Friday, December 29, 2006

Jamba Juice - More Calories than a Footlong Meatball Sub!

It's possible that fruit and vegetables are the easiest products in the world to market as healthy.

Everyone and his mother, this blog included, touts the health benefits of fruit and vegetable consumption.

That said, there's a world of difference between eating fruit and drinking it, and part of that world is calories.

Jamba Juice, a rapidly growing fruit smoothie franchise is a case in point.

On their website, they blindly stick to the low fat message and extol the virtue of carbohydrates,

"You can see that fat on a weight basis yields more than twice the energy per gram compared to carbohydrates and proteins. But since the body uses carbohydrates for energy, and carbohydrate foods also provide other nutrients, you should try to meet your energy needs with carbohydrates rather than fats."
So how much energy are we talking about at Jamba Juice?

Insane amounts!

If you were to drink their "Power" version of virtually any of their products, you're drinking more calories than a Big Mac.

If you were to choose unwisely (with unwise here not really referring to calories, but rather to a choice that you felt was a healthy one because it was Jamba Juice after all), and had their Power Peanut Butter Moo'd, which as described by the Jamba Juice website is,
"Made with all-natural peanut butter, this super-smoothie is chock full of good stuff and tastes great too."
and then you looked at the ingredients,
"nonfat frozen yogurt, chocolate moo’d base, soymilk, ice, frozen bananas, all-natural peanut butter"
and thought, gee, that seems healthy, I'll have that, wanna know what you'd be having?

1170 Calories! The equivalent of 2 Big Macs, a foot long meatball marinara sub, a 1.5lb T-Bone steak or almost a full cup of peanut butter.


So why did I go off on this Jamba Juice rant? Well for Funny Friday of course.

Here's Natalie Portman in one of the best skits I've seen on SNL in years, making fun of the added health benefits of the "boosts" of Jamba Juice.

Have a great weekend and happy New Year!

Thursday, December 28, 2006

Why Does Universal Studios care more about you than Health Canada?

Well, maybe that's just blogger license to get you to read, but as of this Christmas Eve, Universal Studios Hollywood is trans-fat free.

Trans-fats, as covered in one of my prior posts, aren't very good for you. Trans fats have been shown to raise bad cholesterol, raise triglycerides, lower good cholesterol and make our blood stickier increasing the risk of blood clots. Trans fats have also been shown to increase the process of inflammation in our body which in turn has been implicated in heart disease and diabetes and may well also be involved in other disease processes.

Amazingly in Canada despite the wealth of knowledge on the risks of trans-fats, despite the June 2006 final report of Health Canada's trans-fat task force calling for a dramatic regulatory minimization of trans-fat in our food supply, it appears to this outsider at least, that Health Canada has spent the last 6 months apparently doing nothing to try to put their recommendations into action (no doubt much to the joy of the Canadian Restaurants and Food Services Association and the Food and Consumer Products of Canada Association - Merry Christmas Big Food, Love, Health Canada).

The thing is, we're talking about a product which without tremendous upheaval (Denmark has been trans-fat free since December 2003) can indeed be removed from the food supply. If applied to North America, according to the Center for Science in the Public interest, a trans-fat ban could save 11,000-30,000 lives per year along with $50 billion in annual health care costs.

I suppose given my experiences with Health Canada and Canada's Food Guide, I shouldn't be too surprised - remember, Health Canada didn't even bother to mention the words trans-fats in the draft of their upcoming new Food Guide.

Sometimes I wish I lived in Denmark.

Kudos to Universal Studios.

Wednesday, December 27, 2006

Weight Loss Decreases your Risk of Aggressive Prostate Cancer

This month's Cancer Epidemiology Biomarkers and Prevention journal has a fascinating study on the effect of weight loss on the development of prostate cancer (Full-text free here).

Author Carmen Rodriguez and colleagues were curious to see whether or not weight loss affected the risk of prostate cancer.

Seven of nine prior prospective studies had demonstrated that increased weight was associated not with increased risks of prostate cancer overall, but rather increased risk of aggressive prostate cancer and prostate cancer mortality.

The study population started with the 86,404 male participants of the Cancer Prevention Study II Nutrition Cohort followed by the American Cancer Society since 1992.

In a methodology too rarely seen in weight loss studies, the authors chose to exclude the first 2 years of followup (1992-1994) for their 11 year study due to the fact that many diseases lead to weight loss, and should initial weight loss be unintentional and due to an as yet diagnosed serious illness, the results from those individuals would negatively skew the results of the study. This type of lead-in bias in studies including weight as a variable has certainly tainted the results of the many of them that did not include a first-few years weight loss exclusion criteria.

The results were rather striking.

Firstly the risk of low-grade (less aggressive) prostate cancer actually decreased significantly with increasing weight! In contrast however, the risk of high grade (more aggressive) prostate increased with increasing weight, as did the risk of metastatic spread from the prostate and prostate cancer mortality.

(For the authors comments as to some possible biological explanations for these trends, read their clear discussion in their paper)

In terms of weight loss, men who lost 11 or more pounds between 1982 and 1992 had a 40% lower risk of developing aggressive prostate cancer!

That weight increases your risk of developing cancer has certainly been established beyond any significant shadows of doubt in multiple prior studies. What's so exciting about this study is that it's now the second study that has specifically identified intentional weight loss as a means to decrease your risk of cancer (the first demonstrating that women who lost 22lbs had a 60% decrease in their risk of developing breast cancer, published in 2006 in JAMA).

11 pounds is certainly not 100!

Truly even small amounts of weight loss can lead to dramatic affects on your health.

Tuesday, December 26, 2006

Children's Fitness Tax Credit for Rich Canadians

Last week Jim Flaherty, the Minister of Finance, released the guidelines for the Children's Fitness Tax Credit.

If you want to use it, it's sure as heck gonna cost ya.

In order to qualify you'll have to enroll your child in an ongoing supervised program that,

"includes a significant amount of physical activity that contributes to cardio-respiratory endurance, plus one or more of: Muscular strength, muscular endurance, flexibility, and balance."
But wait, there's more! Eligible programs must,
"last at least eight weeks at a minimum of one session per week"
That sure sounds like one hell of an expensive tax credit as it's not as if the credit's going to cover the costs of these programs in their entirety!

What about the Canadians who can't afford to send their children to organized programs?

What about the Canadians who might live in the country where the availablity of such programs is minimal?

What about the Canadians whose kids don't happen to enjoy organized sports?

What about the Canadians who are too busy trying to put food on their tables to drive their kids around to sports, let alone outfitting them in gear and paying for their supervision?

Does the government really think that a small tax credit is actually going to enable families who otherwise can't afford to send or outfit their children for organized sports to actually do so?

Why can't the tax credit be applied to anything that might promote physical activity in children?

What about the purchase of skates? A family might not be able to afford to send their kid to play competitive hockey, but a pair of skates and a local rink sure can afford a kid a great deal of exercise.

What about running shoes, a sled, roller blades, a baseball glove, a football or a basketball net?

Why does play have to be organized and supervised in order to be valuable as a determinant of health?

It may surprise you to learn that over the course of the last seven years, Canada has posted a budget surplus of over $60 billion, and it's predicted that there will be similar surpluses over the next seven years.

Why not use some of it to help all of our children become more active, not just the rich ones?

Monday, December 25, 2006

CLA - Far from a Magic Weight Loss Bullet

The media are alive with the sound of CLA!

I can't get over the number of articles I've read, in both mainstream and blogosphere press, about the benefits of supplementation with CLA (conjugated linoleic acid) on body weight and body fat percentage, and all from a very small, limited, and poorly designed study.

The study took 40 (yes, just 40) people and randomly assigned 20 to receive a CLA supplement and 20 to a placebo for a 6 month period. The subjects were exclusively young (between the ages of 18 and 44) and none of them were obese to begin with (BMI between 25 and 30). They were watched to see if there was a difference in weight loss and/or a difference in their body fat percentage.

The study was written in a manner that was supposed to reflect "holiday weight gain" by being conducted over the course of last year's Christmas holiday season. That said, while the study participants were indeed controlled so that the placebo and control groups were roughly the same age and weight, what was not controlled for was lifestyle.

What do I mean by that? Well, there's no note about whether or not the participants used gyms, whether or not they had sedentary or active jobs and importantly, given the aim to discuss "Holiday" weight gain, their religions, whether or not they had large family gatherings over the holiday season and whether or not they themselves celebrated a holiday season were not mentioned in the methodology or controls.

Regardless, even if we ignore the clear lack of appropriate controls, the results were far from spectacular.

With a percentage just barely greater than would happen by chance, the folks in the CLA group lost a grand total of 1.3lbs and their body fat percentage went down by 1%.

So what can we conclude from this paper?

Not too much.

Best case conclusion:

If you're a non-obese, young adult and you want to spend over $20 a month on CLA supplements, you may lose 1.3lbs over a 6 month period.

Wanna know how else you could lose 1.3lbs over a 6 month period?

Burn or not eat 25 calories a day.

Hmmm, let's see, $120 in pills that may have long term risk (in multiple studies CLA has been shown to increase insulin resistance and increase deposition of fat in the liver and spleen) or you could simply walk for an extra 5 minutes every day.

As I tell all my patients, if there was something that I could sell them that would help them lose weight and help me pay the rent, I would.

Guess I'm the scrooge of supplements 'cause I don't sell any!

Merry Christmas to all those celebrating, and a big Bah-Humbug to the neutraceutical corporations and the press who get folks excited about non-exciting stuff!

Friday, December 22, 2006

The Creepiest Fast Food Mascots Ever!

Today for Funny Friday, a blast from the past.

The creepiest fast food mascots ever envisioned.

Watching the commercials I wonder two things: Firstly, how high were the folks who came up with these spots and secondly how is it possible that the folks over at Quiznos signed off on them?

So without further adieu, I bring you Quiznos' singing teratomas!

Have a great weekend!

[Hat tip and more creepy fast food mascots here]

Why the City is Now Wasting Less of my Tax Dollars

Just a follow up on the couriered packages sent by the City.

I have a friend and colleague in Ottawa Public Health with who I had addressed my concerns regarding the delivery costs of questionably useful materials.

I have been reassured by him that indeed this has been looked into and considered and here is the scoop:

  • With regards to the mailing on shaken baby syndrome, the costs were funded by the Province, not the City and it was sent out to less than 500 local family physicians at a cost of closer to $2,000 or $4 per shipment.

  • With regards to the actual content, the City is going to take a step back to take more time to evaluate the usefulness of the materials sent out.

  • With regards to offices where there are multiple doctors (like my friend who in his 11 person practice received 44 shaken baby posters with each doc getting their very own 4) they will only be sending one or two for the whole practice.

  • My friend with the City noted that he was told the cost of the shipment was less than what Canada Post had offered, and I believe that only with regards to courier costs, or same day delivery costs. At $4 per shipment, the cost is roughly the same as it would have been with regular mail without any discount whatsoever applied for bulk.

    I discussed this matter with a high-ranking executive from Canada Post and was assured that there was no way that any type of couriered shipment could be cheaper than a bulk rate on regular mail.

    I will continue to follow with interest the issue on mailing costs. I have asked the gentleman from Canada Post to provide me with a name of a salesperson so I can have him or her speak to my friend over at the City and hopefully I will have a final answer on that matter of cost soon.

    Regardless, kudos to the City for looking into the matter so quickly and for making some very positive changes!

    Thursday, December 21, 2006

    New Chinese Adoption Rules Ban the Very Obese

    Since 1985 there have been close to 60,000 children adopted from China to parents in the United States. Last year alone there were close to 8,000.

    The Chinese government, undeniably not one to be overly concerned with rights, recently imposed some new rules whereby they've imposed some exclusion criteria on foreign adoption applicants. They've barred applicants who are unmarried, over 50, on antidepressants, have a "severe facial deformity" or meet the NHLBI's definition of extreme obesity with a body mass index greater than 40.

    I'm at a bit of a loss.

    On the one hand, there's no doubt whatsoever that having a body mass index greater than 40 confers very dramatic medical risk of both illness and premature death. On the other hand, so too does smoking, a recent admission to the hospital for congestive heart disease, a diagnosis of cancer, and a myriad of other medical conditions.

    Now it's possible that China discriminates against the other medical conditions as well, though certainly the article I read didn't mention them.

    Bias against the obese is longstanding, not just in China, but globally. I still see political cartoons, regular cartoons and articles vilifying the obese. I still see "fat suits" advertised as fun Halloween costumes. To read about some of the bias against obesity in American society, read Kelly Brownell's fantastic paper on the matter.

    Do you have negative attitudes towards the obese? Studies have shown that most of us do, there have even been studies that show folks with weight to lose look down on other folks with weight to lose.

    The first step to stopping bias is identifying it. Take stock of your own responses and thoughts on obesity. The next time you interact with an individual with weight to lose, try and identify whether or not you've got negative associations, and then more importantly, try to rid yourself of them.

    Obesity is predominantly a disease of the environment, not the individual.

    I wonder whether or not China's new rules will affect the number of children adopted. While the BMI over 40 crowd is not terrifically large, it is growing rapidly. I imagine the bigger hit will be the ban on folks taking antidepressants, they're much more common, perhaps partially because societal bias as a whole is so damn pervasive and so damn depressing.

    Wednesday, December 20, 2006

    Stupidest Weight Loss Drug Ever?

    Compellis Pharmaceuticals has secured a patent on a new pharmacological means to treat obesity.

    Their solution?

    A nasal spray that would take away your sense of smell and taste. The theory I suppose, if you don't like what you're eating because you can't taste it you'll eat less. If you read their patent application you'll find that it worked on rats!

    While I'm well aware that weight is a terrifically important determinant of health and that folks will try a lot of crazy stuff to help themselves lose, do the folks over at Compellis really think that people would be willing to give up one of life's most basic pleasures, the taste of food, to lose weight?

    Clearly they must, and certainly people might be willing to put up with that loss of pleasure while they lose weight, but as with any weight loss effort that involves any sort of suffering, as soon as the scale stops whispering sweet nothings, most folks will decide they want the suffering to end.

    As I've stated in many posts before, unless you like the way you're losing weight; unless you plan on continuing to live that way forever; it'll never stay off.

    If only Compellis were a public company that I could sell short....

    Tuesday, December 19, 2006

    Kids, remember to drink your Diet Coke Multivitamin!

    Perhaps someday soon we'll be seeing ads like this old one for Ovaltine from Coca Cola soon.

    According to Beverage Digest, the Coca Cola company plans to roll out Diet Coke Plus.

    Plus what you ask?

    Why plus vitamins, minerals and herbs and course.

    A veritable multi-vitamin in a pop can.

    Because nothing says healthy like Diet Coke.

    Except perhaps Ovaltine (chocolate vitamin powder added to milk) which according to the old ad has:

  • More vitamin C than 4 ounces of orange juice
  • More vitamin B than 3 servings of oatmeal
  • More vitamin D than 10 ounces of butter
  • More protein than 3 eggs
  • More vitamin G (for those of you confused, Vitamin G is riboflavin) than 1 pound of sirloin steak
  • More iron than 3 servings of spinach
  • More niacin than 6 slices of enriched bread
  • More vitamin A than 2 servings of peas
  • More calcium and phosphorus than 2.5 servings of American cheese
  • And more food energy (calories) than 2 dishes of ice cream.

    MMMmmm food energy.

    Ovaltine by the way is still around. Now they also market directly to children with a product they call Max for Milk complete with happy cartoon boy.

    Their website states,
    "Just simply mix it with cold milk for a wholesome milkshake drink your kids can enjoy every day."
    They also state,
    "Each drink is made with the wholesome goodness of barley and malt, and contains 11 vitamins and 4 minerals – great to keep kids going! It also contains no artificial colours or sweeteners and is low in fat."
    It's a good thing for Ovaltine that no one makes ice cream with multivitamins in it because that would be direct competition.

    Everyone knows ice cream would be a great choice if there were multi-vitamins included!

    Multi-vitamins make everything healthy, chocolate milk, carbonated beverages - you name it, it'll be good.

    If you're confused here, please go back and include dripping sarcasm with the last two lines.

    Frankly as far as I'm concerned, I'm turning down Ovaltine and Diet Coke Plus in favour of my new favourite functional food - Fibe Mini! I don't know what's in it, but as you can see from the following video, drinking it will morph you into a winged, lightsaber wielding superhero able to vanquish giant life size parasites and bacteria and bring joy back to the world!

  • Monday, December 18, 2006

    The Skinny on Low Fat and Breast Cancer

    It's because of headlines like this that I actually started writing this blog,

    "Lower-fat diets cut breast cancer recurrence: Study".
    They've been all over the net and newspapers over the course of the past few days, all because of a study that has followed 2,437 breast cancer survivors and compared those who followed a low-fat diet with those that didn't with regards to breast cancer recurrence.

    The results, trumpeted loudly in the press, report that those with a lower fat diet had a 24% lower risk of breast cancer recurrence over a 7 year period.

    Sounds great right? Low-fat must be the only way to go right?

    Probably not.

    It's not that a low-fat diet is a bad thing. It's not that I'm telling people not to follow low-fat approaches. It's just that the most likely reason for the reduction in recurrence in the low-fat group is the fact that the low-fat group lost weight.

    Obesity and the risk of cancer is a very well established fact. The biggest study looking at cancer and obesity was conducted by Calle et al and published in the New England Journal of Medicine. The authors, after following over 900,000 men and women for over 16 years concluded that 20% of all cancer deaths in women were associated with overweight and obesity as were 14% of all cancer deaths in men.

    To me, there's no doubt that there were some women in the control group (the non low-fat group) that also lost weight. I have no doubt because many women will take the diagnosis of breast cancer and use it to inspire them to live much healthier lives than before their diagnoses, improving their fitness, their dietary choices and quite often, their weights. Given that there is no formal in-paper comparison between low-fat weight losers' and regular fat weight losers' risks, and given that I'm by nature a highly suspicious guy, and given that an article stating that a low-fat diet reduces breast cancer recurrence risk is a much more exciting result than one that does not, I can't help but wonder if either the authors had those numbers and chose not to report the result that any way you lose weight is good, or if they purposely avoided crunching those numbers so as not to have to report them.

    This argument wasn't lost on the American Cancer Society either, who in the press report I read specifically pointed out,
    "that studies focusing on fat in the diet have not clearly shown this to be a breast cancer risk factor, although being overweight has been found to raise breast cancer risk, especially for women after menopause."
    Clearly the argument wasn't lost on the authors of this study either as the last line of the Reuters piece reads,
    "The researchers noted that women who ate less fat lost weight, and that the weight loss may have been at least partially responsible for lowering the relapse risk rather than the reduced fat intake alone."
    So if you've had breast cancer should you go on a low-fat diet to improve your chances? Sure, but ONLY if you actually feel like you can live on that low-fat diet forever and more importantly ONLY if your low-fat diet leads you to lose weight.

    Remember, weight loss has nothing to do with low-fat or low-carb. Weight loss has everything to do simply with lower calories, and whatever way works for you is good.

    Friday, December 15, 2006

    The World's Best Potato Latkes!

    So Chanukah lands on Funny Friday, and therefore I've got to find something appropriate to both celebrations.

    I found something great, but first something else great, a recipe for my wife's potato latkes:

    Be forewarned - high Calorie, not very nutritious, but very, very yummy. Considering she makes them about twice a year, I feel fairly safe.

    If you shape your latkes to be no more than about 1cm thick and about 10cm in diameter, we worked out the calories last year to be about 80-100 per latke.

    6 potatoes peeled, pared, grated and drained well (squeeze out as much of the potato juice as you can - cheesecloth works great)
    One small onion, grated
    3 eggs
    1 tsp salt
    1/2 tsp pepper
    1/4 cup flour
    1 tbsp canola oil
    2tsp baking powder
    Canola oil for frying

    Combine all ingredients and either fry in pan with oil (flipping once when edges start to get crispy or look brown) OR bake in oven at 400F on oiled baking sheet/tin foil, flipping when edges look brown (obviously far fewer Calories if baked). Let cool on very absorbent paper towels and enjoy!

    Thursday, December 14, 2006

    Why Does the City Waste My Tax Dollars Part II

    15 minutes ago I received another couriered package from the City of Ottawa Public Health department. My understanding is that these packages go to every doctor in Ottawa.

    In this high priority package (it was shipped via DHL Express, not DHL Ground) was 4 copies of a poster that advises a person to hold and rock but never shake a baby.

    Indeed an important message, but really, did it need to be couriered to me express? Is tomorrow National Shake Your Baby Day and therefore an urgent pressing emergency public health measure?

    Again I went to DHL's website and plugged in the dimensions and weight of the parcel. I wasn't given the option of DHL Express pricing but DHL ground had a rough cost of $15 per 4 posters.

    Using the CPSO Doctor Search tool 3,359 doctors in Ottawa.

    That's $50,385 in courier costs!

    So for those keeping score, in 9 weeks our City has spent $100,770 to courier doctors a bunch of pretty much useless and certainly non-urgent materials (in early November I received my urgently couriered Flu Pandemic Preparedness Handouts).

    Sure doesn't give me any warm and fuzzies.

    UPDATE: See most recent post detailing City's investigation

    What's Wrong with our Food Supply - on a Stick!

    Drumroll please.

    220 Calories each not including syrup. 53% of Calories from fat, including 4 grams of saturated fat.

    How many are you going to have for breakfast?

    Mmmm Frankenfood!

    Rather than spend time trying to wax eloquently about them, I'll hand it over to an absolute hero of mine to do that for me - Mr. Jon Stewart.

    Watch it quickly cause Viacom's lawyers are likely to yank it off the youtube.

    Tuesday, December 12, 2006

    The Easy Way to Read a Food Label

    I scratch my head when I look at food labels. I can't imagine that the average consumer cares to know all of the information provided and can't help but wonder whether or not having so much information may simply cause the consumer to avoid using it.

    Take for example Canadian Member of Parliament Rick Dykstra. In discussing the unfortunately defeated Bill C-283 he commented on his use of food labels,

    "The frustrating part for me is that I don't know what three-quarters of the things are that are actually on the label itself, and then I need to get a magnifying glass to read what I don't know."
    Rick's definitely not alone in his confusion, so for all of the Ricks out there, here is the quick, down-and-dirty, 4 step Nutrition Facts label reading program.

    Step #1: Look at the Serving Size. Until Health Canada mandates more useful and toothful labeling laws, serving sizes are pretty arbitrary. Sometimes you'll see things like 1/2 a cookie serving sizes or 1/4 of a bag of microwave popcorn. Multiply everything on the label by the number of "servings" you personally imagine consuming.

    Step #2: Look at the Calories. If you're watching your weight or concerned therein, less is more when it comes to Calories.

    Step #3: Look at the fats. If you can avoid buying foods with trans-fats, do so. When it comes to saturated fats, less is more but don't sweat them too much. When it comes to unsaturated fats, don't worry about them at all and in fact, more is more.

    Step #4: Look at the sugar. 4 grams of sugar per teaspoon (so you can quickly divide and see how many teaspoons of sugar you're getting). Less is more.

    Seem too easy? Want some advanced techniques?

    Advanced Step #1: Look at the fibre content. More is more.

    Advanced Step #2: Look at the sodium content. Less is more.

    Advanced Step #3: Look at the ingredients list. If sugar is listed as one of the top three ingredients, try and find an alternative.

    Don't worry about the percentage daily values stuff, don't worry about the micronutrients (the various vitamins and minerals), and don't worry if you don't know for instance how much sodium is too much. The more frequently you look at the labels, the more of a grounding you'll get in what's out there and the more you'll know what's a lot and what's a little.

    With regards to micronutrients and the percent daily values stuff, I recommend a multivitamin, and the cheap ones by the way work fine.

    Consider a multivitamin nutritional insurance, not a license to eat poorly. Just because I have car and home insurance doesn't mean I don't buckle my seatbelt, drive safely and lock my house when I leave.

    If you're concerned about your health, not reading food labels before you eat something is comparable to being concerned about your finances but not looking at price tags when you go shopping - a bad idea.

    Monday, December 11, 2006

    Low-fat Foods May Make you Fat!

    At least that's what the headlines are going to read once they get hold of Brian Wansink's latest paper.

    Published in this month's Journal of Marketing Research, his paper (full-text of his article freely provided by Dr. Wansink on his website in Word format in the "Free Stuff" section) explores the influence that a label like, "Low-fat" has on consumption.

    First some minor background and the take home point of this blog entry:

    Now onto the studies.

    In study #1, University open house attendees were taken to one of two bowls. One contained regular M&Ms labeled, "New Colors of Regular M&Ms" and the other the same M&Ms this time artificially labeled, "New Low-Fat M&Ms".

    Low-fat labeling led participants in the study to eat 28.4% more M&Ms, and interestingly participants who were already classifiable as being overweight (via body-mass index means), took 16.7% more M&Ms than healthy weight participants.

    Dr. Wansink and authors postulated that perhaps this was due to the fact that the "Low-fat" label seemed to affect the over-underestimation of calories by overweight participants compared with healthy weight participants.

    Only problem with this experiment is the fact that there is no such thing as a "Low-Fat" M&M therefore one might assume that with a truly low-fat product, the increased consumption due to the labeling might not be reflected in consuming more calories.

    The thing is, you'd likely be wrong.

    Dr. Wansink's no dummy and of course, he surveyed the fat and calorie content of ALL brands of chocolate candies, bars, cookies, milk drinks and muffins with at least a 5% market share. He found that 17 products had both a "Regular" and a "Low-Fat" version. The serving sizes were comparable for all products.

    On average the "Low-Fat" products contained 59% less fat than their "Regular" counterparts, but ONLY 15% fewer calories!

    Taking his original study with M&Ms, if there were a low-fat M&M with 59% less fat and 15% fewer calories than regular M&Ms, participants would still have consumed 9% more calories from the low-fat product.

    Dr. Wansink goes further and quotes the work of Marion Nestle who found that ingredients used to replace fat often tend to make people hungrier and therefore he feels that in fact eating "Low-Fat" labeled products may well causes us to consume even more than an additional 9% of calories!

    To ensure that this wasn't due simply to the fact that "Low-Fat M&Ms" were something perceived as a too good to be true item that then led to over consumption, Dr. Wansink performed a similar experiment using granola. He found very similar results and then when comparing his statistics with real world products found that the "Low-Fat" label would lead a person to consume 33% more calories than the "Regular" version.

    The paper concludes:
    1. Labeling snacks as “low fat” increases food intake
    2. For normal weight people, “low fat” labeling increases consumption most with foods that are believed to be relatively healthy.
    3. For overweight people, “low fat” labeling increases their consumption of all foods.
    Bottom line - Don't get conned by Big Food.

    Don't take anything at face value. Ignore claims like "Low-fat", "Low-carb" and definitely be very leery of both industry sponsored Healthy Options stamps like the as “Sensible Snacking” (Nabisco/Kraft), “Smart Spot” (Pepsico), or “Healthy Living” (Unilever) and even non-industry sponsored stamps like the Health Check from the Heart and Stroke Foundation.

    Just because there's a claim or stamp on a product does not make it healthy, nor does it mean it's low calorie.

    Stay tuned tomorrow for down and dirty label reading. All you need to know, in 4 easy steps!

    Sunday, December 10, 2006

    Whitey, Yellowy, Goopy Gold - $5,000 a Litre Biodiesel!

    There's gold in them-thar bellies!

    I'm not sure if this qualifies as a smack your forehead, why didn't I think of that story, but you have to admire the lateral thinking.

    Lauri Venoy, a Norwegian businessman, has apparently signed a deal to obtain over 11,000 litres of human fat a week.

    What will he do with all that fat you ask? Well he sees it as white gold - he plans to convert it into combustible, foreign-oil-dependence killing, car-fueling, biodiesel!

    Wisely, he's not basing his business in Norway, but rather in the USA where there is much greater abundance of natural resources.

    Ever the businessman, Venoy plants seeds for growth stating,

    "Maybe we should urge people to eat more so we can create more raw material for fuel"
    Thankfully for Venoy, there is no shortage of people trying to convince us to eat more (Big Food, and these days in Canada, Health Canada) and with 65-75% of North Americans overweight or obese, there's no shortage of "raw materials".

    Don't worry about the cost at the pumps though, the $5,000 a litre is for the patient.

    I imagine once outside of the body, human fat's probably pretty cheap.

    Friday, December 08, 2006

    Scary Poppins!

    As more frequent readers of my blog know, Fridays lately have not been so funny. The problem was during the posting of the Canada's Food Guide series, I had a tough time finding anything humourous.

    Now that the series is completed, I can go back to the relatively new tradition of Funny Fridays.

    Today's post - a brilliant recut of the original Mary Poppins film to create a trailer for the new horror film, Scary Mary.

    Have a great weekend.

    Thursday, December 07, 2006

    Enviga - Burn your Money....I mean your Calories

    Coca Cola and Nestle, a match made in marketing heaven, are about to release Enviga, which according to Dr. Rhona Applebaum, the chief scientist of the Coca Cola company (that's what the press release calls her anyhow), the "perfect partnership of science and nature".

    So what does this perfect partnership entail? A crap load of caffeine (3x the caffeine of a can of Coca Cola), and a component of green tea lovingly named epigallocatechin gallate, or EGCG. And EGCG, what does it do? According to Dr. Hilary Green, corporate shill and sell-out scientist for Nestle, it "speeds up metabolism and increases energy use, especially when combined with caffeine". Put this all together and Coca Cola and Nestle's marketing campaign tells us that if we drink 3 cans of this stuff a day, we'll lose weight!

    Can you say ka-ching?

    So first, let's ask how much weight we're talking here. According to the companies', an extra 60-100 calories a day or 6-10lbs per year. Remember that number, I'll come back to it.

    So how much do we have to pay for the privilege of losing an extra 6lbs in a year? Roughly $1500 given that each can costs on average $1.39 and you'll have to drink over 1,100 of them a year.

    Marketing in the test market of New York is fierce with billboards stating, "Burning Calories is now officially delicious", and "Be Positive, Drink Negative".

    The science by the way, surprise surprise, is lacking to say the least, but I'm not even going to bother getting into it.

    I know, you've been reading my blog and are baffled by the fact I'm resisting an opportunity to provide references.

    Here's a case where I don't need references, but if you want some, feel free to turn to the Center for Science in the Public Interest who 3 days ago sent a cease and desist letter to the Enviga folks.

    Why don't I need references? Let's go back to that 60-100 calories burned. Let's even assume it's true. What else burns 60-100 calories - drinking 8 glasses of fridge cold water a day or really drinking 8 glasses of any cold zero-calorie beverage a day (because it takes energy to raise the temperature of the cold liquid) or taking just three extra 5 minute walks a day.

    Any zero-calorie beverage marketers reading my blog? If so, take the wind out of this Frankenfood's sales by starting your own drink negative campaign!

    So what would you rather do? Drink 8 glasses of cold water a day, go for three 5 minute walks a day, drink 4 glasses of cold water and take one 7.5 minute walk a day, go for three 10 minute walks a day, or would you rather spend $1500/year and in so doing help pay the salary of a clear researcher of the night who actually put her name behind the statement calling Enviga a "perfect partnership of science and nature"?

    Shame on Dr. Rhona Applebaum selling her name that way, shame on Dr. Hilary Green for promoting shaky science as fact, and shame on you if you buy into this incredibly stupid campaign.

    (Looking for the Food Guide series? It can be found if you click here.)

    Tuesday, December 05, 2006

    Colonel Sanders - Your Personal Health Guardian

    As you can plainly see from this ad, the Colonel espouses a healthy living attitude as I'm sure that the football on the ad means that I should be playing rather than watching football.

    What's that? You think it's about eating a bucket of fried chicken while watching football?

    Couldn't be. You know how I know? Yesterday while researching KFCs plans to scare away invading aliens I stumbled across their nutrition resources in a page Con-Agra calls, "Keep it Balanced" and it was on that page that I finally learned how to manage my weight and enjoy fried foods along with a few wonderful quobesities!

    You see, according to the nutritional wizards working for Supreme Overlord Sanders (if you're confused, scroll down to yesterday's post),

    "Many quick picks like tacos and pizza are full of important nutrients [Hey, Health Canada LOVES nutrients!] providing three or four food groups all in one."
    So you see, they're SMART picks! So when I eat a pizza, I'm getting TONS of nutrients and basically a salad because I have tomato sauce with onions, hot peppers and pineapples!

    But Supreme Overlord Sanders, even you must admit it seems like the World is getting heavier quite quickly. Did you see the report that said that there were now more overweight Africans than underweight Africans [a huge blow to the clean-your-plate club motivational speaking wing]? Well, those nutritional wizards know what to do,
    "No single food causes weight gain [that's right, if you just eat one piece of food a day, you'll never gain weight]. It's about the total calories. So make your calories count by eating foods rich in nutrition [like Tacos and Pizza], and kick up the exercise a few notches when you eat more than you need."
    Clearly those Africans must not exercise enough!

    What I'll probably do for dinner - I think I'll have a KFC crispy twister sandwich (670 calories), along with KFC potato wedges (240 calories), a slice of KFC pecan pie (480 calories) and a large Pepsi (280 calories) and then when I get home, I'll just tell my wife and 27 month old daughter that I love them but the Colonel says I have to kick up my exercises a few notches and then I'll go for the 3 hours of running that I would need to take to burn off the over 1600 calories I ate for dinner at KFC. You know, I guess that's unfair, I do after all need some calories for dinner, so I guess I'll go for a short 2 hour run and keep some of those chalk full of nutrients calories just for me.

    Gee, those folks over at Con-Agra foods sure are smart! I hope that Health Canada consulted them when creating their new Food Guide.

    Great news! On the Food Guide's revision 12-member Advisory Board sits Ms. Carolyn O'Brien, the Director of Scientific & Regulatory Affairs at the Food and Consumer Products Manufacturers of Canada - a purely industry based organization whose members include KFCs Con-Agra!

    Hurray! Way to go Health Canada! No one knows nutrition better than the Colonel, and no one cares more about the health and welfare of Canadians than the food industry. Right?

    (Looking for the Food Guide series? It can be found if you click here.)

    Monday, December 04, 2006

    A Giant Warning to Space Aliens!

    As if enlightened extra-terrestrials needed another reason to avoid popping by!

    The first corporate logo to be visible to the Hubble telescopes of other intelligent lifeforms - KFC.

    I wonder if they'll think the Colonel is the supreme overlord of Earth?

    All hail Supreme Overlord Sanders, champion of deep fryers, feeder of families and scourge of chickens!

    (Looking for the Food Guide series? It can be found if you click here.)

    Saturday, November 18, 2006

    Health Canada Quobesities

    While researching this series, I read through a great many comments made by Health Canada officials regarding the Food Guide.

    Some were remarkable due to their comparison with the path the Food Guide revisions have actually taken, and others were remarkable simply due to what was said.

    In no particular order, what follows are some of my favourite Health Canada Food Guide related Quobesities:

    1. On obesity in general

    "Obesity is a very complex issue but I think that we’re not needing to label it as a disease"
    despite it being labeled a disease by the World Health Organization , the National Institutes of Health, and virtually every major medical organization in the world.

    2. On blindly following the Food Guide to maintain a "healthy weight" without paying any attention to calories,
    "Canadians who follow the draft guide will in fact find that they will maintain a healthy weight"
    Magically I suppose.

    3. On the revision process,
    "The revision process is evidence-based, collaborative, transparent and tied to public-health priorities",
    but don't ask them to show you the revisions, the evidence or the process itself because those are secret.

    4. On what the industry actually contributes to the Food Guide revision process,
    "The lobbying is intense but the revisions will be based on proper nutrition."
    And in the same article a note saying that the Beef Information Centre is pushing for more beef (got it), Refreshments Canada is pushing to not have a list of good and bad foods (got it), Kellogg's is lobbying over serving size (got it), and the Canadian Poultry and Egg Processors Council pushing to ensure that the Food Guide doesn't specifically call out packaged and restaurant foods (got it).

    5. On fruits and vegetables,
    "For example, we know that fruits and vegetables provide protection against forms of cancer and cardiovascular disease"
    BUT they're going to recommend that you eat less of them!

    6. On "Other" foods,
    "It means we're talking about breads and cereals, not croissants and muffins. There's very little room for extras in this pattern such as cakes pastries, french fries, ice cream and alcohol. It requires different choices to be made"
    BUT they won't provide you with any guidance on other foods, they'll simply pretend they don't exist despite the fact that they know that Canadians on average get 25% of their calories from "Other" foods.

    7. On their revision,
    "What we did in November was come out with a platform. It was the best we could do at the time. What we heard back was, "Sorry, it's not good enough". So what we've done is take the nature of "Sorry, it's not good enough," and we have taken the next steps."
    22 months was just not enough time to come out with a good product? What? You want to see the changes they've made? Sorry, not going to happen.

    8. On those very changes,
    "Help me guys, is there another piece here?"
    Question asked by Health Canada official to other Health Canada officials after Liberal MP Ruby Dhalla asked if they could provide another example of the changes they'd made to their "Sorry, not good enough" draft after they had provided the singular example of sodium.

    9. On their listening skills,
    "So we've spent an enormous amount of time trying to take the input that's been given to us, understand it, reflect on it, and make sure that when we finish the process we have something that's stronger"
    Yet when they asked Dr. Arya Sharma, the head of the Canadian Obesity Network if he felt there should be guidance on Calories and he said to them "YES", their enormous amount of time taking his input, understanding his input and reflecting on his input led them to report to the House of Commons that,
    "I can tell you that we've actually met with the scientific director of the Canadian Obesity Network, Dr. Sharma. We asked him whether he thought we should be talking about caloires. His answer was no."
    10. On nutrients being more important than foods,
    "An earlier comment said that we seem to be preoccupied with nutrient adequacy. We are not. If I leave you with one thought, it is that the chronic disease prevention components of this guide are every bit as important to us as the nutrient adequacy"
    Yet they do not recommend maximizing whole grains and minimizing refined, they do not recommend decreased red meat consumption, they do not recommend the preferential consumption of fish over other protein sources, they recommend you eat fewer fruits and vegetables and plenty of dairy despite the fact that ALL of those shortcomings fly in the face of what we understand about diet and the prevention of chronic diseases.

    11. On using current Canadian dietary habits as a design basis,
    "We can't develop a de novo pattern"
    Ummmmm, why not?

    12. On the release of the new Food Guide,
    "I can categorically tell you that when this Food Guide comes out there will be criticism"
    Well isn't that something, I actually agree with Health Canada!

    What Can You Do? - Some ideas about how to make your concerns known, and where can you turn to for sound dietary advice?

    Yesterday: Guidance? What Guidance? - The sage advice of the Food Guide on how to manage your weight

    What Can You Do?

    Well if you haven't guessed it already, my first piece of advice is, don't follow Canada's Food Guide. It's not even remotely reflective of our current understanding of the effects of food on chronic disease prevention, it's rife with the involvement of politics and the food industry and if you do choose to follow it, you'll probably gain weight.

    Does the fact that Health Canada is about to release this Food Guide without allowing for any further input or revisions upset you? Does it bother you that it's what's going to be taught to your children in schools, handed out in doctors' offices and taught as gospel to dietitians across Canada? Do you find it frustrating that those Canadians who are concerned enough to look for help with either nutrition or weight management will be pointed towards a terrifically flawed food plan?

    If it does, then consider actually doing something about it.

    Noise actually does make a difference and one of the best ways to make noise is to write or better yet call your local MP and explain to them your concerns. If you're not sure who your MP is, no worries, simply click here and using your postal code, you will be provided with your local MPs name, telephone number, fax number and email.

    If you'd like, cut and paste the following brief message, modify it as you see fit and email away,

    Dear (insert your MP's name here),

    I am writing to you today to voice my concern regarding the pending release of the revised Canada's Food Guide to Healthy Eating. The recommendations being made by the draft guide are not reflective of science and medicine's current understanding of the impact of diet on chronic disease prevention, including but not limited to obesity.

    Considering the fact that at least 25,000 Canadians die annually due to diet and weight related illnesses at a cost to Canada of over $6 billion dollars, to ignore this issue would be a grave mistake.

    It has been 14 years since the Food Guide's last revision. Expert physicians and representatives from the non-profit nutritional advocacy group the Centre for Science in the Public Interest have testified before the House of Commons Standing Committee on Health as to the dietary shortcomings of this pending release.

    I am writing to you today to urge you to ensure that before a new Food Guide is released and before we are subjected to another 14 years of inaccurate dietary advice and consequently unnecessary morbidity and mortality for Canadians, that both the draft Food Guide and the process by which its recommendations are crafted be reviewed.

    Another way to make noise is to spread this series around. The link to the kick off of this series is here:

    Please link to it on your websites, blogs, any forums you might frequent and in emails to your friends and families lists. The more people who are aware of how Health Canada has handled these Food Guide revisions, the more likely that meaningful improvements take place.

    In terms of an evidence-based plan for healthy eating, look no further than the picture at the top of this post. That's a picture of Dr. Walter Willett's Healthy Eating Pyramid. Not only is it evidence based, but part of that evidence was Dr. Willett's proof that following it demonstrated a markedly reduced risk of chronic diseases vs. following the American (and for all intents and purposes the Canadian) Food Guide. For a detailed trip through his recommendations, pick up his fabulous book, Eat, Drink and be Healthy

    With regards to weight management, you have to separate the concept of healthy eating from weight management. Healthy eating wise, stick to Dr. Willett's pyramid. Weight management wise, lessons learned from the National Weight Control Registry along with my experiences with close to 1,000 patients suggest the following Top Ten style list to be extremely important for successful weight management:
    1. Figure out how many you burn in a daytime. The best calculator I've found to do this is located here. Eating 500 fewer Calories per day should lead to a weekly 1lb weight loss.
    2. Keep track of what you're eating - whether via a food diary, routine eating or your own system, knowing how many Calories you've had is extremely helpful in guiding your decisions. There are online resources to do so including Calorie King ($30/yr) and Spark People (free).
    3. Don't lose too quickly. Remember, if you don't like the way that you're losing weight, you're almost certainly going to gain it back when you stop living that way. The only way to lose weight rapidly is to eat far too little, and unless you plan on eating far too little forever, it's not a good plan.
    4. Don't get hungry! Eat 3 meals and 3 snacks daily, not going more than 3 hours without eating. Waiting until you're hungry to eat will of course lead to more challenges - we don't crave green leafy salads when we're hungry
    5. Try to include protein with each meal and snack as protein is more filling, delays the body's absorption of carbohydrates and helps smooth out the body's insulin response.
    6. Practice Calorie awareness! Before I buy anything I look at the price tag. Before I eat anything, I check out the Calories. Doesn't mean I don't eat high Calorie items from time to time, it's just that I pick and choose when. Not knowing the Calories before I ate would be like me shopping by handing out blank checks.
    7. Eat breakfast! Make sure that you have at least 300 Calories, that it's within at most an hour of waking and that protein's included.
    8. Minimize eating out. If you're not in charge of the cooking, you're not in charge of the Calories and Calories sell. A restaurant's job is to bring you back. Their portions will be larger and their ingredients higher in Calories. It's extremely challenging to lose weight with frequent meals out.
    9. Don't drink your Calories. Liquid Calories don't help with feeling full. Fruit juice drop per drop has more Calories than Coca Cola. Milk as discussed in a prior post, may not be the healthiest drink in the world. I recommend lots of water and taking advantage of the myriad of zero-calorie beverages available. While much to do has been made about potential risks of sweeteners, every rigorous scientific study has found them to be safe, however even if you want to worry about the potential for a remote or rare risk, there's no doubt there are greater risks with weight.
    10. Find as many ten minutes as possible to exercise (brisk walking, housework, playing with your kids all count). Exercise for weight management is cumulative - it's like going to the bank. If you deposit $10 four times a day at the end of the day you've got $40, you don't need 40 minute blocks of exercise to make a difference. Aim if you can for between 250-350 minutes of exercise weekly. A great book on the subject is the No Sweat Exercise Plan by Harvard cardiologist Dr. Harvey Simon
    Not included in the Top Ten list but perhaps more important than anything is the following: Don't set number goals. There are lots of numbers that you might try to pick on or goal set with - weight, body mass index, body fat percentage, waist circumference, waist-to-hip ratio. Frankly they're not that useful. They're really only useful for two things. Firstly you can use them to try to work out whether or not your weight carries with it any medical risk and secondly you can use them as potential calls to action, but I've got to reiterate, don't set goals with them.

    The only goal worth setting is living the best you can. If you can't eat less and you can't exercise more within the context of a lifestyle that you're actually enjoying, then whatever your weight is, it's great. Remember that even a 5% weight loss has a significant medical benefit.

    I hope you enjoyed this series on Canada's Food Guide and while I'm not holding my breath, maybe with enough noise you won't soon be reading an editorial written by me about how bad our new Guide is when it does officially get rolled out.

    Yesterday: Health Canada's Quobesities - My favourite quotes from Health Canada officials on the matter of the Food Guide.

    Guidance? What Guidance?

    Obesity and overweight rates in Canada are skyrocketing. Official statistics state that almost two thirds of our population is overweight or obese. Fact is, the number actually probably closer to three quarters. If you click on the picture above you'll see obesity rates (overweight not included in slide) based off of measured Canadian heights and weights whereas all the official statistics are based off of self-reported heights and weights - turns out when Health Canada calls to ask how tall and heavy we are, many Canadians under report their weight and/or over report their height.

    So if 65-75% of the population is overweight or obese, and if obesity costs Canada close to $7 billion per year in direct health care and lost productivity costs, and if obesity is responsible for the death of 1 in 10 Canadians between the ages of 20 and 64, and if at one of obesity's root causes are the foods we're choosing, and if the Food Guide revision was launched with obesity as a primary focus, and if we ignore the fact that the calorie models are flawed and that by focusing on nutrients we ignore the bigger picture of chronic disease prevention (including but not limited to obesity), then what sage advice does this new Food Guide provide Canadians on how to manage their weight?

    For your benefit, I am going to copy every single statement from the Food Guide that relates to what they refer to as "Healthy Weight".

    1. Aim for the number of choices recommended in "Your Guide to Daily Food Choices" for your age and sex.
    2. Try not to eat too much more or too much less.
    3. Be aware of your portion sizes. Use the Food Guide to assess how much you eat.
    4. Choose foods and beverages that are lower in Calories and fat
    5. Be physically active each day
    6. Eating the amount of food suggested in "Your Guide to Daily Food Choices" should help adults achieve and maintain a healthy weight. You can tell if you are eating too much or too little food by how your weight changes over time.
    7. If you are at a healthy weight and find that you need more calories, have more choices from the four food groups.

    So let me get this straight. Obesity's one of the main reasons Health Canada launched the revision process, contributes dramatically to our health care expenditures, kills tens of thousands of Canadians each year and the sum total of their advice is weigh yourself daily and if you gain weight eat less? Gee, that's helpful.

    I especially like the point that explicitly tells Canadians that if they're at a healthy weight and need more calories, they should eat more! Doesn't eating more calories cause weight gain? Shouldn't there instead be guidance on how to utilize behaviour and food choices so as to minimize, if not eliminate hunger?

    The problem is Health Canada seems mired in the ridiculous notion that "Healthy Eating" leads you to "Healthy Weights". Healthy eating and weight management are two completely separate entities. Healthy eating involves the foods that you choose, while weight management involves the Calories you choose. You can gain weight eating only salad if you eat enough of it.

    Don't believe me? Here's a sample diet that our registered dietitian Shawna Hunt created and presented to Health Canada at our sit down meeting. She designed it using the draft Food Guide and adhered to its every rule and recommendation as applied to women between the ages of 18-50. It's meant to represent what a person might consume while trying to "Eat Healthy", but without understanding Calories. Eat it and you'll consume 2800 Calories of very healthy food. She even went light on the "Other" foods despite the fact that as you've read, they make up 25% of the energy you're consuming.

    So if obesity's a great concern for Health Canada, and if "Energy" is measured in Calories, why isn't there some guidance surrounding Calories.

    Do you think it would be useful to know roughly how many Calories your body burns in a daytime? If you knew how many Calories you burned, it would almost certainly influence your decisions as to what to eat. The easiest analogy is money. You need to know how much money you make in order to determine not only how much you can spend, but also to give you an understanding of the value of money because if you don't know how much money you make, knowing how much something costs becomes much less useful. Similarly, if you don't know how many Calories you burn, that big, bold first piece of information on the Nutrition Facts label, Calories, can't help you as much. It's less helpful because while of course you know that more Calories lead to heavier weights, if you don't know how many you burn, you won't know how much is too much.

    If we take that hypothetical, sedentary, 5ft 4inch 50 year old woman, she would likely do well to know that at a healthy weight, she only burns on the order of 1500 Calories per day. Knowing that may make her think twice about whether or not she needs the 750 Calorie Starbucks Island Oat bar featured in a prior post.

    Sadly, when discussing this very issue, Health Canada resorted to out and out lying. Here's the exchange from the October 24th meeting at the House of Commons. Health Canada had just been asked if they knew about my concerns regarding their lack of Caloric guidance,
    "It is a perspective that I know has been expressed by him, and it is a perspective that isn't shared widely by others. We take this very seriously. We don't just casually say we don't agree with something. We are very careful about this.

    I can take tell you that we've actually met with the scientific director of the Canadian Obesity Network, Dr. Sharma. We asked him whether he thought we should be talking about Calories. His answer was no."
    Actually, his answer was "Yes".

    Unbeknownst to Health Canada, Dr. Sharma and I had just spent the weekend at the Obesity Society conference in Boston and we found some time to chat. Among other discussions, we had talked about the value of Caloric guidance and the role of what I'll call Caloric awareness in helping our country's obesity concerns. I emailed him about what Health Canada had reported that he'd said and here's his response,
    "Interesting, because I also just heard from Mary Bush.

    I don't think I ever said Calories are not important and no guidance should be given ...

    I think I did agree in general that there should be some guidance for normal Caloric intake - making it clear that there is a range compatible with maintaining a normal weight and that individuals' requirements may vary ...

    I think, all I said was that I did not feel strongly about Calorie counting - but I agree that for people to have some idea of their requirements and some general idea about how many Calories are in what foods would be helpful."
    So did Health Canada knowingly lie? Probably not. The slightly nicer than lying option, is that when Dr. Sharma clearly stated that he thought some basic Caloric guidance would be useful, Health Canada wasn't actually listening they were just hearing.

    As I've been saying throughout this series, the issues I'm bringing up are not medical secrets. The fact that at the end of the day eating more calories than you burn leads to weight gain - is not a surprise or a secret to Health Canada, it's just that Health Canada clearly chooses what it wants to hear rather than relying on best evidence to guide their guidance.

    Tomorrow: Health Canada's Quobesities - My favourite quotes from Health Canada officials on the matter of the Food Guide.

    Yesterday: Oh, and you Can't have Ketchup - How Health Canada has ignored 25% of your dietary energy intake.

    Oh, and you can't have Ketchup!

    I sure hope you don't like ketchup.

    I also hope you don't like jams, jellies, potato chips, chocolate, soft drinks or alcohol because as far as Health Canada's concerned, you simply can't have them. For they are the Other foods of the 1992 Food Guide, but in our new version, Health Canada would prefer to pretend that they simply don't exist.

    Funny thing about them not existing.

    I sure think they exist. I'm sure you think they exist. Statistics Canada sure thinks they exist. In fact Statistics Canada thinks that Canadians obtain almost 25% of their total daily calorie intake from these "Other" foods, a result none too surprising since identical results came from a 2001 study in the Canadian Journal of Dietetic Practice and Research.

    Ok, so maybe I'm taking a bit of blogger license by stating that Health Canada doesn't think Other foods exist. Actually, I'm being kind, the truth is far more disturbing. Health Canada knows they exist, but they choose to ignore them.

    Health Canada, during their questioning in front of the Standing Committee on Health had a few succinct words to say about their approach to "Other" foods,

    "The issue is very dead-on. Canadians consume a large percentage of their energy--22% for ages 4 to 18, that we know from CCHS 2.2--from foods that aren't part of your basic food supply. I will repeat what I said earlier. This food guide is talking about tough choices."
    They report that their Guide leaves little room for error, meaning that if you were to stray from the Guide even a little, you may well find yourself gaining weight.

    Let's pretend for a moment (and I really mean pretend) that Health Canada's caloric modeling, despite it being based off out-dated and artificial 1997 Nutrient File calories is correct. If you take their calories and then add 25%, well that's a heck of a lot more calories!

    Hey wait a second, doesn't consuming a heck of a lot more calories lead to weight gain?

    So let me ask you, do you think it's a good idea to simply ignore 25% of the food that Canadians are currently consuming? I sure don't, but if we resign ourselves to the fact that there are a lot of "tough" choices to be made here, as Health Canada themselves stated at the House, I suppose that must mean that Health Canada has provided us with some rock solid guidance as to how to find and minimize these "Other" foods since it seems as if their solution for "Other" foods is for Canadians never to have them.

    Think again.

    It is ridiculous to suggest that Canadians cannot and should not choose condiments. It is ridiculous to assume that Canadians will stop eating dessert. It is unconscionable that the new Food Guide ignores 25% of all of the foods consumed by Canadians, preferring to turn a blind eye than to craft helpful recommendations as the "guidance" you'll read about tomorrow is as ridiculous as ignoring the fact that Canadians consume a great deal of "Other".

    Tomorrow: Guidance? What Guidance? - The sage advice of the Food Guide on how to manage your weight

    Yesterday: A Match NOT Made in Heaven - The 1997 Nutrient File and Canada's Food Guide working together to increase obesity.

    A Match NOT Made in Heaven

    Back in April my concerns regarding calories and the draft Food Guide were published in the Canadian Medical Association Journal (CMAJ). This wasn't the first time I had voiced my concerns, the first time was at a Think Tank on obesity where I had the opportunity to lunch with Health Canada officials. At that time my concerns were dismissed seemingly out of hand, but within days of publication in the CMAJ, Health Canada called and asked for a sit down.

    As I mentioned in my earlier post, Consultation, What Consultation, to me at least it seemed that Health Canada certainly wanted to hear me, but did not especially want to actually listen to me. They spent most of the meeting trying to explain the fact that they had done caloric modeling and that their diet models had fewer calories than Shawna, our dietitian, had predicted.

    Counting calories is actually a pretty easy thing to do - there's really not a lot of room for error. There are many online and print resources for tracking calories, and as it turns out, it was due to Shawna and Health Canada's choices of resources (and Health Canada's refusal to acknowledge "Other" foods - will get to that tomorrow) that led to their differences in numbers.

    Shawna used real-world resources. She used actual products' Nutrition Facts labels and the 2006 version of the Calorie King Calorie, Fat and Carbohydrate Counter. Health Canada on the other hand used the almost a decade old 1997 Nutrient File.

    So let me ask you a question. If you were counting calories, but your calorie database was out-of-date do you think you'd be counting accurately?

    Here's another question, if your calorie database grossly underestimated the number of calories in foods, do you think that maybe, even if you were keeping track, you'd be eating more calories than you thought?

    Well guess what, the 1997 Nutrient File is terribly out-of-date and does indeed grossly underestimate the number of calories in foods, and that's one of the reasons why Health Canada came up with much lower numbers than Shawna did when calculating the calories following the Food Guide would lead you to consume.

    To explain what I mean, I'll use an example. Before my House of Commons testimony I went into my local supermarket and looked at their bread section. While the 1997 Nutrient File and consequently the Food Guide conclude that a slice of multi grain bread weighs 26g and contains 65 calories, that was true with only 1 of the 31 total loaves available for sale. Of the remaining loaves, over 2/3 weighed 60% more than expected by Canada’s Food Guide. Two of the most popular multi grain loaves, Dempster's Multigrain and Country Harvest 12 grain each had slices that weighed 45grams and contained 130 and 135 calories per slice respectively or DOUBLE what the 1997 Nutrient File says they should.

    Remember, with regard to weight, its currency is calories. If for one year the only thing I did differently was eat one sandwich with Dempster's or Country Harvest bread in place of the non-existent 1997 Nutrient File bread, I might gain 13.5lbs more than Health Canada would predict. Why? Calories. Don't believe me, here's the calculation:

    (260cals Dempster's - 130cals Nutrient file) = 130 cals per day more

    130 cals per day x 365 days per year = 47,450 cals extra per year

    47,450 extra cals per year / 3,500 cals per pound = 13.55lbs
    And of course it's not just bread. The 1997 Nutrient Files says a commercial blueberry muffin has 197 calories. Tim Horton's says it has 340 calories. It's even off on fruits and vegetables because the average sizes have grown. I weighed a potato at home and it was 75% larger than the ones listed in the 1997 Nutrient File and to my eyes, it looked like a pretty average sized potato.

    The thing that's the most remarkable is that even if you take Health Canada's calorie models as accurate, they still recommend far too many calories. Health Canada informed me that a 19-50 year old woman following the new Food Guide would consume 1,750 calories daily.

    Using that number let's take a pretty typical hypothetical Canadian - a 50 year old, sedentary, 5ft 4 woman. According to the Mifflin St-Jeor equation, currently the best equation we've got to predict calorie requirements, if she were to eat 1,750 calories daily that would lead her to a weight of 188lbs and a medical diagnosis of obesity with a body mass index of 32 (if you want to calculate this yourself, I used an exercise coefficient of 1.2).

    So does the Food Guide contribute to obesity rates in Canada?

    If it's followed it sure does - it recommends far too many calories. Of course whether or not the Food Guide's followed is a tough question to answer since formal studies have not been done to determine the percentage of the population who try to tailor their diets to meet the Guide's recommendations.

    That being said, below is a graph from Statistics Canada detailing the average number of calories consumed by Canadians. Notice what starts to happen in 1992 when the then new Food Guide came out.

    So what did the 1992 Food Guide recommend? Well it recommended that we consume 25% more meat, 50% more milk products, 67% more fruit and vegetables, and much to the delight of grain farmers I'm sure, 112% more grain products than the 1982 Guide.

    Health Canada at this point usually likes to try to make me look ridiculous by trying to state that I place the blame for Canadian obesity rates solely on Canada's Food Guide. So I'll be very clear here, I'm not putting all of the blame of Canada's rising obesity rates on the Food Guide - but to pretend that it has not or could not be a factor would be a gross oversight given the dramatic increase in per capita calorie consumption that began in 1992, the dramatic rise in obesity rates in Canada since 1992, the fact that according to Statistics Canada, obesity rates between 1978-1992 had remained steady and the fact that the Food Guide recommends a ridiculously large amount of food.

    Even according to Health Canada themselves, the 1992 Food Guide provided incredible amounts of food,
    "If you follow the Food Guide, you will get between 1800 and 3200 Calories each day."
    Take that same 5 ft 4 sedentary 50 year old and give her 2500 calories a day and given enough time, she could end up over 300lbs.

    And you should know, that 2500 calories does not include "Other" foods, which Health Canada in their seemingly infinite wisdom, have simply decided to ignore in the coming Food Guide.

    Tomorrow: Oh, and you Can't have Ketchup - How Health Canada has ignored 25% of your dietary energy intake.

    Yesterday: Drink Lots and Lots of Milk - Don't worry about all that research that suggests that in fact it might not be so good for you.