Saturday, February 27, 2010

Saturday Stories

Everthing you ever wanted to know about The Bloom Box - the future of home energy? Via Mashable

The Atlantic Monthly asks who has better local produce, Whole Foods or Walmart?

The New York Times takes a contrarian look at dietary salt reform.

Marion Nestle and David Ludwig make the case for banning all front-of-package labels in the month's Journal of the American Medical Association.

The New York Times on bribery and Big Food.

Dan Gardner continues his critical look at the Olympics - in this week's column he tackles the cost/benefit of it all.

[BTW - will be on Dr. Barry Dworkin's Sunday House Call radio show tomorrow from 4-5EST chatting about Codex and Canada's drive to fortify the global food supply and taking calls. You can listen online at]

Friday, February 26, 2010

NASA readies their most ambitious mission to date!

To meet girls.

Today's Funny Friday comes from those brilliant folks over at the Onion News Network and on NASA's mission to meet that hot girl at the laundromat.

Have a great weekend!

Thursday, February 25, 2010

Coca Cola's Amy Laski explains why Coke is great!

What a heart warming story.

In a response to Dan Gardner's excellent column that called out Olympic sponsorships like Coca Cola and McDonald's as an anathema to the spirit of healthy living, Coca Cola's Canadian Communication Manager Amy Laski wrote a letter to the editor that detailed why Coke is great and why Coca Cola couldn't possibly be a player in obesity.

Her first argument? Coca Cola has been sponsoring the Olympics since 1928 but obesity rates really only started their spectacular rise in the very early 70s. Clearly if Coke's sponsorship of the Olympics had an impact on obesity, we should have seen obesity rates rise in the 30s and onwards.

Now that's a brilliant argument isn't it? I've actually never heard that one. Bravo Amy! Because people drank just as much Coca Cola back in 1928 as they do now, right? No? They didn't drink as much Coca Cola as now? Would that matter? I wonder what that graph up above would think about your argument?

Next Amy tells us that between 1999 and 2008 people consumed fewer soft drinks while at the same time physical activity dropped and so it couldn't be soft drinks and it must be inactivity that's led to rising obesity rates, right? Because really the only two variables in obesity are the amount of Coca Cola you drink and how active you are? And obesity only became a problem in and around 1999?

Amy also points out, in an argument reminiscent of the bad old days when doctors helped Big Tobacco in their attempts to convince the public cigarettes weren't bad, that Coca Cola created a "red ribbon panel" partnering up with the Heart and Stroke Foundation, ParticipACTION and the Canadian Diabetes Association and holds that out seemingly as proof of their great intentions (and at the same time highlighting just exactly why these organizations shouldn't be making deals with Big Food devils). I mean really, how could Coca Cola and soft drinks be bad if the Heart and Stroke Foundation, the Canadian Diabetes Association and ParticipACTION have teamed up with them? It's innocence by association don't you know?

Lastly Amy notes that soft drinks contribute 2.5% of total daily Canadian calories and then tries to slough that off as nothing.

2.5% of total daily calories consumed by Canadians come from soft drinks? That ain't nothing! The average Canadian currently consumes 2,400 calories. Now that's probably a very lowball figure as it's based off of always overly conservative dietary recall data. But even using that lowball figure that means each and every Canadian consumes 60 calories or two thirds of a can of a soft drink like Coca Cola daily. But of course not everyone consumes soft drinks. I bet between young children and folks who are watching their health or their weight it wouldn't be too much of a stretch to suggest that 33% of the population almost never drink soft drinks which means then that average soft-drinking Canadian consumes a can daily.

What happens if you drink a can of Coke daily for a year? Well you'd end up slurping up 32,850 calories along with nearly 40 cups of sugar. Drink a Coke a day for a decade and that'd translate to 94 pounds worth of Coca Cola calories and 400 cups (>200lbs!) of sugar.

Yeah, 2.5% of total daily calories is nearly nothing.

Reading her letter led me to wonder - is Amy Laski stupid, or does she just think we are?

Wednesday, February 24, 2010

food with a lower-case "f"!

Though most of us call it, "processed food" in this case Mrs. Q.'s going to show us it's, "school food".

Who's Mrs. Q.?

She's an anonymous teacher, at an anonymous school, in an anonymous State, who's taken it upon herself to eat school lunch, "just like the kids", every day in 2010.

She's also blogging about her experience.

Her blog, Fed Up: School Lunch Project describes what we're feeding our children and while her school's in the States, there's no reason to believe things are any better here in Canada.

What really blows me away - and I'm not talking about the obvious how can we serve kids the stuff we teach them is bad for us? What really blows me away is the fact that people make arguments about why it is we can't possibly change what the kids are eating because it'd be too difficult and/or too expensive.

Really? You want to save money on the backs of our children's health? We shouldn't try because it'd be challenging?

Great lessons for our kids there.

Oh, and for the Canadian readers, too expensive? Can't just look at school bottom lines as we live in a country with socialized medicine where the effects of poor diets indeed hit the country's bottom lines (and bottoms).

Too expensive to reform school food in Canada? I'd argue we can't afford not to.

In case you're wondering what good school food looks like, Mrs. Q. provided a link to Madison Wisconsin's REAP Program. Have a peek and see what can be done.

Just because something's tough to do, doesn't mean we shouldn't figure out a way to do it.

Tuesday, February 23, 2010

Food with a capital "F"!

I'm sure you've heard of Jamie Oliver. He's a 34 year old chef from England who has launched one of the world's more effective campaigns for healthy eating.

The crux of his message? Cook. Don't pick up takeout. Don't reheat boxes. Cook. Take actual whole foods, spend a few moments in your kitchen, and cook.

If you were only allowed to choose one intervention to make to improve your health there's no doubt it should be to cook.

Great chance too that it'd have a positive impact on your weight.

Are cooking classes mandatory in Canadian schools? Nope.

Are there free government sponsored cooking workshops? Nope.

Is the government considering a means to subsidize whole foods, the building blocks of cooking? Nope.

Would any of those measures be difficult to implement? Nope.

Should we hold our breath until they happen? Nope.

Sadly I don't think things have got bad enough to warrant our government actually taking food seriously. Yet Jamie's right to label this a catastrophe.

You know there is this bad habit of folks stepping back and saying that all of this is too complicated. That healthy eating is too complicated, that obesity is too complicated. That everything is too complicated to turn around. Consequently it seems public health efforts are paralyzed.

You know what, yup this stuff is complicated. How we got to this point is complicated. Food labeling is complicated. Nutrients are complicated.

Cooking on the other hand isn't all that complicated and its impact would be immense.

Combine Jamie Oliver's perfectly aimed recommendation to ensure every graduating high school student knows how to cook at least 10 healthy, affordable meals, with Michael Pollan's 7 word manifesto,

"Eat food. Not too much. Mostly plants."
and we'd be saving innumerable lives.

Jamie's wish?
"My wish is for you to help a strong, sustainable movement, to educate every child about food. To inspire families to cook again and empower people everywhere to fight obesity."
Watch Jamie's speech from TED 2010. Set aside the 20 mins and if you don't have time today, bookmark this post and come back when you've got a moment.

Stay tuned tomorrow when I show you what we're up against in the schools.

Monday, February 22, 2010

Top 10 rules for writing a critical blog.

Think of it as Critical Blogging 101 - but first a back story.

So there's this guy named Drew Harvey and he doesn't seem to like me very much.

Apparently Drew believes that my criticism of the Food Guide contributes to the obesity epidemic and he "questions my motives" for being critical and calls them "self-serving" on his blog.

Now I didn't bother engaging Drew on his argument. Basically it boiled down to yes, industry is involved in the creation of the Guide but hey, the Guide suggests you eat lots of fruits and vegetables so how can it be bad or obesogenic and criticizing it only pushes people into the arms of pill pushers and diet peddlers.

So while I didn't weigh in myself what I did was punt his blog out into the ether by linking to it on Twitter and Facebook figuring that some of my friends and readers might have something to say, and in responding to them Drew ended up leading a real-time seminar on how not to host a critical blog.

While watching the scramble that ensued, I thought perhaps going over some dos and don'ts of critical blogging might make for a good post. So here are some rules that are well worth considering if you're planning on writing an opinionated blog:

1. Do your homework.

Before you choose to blog about someone or something make sure you really understand what they're saying or doing.

For example, if you want to criticize me regarding my take on the Food Guide it's probably best to really understand my take on the Food Guide.

2. Have an evidence-based leg to stand on.

If you're going to attack someone or something the most important thing to have on hand is evidence supporting your position.

As one deleted commenter on Drew's blog noted, a straw-man argument (creating the illusion that you've check-mated someone else's argument by substituting a distracting and easily refutable argument that the someone else didn't actually make) isn't an evidence base.

In Drew's case he creates a straw-man argument by suggesting I must have ulterior motives because I criticize a Guide that promotes the consumption of healthy-for-you fruits and vegetables, and given that fruits and vegetables are low-calorie options, following the Guide couldn't possibly make you fat. In turn that doesn't actually speak to my criticisms of the Guide but does serve to try to paint me as a ridiculous man of straw who's easily blown down.

3. If you can't take the heat, don't turn on your oven.

Simply put, don't ever publish a post critical of someone or something without the expectation that people will disagree with you and potentially even write some nasty things in your comments.

Turning off commenting like Drew did on Saturday isn't a great plan either.

4. Don't mess with your comments.

Or better yet, choose a blogging platform that doesn't allow you to.

Blogger, the platform I use, allows me to delete comments but not to edit them, and as I spell out on the sidebar of my blog, the only comments I actively delete are those containing profanities or spam.

Drew, when faced a whole slew of inflammatory comments chose first to delete the ones he didn't like, but then things got really weird. He went on to: Post-edit his own comments; amazingly added my name to comments that I didn't write (and I thought I had chutzpah); deleted every single one of the comments; only to finally bring back a carefully selected few.

Unfortunately this left behind an incoherent jumble on his blog with comments referring back to comments that are no longer there and leading one of his commenters to ask,

"How would anyone ever follow anything on here with any semblance of a 'conversation' of ideas if they just showed up now?"
5. Don't misrepresent yourself.

One of the first comments that Drew deleted questioned his websites' representations of himself as a, "professor of nutrition, physiology and behavior modification", and, "a leading author, researcher, and lecturer in the areas of nutrition, exercise, and weight management".

I won't bother raking Drew through the muck of the deleted comment but what I will say is that you'd better be able to healthily defend all of the statements you make about yourself on your website or at the very least have a track record that speaks for itself.

6. Don't be surprised if the person you're attacking decides to write back.

This blog is an open forum and I encourage anyone who thinks I'm out to lunch to tell me so in the comments - anonymously or otherwise.

Over the years there have been some great comments written by folks who think I've wronged them. Perhaps the best example of this would be Canadian reality TV trainer Nadeen Boman's very thoughtful comment on what I see as her negative contribution to body image in Canada. Hers was the 4th comment in and it led me to write a followup post asking if people agreed with her.

Oh, and if you do decide to allow anonymous posting on your blog you shouldn't be be upset or surprised if people choose to use it.

7. Not every squeak deserves a roar.

You’ve got to pick and choose your battles. Depending on the degree or the source of the squeak you might not want to bother with a post or a response as in some senses that may validate the argument of the person who’s squeaking.

8. Don’t feed the trolls.

A troll is someone who leaves comments or posts that are meant to goad you into roaring at a squeak. For instance it’s highly likely that someone in today's comments will talk about how they’re not going to write a full comment because that would validate my squeaking. If you want to see some non-hypothetical trolls have a peek at the comments left on yesterday's post.

Trolls are best left ignored.

The worst thing you could do? Lose your cool and respond with a gigantic knee jerk as that'll likely just serve to make you look foolish.

9. Don’t break the law.

Libel and defamation are serious charges, and while truth and fair comment are strong defenses, you’d still better make sure that what you’re writing is truth or fair comment.

Drew’s opinion that I shouldn’t be criticizing the Food Guide is indeed fair comment. On the other hand suggesting I have ulterior motives for my criticisms might be construed as libel, while adding my name to comments I didn’t write is just plain illegal.

10. Keep your cool and be able to admit you’re wrong.

I know I've lost my cool on the blog from time to time and I've probably looked pretty silly doing so. That said, I try my best.

More important than keeping your cool is having the ability to admit when you’re wrong. Case in point on my blog? For a recent example check out my post and the comments regarding UFit. While I wasn’t wholly wrong, I certainly was partially wrong, something I owned up to quickly in the comments and the post when it became clear that I wasn’t fully informed (goes back to the Do Your Homework rule).

Bottom line?

Blogging's rapid fire. It's easy to take shortcuts and not do your homework. Remember too that there's no one easier to convince you're right than yourself. While at times blogging can certainly feel like a blood sport, you should still strive to keep your wits about you, play hard and play smart.

Lets hope I didn't make Drew sweat or swear too much this weekend.

Drew, like rule #6 points out, you shouldn't be surprised if the person you're writing about writes back. I guess an addendum there is that you shouldn't be surprised if the person you're casting aspersions about on your blog as having shady, self-serving motives decides to mess with you.

That said Drew, if you're reading this and you want to debate the Food Guide's pros and cons, please feel free to leave angry comments on your or my blog but perhaps first take the time to actually read my series on the Food Guide rather than just its landing page. Given that apparently you're concerned by my understanding of the Guide's fruit and vegetable recommendations and the Guide's calorific nature, why don't you start by reading the post I wrote on the Guide's fruit and vegetable recommendations, followed by this post, and this post on why the Food Guide's certainly obesogenic.

Saturday, February 20, 2010

Saturday Stories

Stories that managed to capture my minuscule attention span this week:

Remember that guy who was supposedly in a coma for 23 years and suddenly began communicating? Orac from Respectful Insolence does and his cry of "bullsh*t" has now been confirmed.

Dan Gardner from the Ottawa Citizen tells us what he thinks of the Olympics (Can't say I disagree with him, though I do enjoy watching them).

The Atlanta Journal Constitution on how obesity is a threat to America's national security.

Lastly an angry guy named Drew Harvey thinks I contribute to the obesity epidemic by criticizing the Food Guide and that I have a hidden agenda therein. If you want a lesson in how not to handle angry comments click on through - though they won't be there. Drew deleted them all. Then he put a very select few back up. Who knows what he'll do next? Don't worry though, the whole thing is quite blogworthy, definitely a "teachable moment", and will be the subject of a post here next week.

(BTW: Thrilled to see in the comment section of Drew's rant (now deleted) that the public questions the Food Guide whenever he hands it out. He had written,

"Why can't I hand out the Food Guide to elementary school students or to adults at a recreation center without hearing regurgitated points against the guide?"
Thanks Drew - yesterday you made my day. Glad to hear that I've helped to normalize the Guide's critical appraisal to the point where even elementary school children are able to see its shortcomings. Perhaps next time around it'll actually be evidence based.)

Friday, February 19, 2010

The alternate Google Superbowl Ad.

The Superbowl of advertisements occurred two weeks ago and for those of you who haven't seen it, Google actually had an ad.

Why Google, now a recognized verb, needs an ad I'm not sure but in case you haven't seen it, you can watch by clicking here.

Today's Funny Friday? An alternate ad that didn't run (and remember, email subscribers need to head to the blog to watch).

Have a great weekend!

Thursday, February 18, 2010

Health Canada wants to fortify junk food on a global scale

(This is a companion piece to the news story I wrote for the Canadian Medical Association Journal. Be sure to check it out. Some wonderful quotes from a very pleasant interview with Dr. Valerie Tarasuk from the University of Toronto and the article will provide a bit more in terms of explanation as to why this plan is so misguided than this blog post.)

Regular readers may remember a few months ago when I blogged about Health Canada's plan to allow the food industry to fortify junk food. That blog led to the story being picked up by the Canadian Medical Association Journal and then the mainstream media and ultimately led to a retraction of the policy.

I had thought the issue was dead and gone but apparently when Health Canada hit bottom on junk food fortification they began to dig furiously.

To explain the latest Health Canada nutritional debacle I need to provide you with some background into something called the Codex Alimentarius Commission (Codex for short).

The Codex was established in 1963 as a joint venture between the Food and Agriculture Organization of the United Nations and the World Health Organization and even though you may never have heard of it before, it plays an integral role in the development of national nutrition policies the world over. Here's how Codex describes its role,

"The Codex Alimentarius, or the food code, has become the global reference point for consumers, food producers and processors, national food control agencies and the international food trade. The code has had an enormous impact on the thinking of food producers and processors as well as on the awareness of the end users – the consumers. Its influence extends to every continent, and its contribution to the protection of public health and fair practices in the food trade is immeasurable."
In 1985 the United Nations General Assembly stated that,
"When formulating national policies and plans with regard to food, Governments should take into account the need of all consumers for food security and should support and, as far as possible, adopt standards from the Food and Agriculture Organization’s ... and the World Health Organization’s Codex Alimentarius"
Basically the Codex serves as the reference standard for national nutrition policy decisions the world over and with 94% of the world's nations being members representing 99% of the global population there truly is no more important nutritional document on the planet.

Currently the Codex has a set of general principles for the addition of essential nutritients to foods (CAC/GL 09-1987 (amended 1989, 1991) that states that in terms of when it would be appropriate to fortify,
"There should be a demonstrated need for increasing the intake of an essential nutrient in one or more population groups. This may be in the form of actual clinical or subclinical evidence of deficiency, estimates indicating low levels of intake of nutrients or possible deficiencies likely to develop because of changes taking place in food habits."
Simply put, the Codex thinks that adding nutrients to foods should only be in response to true population based need. Seems pretty reasonable to me.

So what does Canada want to do? Canada is lobbying to have the Codex change their general principles on food fortification to,
"expand their applicability to include the discretionary addition of vitamin and mineral nutrients to foods for purposes beyond the prevention or correction of demonstrated deficiencies."
Translation? Canada wants the Codex to abandon the general principle that foods should only be fortified when there's a demonstrated population based need. Further translation? Canada wants allow for food manufacturers the world over to fortify food at their discretion.

So why would they want to do this? According to the discussion paper submitted by Canada it's because,
"changes in lifestyle and dietary habits have also prompted a growing interest by the food industry to provide consumers with a wider selection of fortified foods"
Another arugment in favour of allowing for by definition unnecessary fortification is that some jurisdictions have already allowed for this type of fortification.

Great arguments those. Let's change the Codex so that the food industry can sell consumers a bushel full of fortified junky foods because there have been a few member countries where this is already occuring. What's next? The police lobbying to increase speed limits on highways because there are already a bunch of speeders?

Looking into the history of the Codex one finds quite quickly that preventing willy-nilly food fortification is one of it's seminal reasons for Codex' existence. In their own backgrounder the Codex refers to the "Problem of Food Additives" as being a contributor to its inception and quotes a 1955 joint WHO/FAO expert committee on nutrition as stating,
"the increasing, and sometimes insufficiently controlled, use of food additives has become a matter of public and administrative concern"
I suppose Canada disagrees.

The Canadian proposal notes,
"The Principles aim to prevent the indiscriminate addition of esential nutrients to foods thereby decreasing the risk of health hazard due to essential nutrient excesses deficits or imbalances."
That's actually a direct quote from the General Principles. It's the fourth bullet Looking back at the current General Principles document it's interesting to note a sentence the Canadian revision proposal leaves out. The fourth bullet doesn't end with that first sentence, it goes on to state that by preventing the indescriminate addition of nutrients to foods,
"This will also help to prevent practices which may mislead or deceive the consumer."
I guess Health Canada doesn't care as much about the consumer as it does about the manufacturer.

When I questioned Health Canada about this on behalf of the CMAJ I received the response,
given the increase in food-like fortified products entering the market, it is the responsibility of Health Canada to develop a framework to manage the safety of these products effectively
and that the review of Codex’ general principles will serve to allow for a debate at the international level as to the types of constraints that need to be placed on voluntary fortification.

Some however might wonder why it is Health Canada, when faced with a global epidemic of obesity and literally tens of thousands of supermarket products, is hoping to enable the world’s food manufacturers to produce more “food-like” substances and potentially shift dietary consumption away from healthier whole-food choices.

Broccoli is after all, already very well fortified.

[Interesting side note. The current initiative on the part of Health Canada is being led by Christina Zehaluk. I emailed Christina to ask for an interview and she agreed saying she'd be pleased to speak with me but that I'd have to go through Health Canada's Strategic Communications Directorate first. They refused to allow me to interview Christina or anyone else for that matter with the Health Canada spokesperson stating,
"I have tried my best to locate a suitable spokesperson to speak on the topic, but unfortunately none are available."
So instead of letting me speak with the head of the file and someone who reported to me she'd be happy to chat, instead they took nearly a month to answer 8 questions I had to send them via email. Your tax dollars at work.]

Come back around 10am.

That's when today's real post goes live.

How come? Apparently I'm not allowed to scoop myself.

That piece I've been alluding to about Health Canada and their most recent nutritional debacle - it'll be up here just as soon as the news piece I wrote about it for the CMAJ is published and I'm told that'll be nearish to 10am.

Stay tuned!

Wednesday, February 17, 2010

My 1,000th Post!

Hard to believe - 1,000 posts and likely over 1,000,000 words.

I started Weighty Matters on the recommendation of a friend of mine, Matthew, who's a partner in a PR firm and after chatting with him he suggested that I had a lot to say and perhaps I should consider starting a blog. I guess there's a reason he makes the big bucks in PR as I still can't get over how much noise a small-time doctor with a private practice and a computer can actually make and I'm humbled by it regularly and thanks to the blog I've been able to do many things I never would have expected (like speak in Canada's House of Commons).

So why do I do what I do? I got asked that question last week in a meeting my blog led me to with a very nice VP of publishing at a large Canadian medical company. He wanted to know what my motivation was for writing (and for giving him a hard time about some things from one of his magazines). I explained to him that my motivation's simple - it's the battle of right versus wrong. Not to suggest I'm always right (ask my wife - I'm not), but rather if I feel that there's something, someone, or some group out there that absolutely should know better yet continues to do the wrong thing (the examples of Health Check, Canada's Food Guide, double-speaking corporate dietitians and deceptive Big Food marketing leap to mind), it just lights my fire.

I realize that at times I'm irreverent and my tone often strident, and perhaps you might occasionally think I'm being cruel, but sometimes I wonder if I really have much choice. What do I mean by that? Well I remember one email I received - it was from an upset dietitian who felt that my calling out one of her colleagues for some of the ridiculous stuff she said about her Big Food bosses' products somehow cast a bad light on her profession. I pointed out to her two things. Firstly that I call out a lot of professions (RDs, MDs, PhDs, advertisers, etc.) and certainly wasn't singling out hers and secondly that there didn't seem to be anyone else calling them like they are.

At the end off the day my blog's an open forum. Everyone has the right to post in the comments and if you sniff around there enough you'll find that I certainly don't delete ones that feel I'm out to lunch.

What am I getting at from this ramble?

It's a request.

Speak up. Whether it's on the blog in the comments, with your professional organizations, at your school board meetings or at your dinner table, because one thing's for sure - if no one ever says anything about stuff that's not right, nothing will ever change.

My promise to you?

I won't back down.

Thanks for reading,

[Thanks to a very kind soul for Simpsonizing me. Don't know if he wants attention so can't thank him by name.]

Tuesday, February 16, 2010

Are TV commercials solely responsible for screen time weight?

What a great study.

The authors analyzed the television viewing habits of 2,037 children between the ages of 0 and 12 back and the outcome they were interested in was BMI. Parents were given diaries where they tracked among other things the format of the television their children watched. Formats could be educational viewing on broadcast or cable (shows like Sesame Street), education viewing on DVD or video (same shows as on cable but without advertisements), children's entertainment viewing on DVD or video (such as Disney movies or advertisement free television cartoons), children's entertainment viewing on broadcast or cable, and lastly general audience viewing on broadcast or cable. Researchers also divided the children into groups below the age of 7 and above as those below 7 have been shown to be unable to differentiate truth from advertising.

They controlled for many variables. Physical activity, gender, age, ethnicity, sleep duration, eating in front of the television, mother's BMI, and mother's education.

The results were striking. For children younger than 7 each hour of commercial viewing was associated with a 0.11 increase in BMI scores after controlling for all of the aforementioned variables. For children older than 7, when controlled for all of the aforementioned variables and also the child's baseline BMI, again commercial viewing was once again significantly associated with increased risk of obesity.

The fact that the researchers controlled for so many variables and perhaps most importantly to challenging conventional dogma, physical activity, demonstrated to them that it's not what television is keeping kids away from (active play) that leads to obesity but rather that the viewing itself is causal for obesity and more specifically, the viewing of commercial advertisements.

Why might that be? The authors point out that children younger than 5 see an average of 400 television commercials each year (or 30 hours worth), during Saturday morning cartoons they see an average of 1 food ad every 5 minutes, and that 95% of foods advertised on television were of poor nutritional value. Equally frightening? They point out that the average first-grade child can identify over 200 brands.

So what does all this mean? It means it's probably not about how much they're watching, it's about what they're watching and while efforts to get kids off the couch to play certainly can play a role in reducing the burden of childhood obesity, it's not the playing that helps, it's getting them out of marketers' cross hairs.

Given that to date there has not been a single public health intervention that has led to long term reductions in screen-time, shouldn't we instead be focusing our efforts on enacting legislation to ban television based food marketing to children in general?

Zimmerman, F., & Bell, J. (2009). Associations of Television Content Type and Obesity in Children American Journal of Public Health, 100 (2), 334-340 DOI: 10.2105/AJPH.2008.155119

Monday, February 15, 2010

Spain aiming to ban anorexia inducing ads

Want to know the number one predictor for the development of an eating disorder? Poor body image. And in an attempt to minimize the effect of the media on body image there's a bill proposed in Spain that will ban television commercials for plastic surgery and "slimming products" before 10pm.

Interestingly in the early stages of the bill there was also a provision regarding banning promotions for low-fat foods. I guess lawmakers figured that the ads therein would also be busily promoting what they're calling, "the cult of the body".

Now I'm all for banning these types of advertisements which in turn may indeed be contributing to eating disorders such as anorexia among Spanish youth. But where's the ban that might help with obesity?

According to a recent article in European Psychiatry, the incidence of eating disorders among Spanish adolescent girls is in the neighbourhood of 5% where roughly 75% will recover and 25% will face difficult long term courses.

Now let's peek at Spanish overweight and obesity rates. Roughly 45% of Spanish adults are overweight and 13% are obese. Among Spanish children the rates back in 1995 were 15% obese and 35% overweight.

Sure makes you wonder about priorities.

The thing is, it's easy politically to look at banning "slimming product" and plastic surgery advertisements - they don't have a tremendous lobby. Food on the other hand does which is likely why the provision to extend the ban to advertisements for low-fat foods was quickly stripped from the bill.

At the end of the day Big Food is a force to be reckoned with and even though banning advertisements for junk foods almost certainly would have an impact on rates of childhood and adult obesity (more on this tomorrow), rates orders of magnitude higher than those of eating disorders, you can bet your bottom euro that the Spanish parliament isn't going to be entertaining a ban on them any time soon.

Saturday, February 13, 2010

Saturday Stories

Stories that managed to capture my minuscule attention span this week:

The National Post on how apparently in Quebec if you're obese, it's your "human right" to have a parking spot close to your condo's entrance.

New Scientist on how our world is just a hologram.

My friend Arya Sharma on Obesity Notes and his call for a Canadian Jamie Oliver or Michelle Obama.

Friday, February 12, 2010

Finally! A real McDonald's/elite athlete commercial!

I mean McJohnson's!

This is a first on the blog, a last second Funny Friday switch.

Think on this when you see the inevitable barrage of McDonald's Olympics commercials over the next few weeks.

Have a great weekend!

[Hat tip to loyal blog reader Taryn!]

Thursday, February 11, 2010

Bad news for Wii Fit curing childhood obesity.

Scott Owens, a researcher out in Mississippi decided to see what Wii Fit would do to family fitness so he loaned out 8 Wii Fits to 8 different families and was looking to see if it would help those families get more fit.

The study had two parts. 3 months where he studied the families' fitness levels before the introduction of the Wii Fit and 3 months post introduction. In so doing he used accelerometers, body composition analyses, aerobic capacity, and balance

What did he find?

In kids, while aerobic fitness did increase during the 3 months of Wii Fit, there were no changes to any other parameter.

More importantly, while initially a big hit in the homes, by the end of the 3 months the average family was only spending 4 minutes a day on the Wii Fit.

4 minutes a day sure ain't going to do much.

My advice? Buy a Wii for fun, go outside for fitness.

[Via as the study has yet to be published]

Tuesday, February 09, 2010

Why Health Check's serving sizes are inexcusable.

Headlines this past weekend read that the FDA is about to crack down on food labels' unrealistic serving sizes.

Serving sizes matter so much because as far as the nutrition facts panels go, the breakdown of contents is described in terms of the reported serving sizes. Unrealistically small serving sizes lead to more favourable sounding breakdowns of calories, sodium etc.

For Big Food - it's not really their fault. They're just getting away with what labeling laws have to date allowed them to get away with. Of course the same cannot be said to be true about the Heart and Stroke Foundation's self-administered Health Check program. Simply put, Health Check's nutritional criteria certainly need not be based or built off of patently unrealistic serving sizes - yet they are.

To illustrate what I'm talking about let's take a look at two of the more popular categories - soups and canned beans.

First up is Campbell's Butternut Squash Gardennay Soup. The Heart and Stroke Foundation happily gives it a Health Check because it has 650mg of sodium per nutrition facts panel serving (close to 1/2 of the Heart and Stroke's total daily maximal sodium recommendation) and soups clearly help pay the bills at Health Check. But what's a serving? The panel says a serving is 250mL. 250mL is a cup. Ask any restaurateur and they'll tell you, cups and bowls aren't the same. Most folks sitting down for soup at home are going to eat a bowl.

The New York Times article linked up above also doesn't think a cup's a reasonable, real-life serving of soup and had this to say,

"Many of the soups are billed as “Heart Healthy” and claim to have a reasonable amount of salt per serving. But a shopper has to examine the label closely to understand that the salt claim refers to half a bowl. A full bowl may contain close to half the daily salt allowance recommended for people with high blood pressure."
That picture up top? That's one of my home bowls with a single "serving" of soup in it. Now my bowls aren't particularly large bowls and certainly that single cup in one of my bowls sure doesn't look very satisfying. No question, when we eat soup in our home (and I imagine in your homes too) it's 2 cups per bowl.

So now back to that Health Check'ed soup - my real life serving would therefore give me 1,300mg of sodium. That's 200mg shy of the Heart and Stroke Foundation's total daily maximum.

Think it's just me, that somehow I've either got gigantic bowls, a huge appetite or simply have it in for Health Check? Let's switch to beans.

This past weekend I read an article in the Ottawa Citizen. It was entitled, "Decoding a can of beans" and it looked at the food label of the Health Check'ed Heinz Chili Style Pinto & Red Kidney Beans. The published serving size on the beans is 1/2 a cup. According to the Citizen,
"The sodium content is very high: if you ate a full cup of these beans, a reasonable quantity, you would consume 840 milligrams of sodium",
leading dietitian Rachelle Charlebois to comment,
"If it wasn't for the sodium, canned beans would be such a healthy alternative to lunch meats"
And these are the beans with the Health Check and that photo up above includes what 1/2 a cup of 'em look like.

Health Check'ed soup and beans for dinner? Even if you eat Heart and Stroke sized portions you'd get 1,070mg of sodium (a huge and shameful to be approved by the Heart and Stroke Foundation amount in and of itself). If you eat real life portions because you a) Want a substantial meal and b) Trust the Heart and Stroke Foundation enough not to weigh and measure your food, they'll hand you a heart stopping 2,140mg of sodium. 30% more sodium than the Heart and Stroke Foundation's own total daily recommended maximum!

Now toss in a glass of tomato juice (480mg sodium per glass of the stuff is ok by Health Check) and you're at 2,620mg of sodium in a single Health Check'ed meal and rapidly closing in on two days worth of maximal Heart and Stroke Foundation sodium.

The Heart and Stroke Foundation has no excuses. Remember with Health Check there's an independent body in charge of setting up shop. Unlike nutrition facts panels which are are mandated from on high, Health Check can set any old levels they want and yet they've chosen to set levels that in the majority of Health Check'ed cases are downright bad for you.

So unbelievably sad, pathetic and shameful to abuse the public's trust that way.

(And don't try to talk to me about Health Check's new so-called stricter criteria - the soup'll drop to 960mg per real life serving, the beans to 720mg while the tomato juice is already "stricter" at 480mg per glass)

Monday, February 08, 2010

A pea sized bite of salmon has 3x the DHA of Dairyland's Li'L Ones yogurt with DHA!

"A Li'L Story
by Li'L Ones

Once upon a time there were Big Ones who had Little Ones. The Big Ones wanted the Little Ones to be healthy and strong, so they said to the Little Ones, "You must always eat all your meat and all your vegetables."

The Little Ones wanted to be healthy and strong too, so they told the Big Ones, "We won't always eat all our meat and all our vegetables, but we'll always eat all our Li'L Ones yogurt."

So the Big Ones read the label on the Li'L Ones yogurt, and they saw that the Little Ones were very smart indeed, which wasn't surprising because Li'L Ones has DHA. Plus it's made with whole milk to keep them healthy and strong.

So the Big Ones bought their Little Ones lots of Li'L Ones yogurt and they all lived happily every always."

So this Big One decided to read the label on the Li'L Ones yogurt, and this Big One decided to read the whole label, not just the front of the package, or the cute storybook on their website (as seen below).

Want to know what this Big One found?

This Big One found that the nutrition facts panel on Li'L Ones yogurt, the one the Little Ones "will always eat", the one whose website states was developed with the help of dietitians and shouts is,
Well that very same yogurt's nutrition facts panel reports that while there are nearly 4 teaspoons of sugar per serving of Li'L Ones, there are 0g of Omega-3 Polyunsaturates.

Wait a sec', isn't DHA an Omega-3 polyunsaturated fat?

So this Big One called up Dairyland customer service to ask about DHA and was told that the amount of DHA that's added to Li'L Ones yogurt is so low that labeling laws in Canada forbid them from reporting any! All told per serving there's only 25mg of DHA, an amount so small that were your toddler to eat a single pea sized serving of salmon they'd be eating the equivalent nearly 3 Li'L Ones worth of DHA! And if you managed to convince your toddler to eat a small 2.5 ounce serving of salmon they'd be getting the DHA equivalent of 64.4 Li'L Ones.

So what does Dairyland's RD have to say about her company's incredibly sugary product, that as far as Health Canada's concerned has 0g of DHA yet markets itself as brain, eye and nerve food for toddlers?
"Toddlers need sufficient intake of the omega-3 fat called DHA, which supports the normal development of the brain, eyes and nerves. It can be found in salmon, trout, enriched eggs and Dairy-Oh! Milk and Li’L Ones yogurt."
Gee thanks - great job promoting your company's product at the expense of properly interpreting a nutrition facts panel for the public.

Saturday, February 06, 2010

Saturday Stories

Stories that managed to capture my minuscule attention span this week:

Brian Switek of Laelaps covers the much bally-hoo'd report on barefoot running (complete with cool video.

The New York Times covers the story of how an all-American kid became a terrorist leader in Somalia.

Orac from Respectful Insolence schools reporters in how not to report science and medical news.

Steven Novella from Neurologica further eviscerates the Desiree Jennings dystonia case.

Julie from Dinner with Julie announces the launch of Blogaid: Recipes for Haiti. 27 food bloggers band together to create a cookbook with proceeds going to help support relief efforts in Haiti.

And for a self serving one - CBC Marketplace has me have a peek at the studies Herbal Magic suggests supports 2 of their products' efficacies.

Lastly, ever wonder what happens to a man kicked in the groin with 1,100lbs of force? Well wonder no more and watch this video from the show Sport Science (email subscribers will need to head to the blog to view):

Friday, February 05, 2010

The Majesty of Farmville

Not everyone's going to know what this video's about, but that won't make it any less funny.

It's about a "game" on Facebook called Farmville whose users litter a person's Facebook alerts with Farmville updates.

Funny Friday's video takes a look at the unbelievably intense gameplay.

Have a great weekend!

Thursday, February 04, 2010

Must see TV alert!

Forgot to mention.

Tomorrow CBC's award winning investigative journalism show Marketplace will be airing their special on Herbal Magic.

Not sure how much of me will be in the show, but I was honoured to have been asked to help out and give my opinion on some of the practices going on over there.

Having seen some (or all, not sure) of the hidden video I can say it ought to be a fun show.

CBC Marketplace airs at Fridays at 8:30pm EST, Saturdays at 5:30pm and Sundays at 2:30am and 6:30am.

You'll also be able to watch it online at from Saturday onward.

Should we be treating children for obesity?

Long term readers of my blog may know that generally I'm leery of childhood obesity treatment programs (if you've got to this page from the CBC website on bariatric surgery and teens, please be aware that this blog post has solely to do with medical weight management programs and that surgery may in many cases be an extremely appropriate teenage option).

My issues with them are pretty straightforward. I worry about what it will do to the self-esteem and body image of a child to be put through an inter-disciplinary weight management program (kid, you're so fat you need a team of doctors and dietitians to help you); I worry that kids are not emotionally or cognitively mature enough to have insight into treatment (especially younger kids); and I worry that by treating the kid we're avoiding the cause - the parents who've enabled whatever behaviours that have led their kids to need help in the first place and the environment in which we all now live.

Really the only time I think it's suitable to treat children is when there are already established co-morbidities - hypertension, hyperlipidemia, diabetes, non-alcoholic steatohepatitis, etc. Otherwise I think we should be treating their parents and encouraging them to live the lives they want their children to live and to teach their children through role modeling rather than lecturing.

Well here's a worry I didn't have before but I do now. I worry that maybe you can't even give childhood obesity treatment programs away.

What do I mean?

Have a peek at this news article. The article's about a young girl named Paris living in Chicago. Paris is overweight and Paris' pediatrician urged her to participate in a year long program of weekly sessions with a dietitian, a personal trainer and a physician held at Chicago's Rush University. The program was offered free of charge. They'd have workouts with the trainer when they were there, and the docs and RDs would help them work on lifestyle changes.

At the outset, things went great for Paris but then life intervened. She and her family started missing appointments, Paris started eating out more often and despite an initial loss, by the end of the year Paris had gained 12lbs.

The not for profit cost estimate for the year of intensive therapy was in the neighbourhood of $4,000.

So at the end of the day here's a motivated family (they had to have been to commit to weekly visits for a year), a desperate teen with a $4,000 scholarship to an intensive treatment program - a program that provided an exemplary level of care consistent with the recent recommendations of the US Preventive Task Force, that fairly quickly the family and the teen blew off.

I know, one isn't exactly a sample size but given the challenge I see in compliance with adults, when I couple that with the inherent lack of organization of a child/teen along with the realities of life and the pressures of youth I worry that these interventions might in fact do more harm than good (harm to self-esteem and body image with a lack of demonstrable lifelong success despite the best of intentions).

Now I don't have any basis for my worries other than my gut. Hopefully there's someone out there following children through these programs into their adulthood to track their mental well being, their body image, their self-esteem and their weight, and until I see those studies saying I've got nothing to worry about, I'm going to stick to my adults only approach.

In my mind prevention is the key to dealing with childhood obesity, not treatment and while maybe I'm a broken record, here are some suggestions:

  • Expanded and enhanced nutritional education in schools encompassing energy balance with an emphasis on energy in and spread throughout the curriculum (reading comprehension, math, geography etc.); mandatory posting of calories on menus in schools; ridding schools of energy dense highly processed garbage; mandatory cooking courses (where parents are encouraged to attend); snack time built into the curriculum and the establishment of a national nutrition policy and food program for schools.

  • A federal ban on advertising targeting children.

  • Mandatory calorie posting in chain restaurants.

  • New zoning laws to ensure variety stores and fast food restaurants be further than walking distance from schools.

  • Massive public education campaigns on the importance of eating frequently, having breakfast, having minimums of calories per meal and snack, the importance of protein and fibre in satiety, calories needed per person per day and basic label reading.

  • New labeling laws to ensure more uniformity in suggested serving size and the inclusion of calories per package as well as a ban on misleading front-of-package health claims and programs.

  • The establishment of a nominal junk food and/or soft drink tax (a penny an ounce sounds good to me) with proceeds to subsidize the costs of fresh whole foods.
  • Changes to the existing tax laws so as to remove tax from healthful, whole foods.

  • Tax deduction status for all sports equipment, gym memberships, organized sports for kids and adults alike.

  • Those are just off the top of my head. Put together a think-tank and we can come up with dozens more. If we want to tackle childhood obesity we have to tackle the cause - the environment and the parents. Tackling the kids just puts them at risk for injury.

    Whitlock, E., O'Connor, E., Williams, S., Beil, T., & Lutz, K. (2010). Effectiveness of Weight Management Interventions in Children: A Targeted Systematic Review for the USPSTF PEDIATRICS, 125 (2) DOI: 10.1542/peds.2009-1955

    [Hat tip to BMI's Director of Operations Lorne for pointing me to the article]

    Wednesday, February 03, 2010

    10 potentially fatal, yet still approved by Health Canada "natural" weight loss products

    And the saddest part of this story? Health Canada knows they're potentially fatal yet instead of pulling them off the market, they've issued a warning that states,

    "The risk to Canadians includes choking and/or blockage of the throat, esophagus or intestine"
    So what are the products? They're the ones that contain "glucomannan", a pectin like fibre that when mixed with water (or bodily fluids) forms a gel that according to one product's website, "multiplies in volume by 17 times" leading you to feel fuller (and apparently potentially cause you to choke to death or suffer a bowel obstruction). Currently according to the Natural Food Directorate's search by ingredient feature, there are 10 such products officially licensed in Canada.

    So is glucommanan so wonderful it's worth risking choking to death or a bowel obstruction? Some small scale studies do suggest that glucommanan might lead a person to lose 3-5lbs more than not taking glucomannan.

    Sounds like a great plan.

    So how many of our tax dollars go to fund the Natural Health Products Directorate? They're doing a bang up job.

    Tuesday, February 02, 2010

    Breaking News: Official Health Check endorsement of Pizza Hut!

    'Cause nothing's healthier than taking your family to Pizza Hut for supper.

    Here's the quote from the press release,

    "We know that many people want healthy choices when they dine out and having Health Check on the Pizza Hut menu helps them easily identify those healthy options,” says Julie Lau, Heart and Stroke Foundation registered dietitian for BC."
    What a sad, sad state of affairs.

    Have they no shame?

    While the options may be "less bad" than other options on Pizza Hut's menu, that doesn't make them "healthy", nor does it preclude other members of your family (or you) from ordering non-Check'ed items while they're there.

    Reading the small print on Pizza Hut's website one finds that a Health Check'ed serving of pizza is 2 slices and a Health Check'ed serving of pasta is 1/3 of a tray.

    (Straw poll - you've gone out to eat pizza in a restaurant, are you done after 2 slices?)

    A commenter the other day said that it's meant to help folks who've already made the decision to eat out, eat healthier and I suggested that'd be like the Canadian Lung Association endorsing "light" cigarettes to folks who've already made the decision to smoke.

    How do they sleep at night?

    Gerber Graduates wins the dubious 2010 Salt Lick Award!

    Ah Gerber baby foods, now a Nestlé company where,

    "Together, Nestlé & Gerber have made an unwavering commitment to a healthier generation, one baby at a time. It’s our pledge to support the healthy growth and development of babies around the world. And, you’ll see this commitment in everything we do - bringing you and baby innovative and trusted feeding solutions from birth through preschool, and everything in between"
    So together what have Gerber and Nestlé brought?

    Salt. Lots and lots of salt.

    This morning the Canadian Stroke Network and the Advanced Foods and Materials Network announced that the Gerber Graduates toddler food product line won the 2010 Salt Lick Award.

    So how much salt we talking?

    Looking at Gerber Graduates Chicken and Pasta Wheel Pickups we're talking 550mg of sodium, more than half a toddler needs in a daytime and the equivalent amount of sodium found in 2 orders of medium fries at McDonald's.

    Guess they're trying to graduate them to full blown heart disease.

    Great job Gerber and Nestlé, your caring for kids is truly blogworthy.

    Monday, February 01, 2010

    The McHealth Check? The Heart and Stroke Foundation heads to McDonald's!

    Of course!

    Because Canadians don't eat out often enough, right? Certainly health authorities should be doing whatever they can to encourage Canadians to eat out more often, right? Clearly it's not enough that food dollars spent outside the home have risen nearly 20% since the 70s to a whopping 54%, we should be aiming higher, right? Oh, and eating out being a seminal component of our rising obesity rate, who cares, right? Certainly not the Heart and Stroke Foundation, and really, who better to champion eating out than their atrocious Health Check program?

    You know the program. It's the one that has less stringent criteria than the almost instantaneously laughed out of business Smart Choices program in the States. It's the one that gives its seal of approval to restaurant meals at fast casual restaurants like Boston Pizza to entrees that have up to 960mg of sodium (and that's the new "stricter" criteria) or nearly 2/3 of the Heart and Stroke Foundation's own daily recommended 1,500mg maximal sodium intake. It's also the one that Heart and Stroke Foundation Registered Dietitian Carol Dombrow proudly reports,

    "When you see the Health Check symbol on a food package or restaurant menu, you know the Heart and Stroke Foundation’s registered dietitians have evaluated this item and it can contribute to an overall healthy diet. Look for the Health Check symbol to help you make wise choices."
    Well guess what? Health Check's coming to a McDonald's near you.

    Yup, the brilliant dietetic brain trust over at Health Check is about to roll out Health Check'ed items at McDonald's, Tim Horton's, Subway and other fast food restaurants.

    Genius! What better way to promote health than to give Canadians a reason to feel good about eating industrially processed food-like substances rather than cooking with real whole foods?

    I know, you think I must be making this up. Sadly I'm not. A few days ago I took a survey from the Heart and Stroke Foundation about their involvement in restaurants and came across question #7 (click the picture below to see it all blown up).

    Here's what it reported/asked (emphasis mine),
    "The Heart and Stroke Foundation is extending its Health Check program to Quick Service Restaurants, such as McDonald's, Subway and Tim Horton's. Healthy meals will be identified on the menu with the Health Check logo. Brochures explaining the program and the nutrient requirements will be supplied, and training will be provided to restaurant employees.

    Do you foresee any major obstacles to the success for this program?
    Nope, I don't see any major obstacles. You see the Heart and Stroke Foundation is clearly comfortable pimping out their good name to pretty much anyone who asks, and given how pathetically underpowered their inclusionary nutritional criteria are, that opens up the door to healthy eating titans like McDonald's to help line Heart and Stroke Foundation pockets.

    Outraged? Think the Heart and Stroke Foundation should be going out of their way to encourage cooking with whole foods, not eating out? Think it obscene that Heart and Stroke Foundation Health Checks will soon adorn the menu at McDonald's? Please don't stay silent, not this time. This time, if you're a concerned allied health professional, a concerned parent, or just plain concerned, please take just a few brief moments of your time and click here to send an email to Sally Brown, the Foundation's CEO, Stephen Samis, the Foundation's Scientific Director, Terry Dean, the General Manager of Health Check and copied on the email will be Health Check's Technical Advisors and Health Check's Strategic Advisory Panel.

    I can only hold out hope that Health Check's partnership with McDonald's will do to them what Smart Choices' partnership with Froot Loops did - expose the Health Check program for exactly what it is - an irresponsible program that confuses and misinforms Canadians about what is and what is not healthy.

    Social media folks - please tweet this (retweet button below), blog about it, link to it and just plain make noise. I haven't seen the Checks in McDonald's yet and maybe, just maybe, enough noise will make it through the few feet of sand the Heart and Stroke Foundation folks have shoved their heads into and knock a tiny bit of sense into them and put an end to this madness before it formally begins.

    Don't want to do any of that? Well then why don't you at least keep your eyes open for Heart and Stroke Foundation, and apparently fast-food loving, registered dietitian Carol Dombrow eating at McDonald's and making the "wise choices" the program she proudly shills for is soon going to be encouraging everyone to make.

    Filet-O-Fish anyone?

    [Hat tip to blogging friend and registered dietitian Vincci who pointed me to the survey via her blog C'eci n'est pas un food blog]