdown you'll find that the "bites" are 32% sugar by weight, that they have virtually nothing nutritionally redeeming in them (that 2g of fibre - you can get that from half a small apple), and that their 11 grams (nearly 3 teaspoons) of sugar per serving are just 0.1 grams shy of the sugar you'd find in an equivalent weight of Chips-Ahoy cookies.

So are these "bites" cookies? Well they sure look like cookies. I'm guessing they also taste like cookies. They certainly pack the sugar of cookies. But unlike cookies, these healthwashed "bites" are being marketed to people, likely including parents of young children, as being a healthy, good for you, choice. That in fact makes them worse than cookies because at least with cookies you won't be as likely to kid yourself into thinking they're healthy choices for you or your children.

Would love to know what the Heart and Stroke Foundation's Health Check folks call these things, because if they're not cookies, I'm not sure what I'd call them.

Guest Post: Parental No Files - The Exhausted Dietitian Mom

Today's guest posting comes from Registered Dietitian and blog reader Rebecca Davids. It seems my "Parental No" files struck a cord in her - so much so that she felt compelled to write to me and at my request, agreed to allow me to post her letter to me as a guest posting.

[BTW - you can follow Rebecca on Twitter]

The Exhausted Dietitian Mom

I am exhausted. I really am.

I have 6 year old twins – a boy and a girl. No they are not identical (that is a different rant). I say ‘no’ a lot. All the time in fact. More than I should have to. It is really starting to annoy me.

Like most parents, I’ve found myself entrenched in the world of extra-curricular activities. Two kids, very different interests and abilities result in weekly trips to my local swimming school, recreation centre, hockey arena and dance school. Again, like many parents, each week I strive to give my kids both structured and unstructured physical activity opportunities. Here’s the thing, each and every time my kids head off to one of their activities, they are inundated with junk food offers and unhealthy messages.

A few cases in point:

Swimming – My local swim school gets the award for worst offender possible. Access to junk food and offering ‘treats’ as reward is constant. There is a vending machine full of candy, an eye-level glass display case at the front desk full of candy, pop and chips and ‘treats’ given at the end of each session and at each holiday. I cannot count the number of kids that march out of swimming lessons, presumably heading home for dinner, sucking away on a ring pop.

Dance studio – until this year there was an actual ROOM full of chocolate bars, candy, potato chips, juice etc. This year the dedicated room is gone, but you can still find a selection of junk in the studio ‘store’. In their summer camp brochure, they encourage parents to pre-purchase a ‘card’ so your child can buy items at the tuck shop during the day.

Hockey/local arena – Let’s start with the fact that my kid is called a “TimBit”. Not that he isn’t incredibly adorable. He is, as are all the other 6 year olds with jerseys down to their knees skating and sliding all over the ice, but here’s the thing - there really isn’t any other hockey option in Canada. All kids in his division are TimBits and based on the uniforms of the bigger kids I see in the arena, he’ll graduate into a McDonald’s sponsored jersey next. Once we get past the sponsorship we move on to the snack bar and likely, not much has to be said here. Healthy options are just not on the menu. The only saving grace about the arena and rec centre is that these are ‘public spaces’ and I also know rec centres are on the agenda of public health for action. I also know how long it takes to change things.

At each and every one of their activities ‘junk food’ plays a part. The message my kids get week after week is –“Exercise, play hard and be physical – good job! Now go have some junk food to reward yourself!” At age six, and despite my best efforts, they do associate success, play, and winning with ‘treats’. It drives me batty.

It isn’t just sports and activities. The pervasive junk food offerings are just as common at school – the fundraisers, the ‘special’ days and the hot-lunch offerings. It is also at summer camp and really, pretty much each and every place we go as a family.

So, back to why I’m exhausted.

It isn’t because life is busy. It isn’t because my kids will ask me on a weekly basis for a chocolate, donut or ring pop. I don’t blame them – they are six and there is a yummy sweet snack in their face. It is their job to check me out to see if I’ll say yes.

I’m plain tired (and getting pissed off too) that I have to say no. All the time. I have to say no more than I should have to.

See it is easy for me to say no. I’ve never said yes. Not once. My kids don’t actually expect me to get them junk food after their activities. In fact, I’m sure they would be shocked. It isn’t that I don’t say yes to less than healthy foods – trust me, I do, but I do so at the times and locations of my choice.

So then I was thinking. It is easy (albeit exhausting) for me to say no. I know why I need to say no. I have two degrees in food and nutrition. I work as a dietitian in public health, which means I talk food and nutrition for a living and I’m paid to be well-read on the subject. I’m also fortunate enough to have the financial means to buy tasty fruits and vegetables that might not be on sale. I have the time, energy and a support system to ensure I provide homemade meals and snacks. I can experiment with all sorts of healthy recipes and dishes. I also can make the time to cook and bake with my kids – creating foods at home that are as ‘cool’ as the stuff in the store.

I know how exhausting it is to say no all the time to the pervasive junk food offerings. I know it is even harder for others. As a dietitian-mom, I feel for the moms (and dads too) who struggle to afford healthy foods, struggle to create a home where healthy food is the norm and where affording a relatively inexpensive ‘treat’ is the maximum they can buy for their child, not the minimum. I feel for the moms who don’t have the extra time, energy or resources to teach their kids to cook or experiment with healthy food.

So that is it. I’m tired. I’m tired of saying no when I should not be put in the position in the first place. I’m tired of, in spite of my best interests and teaching, that my kids are inundated with the messages of junk food – all the time.

Where does that leave me (and likely many others)? Other than being a royally pissed off dietitian-mom? Overwhelmed by the enormity of the situation and how to change it. Frustrated by the pace of change, but resigned that this is going to take a generation to shift. Motivated by people who are speaking out. Ready to jump in and do my part.

I’m ready to start filling the sandbags. One at a time.

Rebecca Davids, MSc, RD

Saturday Stories: Paleo diets, Husbands, and Reclining Seats

David Despain covers a recent conference on paleo diets.

Author Ann Douglas tells her husband how much she weighs (after 26 years of marriage) and the world does not end.

Here's a piece I loved from Slate on reclining airplane seats and how people who use them might be evil and so too might be whoever invented them.

A bonus piece this week too as an update to a post I wrote on Wednesday. Alberta Health Services denies backgrounder on vegan diets that didn't provide any advice on how to obtain certain nutrients other than eat animals was meant to diss vegan diets.

[And in case you don't follow me on Twitter or Facebook, here's this week's column at US News and World Report that in just 48 hours had been amazingly been liked over 24,000 times asking Why is Everyone Always Giving My Kids Junk Food? And here's an interview that I did on weight, parenting and kids.]

How to Respond to Your Life's Trolls!

Trolls.

They're the folks who post rude angry emails if heaven forbid my opinions don't jive with theirs.

From the moment this Funny Friday video subject uttered its first peep I knew it would be forevermore how I pictured my angry tub thumpers. Keep this link on file and then whenever a troll pops up in your life, just send them to this piece.

Have a great weekend!

(Email subscribers, you have to head to the blog to watch)

Why Is Alberta Health Services Dissing Vegan Diets?

This one's a bit nutty.

So apparently Alberta Health Services, the official provincial health folks, are alarmed by vegan diets.

So much so in fact that they published a one page backgrounder for "professional purposes only" developed by the province's official registered dietitians in response to the movie Forks over Knives which in turn makes the case for vegan diets to prevent chronic diseases. The response suggests animals really ought to be part of everyone's diet.

The backgrounder was leaked to me by someone who wishes to remain nameless, but here is part of what they had to say along with the leak,

"This response agitates me, to say the least. Especially about the milk, "low fat" cheese issue and the dairy industry influence."

I reached out to my friend Andy Bellatti who himself is both an RD and someone who enjoys a vegan diet and asked him for his thoughts. As I expected, he didn't mince words,

"This seems more like a press release for meat and dairy than an educational brochure on plant-based diets. To put it simply, every single nutrient in dairy products can be obtained from a plant-based food. I am also baffled that the "meat and alternatives" list does not include beans, nuts, and seeds.

Furthermore, planning is essential for all diets. Without careful planning, an omnivore can end up not consuming enough fiber or dark leafy green vegetables. The idea that the mere act of eschewing meat and dairy practically necessitates a flowchart to make sure one's diet is balanced is untrue."

Could the fact that Alberta is the beef capital of Canada have anything to do with the alarm?

Book Review: Melanie Warner's Pandora's Lunchbox

[Full disclosure: I was sent a free copy of the book by the author]

Sometime around two years ago one of my very favourite food industry journalists - Melanie Warner -  disappeared. Her articles stopped appearing online, and her Twitter feed went dark. I’m not sure how long it took me to notice she was gone, but when I did I reached out to find out if she was ok, and she wrote back that she was working on a book about the food industry – a fact that took some of the sting away from her disappearance.

Well here we are, two years later, and next week her book, Pandora’s Lunchbox: How Processed Food Took Over the American Meal, is set to launch and Melanie kindly sent me an advanced copy.

The book’s fascinating. While other books have been written highlighting what I see as the tragic decline of actual food in North America (Fast Food Nation, Food Politics, The Omnivore’s Dilemma, and more), rather than focus exclusively on fast food, or on Big Food’s political shenanigans, or on how-to fix what’s broken, Warner does all three with her lens focused on the history and science behind the industrialization of the food supply, and in the process, highlights some of the health problems and unknowns that are uniquely consequent to the way our land of plenty got that way.

Warner reports that her interest was piqued consequent to her tremendously odd processed food collection – a collection she started to satisfy her desire to see how long beyond a processed food’s printed best before date that food would continue to be edible. From 9 month old only slightly brown around the edges guacamole, to 2 year old somewhat shrunken and crystallized processed cheese slices, to cereals older than 2 of my children that still look and taste like new, to chicken “nuggets” that rather than being immortal, liquefied (rather than rotted) within 10 days, Warner set out to figure out why.

Her book explores the history of some of the food industry’s biggest sellers: “Eternal” sliced cheese and the mistake that led to its creation; processed cereal and the story of a man who bragged that he never consummated his 40 year old marriage; discretionary fortification of foods and how and why your milk might contain extracts of sheep wool to return to it some of the vitamins stripped clean by the unbelievably harsh world of processing; the growth of soy and a tale of food flavourists and the debate over omega 3 and 6 ratios; whether or not there is such a thing as a healthy processed food, and much, much more.

Warner attributes her interest in food to her mother Therese who both accidentally ate the 9 month old guacamole (without negative effect), and also instilled in Warner two important messages, “What you put into your body matters, Melanie”, and, “Just because it’s edible doesn’t mean it’s good for you”.

Warner isn’t as merciless in Pandora’s Lunchbox as I’d seen her be before she went dark and I wouldn’t be at all surprised were I to learn that her editor, or the legal team over at Scribner, had her tone her message down some, but mercy notwithstanding, the book’s fantastic and fascinating and while she doesn’t spend too much time on it, she certainly gives us her prescription for how to stay safe in a land full of more than 5,000 food additives. She calls it a "new food ratio" and I think it’s a great one. Riffing off of the industry’s seminal BS, “Everything in moderation” Warner applies it to processed foods and suggests that if processed foods made up 30% or less of the average person’s diet, that person would be doing pretty well indeed.

Warner, like I’ve been in the past, is very clear, “There are bad foods”, and this book highlights more than a few of them as well as some of the machinations the food industry has wrought to keep them on our tables. As to the food industry’s role as a “stakeholder”, again she bluntly echoes a message that readers of this blog are likely quite familiar with,

“It’s not that large packaged-food companies can’t have any impact. It’s that their contribution to the overall problem is always going to be miniscule. Pepsi, Kraft, Kellogg’s ConAgra and General Mills won’t be the ones to improve our diets and fix our health problems, and we should stop asking them to”

Amen Melanie.

[If you'd like, you can order Melanie's book on Amazon.com by means of this affiliate link]

Guest Post: Dietitians Call for Integrity

Today's guest posting is another from my friend Andy Bellatti, MS, RD. Andy is a Las Vegas-based registered dietitian with a plant-centric and whole-food focus. His work has been published in Grist, The Huffington Post, Today’s Dietitian, Food Safety News, and Civil Eats, among others. He is as passionate about healthful eating as he is about food politics, deceptive Big Food marketing, and issues of sustainability, animal welfare, and social justice in our food system. He is the creator of the Small Bites blog (which, though now closed, spans five years and 2,000 posts). You can also follow Andy on Twitter and Facebook.

Today's post highlights Andy's latest initiative - a group he's named Dietitians for Professional Integrity, and it's one that I wholeheartedly support! And before somebody gets their feathers in a ruffle, neither Andy nor I am suggesting Dietitians don't have professional integrity - rather that his group represents a grass roots rallying cry for their Academy to question theirs.

Dietitians Call for Integrity

Since the release of public health lawyer Michele Simon's report on the Academy of Nutrition and Dietetics' corporate partnerships last month, the Registered Dietitian community has had much to talk about. A recent Twitter chat about this topic had such high turnout that “#RDChat” made it to Twitter's Trending Topics, demonstrating that dialogue on this issue has been long overdue.

And, now, a new development: a coalition known as Dietitians for Professional Integrity launched its Facebook page last Wednesday, obtaining 485 “likes” in its first 12 hours. The group – co-founded by myself and 15 dietitian colleagues – is made up of Registered Dietitians, Dietetic Technicians, and dietetic students (as well as their supporters) and advocates for greater financial transparency as well as ethical, socially responsible, and relevant corporate sponsorships within the Academy of Nutrition and Dietetics (AND).

Apart from serving as a central hub for like-minded individuals to voice their displeasure with AND's current corporate sponsorship model, a “statement of concern” from a dietetics professional or student is shared on the page every weekday. The hope is that these statements will further stimulate discussion, better connect colleagues, and demonstrate that current AND President Ethan Bergman was misguided and ill-informed when he recently stated that every AND member supports the Academy's current food industry partnerships.

Many of the dietetic professionals who joined the group expressed how important it is to have forum where they can express the frustrations they have felt for so long (frustrations that were expressed to the Academy and often did not receive a response) and not just be heard, but also work towards better sponsorships that do not discredit the credential they worked for.

In response to criticism that speaking out against their professional organization is disloyal, the Dietitians for Professional Integrity group states the following in their Frequently Asked Questions document:

“We do not believe it is disloyal to demand that our professional organization behave in a more responsible fashion. We value our credential and want it to be represented in an honorable way.

We believe change can only come from speaking out and voicing concerns. All social movements that led to positive change started with a group of people who expressed their dissatisfaction with the status quo and mobilized others. Remaining silent under the guise of loyalty does not address issues, help foster dialogue, or provide room for problem-solving.

As a point of reference: the American Medical Association did not publicly cut ties with Big Tobacco until 1978, despite decades of research showing the harmful effects of smoking. Some doctors began raising concerns about their professional organization's financial ties to tobacco companies as early as 1964. It was precisely this leadership and advocacy, combined with scientific evidence and public pressure, that brought about change. Imagine if no doctors ever dared to challenge their own professional organization and instead simply felt comforted by their professional organization's stance.”

The group wants the Academy “to develop clear guidelines to differentiate between sponsorships associated with foods and products that have no place in a healthy diet (such as soda, potato chips, and candy) and sponsorships that offer some value to a significant portion of their membership and also engage in ethical environmental and labor practices”.

It also suggest five specific recommendations:

1. Host a point-counterpoint panel/moderated debate on this topic at this year's Academy of Nutrition and Dietetics conference (to be held in Houston in October);

2. Greater transparency and full disclosure of finances;

3. Address this issue to its constituents;

4. Reject corporate-sponsored education (with certain exceptions – such as a company that makes parenteral nutrition formula educating dietitians on the management of specific clinical nutrition pathologies);

5. Adopt more ethical corporate sponsorship guidelines that truly reflect AND's mission (using the Hunger & Environmental Nutrition Dietetic Group's ethical sponsorship guidelines as a model).

While the diverse dietitians in this group work in a wide range of clinical, community, research, and private practice settings, they are united by their desire to no longer have their credential tarnished and co-opted by ties to the very companies that have continually fought tooth and nail against public health and sound nutrition. The time has come for the Academy of Nutrition and Dietetics to do right by its members and put an end to insidious and troublesome partnerships with the food industry's most notorious players.

If you support the mission of this group, please head to the Dietitians for Professional Integrity Facebook page and click “Like”!

Am I Dreaming? Walmart Considering Healthy Checkout Aisles?

While I might quibble some with what's defined as "healthy", a Walmart in West Virginia is setting an example for the nation - instead of candy and glossy magazines they've put together checkout aisles with fresh fruits and vegetables, along with sporting goods.

And guess what? According to the store manager customers love it and sales are up!

Wish these were the norm rather than the exception.

To have a peek, here's a news report covering their experiences to date.

Saturday Stories: Fats, Depression, and Osama Bin Laden

Great Consumers Reports' review of the state of the evidence on which fats are healthful and which are not.

Overcoming Gymnausea with a heartfelt and personal take on what is depression?

Esquire's Phil Bronstein with a riveting read on what life's been like for Osama Bin Laden's shooter since that night in Abbottabad.

[And if you don't follow me on Twitter or Facebook, this week's weekly US News and World Report column is about why I think there is no cure for obesity.]