Juice is NOT a F@*#ing Fruit Part II

Juice is an incredibly frustrating beverage. Despite packing the same caloric and sugary punch of Coca-Cola, unlike sugared soda, juice's undeserved health halo regularly leads to its provision, consumption (and often over consumption) in the name of nutrition - especially to and by our children.

And kids really shouldn't be drinking the stuff, or at the very least, not in the name of health.

The Canadian Pediatric Society and the American Academy of Pediatrics both recommend that juice be capped for kids at half a cup daily. And make no mistake, the capping isn't because juice is so damn good for the kids that we don't want them to drink too much of it, but rather because every glass contains 5 teaspoons of sugar (or more) and calories which won't be compensated for with decreased portions at their next meals.

The World Health Organization also considers juice to be nothing more than a sugar delivery vehicle and in their recent draft guidelines on sugar consumption specifically call out juice as a source of undesirable free sugars.

Yet there's this piece that came across my Newswire just last week. It was a press release put out by Coca-Cola (makers of Minute Maid) and Breakfast Club of Canada and it featured Teresa Piruzza, MPP for Windsor West and Minister of Children and Youth Services launching the newest Ontario Breakfast Club, which judging from the press photo up above involves the indoctrination of children into believing that fruit juice is a healthy part of their breakfast and the provision of juice boxes (containing more juice than our experts' daily recommended maximum), festooned with cartoon characters that in turn might further increase a child's consumption and desire for same.

Can you imagine a similar scene with the Minister of Children and Youth Services grinning and handing out Vitamin C fortified soda, in cartoon covered cans, to children in the name of breakfast?

According to the press release,

"Breakfast Club of Canada supports healthy breakfast programs at 1,266 schools, supporting nearly 130,000 children and serves close to 21 million breakfasts every year and that Minute Maid® has partnered with Breakfast Club of Canada since 2003, donating Minute Maid® juices to support programs across Canada."

Breakfast I'm all for, but marketing sugar to children and washing it in BS "corporate social responsibility", food insecurity, and health is both incredibly misguided, and incredibly sad.

(And if you're looking for Juice is NOT a F@*#ing Fruit Part I click here)

Saturday Stories: Best Diet, Failing Kids, and Parasites

James Hamblin in the Atlantic covers the world's healthiest diet.

Hanna Rosin, also in the Atlantic, wonders whether we should be letting our kids fail more?

And lastly, here's a fabulous TED talk from Ed Yong about how parasites may be controlling our actions.

Did You Know that Oreos Are Responsible for the World's Cocaine Supply?

Today's Funny Friday video is truly shocking.

Gunpowder, cocaine, and more coming from Oreo's secret "unmaking" plants (some swearing).

Have a great weekend!

Health Canada Allows Cupcakes to Claim They're a Source of Calcium and Iron

Just in case you need more convincing that Canada's front-of-package labelling law's laxity leads to nonsensical front-of-package health claims look no further than Duncan Hines' new Strawberry Flavoured Cupcakes whose package reports they're a source of calcium and a source of iron.

And honestly, even if there were calcium and iron emergencies in the population (there aren't), and even if these cupcakes provided a significant amount of either (they don't - 6% of both per cupcake), nothing will change the fact that they're cupcakes and that cupcakes, while delicious, will never be healthful.

So what's in these calcium and iron containing cupcakes? Here's the ingredient list:

Sugar, Enriched Bleached Wheat Flour, Vegetable Oil Shortening [Palm Oil], Strawberry-Flavoured Bits [Sugar, Corn Syrup, Corn Cereal, Partially-Hydrogenated Vegetable Oil (Cottonseed And/Or Soybean), Modified Cornstarch, Citric Acid, Natural And Artificial Flavours, Colour], Sodium Bicarbonate, Sodium Aluminum Phosphate, Dicalcium Phosphate, Monocalcium Phosphate, Wheat Starch, Propylene Esters, Mono And Diglycerides, Sodium Stearoyl-Lactylate, Salt, Dextrose, Cellulose Gum, Xanthan Gum, Citric Acid, Natural And Artificial Flavour, Artificial Flavour, Colour. Frosting Mix: Powdered Sugar [Sugar, Cornstarch], Cream Cheese Powder [Cream Cheese (Cream, Milk, Skim Milk, Whey, Bacterial Culture, Salt, Microbial Enzyme), Whey, Natural Flavour, Tocopherol, Ascorbyl Palmitate], Natural And Artificial Flavour).

The onus shouldn't be on Canadians to have to study the backs of packages' nutrition facts panels to determine if the claims made on the fronts of those same packages hold true, and while you might think to yourself that no-one's going to get duped by a cupcake box, not only would I bet that you're wrong and that those claims may well influence some to consider them to be less unhealthy than they are, I would remind you that there are many other products that are equally but far less obviously awful whose packages dupe the best of us on a daily basis.

[h/t to Random House's Cassandra Sadek]

Canadian Breast Cancer Foundation Fundraising with Healthwashed Junk Food

Sigh.

Junk food fundraising is so common place nowadays that virtually no one blinks an eye when they see it. Worse still, in many cases the dollars received in lieu of healthwashing are minimal.

Take for instance the new partnership between the Canadian Breast Cancer Foundation (CBCF) and the so-called Canadian Healthy Vending company. In return for the use of the CBCF logo on their Max! Healthy Vending Machines the CBCF will receive $48,000.

In discussing the partnership Holly Henderson, the Canadian Breast Cancer Foundation’s Senior Director of Corporate Programs, explains why she feels the fit is good,

"The Foundation is particularly excited about this program as it allows us to extend our message about the importance of healthy lifestyles and reducing breast cancer risk. It’s never too early or too late to take steps to help reduce risk by making healthy choices and learning more about breast health."

So what healthy choices are sold in the pink and healthwashed Max! Healthy Vending Machines? Pretty much the same crap that's in any vending machine only this machine calls its contents healthy. There's sugared soda like Natural Brew Cream Soda (9.5 teaspoons of sugar) and Blue Sky Organic Soda New Century Cola (sweetened with 10 teaspoons organic cane sugar). There are cookies like Enjoy Life's Chocolate Chip and Snickerdoodles (each with the same calories and sugar of Oreos) and chocolate bars like Green & Black's Milk Chocolate (nutritionally nearly identical to the iconic Hershey's Milk Chocolate bar). And of course there are potato chips like Old Dutch Baked Ketchup Chips (which according to the nutritional information on the Old Dutch website chip per chip actually contain more calories and more sodium than their non-baked Old Dutch Ketchup Chip brothers).

These are not what I would describe as healthy snacks. In fact I've argued before that these sorts of snacks are worse than their non-healthwashed counterparts given the likelihood of their overconsumption or more frequent purchase consequent to their healthwashing. No doubt too, regularly consuming these sorts of products might in fact lead a person to gain weight. As far as weight and breast cancer goes, the links, though correlative, still give cause for concern. According to the National Cancer Institute, obesity increases the relative risk of developing post menopausal breast cancer by 50%. They also report that maintaining a body mass index of 25 could prevent 11,000 to 18,000 deaths per year from breast cancer in U.S. women over age 50, that breast cancer is more likely to be detected at a later stage in women with obesity, and that weight gain during adulthood has been found to be the most consistent and strongest predictor of breast cancer risk in studies in which it has been examined.

Shameful.

UPDATE: Crazy that it ever happened in the first place, but the good news is that the CBCF's contract with Canadian Healthy Vending has recently expired and they've no plans to renew!

Metabolically Healthy Obesity and the Risk of Type 2 Diabetes

The term "metabolically healthy obesity" is generally thought to describe excess weight in individuals who don't have any weight-relatable medical conditions. When discussing whether or not these individuals should be counselled to lose weight many point to their potential risk of developing weight-relatable conditions as a reason to do so, and truly, that makes good sense, though looking at the data from my friend and colleague Arya Sharma, it would appear that truly metabolically healthy obesity carries virtually no excess mortality risk - at least not over the 16 years of NHANES data they studied. In Arya's work (graph from same up above) those individuals who are at no risk are staged as EOSS zero - which means that they truly had no discernible weight relatable issues whatsoever - they indeed had metabolically healthy obesity.

So how then to explain the outcomes from a paper published yesterday in Obesity Reviews? The paper, Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies, was a meta-analysis using data from the English Longitudinal Study of Aging and it concluded that those with what they defined as "metabolically healthy obesity" had a 4 fold higher risk of developing type 2 diabetes over a 6 year period than individuals with "metabolically healthy normal weight". The authors then conclude,

"Prospective evidence does not indicate that healthy obesity is a harmless condition."

But before you agree with them there's something important you need to know. Whereas Arya (rightly as far as I'm concerned) defines metabolically healthy obesity (EOSS 0) as an individual who has ZERO weight-relatable conditions, the authors here considered a person to have "metabolically healthy obesity" even if they had one of the following issues: hypertension, impaired glycaemic control, systemic inflammation, adverse high-density lipoprotein cholesterol or adverse triglycerides.

Rather disingenuous don't you think, to describe the increased relative risk of developing type 2 diabetes in individuals who are most assuredly not metabolically healthy as purely consequent to their weight?

Regardless of your weight, if you have hypertension, impaired glycaemic control, systemic inflammation, adverse high-density lipoprotein cholesterol or adverse triglycerides then you are not metabolically healthy, and studies that explicitly suggest otherwise aren't doing anyone any favours, nor answering any questions about risks in those with truly metabolically healthy obesity.

Talk About Commitment to a Low-Carb, Sugar Free Lifestyle

So what do you do if you're young, wealthy, and an ardent believer in a low-carb, sugar free lifestyle?

Well if you're Meredith Loring and Sami Inkinen you plan a 2400 mile unsupported low-carb, sugar-free, row (meaning they're hauling their food with them - just not carbs or sugar) from San Francisco to Honolulu - a trip only twelve people have ever managed before. They've dubbed it the Fat Chance Row.

Food wise between them they'll be consuming 14,000 calories daily with a breakdown of 70% fat, 20% protein and 10% carbohydrates.

They're rowing or a cause too and looking for donations where 100% of the proceeds will go to anti-sugar crusader Dr. Robert Lustig's Institute for Responsible Nutrition.

Regardless of where your dietary beliefs lie, you have to admire their spirit, and reading through their site, they seem like fun folks, but watching their blog's videos and just pondering their challenge, you know it won't be a picnic. Sami knows that too as evidenced by my favourite quote from their website which came from his bio,

"Sami’s married to Meredith and hopes that the expedition doesn’t change that fact.".

I look forward to watching their progress. They embark this June.



[h/t to the Cutting Factory's Michèle Hozer]

Saturday Stories: Saving Lives, Drug Prices, and Protein

80,000 hours ponders how many lives a doctor actually saves in a career.

Andre Picard in the Globe and Mail explores the need for, no matter how painful, dispassionate analysis in setting drug prices.

Kris Gunnars over on Authority Nutrition covers dietary protein.

[And if you don't follow me on Twitter or Facebook here's my interview with Anna Maria Tremonti for CBC's The Current where we had the luxury of time to really discuss The Diet Fix, and here's a piece I did for the Globe and Mail rebutting Margaret Wente's ill-informed assertion that menu board calories are a bad plan]

Today Funny Friday Being Replaced by Awesome Science Friday!

Such a heart warming video I felt I had to share even though it's not Funny.

Here's Professor Andre Linde and his reaction upon hearing the news that his 30 year old theory regarding the big bang had been proven to be true - something that my theoretical physicist mother tells me is a huge, huge, almost certain to win him a Nobel Prize deal.

Science!

For Sugary Cereal Maker Kellogg's There's No Such Thing as Sugar

For those of you who still think the food industry is a helpful part of the solution to our modern day weight and nutrition woes I present the Kellogg's Together Counts label reading course.

Together Counts is the food industry's self-congratulatory attempt to be part of the dialogue regarding weight, nutrition and health in society today. My cynical view is that it's there to help to forestall the inevitable industry unfriendly legislation that we will see down the road. It's also there to foment misinformation.

Take this piece for example. It's entitled, "Eyes on the Prize: How to Spot Wholesome Foods" and it's written by Together Counts partner and sugary cereal kingpin Kellogg's. The article's about how to read a food label because as the article states,

"at least 60% of Americans are in fact paying more attention to the numbers on the food packages they buy. But if you don’t know what to look for on the label—or are only noticing the calories—chances are you’re not seeing the complete picture of your favorite eats. As a member of the Together Counts™ program, Kellogg’s wants to make it easy to keep your eyes on nutritional value with these quick tips."

Hurray for Kellogg's!

So let's say you take this Kellogg's course. What should you look at when evaluating Kellogg's Honey Smacks? Well according to Kellogg's you should consider their serving size, fat and cholesterol, fibre content, sodium and vitamins. Well by those measures this stuff sure is pretty awesome!

Let's see, pretty clear cut serving size, almost no fat, very low sodium, and TONS of vitamins!

You know I'd imagine most cereals would score highly in the Kellogg's version of wholesome food land. They're all low in fat, sodium, and cholesterol, and they're fortified with vitamins.

What's that?

You think perhaps when considering foods people should also look at sugar?

Well only if you think that a product that by weight is quite literally 55.6% sugar (Kellogg's Honey Smacks) isn't a wholesome food, and if you learn how to read a food label by means of Kellogg's teaching - you won't.

Does Your Doctor Know How to Weigh Your Child? I'm Betting Many Don't.

Image Source

On the surface it doesn't sound all that difficult.

Ask child to stand on scale. Weigh. Record weight. Done.

Working with parents of children with obesity, it seems many doctors nowadays feel it's important to add in some judgement or scary statistics such that after 'weigh' and before 'done' comes a speech on the dangers of weight along with the implicit or explicit suggestion that the child is responsible - either for gaining the weight or for not losing it.

I don't think that's fair. Moreover, I don't think it's helpful and I think it may well do harm.

It's not fair, especially with younger children, given that they're not in charge. They don't do the grocery shopping. They don't cook the meals. They don't set the example. They live the lives their parents teach them to live. They're life's passengers, not the drivers.

It's not helpful because speeches or stats without action plans by definition aren't helpful.

It's potentially harmful because the negative emotions bound to be generated by this sort of an interaction may well erode a child's self-esteem, body image, and their relationship with food. It may also lead that child's parents to adopt a knee-jerk pattern of restriction, guilt and shame that is far more likely to make matters worse than better.

The safest way for a physician to weigh a child is to tell the truth as to why weights are important. The truth is that children need to be weighed because medication is dosed dependent on a child's weight and therefore physicians need to have fairly current weights on their growing patients in case they fall ill and require a prescription. And should a physician have a concern about a child's weight I'd encourage them to have a discussion with that child's parents with the child absent and clearly, there's not much point even having the discussion unless that physician has suggestions or resources beyond the tritely useless truism of "eat less, move more".

Guest Post: The Food Industry Understands Nudge Theory Too

Today's guest post comes from Jill Avis. Jill is a PhD student studying under the supervision of Dr. Geoff Ball in the Department of Pediatrics at the University of Alberta. Her thesis work relates to innovative approaches for the prevention and management of pediatric obesity.

The Negative Nudge

Many readers will be familiar with an approach to behaviour change that has gained popularity in recent years – the nudge. This concept is well-described by Thaler & Sunstein as "the navigation of individuals toward optimal choices without restriction of other options" – in other words, ‘libertarian paternalism.’ For example, placing healthier food options in more visible, convenient locations in school cafeterias or altering the default option to consent for organ donation.

Today, I want to talk about the nudges that work in counterproductive directions – what I call the ‘negative nudge’. Yoni’s blog post last Tuesday reinforced the reality that big corporations, (e.g., Coca-Cola) have the power to sway consumers toward food choices of questionable quality. Not only are we faced with a growing number of processed foods in our food environment, but portion sizes and product packaging have increased substantially, creating a ‘perfect storm’ that encourages us to eat more and more. When paired with the chance of a trip, keepsake “cup,” and a tacit endorsement by Coca-Cola, it is not surprising that people consume increasing amounts of unhealthy foods and drinks.

In Thaler & Sunstein’s book, Nudge, the authors discuss dual process theory, which proposes two processes to explain our decision making - the rational, conscious system and the automatic, unconscious system. This theory may help to explain the disconnect between positive intention and behaviour; individuals who make an explicit pact to ‘shape-up’ or ‘be healthy’ (aka the rational system) face factors processed by the automatic system, which can inhibit adherence to their initial intention. Examples include temptation and mindlessness, or stickier influences, such as endorsements by big corporations. In our food environment, it is difficult to decipher which information is genuine and which is a marketing tactic.

When I stopped in for my daily coffee at the local Second Cup, I took a double-take at one of their advertisements to celebrate 35 years in business; #34 states, “We’ve learned there is a much tastier way to enjoy an apple a day with our caramel apple latte.” Now, do I think that Second Cup had the purposeful intention of negatively influencing Canadians’ already poor eating habits? No. But I believe they are using their power for corporate benefit (profit!) by giving a ‘negative nudge’ to our food choices; share-holders and franchisees seem to be interested in their profit margin at the expense of individuals’ decision-making and dietary quality. This is just one example of the pervasiveness of ads that negatively nudge us – it’s clear we need more nudges that move us in the positive direction.

Salad Does Not a Healthful Menu Make!

Just a short public service post that you can share with whichever of your powers that be that might need it.

Just because your fast service menu or restaurant offers salad doesn't suddenly make your menu healthful.

[And if you're not familiar with the meme, it comes from here]

Saturday Stories: Autism, Murder, and the Food Environment

Ron Suskind in the New York Times with an amazing story centred around his autistic son and Disney.

Andrew Solomon in the New Yorker exploring the agony of being the father of a ruthless killer.

David Sherman in the Ottawa Citizen with a rarity - a news piece that tackles the food environment as a cause of obesity rather than simply blame our supposed lack of willpower.

[And if you don't follow me on Twitter I was doing a bit of media this week. Some highlights include this Breakfast Television interview where I tried a lemon pepper cleanse and this segment on CTV's The Social where I think I might have made Jann Arden and the rest of the ladies a little bit sad by the end.]

This Video Kinda Makes me Wish I was a Gastroenterologist!

Today's Funny Friday looks like a great deal of fun (at the expense of people coming out of the meds that tend to accompany colonoscopies and in the name of colon cancer awareness).

Have a great weekend!

Parental No Files: 9:00AM Class Trip to Disney's Frozen Edition

The institution of eating food at the movies. Where did it come from? Is it just a great excuse (as if we need excuses these days) to snack on junk food?

And it would seem it doesn't matter when we head there, or how old the movie goers might be, the snacks must go on!

Have a peek at that form up above. It was sent to me by a Niagara Region RD named Sandy Maxwell. It was the form sent home from school to one of her friends whose 5 and 7 year olds were slated to take a school trip to see Frozen....at 9am in the morning!

As you can see, no worries about them not having access to junk, and of course, Mom could just say "no" - I'm sure her kids won't mind being the only ones left out of the junky festivities and heck if they do, that couldn't affect their long term relationship with food, could it? Definitely making moms and dads say "no" is the far wiser course of action than a no-junk default and instead requiring moms or dads who want their kids to have junk at 9am in the morning to have to actively seek it out.

Ugh.

UK Based Smartphone App Turns Stair Climbing Into a Game

Love this Step Jockey app out of London.

Apparently stairs there are being labelled with gameified with signs that can be scanned by the app which in turn keeps track of calories burned and stairs taken.

It's being backed by the UK Department of Health and NHS London via the Small Business Research Initiative (SBRI).

That said, I have two concerns.

Firstly it's an energy output app with seemingly no discussion or accounting for energy input - which may well lead individuals to feel like their few flights of daily stairs warrants rewards of dietary indulgence ("because I exercised" foods).

But the more important issue I have is that it's being promoted as a means to lose weight.

Exercise is about health, but were weight management attainable solely on the basis of taking the stairs, the world be a much slimmer place.

I'm all for exercise, but its branding needs to change from one of weight control to one of health, and institutions like the UK Department of Health and NHS London should be leading that charge, not contributing to the misinformation embraced by the food industry that our forks are out-runnable.

Can We Enact Bloomberg's Cup Size Limit at the Movies Please?

I went to the movies a few weeks ago with my wife (we saw Gravity in Imax 3D - can't say I recommend it).

On the way out I noticed a giant Coca-Cola advertisement, and as I'm wont to do, I wandered over to have a closer look.

It highlighted a contest to win a ski vacation in Whistler and you could also buy a commemorative cup at the concession stand.

"Cup" is an interesting term though for a container that holds 44oz (1.3 litres) of sugared soda. For those who care that's 526 calories of Coca-Cola coming from its astonishing 36 teaspoons of sugar!

I can't imagine there are many people on the planet who consciously want to consume 1.3 litres of Coca-Cola with their movie, but I bet many unconsciously do simply consequent to the fact that the only commemorative size available shares more in common with a bucket than a cup.

Kid Targeted Ads for "Healthy" Food Likely to Sell Unhealthy Food Later

Here's another reason why we should be banning all food advertising targeting children and not just the ads targeting junk (and it's not all that surprising) - brand associations last.

But knowing that to be true and proving it matters is different and that brings us to a fascinating (but somewhat challenging to read) series of studies conducted by Paul Connell, Merrie Brooks and Jesper Nielsen who aimed to explore whether or not,

"the messages of fun and happiness so common in children’s advertising create lasting affective associations that cloud people’s judgments about the featured products for the rest of their lives?"

And more to the point here,

"can childhood advertising exposure cause biased evaluations for new products introduced years or even decades later if the same advertising stimuli are used?"

Which translated to our modern day environment where the food industry is angling to avoid legislation designed to ban their ads and instead voluntarily limit their advertising to so-called "healthier" items (or even just to use their mascots to highlight other issues like literacy as in the McDonald's initiative seen in the photo up above) might be asked if the creation of positive brand associations might increase the likelihood of future adult consumption of the truly awful?

Their answer was yes in that they found that it was the positive brand associations with childhood advertising characters that influenced an adult's belief that sugary cereals were more healthful. Older adults who were exposed to Tony the Tiger as children, but not to Coco the Monkey, rated old school Tony's pre-sweetened Frosted Flakes as more healthful than modern day Coco's Kellogg's Cocoa Pops after an exposure to advertising to both, whereas younger adult study participants who had been exposed to both brand mascots rated the cereals equally following exposure to advertising to both.

To suss things out further and rule out the possibility that the mascot simply evoked positive consumption memories they conducted a second experiment whereby people were shown either advertisements involving Ronald McDonald and Toucan Sam (both utilized heavily in advertising for decades including during the childhood of this experiment's participants), or simple photos and descriptors of McDonald's fries or Froot Loops along with accurate brand labels. Participants were then asked to rate the healthfulness of McDonald's fries or Kellogg's Froot Loops. The thinking was that if the ads in the first experiment had triggered a memory of consumption rather than an emotional brand attachment and that memory was responsible for the bias, the photos of those actual childhood foods ought to lead to that same outcome. But they didn't, and again, it was found that ads featuring beloved childhood characters biased adults' opinions on the healthfulness of junk food.

For me though the strangest part of the study had nothing to do with the experiments, but rather the conclusions of the lead author who reported to The Daily Mail,

"We suggest that parents discuss the persuasive nature of advertising with their children, and encourage them to develop critical thinking skills in response to advertising messages."

I found this to be strange in that it seems mind-boggling to me that a professor of marketing is suggesting that despite the billions of dollars a year spent on highly sophisticated advertising targeting children, that the call to action is to suggest that parents have a chat with their kids rather than a call to put an end to kid targeted advertising in the first place (though to be fair, the newspaper may have simply left out that quote).

Saturday Stories: Formaldehyde, Viruses, and Facts up Front

Tara Haelle in Slate wonders whether or not our worries about formaldehyde are justified.

Carl Zimmer in the New York Times describes the resurrection of a 30,000 year old, never before seen, virus (I found this story terrifying even though the virus only infects amoeba).

Marion Nestle skewers the food industry's new commitment to fronts of packages.

And if you wanted to help a researcher out one has asked me to post the following request:

Calling all health care practitioners with an interest in paediatric healthcare! Researchers at Holland Bloorview Kids Rehabilitation Hospital and University of Toronto are looking for input from health care practitioners through a short, anonymous online survey to share your feedback and opinion on the development of a new health screening tool for children: The Healthy Body Scorecard. It aims to address some of the limitations associated with the use of Body Mass Index (BMI) alone and provide a user-friendly tool that will help identify the heath needs of children aged 2-18.

Please follow this link for more information and the survey

[And if you don't follow me on Twitter or Facebook want to mention that my book The Diet Fix, as one of Indigo's online top 50 bestsellers, is currently 50% off (click here to order if you'd like), and here's a segment I did with Global's The Morning Show where I explain how I don't think our struggles with weight have to do with a lack of willpower. And here's a post I wrote from Tom Venuto's blog Burn the Fat on perception vs. reality when it comes to food diaries.]