Wednesday, December 31, 2014

Health Canada's Cadmium Coated Hypocrisy

While I'll be taking a break from blogging for the next few weeks, I'll be posting some of my favourites from back in 2011.
Yesterday Health Canada effectively banned cadmium from children's jewelry.


Because if kids accidentally put it in their mouths, cadmium carries with it a number of medical risks.

And of course it should be banned, after all that's what governments are supposed to do with toxins. Here's our Health Minister Leona Aglukkaq's take on a government's role,
"Consumer products that pose a danger to human health or safety may not be manufactured, distributed, imported or sold in Canada. This proposed guideline makes our expectations of industry clear."
Begs the question of course, why then has the government failed to move on trans-fat?

According to the head of Health Canada's own Trans-Fat Task Force, trans-fats are,
"a "toxic" killer that need to be removed from the food chain as soon as possible"
"the longer we wait, the more illness and in fact death will happen, so we know we have to get it out of our food supply"
and that,
"there is no safe amount of trans consumption"
Tony Clement, the then Minister of Health promised in June 2007 (in a speech that Health Canada conveniently no longer hosts on their websites) that if in 2 years a voluntary approach didn't remove the toxin from our food supply, that regulations would be put in place.

And here we are, over 5 years past that overly generous deadline, and Health Canada's banning cadmium, this despite the fact that the toxin kids in Canada are most likely to put into their mouths in Canada is trans-fat (adults too).

If Health Canada actually cared about our health, trans-fats would have been gone back in 2007, no voluntary free pass, and no lip service about potential regulations.

Only reason trans-fat isn't gone is because politically, it's more challenging to do, and at the end of the day Health Canada sadly, apparently, cares more about politics than it does about the health of Canadian children.

(What it also means is that there isn't much of a pro-cadmium lobby here in Canada, because if there were, there likely wouldn't have been any announcements made yesterday either.)

Tuesday, December 30, 2014

Are You Setting Up Your Kids for a Lifetime of Dietary Struggle?

While I'll be taking a break from blogging for the next few weeks, I'll be posting some of my favourites from back in 2011.
Originally I'd titled this post, Operation Palate Plasticity, but then as I wrote it, I realized it's only the supporting part of this story.

So where to begin. Well, we've got 3 little girls, and I've certainly learned both from experience and from reading medical literature, that if there's a food they reject, the best way for us to get them to eat it is to try, try, try, try, try (and add a whole pile more tries), again.

Our home's rule is simple - one bite to be polite. You have to eat one bite of everything that's put on your plate. If you don't like it after a bite, you don't need to have more, and there's always at least a few different choices per meal (but second meals aren't prepared to replace wholly rejected first ones).

My oldest probably took 30 runs at green leafy salads until she started eating them without pause. My middle kid, 30 runs at sweet potatoes. And the baby? So far she still eats pretty much anything.

Apparently kids' palates are rather plastic, and just like I tell the girls, if you try a food enough times, eventually your tongue will learn to like it.

Well one day a little over a month ago I got to thinking. I wonder if my palate's got any plasticity left?

To test it I chose coffee.

Once upon a time I had been a classic Canadian double-double drinker. By med school I'd swapped cream out for whole milk. Opening up my practice here I swapped down to skim milk and Splenda, but I never could go black.

I tried here and there, but I found black coffee to be more than repulsive. I found it bitter, angry and at odds with my mouth.

Given I drink coffee daily, usually 2 cups, I figured what better item than hideously black coffee to to test whether or not I could retrain my taste buds.

July 29th I started the experiment. The coffee was vile. Hate my mouth vile. I suffered through 2 vile coffees daily for a few weeks, and then, somehow, they went from being absolutely vile, to just being bad. A week later, and suddenly they were tolerable, and as I sit and type now, I'm enjoying my black coffee greatly.

60 cups of coffee is what it took to retrain my palate.

I'd estimate that 60 cups is somewhere on the order of 1,800 sips (comparable in a sense to our one bite rule). So in my n=1 personal experiment, my adult palate appears to be 60 times less plastic than my kids'.

So where am I going with all of this?

I'm going to our children, and not just mine, but yours too.

If children grow up in homes where their palates are trained to enjoy highly processed, highly salted, nutritionally bereft boxed foods, take out meals and restaurants, what chance do you think they'll have at retraining their palates as adults to enjoy more healthful fare? What chance do you think their kids will have?

Eighteen hundred reintroductions is what it took to retrain my adult palate.

Do you think there are many adults who'll bother doing that with anything?

Wouldn't it be easier to train your kids' palates right from the get go setting them up for lifelong dietary success, rather than take the processed and restaurant way out and set them up for a potentially lifelong dietary struggle?

I sure think so.

Monday, December 29, 2014

Is Pretending Food's Not Junk Worse Than Serving Actual Junk?

While I'll be taking a break from blogging for the next few weeks, I'll be posting some of my favourites from back in 2011.
A few days ago I did an interview with CTV NewsChannel on Edmonton schools' "junk food ban", a "ban" enacted with the explicit purpose of helping combat childhood obesity.

I think the producer was a touch surprised during our pre-interview when I explained to her that not only hasn't Edmonton banned junk food, but they've gone and done worse, they've used nutritionism and health haloing to pretend the junk food they're still selling is in fact healthy.

What do I mean?

Instead of regular potato chips, they're selling baked potato chips.

Instead of high calorie candy, they're selling bags of dried apple slices.

Instead of sugared soda and energy drinks, they're selling juice and chocolate milk.

Oh, and they're calling bags of pulverized vegetable pulp, combined with pulverized rice and potato flour (vegetable chips), vegetables.

Hey School Boards! Listen up! Baked chips are still potato chips, they've just got marginally fewer calories and fat grams. Bags of apple slices? Sure they were once apples. In fact they were once 4 apples - with each bag containing all 4 apples' calories - 18% more than a Snickers bar, along with over 15 teaspoons of sugar. Juice? Drop per drop it has the same number of calories and same amount of sugar as soda. Chocolate milk? Double the calories and 20% more sugar.

Baking doesn't make chips healthy!

Dried fruit, while certainly a yummy choice, is just fibre with highly concentrated sugar!

Juice and chocolate milk? Don't get me started.

And vegetable chips as vegetables? Ugh.

Worse still, despite trotting out the banner of childhood obesity, there are no caloric guidelines to the school food reforms, and they still allow for extremely high levels of sodium, which in turn is often used in making highly processed junky food taste good, and consequently home cooking, comparatively bland.

So at the end of the day, what Edmonton (and Ontario, and virtually all Canadian school boards) are doing is still selling junk food, but now they're labeling it as "healthy". They're also contributing to the de-healthy-palate-ification of our children, and making parenting more difficult, even for parents who do say, "No", because now parents like me who actually take the time to teach kids about true evidence based nutrition, have a very real authority figure in schools telling our kids that what we've taught them about juice, chocolate milk, baked chips, pizza and ice cream days, is wrong.

There's a world of difference between slightly less awful and good, and yet here they're serving at best (and that's a huge stretch) slightly less awful food, and telling kids and parents and society that it's good for you.

We're a very long, long way away from healthy schools. If this had been rolled out as a small step towards a much more comprehensive long term reform, maybe I could clap. Given that it's being rolled out as health food, it makes me wonder whether the schools would be better off selling absolute garbage - because at least then they wouldn't be undermining parents like me because they couldn't get away with pretending it was healthy.

Oh, and one side argument. Some folks have said that given kids can just walk across the street and buy junk, that the schools should too. I'm pretty sure they can buy cigarettes across the street - doesn't mean schools should sell them.

Schools should be safe, healthy, exemplary places, because you're damn right, pretty much everywhere else is horrifying.

My two lines in the sand?

1. Schools shouldn't be serving or selling foods that their teachers teach their students not to eat.

2. Schools shouldn't be selling junk food and calling it healthy.

So terrifically sad.

End of rant.

Friday, December 26, 2014

Love Serial? Celebrate Christmas (or Know About Santa)? Watch This.

Today's Funny Friday is a spot on Serial parody involving that jolly old soul from the North Pole.

Have a great weekend!

Wednesday, December 24, 2014

The Deleterious Effect of Snacking on Journalistic and PR Integrity

While I'll be taking a break from blogging for the next few weeks, I'll be posting some of my favourites from back in 2011.
It's been a bad few weeks for obesity related press releases.

The first was that press release from CIHI, where its headline and first paragraph served here in Canada, to lead journalists to declare that all that's necessary to combat obesity are 15 minutes of exercise a day, and a diet rich in fruits and vegetables (and consequently anyone who has obesity is lazy and eats Ding Dongs for supper).

Now there's this one.

It came from the University of North Carolina at Chapel Hill, and it was released in response to the cover story of this month's Obesity medical journal.

The press release was entitled, "New Study Highlights Perils of Snack-Filled Diet", and it made quite a splash, working its way through the Twitterverse, which in turn painted "snacking" as a dangerous behaviour for weight management.

Of course anyone who reads this blog will know that I'm a huge fan of snacking, and so I quickly clicked away at the links to see if maybe I'm wrong and that I should revamp my approach.

So what'd I find?

It had pretty much nothing to do with what I'd call, "snacking".

The article detailed the weight gain history of male Wistar rats, who for 15 weeks were fed one of 3 different diets: A high fat diet, a low fat diet, or a diet the researchers called the "cafeteria" diet, which in turn consisted of all you can eat chow, superimposed with, "3 human snack foods varied daily".

And guess what, rats who were offered unlimited amounts of human "snack" food 3x a day, ate a great deal more calories than their counterparts who were allowed to eat as much boring, unchanging, rat chow as they wanted.

Shocker, no? Rats given unlimited access to food almost certainly more palatable than that of their chow-eating counterparts, ate more.

But again I've got to come back to the question, what's a snack? After all, the press release has me worried that there are perils to my snack-filled diet.

For me a snack might be 25 almonds, or an apple along with an ounce of cheese, or some vegetables and hummus. I strive to have between 150 and 200 calories and a protein source each and every time I snack.

So is that what the rats were fed?


Here's the list of foods to which the rats were given unlimited access:

Froot Loops, Cocoa Puffs, Little Debbies' Fudge Rounds, peanut butter cookies, Reese's Pieces, Hostess blueberry mini-muffins, Cheez-its, Nestle Crunch bars, nacho cheese Doritos, Keebler Townhouse Butter Crackers, Sugar Wafers, Kroger hot dogs, Kroger cheeses, Wedding Cakes, Frito-Lay Lays Wavy chips, Kroger BBQ pork rinds and Kroger pepperoni slices.

So ultimately what this study showed was that caged rats love junk food.

Is that news? How this got published as a cover story for the reputable journal Obesity, rather than simply a footnote in the Journal of Duh, is beyond me (though the authors report the physiologic changes in the junk food fed rats mimic human physiologic changes with metabolic syndrome) , but more importantly, the press release out of the University of North Carolina at Chapel Hill, along with last week's from CIHI, has me wondering about the journalistic ethics of press releases, and the responsibilities of institutional PR departments.

I know that it's all about the headlines, but snacking, while certainly open to debate as to its utility in weight management (in the vein of multiple small meals vs. three square ones) simply wasn't the subject of this journal article. And in this day and age, where multitudes of people get their information in 140 character sound bites, and at best gloss over full press releases, and rarely if ever click through to actual journal articles, headlines matter even more. Folks reading the University of North Carolina at Chapel Hill's headline will take from it that their plan of healthy between meal snacks is a bad one.

Makes me wonder whether or not the rise of Twitter actually puts a greater onus on PR departments to issue non-misleading headlines, even if a truthful one such as, "New Study Highlights the Perils of Unlimited Junk Food Diets", wouldn't garner as many hits.

Perhaps PR departments and journalists should stop snacking on headlines and press releases and instead, eat the whole article before fairly reporting.

Sampey, B., Vanhoose, A., Winfield, H., Freemerman, A., Muehlbauer, M., Fueger, P., Newgard, C., & Makowski, L. (2011). Cafeteria Diet Is a Robust Model of Human Metabolic Syndrome With Liver and Adipose Inflammation: Comparison to High-Fat Diet Obesity, 19 (6), 1109-1117 DOI: 10.1038/oby.2011.18

Tuesday, December 23, 2014

Do You Know How To Feed Your Children?

While I'll be taking a break from blogging for the next few weeks, I'll be posting some of my favourites from back in 2011.
And here I'm not talking about nutrition, I'm talking about how you actually feed them. What are your practices surrounding food? Do you have regular meal times? Do you use coercion to try to inspire vegetable consumption? Do you reward with treats?

Parental feeding practices have been the subject of a great deal of research, and this month, the American Journal of Clinical Nutrition published a handy summary of it all.

Here are the top 10 take home messages:
  1. Pressuring kids to eat fruits and vegetables and markedly limiting their access to sweets and fatty snacks, along with using food as a reward are all strongly linked with dis-inhibited children's eating patterns.
  2. The more inconsistent parents are with either eating schedules or serving healthy vs. unhealthy foods, the greater the negative impact of the parenting styles listed in the first point above.
  3. Having at least one parent at the family meal is associated with better consumption of fruit and vegetables, and a lower risk of skipping breakfast.
  4. Adopting a knee jerk pattern of dietary restriction with an overweight child may drive that child to be more, not less, likely to overeat.
  5. The availability and exposure to foods at home most certainly affects children's long term food selections and preferences.
  6. The earlier and more broadly a child is exposed to different foods, the healthier that child's eventual adult diet.
  7. The more fruits and vegetables available at home the more fruits and vegetables your kids will consume.
  8. The more fruit juice and breakfast bars available at home the less actual fruits and vegetables your kids will consume
  9. The greater the frequency of meals in front of the television and/or the lesser the frequency of family meals, and/or the greater the use of food as a reward, the higher your kids' intake of sugar sweetened beverages.
And number 10?

I'll quote directly from the paper, as it pretty much sums up everything else up:
"Children like what they know and eat what they like."
So to make sure your children know healthy, here are some straight forward prescriptions for healthy home eating:
  • Encourage a wide and varied healthy diet introducing new foods frequently and early.
  • Don't pressure your children to eat (one bite rules are fine), or withhold dessert unless they eat their veggies.
  • Don't reward them with food.
  • Disband the clean your plate club.
  • Keep plenty of fruits and vegetables handy, accessible, visible, washed and prepared and literally smile at your kids when they eat them.
  • Sit at the table and eat with your kids.
  • Don't skip meals.
  • Dramatically minimize meals out and takeout.
  • Ensure that as many meals as possible a week involve the transformation of raw ingredients (not mixing boxes).
  • Involve your kids in cooking.
Or put even more simply?

Live the lives you want your children to live.

Monday, December 22, 2014

Dr. Oz - So Corrupted By Fame He Even Sells Himself Out

While I'll be taking a break from blogging for the next few weeks, I'll be posting some of my favourites from back in 2011.
The other day I received a note from the Dr. Oz PR team informing me of his upcoming show (aired two days ago) on the HCG diet.

For those of you who don't know, the HCG diet is one of those ridiculous injection diets. The kind where you see a physician who prescribes an insanely low number of daily calories (500) along with injections. Here in Canada those injections are usually B-vitamins , while in the States they're often Human Chorionic Gonadotropin (HCG injections for weight loss aren't kosher here in Canada).

The scientific literature on HCG as a weight loss aid is extremely clear. Randomized, double-blinded, placebo controlled trials have demonstrated that HCG shots don't work any better than shots of salt water at appetite suppression or weight loss.

In fact as Travis once pointed out on Obesity Panacea, the disclaimers on HCG providers' own websites speak for themselves as to HCG's utility,
"HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or "normal" distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets"
The show was predictable. Dr. Oz spent the bulk of the show obtaining testimonials from HCG providers and dieters, mentioned how his wife has done the HCG diet, spent a scant amount of time with HCG detractors, mentioned that the complete and utter lack of medical evidence to support its use was counter-balanced by the 4 people he had in his audience who had succeeded in losing weight, called for further study, suggested it was worth a try, and wondered if future research into it may in fact lead to a cure for obesity.

And while that's shocking to anyone who cares about evidence based medicine, it's not so shocking for Dr. Oz as he's long since sold himself out to non-scientific, non-evidence based woo, even promoting a faith healer on his show.

What is perhaps news is a link sent to me by Weight Maven's Beth Mazur. It's a link to one of Dr. Oz' own webpages entitled, "The Shortcuts Dr. Oz Would Never Take" and it was posted just 3 short months ago.

The first shortcut "Dr. Oz would never take"?

The HCG Diet.

Here's what he said about it just 3 months ago,
"Initially, this diet may help you rapidly drop pounds. Ultimately, it destroys your metabolism, as you are essentially starving yourself. Another negative side effect is the loss of muscle mass, so much that you will no longer be able to effectively burn calories."
And now?
"If you find someone like Dr. Emma (the HCG provider he had on his show), I think it's worth trying"
And how much will it cost his viewers who take his advice to try the diet scientifically proven to be useless and the one he himself rightly reports is likely to dramatically impact on muscle mass, so much so that weight regain will be far more likely? Dr. Emma charges her patients $800 for 6 weeks of this sham treatment.

So thanks Dr. Oz for promoting the exploitation of your viewers, for embarrassing our shared profession, and for being such a stellar role model for how not to embrace fame and fortune.

Saturday, December 20, 2014

Saturday Stories: Bulletproof Diets, Weightism, and Fatigue

Image Source
Friend and journalist Julia Belluz from Vox explains why the Bulletproof diet is everything that's wrong with eating in America.

Lindsay Averill on XOJane talks weightism and the terrible things people say to folks with weight.

Friend and journalist Alex Hutchinson with his debut piece in The New Yorker explaining what is fatigue?

Friday, December 19, 2014

Videos Like This Make Me Love The Internet

Today's Funny Friday features arguably the very best Christmas dinner video ever.

Have a great weekend!

Thursday, December 18, 2014

Why Semantics Matter To Food Diaries

Just a quickie on calories and diaries.

As I've mentioned before,
  • People are not walking math formulas whereby if they have 3,500 more or less calories than they burn they'll gain or lose a pound.
  • 3,500 calories of one food or type of food will likely have a different impact on health, hunger, thermic effect, and weight than 3,500 calories of another food or type of food.
  • Different people have different caloric efficiencies whereby they are seemingly able to extract more calories from food or reserves than others and lose weight with more difficulty (and gain with greater ease).
And yet here's the only truth that matters.

From a weight management perspective, the currency of weight is calories. While exchange rates undoubtedly do vary between foods and between individuals, you'll always need your own personal deficit to lose, and surplus to gain.

But "counting" suggests upper limits or ceilings you can't crash. So too do the words, "accountability", and, "honesty" - and yet those words underscore most people's approaches with food diaries.

Food diaries aren't there to tell you whether or not you've been good or bad, how much you're allowed, or how much room is left for dinner. That said, a food diary is for information and while calories certainly aren't the only nutritional determinant of health the fact that they're imperfect doesn't divorce them from having some importance if weight's a concern. The more information you have before you make a decision, the better that decision's likely to be, and in our Willy Wonkian wonderland of food, having more information is a good thing so long you use it as only one piece of a non-judgemental decision.

I guess what I'm trying to say is that the smallest number of calories you'll need to enjoy Christmas is likely to be higher than the smallest number you'll need to enjoy today and that if your general food diary practice is to allow non-contextualized calories make you feel badly about yourself when you "go over", there's a good chance that eventually the guilt you'll feel when real life leads you to higher numbers will see you stop considering the numbers altogether.

Wednesday, December 17, 2014

Why Can't We Just Ignore The Irresistible Bullshit?

I do a lot of interviews with the media about fad diets - pretty much all of which with extremely reputable reporters and news outlets.

I do understand the media's job is to sell media and that fad diets, regardless of their efficacy, sustainability or scientific underpinnings, can fairly be described as newsworthy - especially if wildly popular. I also understand that the public has a seemingly insatiable appetite for entertaining the promise of simple solutions to complex problems. But shouldn't there be a limit to the degree of bullshit a reporter will cover?

Sure, reputable reporters and news outlets generally produce balanced pieces explaining why the bullshit is in fact bullshit, but doesn't simply writing the piece, however balanced it may be, suggest there's a discussion to be had in the first place? That there are two sides to consider?

But if one side is just florid, stinking, hogwash wrapped up in the shiny tinsel of hope and tied with the red velvet bow of marketing, does it really deserve to be shot through the megaphone of a media discussion?

I don't know the answer, but I do know that the bullshit is apparently so irresistible it's bulletproof.

Tuesday, December 16, 2014

Why This Holiday Season Should be All-You-Can-Eat

Ok, so the headline's a bit clickbait-y as there's a qualifying word missing.


This holiday season should be all-you-can-thoughtfully-eat, where thoughtfully means asking just two questions before each and every indulgence.

1. Is it worth it?
2. How much do I need to be happily satisfied?

As I've said many times before, food isn't just fuel. As a species we use food for comfort and for celebration and no doubt for most of us, the answers to those two prior questions will be different in December than in January.

And here's a promise. If you don't ask those questions every indulgence will be worth it and you'll have far more of each than you need to be happily satisfied.

Monday, December 15, 2014

Should Hospital Pharmacies Be Selling Homoeopathic Products?

I've struggled in the past with pharmacies selling nonsense. Invariably I always come back to the fact that pharmacies are businesses like any other and while I would have hoped that ethics would preclude pharmacies from preying on their customers by selling non-evidence based, or worse, proven to be useless bunk, I get that they're in it for the money.

But what about hospital pharmacies? After all, hospitals in Canada are publicly funded, and as such I struggle even more with the notion that the almighty dollar excuses their pharmacies' non-evidence based sale of hope.

That photo up above was taken in the Ottawa Hospital's General campus. The over the counter section in this pharmacy is extremely small (so's the whole pharmacy), and yet even among its very limited selection, there are multiple products that at best can be described as non-evidence based, and at worst as proven to be useless.

So I'm asking, should hospital pharmacies be held to a higher degree of accountability to evidence, and if not, why not?

Saturday, December 13, 2014

Saturday Stories: Gamification, Allowing Natural Death, and Mexican Farm Workers

Matt Siegfried in Lifehacker encourages you to treat exercise like a video game and start leveling up.

[UPDATE: A reader sent me this piece from NerdFitness on leveling up in life from back in 2011. Definitely some similarities.]

Brett Belchetz in The National Post suggests we get rid of the term "Do Not Resuscitate" and replace it with, "Allow Natural Death"

Richard Marosi and Don Bartletti in the LA Times with an amazing mixed media piece on farm labourers in Mexico.

Friday, December 12, 2014

Ever Wonder Why Someone Doesn't Just Throw Salt on Iceman?

Comedian Pete Holmes did, and him as Professor X. firing Iceman is today's Funny Friday.

Have a great weekend!

Thursday, December 11, 2014

National Geographic's Fat Shaming is Shameful (and Ironic)

Weight bias is everywhere.

For instance yesterday it showed up in a National Geographic special on how our environment shapes our decisions for us.

That photo up above is a still from the special which is teaching those who view it two things that aren't true. Firstly that fat people are lazy. Secondly that stair climbing is associated specifically with weight.

Here's the clip:

Hopefully at least one of the National Geographic producers who green-lit the experiment finds their way here and takes a minute to watch the video I'm posting below of the world class obesity researchers and clinicians who I filmed taking the escalator at a recent obesity conference. That clip pretty clearly demonstrates two things, firstly that taking the escalator over the stairs is a very normal behaviour and not one relegated just to those with obesity, and secondly that I fully agree with National Geographic in that without environmental cues, we don't as a species seek out physical activity when an alternative is readily available regardless of whether or not we know better.

And really, that's what's most staggering (and ironic) about this in that the premise of the National Geographic story is that behaviours like stair climbing vs. escalator riding aren't in fact governed by simple conscious choices and instead are greatly influenced by our environment, yet in their execution of trying to prove that point, and by means of ugly, stereotypical weight bias, they end up suggesting to the public the opposite is true and instead reinforce the message that unlike skinny folks, those with weight clearly, consciously, choose escalators (and sloth as a whole) more often.

[Thanks to my friend and colleague Dr. Sean Wharton for sending my way.]

Wednesday, December 10, 2014

Holiday Gear Review: The $25 Coffee Maker That'll Free You From Starbucks

3 Aeropresses in action in Vancouver's Revolver Coffee House
[Full disclosure - Not only did I buy this for myself, but I've bought two so that I can have one at home and one at work. No one asked me to write this review.]

It's called an Aeropress and it's amazing.

It makes what some argue to be the world's best cup of coffee, it's dirt cheap, it's bombproof, it travels extremely well, and if used regularly, it'll save you the ridiculous amounts of money and calories that you might otherwise be spending in Starbucks.

It's got such a cult following that there are Aeropress coffee brewing championships held all over the globe exploring the different ways you can use it to brew.

Personally I use the inverted method (as seen in the video below), though I'm not particularly anal about ensuring perfect quantities, timing and temperature and it still tastes great.

I also purchased this 3rd party stainless steel S filter so I never need to buy the paper ones again.

If you'd like one for yourself or as a gift, here's an Amazon Associates link to buy.

Tuesday, December 09, 2014

Everything is Bull$hit

You can buy this poster here
The sad truth is that healthy living science is nowhere near where the public believes or is told that it is. We just don't have the drilled down specifics of this food vs. that food, or this exercise vs. that exercise, etc.

So what do we know? It's a really safe bet that these 8 behaviours are good for your health:
  1. Cooking foods from fresh whole ingredients and eating them free from distraction
  2. Minimizing restaurant meals
  3. Minimizing consumption of sugary liquids
  4. Drinking alcohol at most in moderation
  5. Exercising as much and as often as you can enjoy
  6. Sleeping well
  7. Cultivating and maintaining friendships
  8. Not smoking
This New Year's resolution season, steer clear of the stupid stuff and focus on as many of those 8 things as you can, because everything else? Everything else is either total but innocent nonsense, too soon to be conclusive hopefulness, genuinely inconsequential minutia, or sheer conflict-of-interest inspired bullshit.

Monday, December 08, 2014

Asking if a Bad Breakfast is Better than No Breakfast is the Wrong Question

Strangely, breakfast is a source of great contention.

There's the camp that says breakfast is the most important meal of the day (be it for weight, health, attention, etc.), and then there's the gleefully contrarian camp that relishes any and every opportunity to "bust the myth" of breakfast as being beneficial or essential to anything.

Now I don't really have a horse in the breakfast race, though I do have some considerations. Personally, I'm a breakfast eater, and in my clinical experience with thousands of patients, it would seem that for many breakfast plays an important role in satiety and control (a phenomenon which at least associatively appears to be true with the thousands and thousands of the National Weight Control Registry's weight loss masters of who nearly 80% report having breakfast). But I wouldn't say I feel passionately about it. Meaning if there were good evidence for me to stop suggesting and consuming it, I'd have no issue doing so.

But there isn't.

Sure there have been studies on breakfast skipping being no big thing, including this recent teeny tiny one (36 subjects split among 3 groups, 4 weeks duration, and only a 2lb difference in weight) which had more than one highly respected colleague of mine conclusively exclaiming breakfast to be officially dead and done. But here's the thing, in this (and most) breakfast studies, the breakfasts themselves were crap.

The breakfasts that I recommend contain 300-500 calories (with liquid calories only as condiments) and a minimum of 20g of protein. For me and for my patients these sorts of breakfasts, when coupled with organized eating throughout the rest of the day, seem to help a great deal with whole day, and even evening, satiety and control. The study breakfasts? Well they're the usually North American drek - highly processed sugary carbs washed down with liquid calories (milk and/or juice) - breakfasts which wouldn't be expected to help with satiety in the short term, let alone long.

But even thoughtful breakfasts don't help everyone. And go figure, there are lots of different people out there. To suggest that breakfast (or snacking, or any other meal or meal frequency prescription) will suit everyone is ridiculous. For some people certain styles and approaches to eating will be incredibly helpful while for others those same approaches will prove a hinderance.

Why researchers and clinicians seem to be stuck on suggesting there one right way to go is beyond me, but if you are aiming to weigh in conclusively on breakfast, at the very least make sure the breakfast in question isn't a bowl of frickin' Frosted Flakes like in the first arm of that study linked up above.

Saturday, December 06, 2014

Saturday Stories: Bigots, Idiots, Francium, and War

Slate's Laura Helmuth doesn't hold back in her description of Nobel prize winner (and seller) James Watson.

David Dunning in the Pacific Standard explains the epidemic of confident idiocy.

Veronique Greenwood in the New York Times covers her great-great aunt's fatal discovery of francium.

Peter Berkowitz in Newsweek covers the next pending Gaza war.

[And if you don't follow me on Twitter or Facebook, here's my review of the important new movie Food Chains in US News and World Report]

Friday, December 05, 2014

A Breathtaking Version of Sia's Song Chandelier

So the backstory for today's Funny Friday video is that this guy lost a fantasy football league bet and as a consequence he had to recreate Sia's Chandelier video. Whether that's true or not doesn't change the fact that it's fantastic!

Have a great weekend!

Thursday, December 04, 2014

Selling This Shouldn't be Legal (And It's Definitely Not Ethical)

Went to get my flu shot the other day at my local Rexall pharmacy.

While waiting I decided to browse and I came across the product I photographed up above.

It's made by a company called Endevr and it bills itself as,
"The Vitamin You Wear"
According to the manufacturer,
"Edge LTE Ion Bracelets feature Ion Technology. They are made from a comfortable, surgical grade silicone that has been infused with seven natural minerals that work together to produce essential negative ions."
Translation? They are made from pseudo-scientific sounding bafflegab and they have zero actual evidence to suggest they do anything other than drain your wallet of money and simultaneously tell anyone who recognizes what you're wearing on your arm that you are overly trusting of front-of-package promises.

The questions I've got:
  • How is it legal in Canada to sell a bracelet full of nothing with a label that explicitly states it's a vitamin?
  • Shouldn't the use of the word, "vitamin", be restricted to, I don't know, vitamins?
  • Is there not an arm of Health Canada that would be able to shut down a product that falsely labels itself a vitamin?
  • Why is Rexall comfortable selling this (and sooooo much other) nonsense?
  • While I appreciate pharmacies are businesses, shouldn't there be at least the smallest modicum of ethics whereby total frickin' BS isn't allowed to be sold or marketed in a store that explicitly targets health?
  • Or is it all just caveat emptor and the dollars are all that matter?

Tuesday, December 02, 2014

Holiday Gear Review: Escali Smart Connect Bluetooth Kitchen Scale

[Full disclosure: I bought this scale myself and am not being paid to review but we do sell them at our office.]
I do love this scale.

As all digital kitchen scales do, this scale can switch from imperial to metric units, has that all important zero button, and doesn't have a ridiculous basket to try to fit things in.

But it also has an app.

The app connects the scale to my iPhone via bluetooth such that when I weigh something on the scale, the app knows, and amazingly, using the app's built in database, I'm able to get a more precise number of calories for whatever item I'm measuring than my eyeballs could afford.

The reviews on Amazon are few and are mixed. A couple speak to the lack of bluetooth connectivity for the Android app, but according to the comments on the app over at Google Play, this has been fixed. Another was upset that they couldn't find a particular brand of Trader Joe pasta in the database. And I guess that would upset me if I were eating a great deal from boxes and jars, but looking up base ingredients I've yet to come across one the scale didn't already have on hand.

Ultimately this scale is for folks who are calorie conscious who tend to cook from fresh whole ingredients and want an easy and accurate way to account for what they're eating.

If you're interested, at least yesterday, the scale was half price on Amazon at $49.99, and here's an Amazon Associates link to their sale page.

Monday, December 01, 2014

Holiday Gear Review: JayBird BlueBuds X Sport Workout Headphone Nirvana

[Full disclosure - I bought these headphones myself and no one asked me to review them]
I love these headphones.

I've spent years trying out different workout headphones, and over the years they've all disappointed me. Either they weren't sufficiently comfortable, or they would fall out, or their cords would get in the way, or the sound would be lacking.

Well my search for the perfect workout headphone ended when my JayBird BlueBudsX Sport Bluetooth Headphones arrived.

Simply put.

They fit great. They sound great. They never fall out. They have an incredible 8 hour battery life. And I can take phone calls with them if need be.

The headphones come with multiple sizes of ear stays and tips, but I also bought the third party Comply noise isolating memory foam tip replacements for them and this made what was already a great purchase, a perfect one.

If you're looking for a special Christmas gift for a gym rat, look no further.

$130 - and if you'd like, here's an Amazon Associates link to grab a pair.

Saturday, November 29, 2014

Saturday Stories: Brazil, Thalidomide, and Menu Board Calories

Tom Philpott in Mother Jones covers Brazil's now official, awesome new national dietary guidelines.

Ingrid Peretz in the Globe and Mail covers the ongoing tragedy of Canada's thaliodomide scandal

Marion Nestle, over on her blog Food Politics, explains the ins, outs, and genuinely happy surprises with the US' new mandatory menu labeling law.

[And if you don't follow me on Facebook or Twitter, here are two videos me and my stache did with The Social. The first is the longer segment on late night snacking, and the latter a quickie on the pros and cons bedtime boozing has on sleep.]

Thanks to everyone who has donated to my Movember fundraising! Thrilled to report as of the time of typing this my fundraising is now up to $3,267! Thrilled a bit too that my itch factory can come off on Sunday.

And if you haven't yet donated, and you enjoy my blog, a blog which is now and will forever be free from advertising and cost, please consider supporting natural forms of birth control by clicking here.]

Friday, November 28, 2014

Are You a Back Home Baller?

Today's Funny Friday video might well speak to some of my US readers - Happy Thanksgiving to you!

Thursday, November 27, 2014

Breakfast Club of Canada Pouring Heaps of Sugar Into Canadian Children

So last week saw Coca-Cola Canada writing about their involvement with Breakfast Club of Canada, a national breakfast charity that serves 90,000 Canadian school children.

Coca-Cola is involved because by way of their orange juice donation they're teaching a whole new generation of kids that OJ and breakfast are a perfect fit.

Though of course juice isn't a perfect fit for anything really as it packs the same sugary caloric punch as soda, and while it does contain a smidgen of vitamins, if you put those very same vitamins into Coca-Cola that certainly wouldn't be a beverage you'd be recommending Breakfast Club of Canada serve 90,000 children daily now is it?

That's why the World Health Organization and Canada's Heart and Stroke Foundation both finger juice as being an unhealthy provider of free sugars.

Another unhealthy provider of free sugars? Chocolate milk.

And yet looking at that photo up above it would seem Breakfast Club of Canada is pouring both into children and with them, 12 teaspoons of sugar - double the World Health Organization's daily recommended maximum - and all before the school's very first bell.

Wednesday, November 26, 2014

How Bad Do We Want Good News Regarding Childhood Obesity? This Bad

So let me set the stage.

Researchers wanted to evaluate the impact of 6-8 months of motivational interviewing, self monitoring, text messaging and email support, had on the weights and behaviours of high school students with obesity. This intervention group was of course matched with a control group that didn't receive all that great attention.

Retention was great with 94% of the intervention group completing their last visit (and 87% of controls).

The results? Well they were published last month in the journal Childhood Obesity.

While 54% of the intervention group either maintained or reduced their BMI scores, the control group did markedly better with 72% of the control kids seeing their BMI scores maintained or reduced.

The difference by the way, according to the authors' statistical analysis, was likely real and significant with a p value of 0.025. And of course, there were confounders, and the authors did present some thoughts as to why they may have seen the results they did.

And yet what was the first of the authors' conclusions about this study where their lengthy and involved intervention was shown to be statistically inferor to doing nothing?
"This SBHC intervention showed successful recruitment and retention of participants and delivery of preventive services in both groups."
Shows you just how badly we want this particular glass to be half-full.

Tuesday, November 25, 2014

A Terrific Short Video on Food, Kids, and Sport

Today's blog post is a video put together by that lady up above. She's Kim Raine. She's super smart, an RD, a professor at the University of Alberta, a colleague and a friend. And damn didn't she put together a great whiteboard style video on how to improve the foods served up with school sports and in our community arenas as part of the Everactive project (worth a click too as well as a share with your local school's officials).

Monday, November 24, 2014

Mere Access to Pots and Seafood Doesn't Lead to Great Cioppino

The study, which sounds quite promising, is titled, "Effectiveness of a Smartphone Application for Weight Loss Compared With Usual Care in Overweight Primary Care Patients: A Randomized, Controlled Trial".

The application being studied for "effectiveness" was myfitnesspal - the world's most popular food diary app. Now you might presume from the title that the study was in fact designed to determine whether or not the use of myfitnesspal in the pursuit of weight loss was effective. You would be wrong however.

Reuters' journalist Andrew Seaman summed up the study's conclusions in just 10 words, "Mere Access to Calorie-Counting App Doesn't Lead to Weight Loss". Yes that's right, all the study looked at was whether or not having a research assistant in a physician's office help a patient to download myfitnesspal to their smartphone and show them a youtube video highlighting its use (presumably this one) would lead that patient to lose weight. That's right, patients who weren't supported in app use, counselled in self-monitoring best practices, and other than one followup a week later for help with "technical problems", had no other points of contact with the research team, didn't lose any remarkable amount of weight. Shocker.

As to how this study was published (and publicized!), and not in the Journal of Duh but actually in Annals of Internal Medicine, speaks to the the fact that obesity and weight management sells, as I can't fathom we would see studies or press coverages of studies that determined:
  • Mere access to dumbbells and barbells doesn't lead to muscle growth.
  • Mere access to running shoes doesn't lead to running.
More amazing to me was this statement made by the authors in the study's discussion,
"Given these results, it may not be worth a clinician's time to prescribe myfitnesspal to every overweight patient with a smartphone."
In turn this leads me to offer the following advice - it may not be worth a patient's time to stay on with any clinician who even remotely entertains the notion that the sole and simple act of recommending a smartphone application for the treatment of obesity could be construed as sufficiently helpful.

And lastly, two more "mere" statements.

Mere access to funding support doesn't lead to useful studies or conclusions.

And sadly, no, mere access to pots and seafood doesn't lead to great cioppino.

Saturday, November 22, 2014

Saturday Stories: Shirtstorm, Ebola, Israel, and PE

Phil Plait in Slate does a masterful job explaining why shirtstorm matters.

Helen Branswell in Scientific American covers the rather dreary topic of how stopping Ebola in Africa might cruelly mean not developing a vaccine.

A great read from Lee Smith in Tablet on Israel, land for peace, and the challenges and responsibilities of a democracy.

Here's a fabulous video shared by Steve Crandall on the value of PE in schools (hint, it's not about weight)

Other than call to action for PPP

[And if you don't follow me on Twitter or Facebook, my piece this week in US News and World Report explored the myth that 95% of people fail diets]

Thanks to everyone who has donated to my Movember fundraising! Thrilled to report as of the time of typing this my fundraising is now up to $3,187!

And if you haven't yet donated, and you enjoy my blog, a blog which is now and will forever be free from advertising and cost, please consider supporting my lip lawn by clicking here.]

Friday, November 21, 2014

At Times in our Lives We're All Golden Retrievers

Today's Funny Friday video features a golden retriever that I can greatly empathize with.

Have a great weekend!

Thursday, November 20, 2014

More Depressing News on School Based PE and Kids

The "Activity Stat" hypothesis suggests that kids are pre-programmed to get a certain amount of exercise each day. If they're more active during their school day they'll be less active after it's done.

The theory was first described in England back in 2011 when objectively measured activity (via accelerometers) from children attending 3 schools with widely varying amounts of prescribed PE, was shown to be roughly equivalent.

Well a few weeks ago, these findings were confirmed in Denmark where researchers compared the objectively measured activity of children in "sport schools" and regular schools. The sport schools provided children with a minimum of 4.5 hours of activity weekly, while the regular schools saw their kids moving weekly for 1.5 hours - and yet all kids, regardless of school, accumulated roughly the same amount of weekly activity.

Me? I'm all for well designed PE classes to help children both develop and accumulate physical literacy and to improve their school based attention and behaviour. I'm also all for increasing recess duration and frequency and lifting school yard safety restrictions. But if you think that simply adding more PE to school is going to have a tremendous impact on getting kids these days to be more active (or lose weight), there's a growing body of evidence that suggests that it won't.

Wednesday, November 19, 2014

Thanks to #Movember, Here's Me Channelling My Best Freddie Mercury

Winter 1996, 2nd Issue, The Auricle
The year was 1996. We were in 2nd year medical school at the University of Toronto and one of us, I can't remember which, came up with the bright idea of having a "Cheesy Moustache Competition" with the proceeds going to the Heart and Stroke Foundation.

40 or so of us in first and second year participated and I still have the photographic proof.

I placed 2nd in the competition (my friend Tony won) dressed in tight leather pants and a black mesh t-shirt, and I promised that were I to hit $3,000 in my Movember fundraising, that I'd post a pic in celebration.

Thanks to everyone who donated, and if you haven't yet and you'd like to donate to my home made brillo pad, you can do so by clicking here.

(And if any former classmates are reading this - do you remember the backstory to our names? I can't.)

Tuesday, November 18, 2014

How to Get a Black Belt in Healthy Living

Find a healthy living dojo (virtual, paper, person, or peer) with a sensei you trust.

Go to as many classes as you can fit into your life.

Start with the basics.

Practice, practice, practice.

Oh, and you're going to fall down a lot, that's inevitable.

Getting back up again, that's one of the most important skills to cultivate.

Black belts aren't things you can get in a hurry.

Just because you can picture what a jumping spinning hook kick looks like, the odds of you being able to do one because you can see it in your mind's eye are pretty low. Skill building doesn't work that way.

So maybe cut yourself some slack, find your sensei, go to class, start with a white belt, and stop expecting yourself to have a black belt just because you've got this mind's eye view of what healthful living looks like.

Monday, November 17, 2014

The End of the Awful Food Frequency Questionnaire is Nigh

Let's hope.

In case you aren't aware, a food frequency questionnaire (FFQ) is the most commonly used method of tracking an individual's diet. Oftentimes decades worth of observational studies are generated from one or two FFQs administered at their starts.

The problem is, whether consciously or unconsciously, we tend to forget our portions and choices and so FFQs are fraught with error.

What we need is a means to track that takes forgetting (and perhaps guilt) out of the picture.

Enter the "Automatic Ingestion Monitor" (AIM).

The AIM is pretty simple. It fits over a user's ear and by means of a motion sensor and a camera, when it detects chewing, it takes photos of what a person's eating and then via Bluetooth transmits those photos to a paired device.

As far as I'm concerned, validation of the AIM device can't come fast enough.

Saturday, November 15, 2014

Saturday Stories: Gaza, Food Policy, Dietary Supplements and More Mo

Gaza burns again and Moshe Phillips and Benyamin Korn in The Algemeiner ask, could the hypocrisy of the international community be any more blatant?

Bittman, Pollan, Salvador and De Schutter in the Washington Post with a strong call for a national food policy.

Virginia Hughes in National Geographic covers the scary and secret ingredients of dietary supplements.

Thanks to everyone who has donated to my Movember fundraising! Thrilled to report as of the time of typing this my fundraising is now up to $2,618! That definitely has me closing in on my reach goal of $3,000 and my 1995 Freddie Mercury stache picture posting.

And if you haven't yet donated, and you enjoy my blog, a blog which is now and will forever be free from advertising and cost, please support my lip kitten by clicking here.]

Friday, November 14, 2014

Awesome Daddy Toddler Dance Battle

Today's Funny Friday has a fabulous 20 month old dancing with his dad.

Have a great weekend!

Thursday, November 13, 2014

Canadian Sugar Institute Denies Silencing Child, Blames School Instead

It's the story that just won't quit.

A few days ago I blogged about Northern Secondary School's bizarre invitation to the Canadian Sugar Institute to come to their "Healthy Hub" cafeteria to, "promote healthy sugary treats".

Next came the story from Ryan Storm, a young 13 year old student at Northern who went to CSI's presentation and reported back that after asking a few questions he was told that his questions were no longer welcome.

Today I'll be posting the email I received from CSI's Manager of Nutrition and Scientific Affairs Dr. Flora Wang. I'm also posting a follow up email from her as in the first email she states that CSI never asked Ryan to stop asking questions. I found it difficult to imagine a reason why Ryan would fabricate that part of the story and when asked specifically she reiterated that while CSI didn't ask Ryan to stop asking questions perhaps the school representatives who were also present had.

Dear Dr. Freedhoff,

We have noted two of your recent blog posts (Nov 10 and Nov 12) and would like to provide important clarification and correct inaccurate information referenced in those posts.

The nutrition professionals at the Canadian Sugar Institute were invited by nutrition representatives of Northern Secondary School’s “The Healthy Hub” program to speak about evidence-based information regarding sugars and carbohydrates in the context of a balanced diet. This was an informal session with a table set up in the cafeteria for interested students and focused on the functional roles of sugars in foods, myths and facts about sugars and activities related to nutrition label reading.

We would like to assure you and your readers that the Canadian Sugar Institute did not engage in any financial or profitable partnerships with Northern Secondary School. The Institute is a non-profit association whose mandate is to communicate science-based information not to encourage/promote the sales of sugar or other specific foods. As such, the Institute was not involved in the promotion or sale of a new banana loaf that was featured in the school cafeteria. We do understand, however, that the banana loaf, prepared by the nutrition students at the school, was in accordance with the strict nutrition standards set by the government for food and beverages sold in publicly funded elementary and secondary schools in Ontario (PPM 150), and was solely a school initiative.

The representatives of the Canadian Sugar Institute who were present at the event are qualified nutrition professionals communicating evidence based information. They included one of our Registered Dietitians with a Masters in Public Health, myself (a PhD in Nutrition and Metabolism) and a Masters of Health Science student in nutrition communications. We welcomed all students’ questions and addressed everyone’s questions including those asked by Ryan. We did not ask anyone to stop asking questions and in no way asked Ryan to leave the presentation. We made no statements about Ryan’s interest or curiosity in food and nutrition. After the event, we were informed that Ryan also spoke with school representatives of “The Healthy Hub” program.

Science-based nutrition information is a priority at the Canadian Sugar Institute. The goal of our Nutrition Information Service is to inform Canadians about sugars in the context of a balanced diet, and to advocate for nutrition policies and recommendations that are based on reliable scientific research. We kindly ask that you share these important points of clarification with your readers.

Kind regards,
Dr. Flora Wang, PhD
Manager, Nutrition & Scientific Affairs
Canadian Sugar Institute
Yoni Freedhoff
Sent- Wednesday, November 12, 2014 2-04 PM
To- Flora Wang
Subject- Re- Response to recent blog posts (Nov 10 and Nov 12)

Happy to share. But need to clarify something. You are in effect stating that Ryan is lying about being told to stop asking questions (or alternatively that he was told his questions would no longer be answered).

Sent from my iPhone
Dear Dr. Freedhoff,

Thanks for responding so quickly. We are simply stating the facts regarding our communications with students including Ryan. Ryan also spoke with school nutrition representatives that were present. We were not involved in those discussions and didn’t answer any questions that were asked of those representatives. As a result, we cannot comment on the interactions Ryan had with school representatives.


Wednesday, November 12, 2014

Canadian Sugar Institute Tells Curious 13 Year Old Boy To Get Lost

Meet Ryan Storm.

Ryan is a 13 year old student at Northern Secondary School. He's also a blogger in his own right, and a budding food activist, and when he heard that his school had invited the Canadian Sugar Institute (CSI) to "promote healthy sugary treats" in his school's cafeteria, he knew he had to be there.

Unfortunately, shortly after Ryan showed up at the Canadian Sugar Institute's display, he was told that their presenters would no longer answer his questions and so I reached out to Ryan with a few questions of my own.

Can you describe the school display from the CSI folks?

CSI had a table right near the doors to the cafeteria, where kids go to buy their food. Their table had a banner on it that read “The Healthy Hub”, which is a school program, that isn’t really very healthy. There were four women staffing the table, but they weren’t wearing uniforms or any identifying marks about where they were from. They also had no Canadian Sugar Institute signage. I was told that they were doing a presentation, but it was more like they had a table at a trade show that people could go up to if they wanted. On the table they had a few black and white photographs of seemingly random foods with the nutrition facts of each pasted on the back. They were trying to tell people how sugar is connected to calories somehow, and I didn’t really understand the point they were trying to get across. They also had a “Jeopardy” game board with categories like “Sugar and Health” and “Sugar and Your Body” and were trying to get people to answer their questions. I chose the “$1,000 question” from the “Sugar and Health” category, which was
“Sugar can be part of a balanced diet.”
I said,
“What is NO?”
and they replied,
“actually it is yes”,
that was my first big inkling of how much of a problem this was. The women were friendly at first and tried to explain to me that since sugar is in almost everything we eat today we should embrace it and then starting talking about how fruits even have sugars.

What was the message the CSI folks were trying to teach the kids in your school.

They were trying to teach about “healthy sugary treats” and actually used that term in promoting it! Absurd! I actually read it and laughed at first because of how much of an oxymoron that was!

How many questions did you ask before you were asked to stop asking questions?

I think I probably asked maybe 4 questions about their work and then 2 questions to see if I could interview them on camera or audio.

What reason did they give you for why they were no longer comfortable fielding your questions?

They thought I was being “too inquisitive” and also “invasive” into their privacy. They mentioned that they were university students and didn’t feel comfortable being asked questions.

Thanks for taking the time to answer my questions Ryan, and thanks too for caring and trying to make a difference.

[And if you want to reach out to Ryan, you can also find him on Twitter]

Tuesday, November 11, 2014

Guest Post: Northern Ontario School of Medicine Gives Chocolate Bars to MDs

When RD Laurel Leconte reached out to me to tell me the tale of the chocolate bar that the Northern Ontario School of Medicine hands out to physician preceptors I knew I had to feature it on my blog and she graciously agreed to this guest posting. No doubt treats are part of life, but as it stands now we as a society are forced to go out of our way to avoid them, rather than out of our way to find them, and medical schools, of all places, ought not to be in the business of providing opportunities for treat avoidance.

Good morning Yoni,

I found this NOSM chocolate bar at a local family health team. The Northern Ontario School of Medicine (NOSM) trains physicians, physician assistants and dietetic interns (registered dietitian students). It provided these chocolate bars to physician preceptors presumably as a thank-you and invitation for the supervision physicians to call the university for support if required.

I was taken aback when I saw the NOSM chocolate bar. To me, it was yet another symbol of the ubiquitous culture of treats in our daily lives. The problem, as your blog convincingly demonstrates, is that “treats” like NOSM chocolate bars, are no longer “treats”. They are everyday occurrences in our society. Foods that were once considered “once in a while indulgences” are now daily, normalized foods. Normalized, daily foods become our “lifestyle.” Therefore this seemingly benign chocolate bar actually represents the negative food landscape that so many well-meaning parties are unknowingly contributing to.

Every time a school sports team sells chocolate bars as a fundraiser, or a skating club holds a bake sale table, or we as parents, use food as a reward, I feel we are contributing to this negative lifestyle which is the opposite of what most of us are hoping to cultivate.

Your blog has challenged some of us to “change the status quo” and identify these instances of unintentional contributions to unhealthy lifestyles. Many of your posts are controversial, as many people don’t share this point of view. I feel strongly that we do need to collectively find opportunities to improve our environment to make the healthy choices the “easy” choices.

Will power is not going to improve the western word’s rates of chronic disease. Many people will say that “treats” like NOSM chocolate bars, can be part of a healthy lifestyle. I wholeheartedly agree. The problem is that we seem to be bombarding ourselves with opportunities to overeat, eat inferior foods and avoid physical activity. We are going to have to continue to challenge the status quo if we want to stem to growing trends of chronic disease.

When I first sent this to you, I wanted to be anonymous because I felt like a hypocrite. I know that in my current personal professional roles, I am contributing to this negative lifestyle landscape in a number of ways. However, I realize that if I am going to continue to thrive in my current profession, I will need to develop a thicker skin and accept confrontation head-on. Your blog has inspired me to become a better advocate for changes I believe in, such as removing pop machines from hospitals, etcetera. In the words of Margaret Meade,
Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.

Laurel LeConte, RD, CDE
Manager, Diabetes Education Program/ Nutrition and Foodservices
Manitoulin Health Centre

Laurel Leconte has been a jack-of-all-trades dietitian on Manitoulin Island for the past 8 ½ years. In her spare time she enjoys running, cooking and wearing disguises to the grocery store. She appreciates the broadened perspective that being a mother of small children brings to her dietetic practice. She would love to network with other dietitians working in similar practice situations.