My top 3 "hidden" causes of weight

Over the years I've seen literally thousands of patients. While certainly many come to my office with a clear understanding of where their weight's come from, a significant percentage come in and truly can't understand why they're having difficulty losing weight or why they gained weight in the first place.

Indeed there are a myriad of sources of struggle, but here are my top 3 (in order):

1. Meal skipping

These folks often come in and tell me they barely eat. Looking at their weight and lifestyle inventory (WALI) these are the folks that skip breakfast, generally avoid daytime snacks, have soups or salads for lunch and then eat a large dinner and often struggle with cravings and impulse control in the evening. I can understand why they feel they barely eat as the vast majority of the day, they're not eating at all. Of course by the time they do eat, they're hungry. And of course when we're hungry our bodies crave calories. So what happens? While it's true they might only eating one substantial meal per day, during that one meal, due to the influence of hunger, they're eating more calories than their bodies burn the whole day and hence, gaining - not losing.

Simple try at home solution: To lose weight you can't be hungry. Eat every 2-3 hours and include protein with all meals and snacks.

2. Eating out

These folks often come in and tell me they only eat healthy. Looking at their WALI you'll see them eating out anywhere from 4-10 times per week. When I point out their frequent meals out these folks will often tell me that they're great at choosing healthy options at restaurants. Unfortunately for them, even healthy options at restaurants can contain ridiculous numbers of calories.

Simple try at home solution: Here's an easy way to think about meals out. Assume that every meal out you eat will result in a day you don't lose. If you eat out 4-5x per week and then add in a few days of normal life stress struggle you might well not lose a pound. Eat out more than that and you're likely to gain. It's important to point out that while I think zero is certainly too few meals out in the context of a realistic and enjoyable lifestyle, to lose weight you'll have to lose the convenience meals out and keep only the truly celebratory ones and occasional social ones.

3. Liquid calories

These folks are often the most confused by their weight. They may be eating regular meals and snacks, eating in and watching their portions. Looking at their WALI you might see them having 2 glasses of milk, one glass of juice and one glass of wine a day. Put together that's roughly 40lbs of liquid, non-filling calories per year.

Simple try at home solution: Don't drink your calories. If you're drinking any beverage for health reasons (milk for calcium, juice for vitamins, wine for heart health, V8 for vegetables, etc.), stop. If you're looking for calcium - take supplements. If you're looking for vitamins - take a multi. If you're looking for heart health - take a 10 minute walk a day and if you're looking for vegetables - eat them. At roughly 10lbs per glass per beverage/day per year none of these so called health benefits are worth their weight.

A trip to the "nutritionist"

Did you know that if you live anywhere in Canada other than Quebec (thanks to Fon10 who noted that in Quebec "nutritionist" is indeed a protected term) you're a nutritionist?

That's because the term isn't protected by any type of regulatory body. If you want to put "Nutritionist" on your business card, go right ahead.

While I'm sure some "Nutritionists" are exceedingly good at what they do, knowledgeable, helpful and evidence based, unfortunately I'm sure that some are well represented by this week's Funny Friday video.

Oh, and don't think I'm being too smug here. There are crappy, quack doctors out there too which reminds me of one of my favourite jokes

Do you know what they call the person who graduates last in their class in medical school?

"Doctor"

Have a great weekend!



[Hat tip to my friend and colleague Dr. Sara Kirk]

Ottawa Citizen Nutrition Watch Week 9 - Not yet.

I'm not sure what the hold up is but it looks like I'm still at bat for nutrition at the Citizen.

My impression had been that a nutritional analysis program was being test driven last week and hence I figured that this week I wouldn't be spending my early morning calculating calories for Citizen recipes. Unfortunately when I opened up today's paper, nutritional analyses were no where to be found.

(for a recap - click over here to understand what this is all about)

Before I get to this week's fare, I'd like to introduce you to Dr. Paul Boivert. Paul's a friend and colleague from Quebec where he's also the communications director of Quebec's federation of Kinesiologists. Paul practices what he preaches having a penchant for good nutrition and engaging in seemingly insane amounts of swimming (generally 4km or more a day, 5 days a week). Here's what Paul had to say to the Citizen,

"Dear Ottawa Citizen Editors,

I congratulate you for publishing interesting healthy recipes in your newspaper.

Many fast food chains make available the Nutrition facts of their foods on the paper place mats and grocery stores sales food with Nutrition facts of the packaging. These information are important for most consumers for better evaluate the nutritional value of foods.

It is the same thing with recipes. It helps to better evaluate the portions to be served for a family and the value of a meal related to salt, fat and calories content, which matter enormously in a weight management program and health concerns like hypertension and prevention of heart diseases.

These information would be a great value if added at the end of your recipes. Unfortunately, these information are missing in your recipes as published recently.

I encourage you, then, to do so for the benefits of your invaluable readers.

Thanks for your support and the consideration of my request,

Paul Boisvert, Ph.D., PEC-SCPE, kinésiologue
Directeur des communications
Fédération des kinésiologues du Québec
http://www.kinesiologue.com/"

If you haven't yet written the Citizen to politely encourage them on this initiative and thank them for their attention, please take a few moments today to do so. Please send kind words of encouragement to Editor-in-Chief Gerry Nott, Food Editor Ron Eade and Wendy Warburton by clicking here.

Here are today's recipes' nutritional breakdowns:

Lamb rack with chimichurri sauce
(per serving if serving 2): 1,429 calories, 49g saturated fat, 691mg sodium, 6g total carbs

Seared duck breast with heirloom tomato, herbs, corn and focaccia salad
(per serving): 424 calories, 3g saturated fat, 95mg sodium, 51g total carbs

Cashew-encrusted halibut with citrus aioli
(per serving): 971 calories, 10g saturated fat, 172mg sodium, 49g total carbs

Cisco Ottawa Bluesfest asian coleslaw
(per serving if serving 4): 115 calories, 1g saturated fat, 52mg sodium, 8g total carbs

Cisco Ottawa Bluesfest couscous salad
(per serving): 468 calories, 4g saturated fat, 44mg sodium, 51g total carbs

Cisco Ottawa Bluesfest roasted beet salad
(per serving if serving 4): 204 calories, 2g saturated fat, 142mg sodium, 16g total carbs

[All recipes calculated using Mastercook 9.0. Today it took roughly 2 minutes per recipe]

Are Canadian restaurants allowed to make health claims?

Somehow I doubt it, but I'm not sure.

Regardless of whether it's legal or not, check out Thai Express' new promotion,

"Feed your Brain

Beef Stir Fry with Eggplant and Vegetables on Rice with a 16oz beverage

Nasunin found in the eggplant skin is a potent antioxidant and free radical scavenger that has been shown to protect cellmemBRANES from damage"

Yup, what could be better for you than fried red meat over white rice with a sugared soda chaser?

I wish there were something we could put in the drinking water that would protect the general public from consuming junk food in response to ridiculous over-simplifications and extrapolations of basic science research.

[Hat tip to loyal blog reader Émilie]

Life after the Biggest Loser

I'm not a big fan of the Biggest Loser.

For those of you who aren't familiar with it the Biggest Loser is a "reality" television show that features extremely overweight folks living on a ranch for 6 months and undereating and overexercising in order to lose weight and potentially win $500,000.

Not exactly the reality that most of my patients face.

In terms of the show's participants life post-show is a mixed bag. Some will parlay their weight loss into new lifestyles and in some cases, new careers.

Unfortunately others won't fare as well.

Now while it's certainly true that there is recidivism with all weight loss programs my beef is not that contestants regain weight, it's what they're taught. Watching the Biggest Loser I can't help but feel that the message it ultimately teaches is that all weight is bad and the scale is the only determinant of how you're doing.

Me?

I think scales tell you what you weigh whereas you tell yourself how you're doing, where how you're doing depends on what you're actually doing. Are you eating in a manner that is both healthy and enjoyable? Are you exercising as much as you can happily include into your busy life?

I came across this article and video online detailing the struggles of a former runner up on the Biggest Loser - Kai. It's well worth the read. Here's a snippet,

"The philosophy of the show -- to radically change diets and exercise patterns of obese people -- seemed to have a hidden message about her character, Zwierstra said. It seemed to say that weakness made people fat. If they just had discipline, if they weren't lazy, they could be thin."

There was a video too - I've included it below. Sadly it's a lot more real than the Biggest Loser will ever be.

344 Pounds - a guy on a journey

I like this guy.

I don't agree with everything he's said and done, but really, who cares if I agree with everything or not.

His name is Tyler and in January he decided that he was going to lose some weight. At the time he weighed 344 pounds and he's set himself a goal of losing 150 of those. He's also set himself up with a blog.

What I love about Tyler's blog is his use of social media to help get him where he's aiming to go. He's using it to keep track of his progress, he's using it to document his journey to one day show his young family who he was during this time period, and he's using it for motivation because for him putting everything out there inspires him.

He tracks his daily calories there (I'd be encouraging him to add in more snacks and better sports nutrition as well as upping his calories a fair bit), he chronicles his own experiences with what works for him in changing his foodscape and fitnesscape, he details his workouts, graphs his weight change, and he even invites commenters on board to help increase the duration of his workout (links and comments add time).

Tyler's found a way to go that he's enjoying and he's certainly losing weight.

Tyler, if you're reading this my main piece of advice for you, whatever you're doing to lose weight, you've got to be prepared to do it forever if you want the weight to stay off.

Best of luck Tyler.

www.344pounds.com

WHO declares latest Evian ad a pandemic!

This ad's certainly gone viral in a hurry!

Today's Funny Friday is Evian's newest campaign.

Have a great weekend!

Ottawa Citizen Nutrition Watch Week 8 - Hope!

And now I can report cautious optimism.

While I can't report on the specifics I can say things are moving forward at the Citizen - this despite CanWest's financial difficulties and staff squeezing and consequently a real testament to the Citizen's dedication to their readers.

(for a recap - click over here to understand what this is all about)

My hope is that this will be one of the last times I'll have to post the Citizen's nutritional information for them!

If you haven't yet written the Citizen to politely encourage them on this initiative and thank them for their attention, please take a few moments today to do so. Please send kind words of encouragement to Editor-in-Chief Gerry Nott, Food Editor Ron Eade and Wendy Warburton by clicking here.

So this week, no additional pressure, no additional letters, just today's recipes' nutritional breakdowns:

Chickpea Curry
(per serving if serving 4): 285 calories, 2g saturated fat, 985mg sodium, 38g total carbs.

Avocado Salad
(per serving): 232 calories, 3g saturated fat, 11mg sodium, 10g total carbs

Cedar-Planked Salmon with Watercress Sauce
(per serving if serving 4): 292 calories, 1g saturated fat, 141mg sodium, 13g total carbs.

[All recipes calculated using Mastercook 9.0. Today it took roughly 2 minutes per recipe]

Has your chicken been "plumped"

Apparently chicken plumping sells $2,000,000,000 of salt water per year in the USA.

What's plumping?

Plumping involves injecting "fresh" chicken with water, salt and sometimes seaweed extract to make the chicken look juicier yet still retain the label, "all natural". Plumping can also raise the amount of sodium per serving of chicken to almost as much as you'd find in a serving of french fries.

How do you defend yourself against being plumped?

Simple. Read the ingredients. If they include water, salt and/or carrageenan you're buying salt water along with your chicken at $4.99 or so a pound.

[Via the WSJ]

Fortified ice cream - an osteoporotic miracle?

Oy.

From the labs at Unilever comes a study that calcium absorption following the consumption of calcium fortified ice-cream was comparable to absorption following the consumption of milk.

Huzzah!?

I suppose that given obesity's ability to increase bone density, by creating calcium fortified ice-cream we might finally have the "natural" cure for osteoporosis.

Some great quotes from the researchers in Food Navigator,

"Concerns over the unhealthy image of ice cream appear unfounded however, with the ice cream being “formulated responsibly in terms of nutritional profile”, wrote van der Hee and her co-workers. Indeed, the energy value for both did not exceed 115 kcal"

So no worries - because no one ever eats more than one serving of ice-cream, right?

van der Hee, R., Miret, S., Slettenaar, M., Duchateau, G., Rietveld, A., Wilkinson, J., Quail, P., Berry, M., Dainty, J., & Teucher, B. (2009). Calcium Absorption from Fortified Ice Cream Formulations Compared with Calcium Absorption from Milk Journal of the American Dietetic Association, 109 (5), 830-835 DOI: 10.1016/j.jada.2009.02.017

Supermarket salads - less healthy than Big Macs?

I've had many patients tell me reassuringly,

"don't worry about my lunches out, I usually go to the supermarket and just buy a salad"

Um, about that salad....

You see a newspaper in England decided to put some of those supermarket salads to the test. They bought a bunch and had them sent to nutritional labs for analysis.

The results (click the photo up top to see them enlarged)?

More calories and more sodium than Big Macs with comparable amounts of saturated fat (though greater amounts of healthy unsaturated fats).

Bottom line?

As always, calories and nutrition are not intuitive. The only way to truly know what you're having is to make it yourself.

Food still junk at Ottawa Hospitals

Today's one of those rare days when something comes up that knocks Funny Friday to the backseat.

Early morning readers of the Citizen may already know this (click here to read the article in the Citizen) but we've revisited Ottawa hospital cafeterias 14 months after we first showed up with my trusty little video camera to see what if anything has changed.

If you recall (and if you don't just click here) 14 months ago I visited Ottawa's hospital cafeterias and I was appalled by the lack of healthy hospital food and so too was the Citizen and later the Canadian Medical Association Journal.

In anycase, a few weeks ago I was speaking with Don Butler from the Citizen and invited him to join me on another cafeteria tour. This past Tuesday we visited cafeterias at CHEO, the Heart Institute, the Civic and the General and sadly, nothing has changed.

I've written a letter to the CEOs of the hospitals (which I'll post below) asking if they would be willing to personally commit to improving the nutrition in their hospitals and I've extended a standing invitation to Don Butler to join me annually to revisit Ottawa's hospital fare to see how things are going.

Bottom line - hospital cafeterias shouldn't simply be no-name junk food restaurants. If anything hospital cafeterias should serve as examples of healthy eating and extend their role as leaders in the provision of health care to their dietary offerings.

[BTW - below the letter are a few videos we shot while walking around and you can hear Don and I discussing some of the available cafeteria fare]

Dear Drs. Kitts, Roberts and Bilodeau,

My name is Yoni Freedhoff and I'm a physician located in Ottawa with special interests in nutrition and in public health advocacy. A little over a year ago I spent some time touring the cafeterias of Ottawa’s various hospitals and was appalled by what I found. Rather than catering to good health and chronic disease prevention by offering nutritious foods I found that Ottawa's hospital cafeterias functioned more as no-name junk food providers and served foods that we as health professionals strongly advise our patients to avoid. Menus generally consisted of a slew of deep-fried fare, trans-fat containing soups, over-sized sandwiches, greasy pizza, walls of chips and soda pop, ice-cream bins, and giant muffins. I published my findings on my blog Weighty Matters and the Ottawa Citizen quickly picked up on the story and wrote a front page piece detailing the situation and followed it up with an editorial that rightly called for the hospitals to clean house in their cafeterias. The CMAJ then got in the mix and invited me to pen an editorial on the matter wherein we called on hospitals to put an end to this deep-fried hypocrisy.

So has there been change? On Tuesday of this week the Citizen's Don Butler and I visited the cafeterias of your hospitals to see what, if anything, had changed. I was disheartened by what we found.

In Mr. Butler's original article an Ottawa Hospital physician reported to him that detailed nutritional information would soon be posted to help patients and staff make more informed and hopefully healthier choices. 14 months later no such posting was visible. 14 month ago Mr. Butler was told that there was already program in place that steered people to healthy choices - "Healthwise". Apparently these reportedly healthy and wise choices are meant to identify meals containing fewer than 500 calories and 800mg of sodium and according to the Heart Institute's VP of communications, "if you see the symbol, you'll know you're eating the right stuff.". The "right stuff"? Since when are meals containing 800mg of sodium, "the right stuff" at a Heart Institute or anywhere else for that matter? Frankly I also doubt the validity of the Healthwise claims regarding calories as one of the "Healthwise" choices 14 months later was fish and chips whereby there's simply no way the calories of deep fried fish and chips come up shy of 500; and regarding sodium every soup on the menu received a "Healthwise" award, yet at the Greenery (the Civic cafeteria) where the only available nutritional information is for soup, only 3 of the 43 listed soups contain less than 800mg of sodium per serving with the average being 957mg.

And about those soups. Did you know that of the Civic and General's 43 listed soups almost 50% of them contain trans-fat (with some having as much as 3g) and almost 50% have more than 1,000mg of sodium per serving?

How is the provision of lowest common denominator nutrition good medicine?

The arguments against reforming hospital cafeterias are both predictable and hollow and usually go as follows:

1. Selling healthy food won't be profitable.

Firstly since when did the hospital as profit centre become the hospital's mission? I thought that hospitals were public institutions geared to provide patients with excellence in health care. Given the incredibly important role of nutrition as a determinant of health and the incredibly important role of the hospital as role model and community leader, serving junk food does not fit either bill. But putting idealism aside, since when does serving healthy foods preclude profit? The Compass Group, the world's largest institutional provider of retail food service delivery, in 2007 attributed part of its rising profits on it's increased focus on healthy foods, and Capital Health in Alberta has in fact demonstrated that not only is serving healthy fare in a hospital feasible but that it's dramatically more successful than their traditional cafeterias. Their Healthy Trendz concept implemented in 19 different hospital based cafeteria and snack bar venues resulted in an overall 67% growth in revenue totalling $12.1 million and a 33% increase in the number of transactions.

2. We're not the food police, (or grown adults should be allowed to choose for themselves).

No we aren't the food police and grown ups are responsible for their own choices. While frankly I am not averse to hospitals selling exclusively healthy foods, to request that hospitals provide healthy, reasonably priced, flavourful options alongside less healthy fare surely does not constitute policing. Regarding choice - absolutely adults are free to make their own choices, however it is surely the hospital's duty to allow patients to make informed decisions as to their care. Given the role of good nutrition in health care, I would argue it is the hospital's responsibility to ensure patients make informed choices therein by at the very least posting nutritional information for each and every item sold. This is not in and of itself a difficult endeavour and certainly menu board calorie posting is slowly becoming law across the globe; was called for by the OMA on April 7th in a press conference; and is currently being debated in the Ontario legislature in the form of Bill 156. Given that Dana Hospitality, the food service provider for the Heart Institute (and perhaps the other hospitals as well), reports directly on their website that, "We provide Nutrient and Ingredient Content Information About the Food We Serve", I can't understand what might be stopping our hospitals from sharing that information with their staff and patients.

3. Healthy food doesn't taste good (or we already sell salads).

Believe it or not this was an argument put forth by an Ottawa Hospital spokesman when Mr. Butler wrote his article last year. I'm saddened to have to include a discussion of this argument here given how nonsensical it is, but nonetheless it will likely come up again. While it may be true that the creation of healthy, flavourful foods that will sell in a cafeteria takes a modicum more creativity than deep frying a potato, that certainly doesn't mean it isn't a doable endeavour. And yes, the hospitals do sell salads. Of course there is far more to healthy eating than simply salads and certainly there needs to be healthy, non-salad bar based options available for main dishes and snacks as well. And about those salads - while the hospitals do indeed sell them, their cost is astronomical. At $1.25 per 100grams the average cost of a plated salad the day we were observing seemed to fall in the $7-8 range - far more expensive then the less healthy, fried, value-meal styled servings at the hospitals various fry counters and sandwich bars and certainly not a price conducive to encouraging their purchase or consumption.

Hospitals should not be in the business of making business for themselves by serving foods known to be contributors to the development of a myriad of chronic diseases, especially not in the absence of healthy choices and readily available nutritional information. Frankly I think it's downright shameful that the very institutions built to protect our health feel comfortable serving junk food not only to their patients but also to the thousands of hardworking and dedicated allied health professionals who have committed their lives to protecting and promoting health, and then when challenged seem to myopically talk of profits rather than focusing on opportunity - the opportunity to become community leaders in what healthy cafeterias can constitute.

Drs. Kitts, Roberts, and Bilodeau, I'd like to ask each of you, are you willing to personally commit to making nutrition a priority in your hospitals?

Sincerely,Yoni Freedhoff, MD
Medical Director, Bariatric Medical Institute

Ottawa Civic Hospital


Ottawa General Hospital


Children's Hospital of Eastern Ontario

Ottawa Citizen Nutrition Watch Week 7 - Bated Breath

So now we wait.

The Citizen folks have copies of the nutritional program I use to analyze their recipes, have seen how quick and easy it is to utilize and have heard why providing its readers with nutritional information would be beneficial to them.

(for a recap - click over here to understand what this is all about)

Let's hope that the wait will be a short one and herein I'd like to make the Citizen one final offer:

If by chance, for reasons I will likely have difficulty appreciating, the Citizen determines it will be too difficult for them to in fact publish nutritional information with their recipes (even with me doing the legwork), I'd like to suggest that instead of publishing nutritional information with each recipe that they instead publish a link to my blog where I will continue to post nutritional values on a weekly basis. For the Citizen this would mean no weekly calculations and the addition of a single, predictable line at the end of each recipe directing their readers here. For me of course it will be a new source of traffic and given that my blog is entirely ad-free and non monetized (except I suppose for the penny a subscription I'd theoretically get from Kindle), not something ethically challenging to promote.

As part of the campaign I've opted to collect the opinions of influential Canadian health professionals as to the utility and value of nutritional information. My hope is that perhaps some of my blog readers might these posts to help inspire their local papers to consider posting as well. Last week we heard from Dr. Norm Campbell, who among other impressive things is the CIHR Research Chair in Hypertension Prevention and Control, and the week before we heard from Kevin Willis the Director of Partnerships at the the Canadian Stroke Network as to why they felt the Citizen ought to take the initiative and publish nutritional information. This week we've got Rosie Schwartz!

Rosie is a Canadian dietetic treasure and is certainly one of the most well known names in the country when it comes to nutrition. A former columnist for the Citizen and National Post (and many more papers), a best selling cookbook author and a regular feature in magazines from coast-to-coast Rosie and I have had the chance to Tweet at each other regularly and via one such tweet she kindly agreed to weigh in on the matter. Here's what Rosie has to say about the value of newspaper nutritionals,

Rosie's Letter


The issue here is simple. There are tens of thousands of Citizen readers for whom nutritional information would be beneficial. Readers with diabetes, hypertension, obesity, kidney disease and those who simply are concerned about their nutritional health. Those individuals would greatly benefit from having access to the nutritional breakdown of the recipes published by the Citizen.

If you've got a moment, even if you've sent emails before, could you please take the time to drop the Citizen a line again to let them know how thankful you are they're seriously considering this initiative? Please email Editor-in-Chief Gerry Nott, Food Editor Ron Eade and Wendy Warburton by clicking here.

Here's the breakdown for this week's batch of Citizen recipes:

Tennessee Big Boy
(per serving): 459 calories, 14g saturated fat, 114mg sodium, 46g total carbs

Gus and Mary's Strawberries, Balsamic Vinegar and Cream
(per serving): 254 calories, 14g saturated fat, 24mg sodium, 14g total carbs

Spinach Salad with Strawberries and Poppy Seed Dressing
(per serving): 132 calories, 1g saturated fat, 112mg sodium, 8g total carbs

Delicious Strawberry Ice Cream
(per cup): 547 calories, 15g saturated fat, 119mg sodium, 64g total carbs
(by means of comparison, Ben & Jerry's Strawberry Ice Cream per cup has 460 calories, 18g saturated fat, 100mg sodium, 52g total carbs)

[All recipes calculated using Mastercook 9.0. Today it took roughly 2 minutes per recipe]

Weighty Matters - Kindle Edition!

So for all the early adopting techies out there I'm pleased to report that Weighty Matters is currently streaming through the ether of America in the form of a Kindle subscription.

For those who don't know what a Kindle is - don't worry about it.

For those who do, feel free to check it out.

And like my blogging inspiration Joe from BookofJoe said,

"Why read for free when you can pay?"

Full disclosure: If you do choose to buy a subscription Amazon will pay me a full penny a day (it'll cost you 3 cents).

Come to think of it, I'm pretty sure you've got better things to do with your pennies.

Feel free to keep reading here for free.

[Happy Canada Day!]

Quit smoking (and junk food?) through brief exercise?

Brains are crazy places.

So neuroscientists using fancy brain imaging (fMRI) devices have demonstrated that nicotine stimulates the brain's mesocorticolimbic system (a reward centre).

Other research has demonstrated those same centres lighting up with food cravings.

Old news, no?

Sure, but new fMRI studies combining smoking cues with exercise may help to explain how exercise helps with weight loss.

Now most people believe exercise's role in weight loss is purely mathematical - it burns calories. While indeed that does play a role, unfortunately exercise doesn't burn nearly as many calories as would be fair and really is generally a minor mathematical player in weight loss. Yet despite it's minor role there's a robust evidence base that suggests exercise is essential in weight management, especially weight maintenance.

So how does it help? If it doesn't burn many calories, what exactly does it do to help with weight control?

Perhaps it changes your brain.

You see a recent study published last year in the journal Psychopharmacology demonstrated that smokers who were nicotine abstinent for 15 hours, when faced with images of smoking had their mesocorticolimbic systems light up like Christmas trees. Yet Those same smokers, when exposed to 10 minutes of exercise prior to the smoking images showed no such lighting.

So could the role of exercise in weight management have more to do with craving control than burnt calories? Do the folks who exercise more effectively turn off the parts of their brains that at times make cravings irresistible?

Only one way to find out. If there's a time of the day that's more difficult for you to manage cravings why not try to build in 10 minutes of brisk walking, gardening, stationary biking, dance or active play and see if it helps to take the edge off? Worst case scenario? You get 10 extra minutes of healthy exercise.

Janse Van Rensburg, K., Taylor, A., Hodgson, T., & Benattayallah, A. (2008). Acute exercise modulates cigarette cravings and brain activation in response to smoking-related images: an fMRI study Psychopharmacology, 203 (3), 589-598 DOI: 10.1007/s00213-008-1405-3

UK anti-obesity advocate pays student volunteers with junk food!?

Meet Ms. Annette Brook.

She's the British Liberal Democrat MP for Mid Dorset and North Poole. She's also a staunch crusader in the fight against childhood obesity.

She's quite outspoken.

Here's a smattering of quotes from her website:

"We welcome the removal of vending machines selling chocolate, fizzy drinks and crisps to encourage young people to seek alternative snack options."

"We have allowed food marketing companies to influence our diets and the television media to further develop our already sedentary lifestyles. We need to empower our citizens to lead a healthy lifestyle and action now is imperative."

"For every £1 spent promoting healthy eating £500 is spent marketing unhealthy food, so the market has clearly failed. Advertising promotions determine our children's food choices and propel them down a single route. The producer is king. I agree that if we limit the advertising of unhealthy food for children, many parents will be under less pressure to give in to their requests for fast food."

"Let us ponder on "You are what you eat". If we keep that at the back of our minds, we will be able to get totally on message."

So how "totally" on message is Ms. Brooke?

Ummm.

You see a story came out in the UK Telegraph yesterday detailing the fact that Ms. Brooke in her submitted annual expenses billed UK taxpayers for all those things she wants to see gone - fizzy drinks, chocolate and cakes.

So wait a second here, aren't I the guy that says life includes chocolate? Yup. So why am I blogging about this? Isn't it Ms. Brooke's right to choose what she wants to eat?

Sure it is, and while it certainly wouldn't look great for Ms. Brookes to regularly be munching on vending machine fare, that's not what makes this story blogworthy. What makes it blogworthy is that Ms. Brookes spokesperson, in defending the expenses explained that the junk wasn't for Ms. Brookes but rather it was for the students who were working in her office without pay.

Yup. Ms. Brookes, crusader against Big Food marketing to kids and junk food in schools pays her own student volunteers with, yup, junk food.

Oy.

Ottawa Citizen Nutrition Watch Saturday Edition (and Update)

Had a nice meeting yesterday with Editor-in-Chief Gerry Nott, Wendy Warburton and (I'm really sorry very nice well-spoken guy with glasses, I can't remember your name, I want to say Peter but not positive). While I won't go into the nitty gritty of the meeting I can tell you that I believe the Citizen is sincerely considering the publication of nutritional information and that there are some real logistics to overcome. That said, given that the total time cost of the endeavour would be between 10 and 20 minutes weekly I'm hopeful that the logistics are surmountable.

Here are the nutritional breakdowns for today's recipes:

Sweet Chili-Maple Grilled Chicken Sandwich:
(per serving NOT including marinade): 620 calories, 829mg sodium, 8g saturated fat, 37g total carbs

Classic Mojito
(per drink): 96 calories, zero fat, 28mg sodium, 8g total carbs

Maker's Margarita
(per drink): 193 calories, zero fat, 2mg sodium, 35g total carbs

'Bin'-gria
(per cup): 174 calories, zero fat, 97mg sodium, 16g total carbs.

[All recipes calculated using Mastercook 9.0. Today it took roughly 2 minutes per recipe]

Cash4Gold - the answer to American economic woes?

Today for Funny Friday here's the Onion News Network exploring a new plan to help refloat the American economy.

Have a great weekend!

Ottawa Citizen Nutrition Watch Week 6 - Great News?

It's been a very exciting week for the "ask before you order" campaign to encourage the Citizen to include nutritional information for its recipes.

(for a recap - click over here to understand what this is all about)

Last weekend, via the social media wonder Twitter, Ron Eade the Citizen's Food Editor and I had a quick back and forth that culminated in us having a nice chat on the phone about the issue. It became clear fairly quickly that we are actually on the same page about the utility and importance of providing readers with nutritional information and that barring any unforeseen logistical barriers, the publication of nutritional information in the Citizen is something he'd be willing to support.

Then two days ago I received an email from Wendy Warburton who had returned from vacation and she let me know that she certainly agrees in principle that publishing nutritional information would be great for Citizen readers and is hopeful there's a program/way out there to do so that's not overly onerous.

And then yesterday Gerry Nott, the Editor in Chief, invited me to come by tomorrow to see if we can't figure out a way to make this happen!

Kudos to the 3 of them and the Citizen for taking the time to honestly consider this.

As part of the campaign I've opted to collect the opinions of influential Canadian health professionals as to the utility and value of nutritional information. My hope is that perhaps some of my blog readers might these posts to help inspire their local papers to consider posting as well. Last week we heard from Dr. Kevin Willis from the Canadian Stroke Network as to why he felt the Citizen ought to take the initiative and publish nutritional information. This week we've got Dr. Norm Campbell.

Dr. Campbell is really a tour-de-force in the global hypertension landscape and among his many accomplishments he is the Canadian Institute of Health Research Chair in Hypertension Prevention and Control, he chairs the Steering and Executive Committees for the Canadian Hypertension Education Program (CHEP), a program designed to improve the treatment and control of hypertension in Canada. He also chairs the Outcomes Research Task Force for the hypertension recommendations process and is a past president of the Canadian Hypertension Society (CHS), the Canadian Coalition for High Blood Pressure Prevention and Control (now Blood Pressure Canada), and the Canadian Society for Clinical Pharmacology.

Here's what Norm had to say - use the slider to zoom in or the far right button below the PDF to get a full screen (email subscribers if you don't see an embedded PDF then click the title at the top to get taken to the blog),



Again, the issue here is simple. There are tens of thousands of Citizen readers for whom nutritional information would be beneficial. Readers with diabetes, hypertension, obesity, kidney disease and those who simply are concerned about their nutritional health. Those individuals would greatly benefit from having access to the nutritional breakdown of the recipes published by the Citizen.

If you've got a moment, even if you've sent emails before, could you please take the time to drop the Citizen a line again to let them know how thankful you are they're seriously considering this initiative? Please email Editor-in-Chief Gerry Nott, Food Editor Ron Eade and Wendy Warburton by clicking here.

Here's the breakdown for this week's batch of Citizen recipes:

Szechwan and Heritage Beer Sauce
(per tablespoon): 13 calories, trace saturated fat, 22mg sodium, 3g total carbs

Strawberry Smootie
(per cup): 95 calories, trace saturated fat (assuming low fat yogurt used), 28mg sodium, 21g total carbs

Strawberry Cheesecake Mousse
(per serving (assuming 6 and 2 tbsp sweetened whipped cream per)): 441 calories, 25g saturated fat, 140mg sodium, 16g total carbs

Jasmine & Lychee Iced Tea
(per cup): 119 calories, trace saturated fat, 8mg sodium, 30g total carbs

Heritage Baby Back Ribs
(per serving): 1,494 calories, 31g saturated fat, 1,279mg sodium, 102g total carbs

Mill Street Coffee Porter Brownies
(per entire recipe): 5,411 calories, 200g saturated fat, 2,904mg sodium, 636g total carbs

Traditional Dark Lager and Cranberry Salad Dressing
(per tablespoon): 26 calories, trace saturated fat, 7mg sodium, 1g total carbs

Mill Street Coffee Porter Chocolate Cake
(per serving assuming 12): 399 calories, 12g saturated fat, 372mg sodium, 53g total carbs

Southern Sweet Tea Pops
(per pop): 248 calories, zero fat, 9mg sodium, 65g total carbs

Grape Pops
(per pop): 140 calories, zero fat, 9mg sodium, 35g total carbs

[All recipes calculated using Mastercook 9.0. Today it took roughly 3 minutes per recipe]

World's Greatest Treadmill Desk?

I love this desk. It's Steelcases's "Sit-to-Walkstation"

I've thought about building my own treadmill desk but my concern has been that certainly at times I'll need to sit.

This desk can do both (it moves).

It can be yours for "just" $4,899

(BTW, in case anyone's feeling stupidly and irresponsibly generous my birthday's at the end of August)

An open letter to Canada's Minister of Health

June 23rd, 2009

Honourable Leona Aglukkaq
Minister of Health
House of Commons
460 Confederation Building
Ottawa, Ontario
K1A 0A6

Dear Minister Aglukkaq,

My name is Yoni Freedhoff and I'm a physician located in Ottawa with special interests in nutrition and in public health advocacy.

I'm writing you today with regard to trans-fat.

As I'm sure you're aware, on June 20th, 2007 your predecessor Tony Clement ignored the recommendations of the Government's own Trans-Fat Task Force that called for the immediate regulation of trans-fats and instead announced,

"today industry is being given notice they have two years to reduce the levels of trans fats or Health Canada will regulate their use."

So how did the food industry use their two-year free pass?

Not well.

Sally Brown, Chair of Canada's Trans-Fat Taskforce reports,

"Although some companies and sectors have stepped up to the plate and done well, overall the food industry is not sufficiently reducing trans fats voluntarily."

What else has happened over the course of the past two years?

Well according to the Heart and Stroke Foundation and the Centre for Science in the Public Interest as a consequence of Health Canada's two years of inaction on trans-fat over 6,000 Canadians lost their lives due to its inclusion in Canada's food supply.

And of course it's not as if Health Canada is incapable of bans on dangerous chemicals. Here's Health Canada's rationale for the banning of bisphenol-A from baby bottles,

"We have immediately taken action on bisphenol A, because we believe it is our responsibility to ensure families, Canadians and our environment are not exposed to a potentially harmful chemical."

Yet in that same press release Health Canada stated,

"The scientists concluded in this assessment that bisphenol A exposure to newborns and infants is below levels that may pose a risk"

And just last week Health Canada announced a ban on six phthalates compounds that the most recent comprehensive review article notes,

"Analysis of all of the available data leads to the conclusion that the risks are low, even lower than originally thought, and that there is no convincing evidence of adverse effects on humans. Since the scientific evidence strongly suggests that risks to humans are low, phthalate regulations that have been enacted are unlikely to lead to any marked improvement in public health."

Contrast those actions with the inaction on trans-fat, a compound that head of the Trans-Fat task force has stated is,

"a "toxic" killer that need to be removed from the food chain as soon as possible"

where,

"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"

Superficially it would appear to me that Health Canada only tends to leap into action on matters that are politically palatable.

If it truly is Health Canada's

"responsibility to ensure families, Canadians and our environment are not exposed to a potentially harmful chemical"

why then is trans-fat still on Canada's store shelves?

Two years is two years too many. Minister Aglukkaq, how many more thousands of Canadians need to die before Health Canada takes real action?

Sincerely,

Dr. Yoni Freedhoff, MD
Medical Director, Bariatric Medical Institute
575 West Hunt Club, Suite 100
Ottawa ON K2G5W5

My CBC interview regarding menu and newspaper calories

Thanks to the crew over at CBC Ottawa Morning for being so kind, courteous and engaging.

For those who might have missed the interview, here it is:

Ottawa Citizen Nutrition Watch Recap!

Welcome CBC Ottawa Morning listeners (and if you're reading this before 7:30am, have a listen to CBC Ottawa Morning this morning at 7:30am!)!

Hopefully you've found your way here to help with the "ask before you order" campaign to have the Citizen include nutritional information in their published calories.

To recap. Roughly six weeks ago I blogged about how I had written a letter to the editor of the Ottawa Citizen asking that they publish nutritional information for its Food Section recipes.

It didn't get published.

I then wrote Ron Eade, the Citizen's longstanding, entertaining and informative Food Editor with the same request and he informed me that it was a budgetary issue and suggested I contact Wendy Warburton the person in charge of making the decision to spend the $16.99 it would cost to buy the software to analyze the recipes.

And so I did.

She didn't write me back.

The next week I offered to do the Citizen's work for them. I offered to use my own software and my own time to analyze the recipes for the Citizen. Ron reported that he'd pass my offer up the chain of command.

I didn't hear back from anyone.

Two weeks ago I emailed the Citizen's Publisher, their VP of Sales and Service and their Editor-in-Chief and I was pleased to hear back from Gerry Nott, Editor-in-Chief. He let me know it was the first he'd heard of the initiative and that he'd discuss our request and my offer with Wendy on her return from vacation on June 22.

Again, the issue here is simple. There are tens of thousands of Citizen readers for whom nutritional information would be beneficial. Readers with diabetes, hypertension, obesity, kidney disease and those who simply are concerned about their nutritional health. Those individuals would greatly benefit from having access to the nutritional breakdown of the recipes published by the Citizen.

Given that I've offered to do all of the Citizen's work for them for free, there really shouldn't be anything stopping them from taking me up on my offer, and today is actually an important day for this campaign as today is the day Wendy Warburton returns from vacation.

On a very positive note, I had a nice chat with Ron Eade this past weekend and it would certainly seem that we're both on the same page with regards to the great importance of societal nutritional awareness.

If you'd like to see nutritional information included in the Citizen, please take a few minutes out of your day and send an email to the Citizen's Editor-in-Chief Gerry Nott, Food Editor Ron Eade and Wendy Warburton by clicking here.

Remember, it was the Citizen's editorial board in their piece on posting calories on menus who suggested that legislation isn't necessary to get restaurants to post calories but rather that consumer demand would do the trick. Let's see if they were right in regard to their own paper.

Bloggers, Twittawa - please consider reposting this today and for those not so savvy with social media - please email this post to your friends.

Who knows, perhaps this campaign can serve as a model for other newspaper changes. Perhaps by getting involved here you'll actually be helping to pave the road to making newspaper published nutritionals the new normal.

Ottawa Citizen Nutrition Watch on Monday's CBC Ottawa Morning!

So we're leaping from social media to real media on Monday morning when following the 7:30AM news I'll be on CBC Radio One's Ottawa Morning.

Tune in to hear about the initiative to have the Citizen provide its readers with nutritional information and about the bizarre concerns of the Dietitians of Canada with NDP MPP Frances Gelinas' private members bill set to put calories on the menus of chain restaurants!

Spread the word!

Ottawa Citizen Nutrition Watch - Saturday Edition

Here are the nutritional breakdowns for today's two recipes - hope you like 'em salty!:

Mama's Meat Loaf:
(per loaf (whole recipe makes 3 loaves)): 2,447 calories, 66g saturated fat, 6,207mg sodium, 117g total carbs

Mama’s Delicious Smashed Potatoes:
(per serving): 386 calories, 12g saturated fat, 634mg sodium, 43g total carbs.

[All recipes calculated using Mastercook 9.0. Today it took roughly 2 minutes per recipe]

Forbidden Brownie

Who among us hasn't eaten something that's hit the ground?

Enjoy this brownie for Funny Friday!

Have a great weekend!

[Happy Birthday Dad!]

Dietitians of Canada hits bottom, digs

Wow, I'm almost speechless, but don't worry, only almost.

Yesterday Don Butler from the Citizen called me about my post regarding Dietitians of Canada's non-support of mandatory calorie labeling.

When he interviewed me he asked me what I thought DC was worried about.

I told him I didn't know but that common arguments include a mistaken belief that posting calories will cause a sudden outbreak of anorexia; that calories are not the only nutritional determinant of food; and that restaurants may have a tough time making calculations (not true for chain restaurants where uniformity of meals is integral in their success and where calorie counts already exist).

I was way out to lunch.

Nope, apparently the Dietitians of Canada are worried that,

"If a person looks at food that way, would they be more likely to make a higher-calorie choice because they think it's going to taste better?"

Oh and also that people aren't going to understand how to use the information,

"If you just post calories on the menu, how well can consumers use that information? That's a question we have."

So basically it seems that Dietitians of Canada are concerned that Canadians are nutritional morons and that they're going to believe menu posted calories are in fact some sort of new fangled taste-score and consequently choose foods with higher numbers because they think that food is likely to be "more tastier".

As I mentioned yesterday, if I were a Canadian Dietitian, I'd be absolutely mortified.

Ottawa Citizen Nutrition Watch Week 5 - Waiting

So we're still waiting for Wendy Warburton to get back from vacation.

To recap. Over a month ago I blogged about how I had written a letter to the editor of the Ottawa Citizen asking that they publish nutritional information for its Food Section recipes.

It didn't get published.

I then wrote Ron Eade, the Citizen's longstanding and well known food columnist and blogger with the same request and he informed me that it was a budgetary issue and suggested I contact Wendy Warburton the person in charge of making the decision to spend the $16.99 it would cost to buy the software to analyze the recipes.

And so I did.

She didn't write me back.

The next week I offered to do the Citizen's work for them. I'd use my own software and my own time to analyze the recipes for the Citizen. Ron reported that he'd pass my offer up the chain of command.

I didn't hear back from anyone.

Last week I emailed the Citizen's Publisher, their VP of Sales and Service and their Editor-in-Chief and I was pleased to hear back from Gerry Nott, Editor-in-Chief, that he'll discuss our request and my offer with Wendy on her return from vacation on June 22.

Again, the issue here is simple. There are tens of thousands of Citizen readers for whom nutritional information would be beneficial. Readers with diabetes, hypertension, obesity, kidney disease and those who simply are concerned about their nutritional health. Those individuals would greatly benefit from having access to the nutritional breakdown of the recipes published by the Citizen.

For the next little while I'm going to try to bring you the thoughts of other Ottawans who care a great deal about nutrition.

This week I'd like to introduce you to Kevin Willis. Kevin's a great guy who cares a great deal about nutrition. Kevin's the Director of Partnerships at the Canadian Stroke Network and part of Health Canada's taskforce on Dietary Sodium Reduction.

Here's what Kevin wrote to Wendy about our "Ask before you order" initiative,

"Dear Wendy,

I am writing to urge you to include nutritional information with your recipes. Everyone needs to be aware of the calories, fat, sugar, and sodium in their food so that they can make informed choices. The Citizen has been one of the leading media sources in explaining to the public the links between dietary sodium and blood pressure. Please give your readers the information they need to help them limit their sodium intake and manage their nutrition.

Yours sincerely,

Dr. Kevin Willis
Member of Health Canada’s Working Group on Dietary Sodium Reduction
--
Director of Partnerships
Canadian Stroke Network"

Now I realize you may have sent emails already, but if you haven't, or if you've never sent one to the Citizen's Editor-in-Chief perhaps you could drop Mr. Nott a line (and included in the email will be Wendy Warburton) and let him know how you feel about the matter so that he's armed with our thoughts before his meeting with Wendy. Please email them by clicking here.

I know this subject has started to be cross-posted on various blogs and Twitter accounts (thanks!) - please consider reposting again or for the first time.

We ARE building momentum. The first two weeks, almost no-one reposted or tweeted this story. Last week I believe over a dozen retweets and it's now been posted on at least 5 local blogs.

Remember, it was the Citizen's editorial board in their piece on posting calories on menus who suggested that legislation isn't necessary to get restaurants to post calories but rather that consumer demand would do the trick. Let's see if they were right with regards to their own paper. Please consumers - make some demands.

Here's the breakdown for this week's batch of Citizen recipes:

Char-Grilled BC Spot Prawns
(per serving assuming no salt to taste and unseasoned breadcrumbs): 565 calories, 7g saturated fat, 388mg sodium, 21g total carbs (a surprising number of calories for a small appetizer)

Ron’s Favourite Maple-Whisky Planked Salmon
(per serving): 369 calories, 1g saturated fat, 119mg sodium, 28g total carbs.

Pacific Cod Skewers with Whiskey Pomegranate Sauce
(per serving assuming 1/16 teaspoon salt each to taste): 304 calories, 2g saturated fat, 156mg sodium, 12g total carbs.

Grilled Atlantic Squid on Pasta Bundles with Chutney
(per serving): 796 calories, 10g saturated fat, 387mg sodium, 68g total carbs

Dad's Fibre Rich Bran Muffins
(per muffin): 153 calories, 1g saturated fat, 170mg sodium, 25g total carbs

Berry Yogurt Parfait
(per serving): 120 calories, 3g saturated fat, 58mg sodium, 16g total carbs (this one will vary dramatically based on your type of yogurt)

[All recipes calculated using Mastercook 9.0. Today it took roughly 4 minutes per recipe]

Dietitians of Canada opposed to calories on menus?

Calories on menus.

I would have thought it's pretty much a no-brainer for any one who cared about nutrition and heath. I mean who could possibly have a problem with providing consumers with information that might help them make better dietary decisions? The information isn't meant to be judgemental. It's not meant to teach people that calories are bad any more than price tags are meant to teach people that dollars are bad. It's just there to help allow consumers to actually make informed choices.

So who's come out vocally in favour of calorie labeling?

The list grows daily and among many others includes:

American Association of Retired Persons

American Cancer Society

American Diabetes Association

American Dietetic Association

American Heart Association

American Medical Association

American Public Health Association

Canadian Obesity Network

Canadian Society for Exercise Physiology

Canadian Teachers' Federation

Canadian Women's Health Network

Centre for Science in the Public Interest

Heart and Stroke Foundation

Institute of Medicine

National Eating Disorder Information Centre

Newfoundland and Labrador Medical Association

Ontario Medical Association

Ontario Society of Nutrition Professionals in Public
Health

Rudd Center for Food Policy and Obesity

Society for Nutrition Education

United States Food and Drug Administration's Obesity Working group

World Health Organization

So who else wants calories on menus?

The public. Polls have consistently placed public support of mandatory calories posting on menus at around 80%.

Who else?

The food industry. Recently in the United States the National Restaurant Association has joined hands with lawmakers to support the passing of a federal bill that would mandate chain restaurants post menu board calories in every single chain restaurant across their country.

So who doesn't want calories on menus?

The Dietitians of Canada.

Yup, that's right, the Dietitians of Canada upon review of Ontario's Bill 156, a bill designed to force chain restaurants in Canada to publish calories on menu boards, decided to send out an email to its members to ask their opinions. You might be thinking that clearly here I'm out to lunch, that there's nothing wrong with DC gathering members' opinions, and you'd be right, assuming that the email simply asked for opinions. But the email didn't simply do that though. No, instead the email primed members' opinions by stating that DC was "concerned" regarding providing Canadians with information about the single most important nutritional determinant of food - calories,

"To: DC Members

Posting of caloric information on menu boards or through a tag attached to individual food items is being proposed through a bill introduced in the Ontario legislature by Frances Gelinas, MPP and NDP Critic for Health. The proposed bill would apply to foodservice operations with annual revenues greater than $5 million, and non-compliance would be fined. The bill also proposes limits on artificial trans fats.

Dietitians of Canada is concerned that there is limited evidence to support a move to posting energy content of foods on restaurant menu boards as a means of influencing consumers to make positive changes in their food selection at this point of purchase. We are interested in identifying your views on this issue as well as identifying relevant evidence to support your views.

Your input will help shape the DC response to this issue. Please take a few moments to complete this brief survey.

The survey should take no more than 5 - 10 minutes to complete. Your response by April 17 is appreciated.

Thank you
Posted by
Linda Dietrich, Regional Executive Director Central and Southern Ontario"

So just to put this in perspective - nutrition advocacy and professional organizations (including the American Dietetic Association - the DC's American counterpart) support mandatory menu labeling, medical organizations support mandatory menu labeling, non-profit health groups support mandatory menu labeling, the public supports menu labeling, even Big Food supports mandatory menu labeling and the Dietitians of Canada have concerns?

What could they possibly be concerned about? They talk of a lack of evidence, but yet there's ample evidence that menu board calories are both an important need and a great idea. But really, even if there wasn't yet ample evidence, what possible reason could DC have to deny Canadians the ability to make more thoughtful dietary decisions by ensuring restaurants provide them with more information? Does DC feel that the calorie section on nutrition facts panels should be removed as well?

Dietitians out there? Do you have any thoughts as to what the Dietitians of Canada might be afraid of and why they seem to be having more difficulty assessing the evidence base than even the food industry?

[If you want your voices heard and you didn't happen to notice the email above, feel free to write to Linda Dietrich and let her know how you feel about the need for menu board labeling by clicking here.]

UPDATE: Thanks to RD who in the comments posted the results of the incredibly skewed survey (meaning if you prime your members by telling them the organization "has concerns" go figure people aren't going to support the concern in question).

So unbelievably only 47% of Canadian dietitians who participated in the survey felt that posting calorie information on menus is an effective means of public education and modifying food choices.

Even more unbelievably only 71% of Canadian dietitians who participated in the survey felt that trans-fats should be banned.

If I were a Canadian dietitian, I'd be absolutely mortified.

You're a bad parent if you don't feed your kids chocolate

That's my take on Kinder's new, "Have you played today" campaign".

The gist of the campaign?

Treats are an important part of parenting and so to be better parents you've got to make sure you give them treats, more specifically - Kinder chocolates.

Now it's true the chocolates are smaller than regular Kinder chocolates, but that's not really the point. The point is here's a campaign with an incredibly unique marketing pitch. Forget probiotics, omega-3 and fibre. Here we've got chocolate being pitched as a parenting tool; a pitch that suggests that you're a bad parent if you don't give them Kinder eggs.

How does it do that?

By recruiting experts to push their message.

Experts? What expert in their right mind would agree to pitch chocolate to children under the banner of good parenting?

Two in fact. Registered Dietitian Mary Bamford and child Psychologist Dr. Anthony Volk.

So what did they have to say?

When I read Mary's piece entitled, "Treating with Food: What's Okay", I learned that Mary advocates giving children 10-15% of their total daily calories in treat form and that doing so would, get this, teach them about portion control,

"For younger children, allowing around 100 calories per day as a treat allows you to teach the importance of portion control. Older children and female teens are allowed 150 to 200 calories per day and 200 to 400 calories per day for active teen boys."

More strikingly I learned that Mary doesn't seem to be aware of treats other than food as not once does she suggest that such treats exist. She also advises parents not to stress about giving their children chocolate every day because,

"The Kinder Survey reveals that 91% of dietitians agree that parents should feel comfortable including chocolate in their children’s diets on a periodic basis."

I suppose "daily" is technically "periodic". Gee thanks Mary for the sage advice of parents' own hands providing 10% of their children's daily calories as treats and backing that up with a spun-by-you statistic that clearly did not apply to the daily provision of the caloric equivalent of 1 can of Coca Cola for toddlers and small children, 2 cans of Coca Cola to teen girls and 4 cans of Coca Cola daily to teen boys

(I use Coca Cola as an example because Mary has also worked for them suggesting that sugared soda availability helps teach about choice and that it's fine for 10% of your child's daily caloric intake to come from sugar lest they become apparently sugar-crazy teenagers,

"If parents don't expose kids to things in our culture, they're going to go crazy in their teens and so really teaching them reasonable choices is a good way to go so getting 10 per cent of your calories from added sugars is quite reasonable")

And the child psychologist, what about him? He had a lot to say - 4 pieces in total. In his article, "Why Treat" he explains that giving your kids Kinder chocolate every day will:

1. Encourage sharing between children, promoting patience, fairness, and social skills.


2. Teach patience and perseverance.


3. Reward positive behaviour.


4. Encourage play.


5. Help build positive parent-child relationships.

To his credit, unlike Mary Bamford he does suggest and support the provision of varied treats but overall hammers home this message,

"Did you know that treats of all kinds – from a special shared experience to a simple chocolate bar – can be used to help build those positive parent-child relationships? In fact, when used as part of overall positive parenting practices, treats can:

• Show children that their parent is concerned about making them happy, and willing to do things that make them happy.
• Set a positive mood to make a child more receptive to what a parent has to say.
• Foster positive interactions between parents and children.

Giving and receiving treats – shared moments of joy – can help to build strong parent-child relationships."

To be clear, it's not as if my wife and I never use food treats with our own children - we surely do but certainly not every day. More importantly our food treats are never given as rewards like Kinder's purchased experts suggest. Why not? Because it's thought that rewarding with food treats (called instrumental feeding) encourages and teaches children to eat for a myriad of cues and may further their risk of eating more than they need, which is probably why in guidelines on the treatment and prevention of childhood obesity rewarding with food is explicitly cautioned against.

So when do we use food treats? Pretty much on a just because/sometimes food basis and we certainly don't link them with the completion of any activity or eating behaviour. We do however treat regularly. Treats may be "special time" with mom or dad, telling them how proud we are of them, how much we love them, warm hugs, favourite activities, etc.

Now I can only hold out hope that Dr. Volk and Mary simply didn't think their involvement with Kinder through, and certainly from Dr. Volk's quote in Sarah Schmidt's article published yesterday in the Vancouver Sun, I wonder whether or not he really understands how Big Food works its magic,

"I think we live in a consumer society, and it’s very refreshing to see companies taking interest in the welfare of children that they’re marketing to. You have to buy things for children, so for a company who wants to sell to children, I think it’s very responsible that they actually try to get experts on board"

Dr. Volk, Kinder's job is to sell chocolate. They used you to do that. Nothing refreshing about it.

[I had seen the campaign months ago but didn't look carefully enough at it. Thanks to Sarah Schmidt from Canwest for forcing me to take a closer look.]