Wednesday, November 28, 2018

Call For Help Part 2: Are You Currently On A Diet? Can You Take 2 Minutes To Complete A VERY Short Survey About It?


Today's survey is a followup to the one we sent out a few months ago. Since then we tweaked it on the advice of both those of you who responded, and some expert input. Even if you filled this out last time, we'd love for you to do so again as we're trying to iron out the kinks and I think (hope) we're pretty much there.
Back in 2012 I first posted my wish for there to be a questionnaire that would serve to help individuals and researchers determine how easy or difficult a particular diet would be to follow.

I called it the Diet Index Enjoyability Total or DIET score, and my hope was that by using a series of simple Likert scales (descriptive scales from 1-10), researchers could set out to evaluate a particular weight loss approach's DIET score where high scores would identify diets that could actually be enjoyed, and where low scores would identify under-eating, highly restrictive, quality of life degrading, dieting misery. This would be useful both to individuals who could use the DIET score to evaluate whatever approach they were considering, but might also serve as a surrogate for shorter term diet studies to give a sense as to whether or not there's a low or high likelihood of long term adherence to a particular study's strategy.

I'm happy to report that the first work on using the DIET score has been conducted by Michelle Jospe at the University of Otago in New Zealand as part of the SWIFT trial, and her and Jill Haszard's early look at the data is promising.

Part of the process required to validate a questionnaire involves a qualitative review to see whether or not it's easy to use, comprehensive, and unbiased, and this here is our second kick at that can.

Monday, November 26, 2018

Once Again I'll Ask, Where The Hell Is Canada's New Food Guide?

This post was first published back in June. Since then, still no Food Guide, as well as the real possibility that not releasing the Guide influenced the New Brunswick provincial election, and just this past week, an incredible dive into juice, food politics, and our as yet unpublished guide. I really can't wrap my head around why it's not out yet beyond politics. That's not something this country should be proud of.
In case you missed the news, New Brunswick recently banned the sale of chocolate milk and juice in their schools.

It's a welcome move, and one that will be undoubtedly be adopted nation wide following the long delayed publication of Canada's next Food Guide.

Canada's Food Guide, last published in 2007, inexplicably and explicitly, reports that chocolate milk is a healthy dairy choice (that it also suggests dairy is such a magical food that it requires it's own Food Guide category is a whole other kettle of inexplicability). Or maybe it isn't that inexplicable in that on the then Food Guide's 12 member advisory committee was Sydney Massey, the Nutrition Education Manager and Spokesperson for the BC Dairy Foundation, where their homepage at the time featured the campaign,
"Don't tell Mom, but Chocolate Milk is good for you"
The next one, won't.

I know this in part because back in 2014, Dr. Hasan Hutchinson, the Director General of Health Canada's Office of Nutrition Policy and Promotion (the office in charge of the Food Guide), agreed with me during our then debate, that chocolate milk shouldn't be deemed a health food by our Food Guide,
"One thing we're doing right now is doing a reassessment of all of those things and certainly me personally, I agree with Yoni that it (chocolate milk) should not be there either"
And in May 2015 he was quoted by the CMAJ on juice stating,
"You won’t be seeing that anymore … and there’ll be a fair number of new materials coming out in the next few months."
I also know this because even McDonald's appreciates that chocolate milk, with more calories and sugar drop per drop than Coca-Cola, shouldn't be routinely offered to children.

So here's my first question.

If, in 2007, Canada's Food Guide had explained that chocolate milk is to milk what apple pie is to apples, and that it should be considered a treat rather than a health food, and that no, juice is not the same as fruit, do you think we'd be seeing these actual responses and comments posted on Facebook and on the CBC article in response to the news out of New Brunswick?
"How the hell can juice be bad for you I doubt orange and apple and cranberry juice is bad for your health CFDA would have ban the stuff decades ago"

"It is crazy and stupid. especially since the school officials are comparing the natural sugars found In the cocoa that makes it chocolate to the artificially added high fructose corn syrup used to sweeten coca cola."

"Ugh get a life people! Chocolate milk is some parents only option to get their kids to drink milk. And as far as juices they sell apple and orange at school so are they now telling us apple and OJ juices are bad??"

"I agree, pop and juice fine. Chocolate milk is filled with nutrients."
Because the thing is, though no one shops with Canada's Food Guide in hand, its recommendations do permeate national consciousness. And more to the point of this post, they inform school food policies. Once the new Food Guide is published, and assuming it explicitly recommends limiting sugar sweetened beverages and juice (and it will), all provinces will undoubtedly soon fall in line with New Brunswick (unless of course the Conservatives, as they promised prior to their election, repeal the ban).

And here's the most pertinent question. It's been 5 years since Dr. Hutchinson agreed chocolate milk should be off the Food Guide's menu, and 3.5 years since he went on record stating that juice's days are also numbered, so how is it possible that we're still waiting?

Saturday, November 24, 2018

Saturday Stories: Juice, George Soros, Death, and a Movember Update

Ann Hui, in The Globe And Mail, with a great case study on how the food industry works by way of the machinations of Big Juice and their attempt to influence Canada's next Food Guide.

James Kirchik, in Tablet, with a useful backgrounder and just who is George Soros?

Peter Kaufman, in Everyday Sociology, with his take as a sociologist on his relatively imminent death.

[And finally huge thanks to those who've already donated to my Movember fundraising efforts. Thanks to your generosity, I've cleared my original goal and now and just a few hundred dollars shy of my stretch goal of $5,500! If you find this blog valuable, if you enjoy these weekend shares, a tax-deductible donation would be very welcome, all you need to do is click here]

Wednesday, November 21, 2018

Yes, Current Evidence Still Suggests That Replacing Saturated Fat With Unsaturated Fat Is Good For You

I was somewhat disheartened the other day when in response to my post about the only 48 (I added "Get Vaccinated") words of health advice you'll ever need that there was quite a bit of confusion and pushback about my recommendation to swap unsaturated fat for saturated when you can - some even suggested it must have been a typo. Well, it wasn't a typo, but it seems it's confused people. "Substitute unsaturated fat FOR saturated fat if you can" is the same thing as stating "Replace saturated fats WITH unsaturated fats if you can".

But there were also plenty who read it right, and who were confused because they believe saturated fat is in fact a healthy choice.

Now I know there's been a whole host of diet gurus, once journalists, and TIME magazine covers telling you that saturated fat is good for you, and while I agree that likely it's not nearly as bad for you as the 90s (or me in the early 2000s) would have asserted, and while yes, there are nuances to all of this, the evidence still implicates saturated fat in the genesis and progression of heart disease.

Don't believe me?


But would you believe Drs. Ludwig and Volek? They're both prominent figures in the low-carb movement (Dr. Ludwig is the lead author on that low-carb diet and increased energy expenditure that dropped last week and the Director of the New Balance Foundation Obesity Prevention Centre at Boston's Children's Hospital, and Dr. Volek is one of the most prolific low carb researchers around and the Founder and Chief Science Officer of Virta Health) and both were contributors to a terrific consensus piece published this week in Science entitled, "Dietary fat: From foe to friend?" (it's full text free right now btw).

The whole piece is worth the read, but in case reading whole pieces isn't your thing, here are their points of consensus with Drs. Willett and Neuhouser (highlight is mine)

Monday, November 19, 2018

The Only 47 Words Of Health Advice You'll Ever Need

[Yesterday @DarrenM898 reminded me of this piece I wrote in 2015, and given the volume of the diet wars these days, thought I'd reshare. Still holds up pretty well I think!]

In no particular order:
  • Get vaccinated.
  • Avoid trans fats.
  • Replace saturated fats with unsaturated if you can.
  • Cook from whole ingredients.
  • Minimize restaurant and ultra-processed foods.
  • Cultivate friendships.
  • Don't smoke.
  • Nurture sleep.
  • Drink alcohol at most moderately.
  • Exercise as often as you can enjoy
  • Only drink those calories that you love
Comparatively, everything else is minutia.

Saturday, November 17, 2018

Saturday Stories: That Low-Carb Diet Study, Medical Conflicts Of Interest, Suicidal Help, And A Movember Update

Julia Belluz, in Vox, with the best coverage of that new low-carb diet study that has everyone talking.

John Mandrola, in Medscape, reflects on conflicts of interest in medicine

Jason Cherkis, in Highline, on, "the best way to save people from suicide"

[And finally huge thanks to those who've already donated to my Movember fundraising efforts. Thanks to your generosity, I'm just a $211 shy of my $4,500 goal! If you find this blog valuable, if you enjoy these weekend shares, a tax-deductible donation would be very welcome, all you need to do is click here]

Monday, November 12, 2018

It Takes the Former Global Senior Director of the Gatorade Sports Science Institute Just 42s To Summarize Why You Almost Certainly Don't Need Sports Drinks

I caught this video a week or so ago.

It features one of the world's most prominent sports nutrition scientists, Asker Jeukendrup, answering the question,
"What is the shortest duration of exercise where eating or drinking is worthwhile?"
The answer?

It was refreshing to hear (see what I did there), especially given Dr. Jeukendrup's prior role as the Global Senior Director of the Gatorade Sports Science Institute (GSSI), that if your workout is less than 45 minutes (and by exercise he clarifies, "all out exercise, not easy running") you need nothing. And if it's 45 minutes to an hour and 15 minutes, a "mouth rinse" will do.

Wish that were printed in bold on the sides of Gatorade bottles, or that their bottles were mouth-rinse sized!

And of course this all reminded me of that time back in 2012 when I tried to create my own homemade version of Powerade after the then Senior Vice President of Coca-Cola's sparkling beverages division told the media that after her son's lacrosse practices, she took him to McDonald's for a 32oz of the stuff. Watching it I also had to wonder, "Did I even lift?" (not as much back then, no)

Saturday, November 10, 2018

Saturday Stories: On Anne Frank, The Hero Chiune Sugihara, Post-Antibiotics, And A Movember Update

Dana Horn, in the Smithsonian Magazine, with an important read on Anne Frank and what might have been had she not been murdered.

David Wolpe, in The New York Times, about a here you've likely never heard of, Chiune Sugihara

Maryn McKenna, in Wired, with more on the post-antibiotic era.

[And finally huge thanks to those who've already donated to my Movember fundraising efforts. Thanks to your generosity, I'm more than 2/3rds of the way to my $4,500 goal. If you find this blog valuable, if you enjoy these weekend shares, a tax-deductible donation would be very welcome, all you need to do is click here]

Monday, November 05, 2018

A Personal Request For Help

And so it begins (again).

This month I pledge to grow my something of a Pedro Pascal inspired lip-terpillar in the name of raising awareness (and $s) for men's health.

If you enjoy my wholly non-monetized blog, I'd like to ask you to donate to my Movember fundraising efforts. I've kicked them off by donating $100 myself and I'm hoping you'll help me to raise more than last year's $4,500.

Contrary to what some believe, Movember is not a prostate cancer charity per se, and though some of its funds do support prostate cancer research and treatment, Movember supports multiple men's health initiatives including those involving mental health, suicide, body image, eating disorders, testicular cancer, substance use disorders, and more. Regarding prostate cancer, I was pleased to see that Movember encourages patients to speak with their physicians about the value (or lack thereof) of PSA screening, rather than suggesting it's a good idea for one and all.

Donating is easy. Just click here and give! And of course, Movember is a registered charity, so all donations are fully tax deductible.

In return I vow to continue to blog freely, to never allow advertisements, and to regularly post pictures of what might well have been an effective form of birth control in my home had I sported it year round back in the day.

For me the ask is also personal. My father was diagnosed with prostate cancer when I was in medical school, and soon I'll need to start wrestling with whether or not with that strong family history, I should walk the slippery slope of testing. My oldest cousin Marshall - we lost him to opioids.

Every dollar counts, no donation is too small.

(And if you want, you can make your donation anonymously so no one (me included) will know you hang out here from time to time.)