Farm To Cafeteria Canada Offering $10,000 Grants. Should Your School Apply? Details Here!

When I first heard about Farm to Cafeteria Canada grants I immediately asked if they wanted to write a guest post explaining how they work. Happily Carolyn Webb, the Coordinator of Sustain Ontario’s Edible Education Network, was able to do so.

Check out this quote from NorKam Senior Secondary in Kamploops, BC,

“This year at NorKam Senior Secondary in Kamloops, BC, our cafeteria class started a salad bar for a fresh, healthy addition to our regular lunch service. We began this semester by growing our own vegetables, herbs and microgreens in anticipation of improving our cafeteria’s menu selection, and quality and freshness of food.”

Would you like to see a similar quote from your school next year?

Or how about these?

“College Heights Secondary School in the Upper Grand District School Board (Ontario) has had a fantastic first year connecting our school to local food and farms, and launching a full salad bar as part of our cafeteria service.”

“The salad bar was a huge hit today. Local carrots, kale salad with Hollyhock dressing, 3 potato salads -a traditional, a wasabi & a vinaigrette; (our vegan option) Amazing nut & bean veggie burgers, baked Halibut with sea asparagus tartar, and barbequed teriyaki spring salmon. Phew! Student prepared, right down to the condiments. (Gid Galang Kuuyas Naay Secondary School, BC).

Farm to Cafeteria Canada is offering $10,000 grants that would allow elementary and secondary schools in British Columbia, Ontario, Quebec, and Newfoundland and Labrador to implement a Farm to School program that includes a salad bar meal service.

Farm to School brings healthy, local food into schools, and provide students with hands-on learning opportunities such as growing and cooking that foster food literacy and enable students to make healthy food choices, all while strengthening the local food system and enhancing school and community connectedness.

The Farm to School Movement is growing across Canada. Today more than 1,100 schools and campuses across Canada have identified that they are providing more than 775,000 students with an opportunity to experience Farm to School through school gardens, cooking programs, salad bars and other activities. These schools and campuses estimate they spend nearly $17.5 million annually on local foods. For more information about Farm to School’s growth in Canada check out Canada’s Farm to School map.

Evidence tells us that when Farm to School is offered in K-12 settings:

• Students eat more servings of fruits and vegetables (on average .99 - 1.3 more servings), consume less unhealthy foods and sodas, reduce screen time and increase physical activity.
• Students are willing to try new and healthy food, and choose healthier options in the school cafeteria and at home.
• More students plan and prepare meals at home and more young children ask their families to make healthier purchases.
• Students are more knowledgeable about their food and the food system.
• Students achieve enhanced overall academic achievement, including grades and test scores.
• Food service staff have increased morale and knowledge about local foods.
• Each new farm to school job contributes to the creation of 1.67 additional jobs.
• Up to $2.16 of economic activity is generated for every $1 spent.
• (This data has been drawn from “The Benefits of Farm to School” (2017), The US National Farm to School Network.)

Farm to Cafeteria Canada is proud to champion Canada’s National Farm to School movement and has established the Farm to School Salad Bar grant stream thanks to contributions from the Public Health Agency of Canada and the Whole Kids Foundation. The aim of these grants is to get more students and school communities engaged in growing, purchasing, harvesting, cooking, serving, learning about, and eating healthy local foods at school.

For more information about how to apply for our 2018 grant opportunity please visit the Farm to School Canada Grants 2018 page. Applications are due by March 31st, 2018.

For more stories of inspiration from our 2016 grantees visit our Farm to School Canada Grants 2016 page!

Carolyn Webb is the Coordinator of Sustain Ontario’s Edible Education Network, a network that brings together groups in Ontario that are connecting children and youth with healthy food systems. The Network’s mission is to better enable these groups to share resources, ideas, and experience, work together on advocacy, and facilitate efforts across the province to get children and youth eating, growing, cooking, celebrating, and learning about healthy, local and sustainably produced food.

Saturday Stories: Tonya Harding, Pizza Cinnamon Rolls, and Romantic Hunter-Gatherers

Taffy Brodesser-Akner, with just a gorgeous piece of writing in the New York Times, with her interview of Tonya Harding.

Geraldine DeRuiter, in Medium, describes her experiences making Mario Batali's sexual misconduct apology pizza cinnamon rolls.

William Buckner, in Quillette, on the romanticization of the hunter-gatherer.

Britain's Food Nannies Will No Longer Sell You 1.75L Bottles of Coca-Cola

Yup, you read that right - if you live in Britain, you might want to stock up on 1.75L bottles of Coca-Cola, as starting in March, you'll be forced to buy only 1.5L bottles.

And yet there's no outcry from the beverage industry.

You'd think there would be. After all, back when nanny Bloomberg tried to pass his cup size ban - the one that would have forced you to buy two 500ml cups if you wanted to drink the volume of a human stomach (1L) worth of soda at once, the beverage industry bought a full page advertisement in the New York Times to complain about it (that's it up above).

But what about Brits' rights to buy 1.75L bottles of liquid candy? Why no screaming about Britain's fun and freedom stealing nanny?

Because Britain's nanny is the beverage industry. You see Coca-Cola, consequent to Britain's new soda tax, wants to ensure people keep buying plenty of product, and to help ease the tax' sting, they're going to stop selling 1.75L bottles (which incur more tax) altogether.

So the next time you're tempted to shout about the nanny state when someone like Bloomberg proposes a new policy designed to encourage decreased consumption of junk food, remember, you already live in a nanny state.

The food industry is your nanny.

(originally posted in response to Philadelphia's similar plan)

Body Weight Set Points. Sociology, Or Physiology?

The notion that bodies possess a weight "set point" is deeply entrenched.

And regardless of the mechanism, what appears to be true is that people tend, following weight loss, to regain the weight they've lost, finding themselves right back where they'd started.

As to the mechanism, there are many theories (including a cool new one that was explored in mice which Dr. Sharma covered last week), but the one that I tend think carries the most weight is sociological, not physiological, in that when we give up on our temporary diet and lifestyle interventions, we revert back to the lives we had been living prior. Those lives, for better or for worse, are comfortable and automatic. They include our dietary likes and dislikes, our cooking skills, our life's responsibilities, the number of meals out we regularly eat on our own, with our families, and with our friends, our sleep patterns, our activity levels, our treats and indiscretions, and so much more.

They also include the same average number of daily calories that they always did.

So why would it be surprising that when we quit our diets and return to all of our normal patterns (and calories), that our weights tend to head back to where they started?

All this to say, aim for the healthiest life that you can actually enjoy, as if life's merely tolerable, you're less likely to stick with it.

Saturday Stories: Siddhartha Mukherjee², and a Tea Party Friendship

Siddhartha Mukherjee in The New Yorker, with his poignant and incredible piece about his father's death.

Siddhartha Mukherjee in The New York Times Magazine, with his description of what happens when a clinical trial fails.

Stephanie Mencimer, in Mother Jones, with her tribute to her late Tea Party friend.

When Diet Meets DNA: A Premature Love Story

For those of you who aren't familiar with doctoral student Kevin Klatt, he's one of the most thoughtful balanced voices on nutrition around. This fall, I noticed Kevin chatting on Twitter about the realities and limitations of nutrigenomics and invited him to write a guest post on same. Happily, he agreed, and as with all of Kevin's writing, his piece is deep, thoughtful, and fair. If you're considering spending money on genetic testing as related to diet, please read his terrific overview before shelling out your hard earned cash.

Tis the season for New Year’s resolutions and this year, buying a diet plan based on your unique genetics stands to be all the rage. As genetic/genomic technology has greatly advanced over the past 2 decades, we've seen a number of genetic testing services for you (and for your dog) pop up and they're more than willing to help you live your best life. Genetics test are increasingly marketed to health-conscious folks who want to maximize their nutritional health, promising to give you diet recommendations tailored to your specific genetics. Numerous articles have popped up over the years about 'eating for your genes' and, of course, those who want to eat for their own genes get links to websites that will happily take your cash and send you a diet report (some will even send you the food!) or supplements matching your specific genetics. So...how legit are these?

The science of 'nutrigenetics', or the study of the interaction between genetic variation and dietary needs, is a real, although very immature, science. Researchers have long known that individuals respond differently to different diets and that genetics probably plays a role in this variation. Despite the marketing trope that diet advice is 'one size fits all', inherent to the Dietary Reference Intakes (DRIs), estimated nutrient requirement and intake guidelines published by the Food and Nutrition Board (FNB) of the National Academies of Science, is the notion that nutrient needs vary. The DRIs establish estimated average needs for specific nutrients, and how variable these needs are, assuming the normal distribution pictured below; from there, policy makers and clinicians can assess whether a population or individual is at a high risk of inadequate nutrient intake. Why do individual nutrient needs vary? For a lot of reasons, such as differences in an individual’s growth and development, microbiomes, medications, physical activity levels, and, yes, genetics! The field of nutrigenetics focuses specifically on how certain genetic variants impact nutrient metabolism and affect nutrient requirements.

EAR: Estimated Average Nutrient Requirement; Intake at which 50% of the population has needs met
RDA: Recommended Dietary Allowances; Intake at which 97.5% of the population has needs met
AI: Adequate Intake; Unclear risk of adequacy at this intake but likely more than needs of the population.

Nutrigeneticists have generally assessed the interaction of diet and genes in a couple ways. In observational/epidemiological analyses, where we collect biomarkers of nutrient status and self-reported dietary intake, individuals in the cohort can be genotyped for a number of genetic variants. In the same way that we account for a other factors ('covariates') in these analyses, like age and sex, we can include genotypes in statistical models, and assess their independent effects and interactions with intake on nutrition-relevant outcomes. In addition to these observational analyses, there are many randomized controlled trials which have assessed the effect of some nutrition-related intervention on an outcome, and have included genotypes in their statistical analysis afterwards. You might see, for example, that a high protein diet intervention had an effect on weight loss, and when you include an obesity risk genotype into the mix, you might observe that one genotype loses more weight than the other. To date, these are the primary ways that nutrition scientists have addressed the topic of nutrigenetics.

While these are scientifically meaningful approaches, the interpretation of these gets a bit funky and can lead over enthusiastic entrepreneurs to selling more hype than science. A few things to consider about nutrigenetics research before you go buying a test:

1. Very little of the evidence establishes 'cause and effect' - The types of research that I described above include genotypes into the analysis of studies that weren't designed to primarily look at genotype-x-nutrient interactions. Ideally, we want studies that are adequately designed and powered to test the effect of a genotype-nutrient interaction from the get go. If you include genotypes into the analysis after the study was designed, it increases the likelihood that you observe a significant association only by chance. One can imagine that in a field with 20+ essential nutrients/dietary components that are of interest, an array of measured health outcomes, and now the addition of innumerable genotypes, we can make a lot of comparisons. While these comparisons might generate some nice hypotheses, they are at a high risk of being false positives.

What the field needs a lot more of are randomized controlled trials where individuals are genotyped before an intervention ('a priori') and then randomized to a dietary intervention. This allows for much stronger causal inference that a genotype does indeed have an effect. We also need repetition of these trials across diverse ancestries - because of the way genes are possibly inherited, genotypes that we think are causal may just be very close to the actual causal genetic variant on a chromosome! To date, there is one pretty good trial that looked-for individuals with the MTHFR who had 2 copies of the variant ('TT') and then randomized them to a riboflavin supplement. We need a lot more of these before we get too excited about genotype-based dietary recommendations.

2. Individualized isn't so individual - The philosophy that often goes along with genotype-based diet advice is that it moves nutrition beyond the ‘mean’ and really gets to the individual. While a fun marketing line that has led to ‘precision’ everything, the reality is a bit bleaker. Genotypes might sound super ‘individual’ but they really just represent subgroups of the population; similar to the way that we already give nutrient recommendations tailored to specific sub-groups of the population based on age, sex, and life stage, the science of nutrigenetics only refines our educated guess at your nutrient needs, it doesn’t define it. Furthermore, as mentioned above, a lot of other factors can affect nutrient needs, and its unlikely that a single genetic variant will be the only reason that individuals differ in their needs.

3. Effect Size - Popular discussions about 'eating for your genes' that have increased the hype surrounding nutrigenetics are not often concordant with the reality of the data. Effect estimates found in post-hoc, adjusted analyses are often modest (and causality still remains uncertain). Where the field has seen very large effect sizes of genetics variants in outright nutrient deficiency feeding studies, these studies are not available for the majority of nutrients nor do they apply to people consuming relatively nutrient sufficient diets.

In the case of the MTHFR C677T variant, where there is a substantial body of experimental and human data to strongly support the causal nature of the variant, its impact on nutrient requirements, in this case folate, doesn’t really change much about dietary recommendations. As the Academy of Nutrition and Dietetics noted in their position statement on nutrigenomics, there's not good evidence that having this variant increases folic acid needs higher than the current DRIs. To date, we're lacking evidence that genetic variants increase needs so dramatically that they suggest current recommendations are inadequate.

4. Outcomes - The field of nutrition has a pretty good track record of preventing outright nutrient deficiency; much of the population isn't walking around with scurvy. Preventing scurvy, however, is probably not the biggest concern of someone thinking about buying a nutrigenetics test. With nutrition, most folks are interested in the diet that will bring them closest to immortality, and at the very least, one that can help prevent chronic diseases. Unfortunately, it's quite hard to perform large randomized controlled trials (to assess causality) for long enough (to observe meaningful outcomes such as heart attacks) in the field of nutrition, which has led to a lot of confusion about how to best give dietary recommendations based on chronic disease outcomes. Do we put more faith in short term trials while measuring some intermediate marker of disease (like blood cholesterol), or do we rely on big epidemiological studies that can't assess causality and often rely on self-reported dietary intakes. These limitations still apply to nutrigenetics! There's some hope that incorporating genetic variants into current analyses might reduce some of the noise in the data, as seen in the relationship between caffeine and heart attack/hypertension. However, this is largely optimistic, and for most genetic variants advertised today, we lack the confidence to say that changing your diet accordingly will causally impact meaningful outcomes in the same way that we lack this inference from general nutrition data. Alas, immortality remains elusive!

5. Repetition, or lack thereof - I personally think the relationship between caffeine intake, genetic variants, and heart attacks is super interesting and one of the more 'low hanging fruit' hypotheses generated from the field of nutrigenetics. However, to date, we don't have additional studies to support these early interesting observations. Repetition of findings is a key component of an evidence-based recommendation. While companies selling you a genotyping kit might be more than happy to hype one promising early study from the field of nutrigenetics, keep in mind that the science in the field is generally super premature. We generally don't have numerous publications showing similar results across a number of studies and populations. It's quite easy to get super excited about genotypes that show promising relationships that sound biologically plausible, but without seeing that relationship often, across several populations, dietary recommendations are nothing short of rushed.

6. But isn't it motivating? #EatForYourGenes. For the clinicians out there, the science of whether genes affect metabolism and your nutrient requirements is cool but what we may really want to know is the likelihood that communicating that genetic information will lead people to eat a meaningfully better diet. Good science and good intentions coming from the nutrition community have tried to get folks to eat fewer calories, less fat, less sugar, more fiber, etc, but this hasn't always translated so well. With personalized nutrition, the field runs the risk of not only communicating recommendations in a way that might not lead to behavior change, but also having folks $pend a bunch of $ on genetic test$ that don't yield meaningful result$. The last thing the field of nutrition needs is another reason for the public not to trust it.

Where's the evidence at on this? The most recent Cochrane Review assessing the impact of conveying genetic information on behavior included 2 diet studies; the Cochrane review estimated a positive effect of conveying genetic information on changing self-reported diet intakes after pooling data from 2 studies. Before you get too excited, these data hardly support buying a genetic test to tailor your diet. The 2 included studies assessed whether conveying mutation information to individuals with familial hypercholesterolemia (FH) would lower fat intake, and the impact of self-reported changes in general diet after receiving information about ApoE genotype in adult offspring whose parents developed Alzheimer's. Neither of these populations are very relevant for the average person looking to get nutrigenetics testing, nor are their self-reported outcomes that impressive. Another systematic review and meta-analysis including 7 randomized and quasi-randomized controlled trials of nutrigenetics interventions on self-reported diet found no significant effect of the intervention.

Since the publishing of these meta-analyses, the Food4Me study was published, a large multi-centre trial where 3 levels of personalized nutrition (compared to 1 generalized diet) advice were provided, with one level including genotype information; the study reported no benefit from the genetic information arm (though the statistical analyses to determine this aren't shown) on total diet scores. A sub-analysis of this study also looked at whether the personalized nutrition advice would improve adherence specifically to a Mediterranean diet score, finding small added effects of genotype on overall Mediterranean diet adherence, an effect driven largely by an increase in tomato sauce consumption. Before you get too excited, we are talking incredibly small effect sizes here: increases of .25-.43 on a 14 point scale. Translation: letting participants know that they have/don't have 5 nutrient-related risk genotypes leads to a clinically meaningless, marginally significant effect on Mediterranean diet score in a secondary analysis of a large trial. Most folks advocating for nutrigenomics testing aren't going to convey the reality of the data to potential consumers. When the clinician digs a bit deeper, it becomes hard to recommend testing to induce motivation in even the most stubborn of clients with heavy wallets. This area also hasn’t thoroughly investigated the flip side in the real world of direct-to-consumer genetic testing – if I don’t have a genetic variant that increases risk, am I less likely to make a certain dietary change? Even if communicating genetic risk leads individuals to make dietary changes, most studies have not assessed whether communicating a lack of genetic risk runs counter to eating a diet in line with current guidelines.

Conclusion: My overall takeaway on nutrigenetics/personalized nutrition -- come for the science, but don't stay expecting to get a super prescriptive diet sent from the DNA gods. We still don't know most of the factors that go into telling what your specific individual nutrient needs are and the available evidence doesn't support the idea that you'll become super motivated and starting making substantial diet changes. It's always up to you if you're in the financial situation where you can blow $100 on a DNA test and want to see what they tell you that you should eat; i'll always recommend that you go over that with your primary care provider and a registered dietitian. Me? I'm gonna need a lot stronger data before anybody tells me to switch my coffee to decaf or go out of my way to eat more or less of some nutrient.

Kevin Klatt is a currently finishing his doctoral work in the Molecular Nutrition program at Cornell University's Division of Nutritional Sciences, where he conducts experimental studies to understand the interactions between 1-carbon and fatty acid metabolism using cell, animal and human trial approaches. You can find him on twitter, and blogging over here.

What Are People Eating (And Not Eating) While Following A Low-Carb Diet?

Photo by Laurel F

Today's guest post comes from Dr. Nicola Guess who I invited to write about her recent study which explored what people on low-carb diets were and weren't eating. The tl;dr version? At least according to their dietary recall, they ate more whole foods, and far less in the way of liquid sugars and combination high-fat, high sugars foods (the ultra-processed stuff) - a potentially more sating pattern, and definitely not one that raises any alarm bells. And just an FYI, Dr. Guess is also very active on Twitter and is definitely worth a follow.

Carbohydrate restriction can be very helpful in the management of type 2 diabetes, particularly with controlling blood sugar levels. However, there have been several concerns cited about low-carbohydrate diets which I think hinders the widespread recommendation of this dietary approach for management of type 2 diabetes. For example, people might be limiting nutrient-rich foods such as fruits, vegetables and pulses. Others might be consuming a very narrow range of foods such as diets characterised by sausages, burgers and butter, with the occasional fried tomato thrown in. Despite the apparent popularity of low-carbohydrate diets, I realised that outside of clinical trials where the diet is prescribed by researchers, very little is actually known about what foods people eat when restricting dietary carbohydrates.

I therefore sought to examine this question by using national dietary surveys in the UK. Earlier this year I examined the National Diet and Nutrition Survey and found that people on a reduced carbohydrate diet (fewer than 40% of kilocalories from carbohydrate) consumed more red and processed meat, butter, oily fish and vegetables, as well as a lower consumption of soft drinks and pulses than people on a higher carbohydrate intake. I could not examine the intake on a low-carbohydrate diet (of which a suggested definition is fewer than 26% of calories from carbohydrates) because only 15 people out of 2263 followed this pattern.

Fortunately, the UK BIOBANK offered the opportunity for me to examine this question in a larger dataset. The UK BIOBANK is a huge population study in the UK which has collected comprehensive demographic, biochemical and lifestyle data in over 500,000 people. Dietary data was collected using a short food frequency and dietary habits questionnaire on the first visit. This basically asked how often people have different types of meat, oily fish, fruits, vegetables and alcohol, and also what type of spread, cereal and bread people consumed. In addition, a 24-hour dietary recall was completed on up to five further occasions. A 24-hour dietary recall asks the participant what food or drinks they consumed over the previous 24-hours, including the portion size of each food or drink consumed.

Using this dataset I was able to compare the dietary intake of people consuming fewer than 26% of kilocalories from carbohydrates to those consuming 45% or more. Confirming the findings from my earlier study, I found that a low-carbohydrate dietary pattern was associated with a significantly higher intake of red meat, oily fish, nuts and seeds but fewer fruits, vegetables and pulses compared to the normal carbohydrate group. In general the consumption of nutrient-rich foods such as nuts, seeds, oily fish and pulses were low in both groups. However, most striking was the difference in the intake of high-sugar, high-fat foods and snacks such as doughnuts, biscuits, cakes, pastries and ice cream. People in the normal carbohydrate group reported a much higher consumption of these foods (a median of six across the five dietary recalls) compared to the low carbohydrate groups (a median of zero!). This mirrored a result from my earlier study - that total carbohydrate restriction is associated with a preferential restriction of foods high in added sugars - a dietary change almost certainly likely to improve health outcomes.

The other striking finding was how few people actually reported a dietary intake consistent with a low-carbohydrate diet. Out of over 210,000 people who had completed dietary data, only 444 had a low-carbohydrate diet as defined by fewer than 26% kcal from carbohydrate. 1953 people reported consuming less than 130g of carbohydrate per day, which is another definition used for a low-carbohydrate diet. In an earlier study in the US, out of over 10,000 people in the Continuing Survey of Food Intake by Individuals, only 412 reported consuming a diet with fewer than 30% kilocalories from carbohydrates. There could be many reasons for this. Potentially, these types of dietary surveys might attract people who are engaged with conventional health advice, and therefore more likely to follow the type of diet recommended by national guidelines. Another reason may be that a low-carbohydrate diet is difficult to follow for most people. It’s worth mentioning that the low-carbohydrate groups had a higher BMI in each of the three dietary surveys I mentioned above. It’s possible that people with a higher BMI were following this diet to try to help them lose weight, but the low overall number reflects the difficulty in sustaining this diet long-term.

A limitation of our study is that we cannot tell whether people were intentionally following a low-carbohydrate pattern. Therefore I next plan to follow people prospectively as they adopt a low-carbohydrate diet. I hope this research helps us understand what foods people consume on a low-carbohydrate diet (especially people on a low-income) and can aid us in offering dietary advice to people wanting to follow this dietary approach.

Shafique M, Russell S, Murdoch S, Bell JD, Guess N. Dietary intake in people consuming a low-carbohydrate diet in the UK Biobank. J Hum Nutr Diet. 2017 Dec 13.

Guess N. Dietary intake in people consuming a reduced-carbohydrate diet in the National Diet and Nutrition Survey. J Hum Nutr Diet. 2017 Jun;30(3):360-368.

Kennedy ET, Bowman SA, Spence JT, Freedman M, King J. Popular diets: correlation to health, nutrition, and obesity. J Am Diet Assoc. 2001 Apr;101(4):411-20. Review.

Dr Nicola Guess is a lecturer in the Department of Nutritional Sciences at King’s College London in the UK and a Registered Dietitian. Her research interests are on the effect of diet on the pathophysiology of type 2 diabetes. 

Saturday Stories: The UN, The Skid Row Fixer, And Polar Bear Propaganda

By Arturo de Frias Marques

Daniel Gordis, in Bloomberg, cogently explaining why Israelis don’t care how the UN votes.

Eddie Kim, in DT News, on Wendell Blassingame, the skid row fixer.

Tim Edwards, in The Walrus, with the problem with polar bear propaganda.

How Your New Year's Resolution To Up Your Exercise Might Lead You To Up Your Weight

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014 and given it's New Year Resolution time, figured this might be worth revisiting.

File this study under reality.

Researchers were curious whether or not labelling exercise "fat-burning" (as many exercise machines do) would have an impact on how much food a person ate post exercising.

The protocol was simple. Subjects were brought individually to a lab and were told they were there to evaluate newly developed training software for bike ergometers. They were then equipped with a heart rate monitor and completed a 20 minute low-moderate intensity cycle. Participants were randomly assigned to have one of two posters tacked to the wall in front of them while they rode. The first had a poster stating, "Fat-burning exercise – developing training software for exercise in the fat-burning zone.", and the second, "Endurance exercise – developing training software for exercise in the endurance zone." Following their rides subjects were told they could help themselves to snacks while completing a survey and were offered water and pretzels. Pretzels consumed were measured by means of a scale before and after each participant.

The results?

"Fat-burning" labels did have some impact, but I'm not going to dwell on it. Instead I want to point out that across both treatments participants burned on average 96 calories during their rides and they then proceeded to eat 135 calories (41% more calories than they burned) of post-exercise pretzels.

Combine these results with those from a study published a few weeks ago that people who went for a walk and told they were "exercising" consumed 41% more calories from indulgent desserts and drinks following a post-walk lunch than those who were told they were walking for "fun".

We do eat because we exercise and I think in large part it's because we've been taught that we're supposed to - both by the food industry (see up above) and sadly too, by public health departments (see down below with the "Less Sit, More Whip" City of Ottawa bus poster) and health professionals who have markedly overplayed exercise's role in weight management.

If you are interested in weight loss, make sure that regardless of how much you're exercising, you're paying attention to to food as well.

Lose weight in the kitchen, gain health in the gym.

Docs! Please Stop Telling Patients How Many Pounds They Need to Lose!

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.

I don't think a week goes by without a patient in my office recounting how at their last physical their doctor told them how many pounds they ought to try to lose. Sometimes those MDs will be going by BMI tables and aiming patients at a BMI less than 27. Othertimes those MDs will be pulling those numbers right out of their proverbial butts with random guesses of how much would be "good" or "healthy".

No doubt too, in the majority of cases, the recommendation to lose a particular amount of weight didn't come with any useful advice on how exactly those pounds were supposed to get lost.

So fellow MDs, if you're reading this, if you think weight is having a negative impact on one of your patient's health or quality of life I do think a respectful discussion of the issue is warranted. But before you go down that road you need to know a few things.

Firstly you need to know that despite what society teaches, we don't have direct control over our weights. Sure, indirectly behavioural choices can influence weight, and yes, we can likely suffer ourselves down to whatever weight we choose, but suffering doesn't last, and consequently the direct control of losing "x" pounds - that's nonsense - if desire, guilt or shame were sufficient to lead to specific amounts of loss the world would be quite slim.

Secondly you need to understand that if you have no useful weight management advice to offer beyond the less than useful, "try to eat less and move more", all you're really doing is undermining your doctor-patient relationship as the likelihood of your patients not wanting to lose if their weights are truly affecting their health or quality of life, is likely close to zero, and yet here you are, their doctor, telling them something they already know, inferring quite clearly that you think that if they just put their minds to it they could make it happen, while simultaneously offering them no actionable help or support whatsoever.

Docs, if you're concerned about one of your patients' weights, make sure you have a realistically actionable plan to help them with. If you yourselves are providing lifestyle advice, please consider personally living by that advice for at least a month or two to ensure it's remotely realistic and to help you to understand what your patients might face as challenges with it. If you don't plan on providing any advice yourself, please explore your community's options and find an organization or an individual that you personally research in regard to their program's safety, efficacy and ethics. And lastly, don't ever target numbers on scales as there's simply no way to ensure your patients will get there, nor is there necessarily any need that they do given that markedly subtotal losses, when combined with lifestyle changes (or even lifestyle changes alone without weight loss), are likely more powerful medically than any drug you have ever prescribed.

Putting this another way, as my friend Dr. Jamie Beckerman is liable to say, the goal is the road, not the destination.

Saturday Stories: Racial Disparity, Swedish Anti-Semitism, Teen Bariatric Surgery, And Aymen Derbali

Nina Martin and Renee Montagne on black women, racial disparity, and dying in pregnancy and childbirth

Paulina Neuding, in the New York Times, with the uncomfortable truth about Swedish anti-Semitism.

Julia Belluz, in Vox, with a rich and thoughtful piece on the story of Jewel, a teen who recently underwent bariatric surgery.

Andrew Potter, in The Globe and Mail, with the story of Quebec mosque shooting hero Aymen Derbali (and if so inclined, here is a link to a current fundraising campaign for him)

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

Image Source

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.

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".

High School Phys-Ed Horror Story Highlights Risk of Tying Exercise To Weight Loss

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.

Thanks to Jonathan Clow for sharing this story with me.

So last year a PE teacher at Huron Park Secondary School in Woodstock, Ontario had their Grade 10 co-ed class use scales and measuring tapes in front of one another to calculate their body mass indices. Why? Because his gym class for the semester was to include once weekly circuit training that consisted of ten 90 second stations of burpees, weighted squats and other squat variations, mountain climbers, with no breaks, then a water break then 2 more circuits at 60 seconds and 30 seconds each without a break in between. At the end of the semester the kids were to once again publicly re-weigh and measure themselves in order to see how much weight their once weekly circuit training helped them to lose.

Oh, and he also allegedly informed the kids whose BMIs were elevated to begin with that they would likely develop diabetes.

No doubt the PE teacher was well-intentioned and felt that both public shame and just a bit of moving around would help his students because as far as he was concerned weight is an "energy balance" issue between in and out and that if he just had the kids up their "out", the problem would be solved. I've no doubt too, that his sentiments represent the societal norm rather than an exception.

I'm told the kids mounted a boycott and letter writing campaign to the school but am unsure on how it all shook out. Fingers crossed for the kids.

I'd imagine there are many more such PE based horror stories out there, and if the teacher or school is reading this, perhaps he might have a peek at this meta-analysis of school PE programs which demonstrated yet again (and yes I know I'm a broken record), that weight wise, kids aren't going to outrun their forks, or this study that suggests negative experiences in high school PE may well discourage the adoption of a commitment to lifelong exercise.

Bottom line for all of us - exercise should be cultivated and promoted on the basis of health and fun, and fat shaming has no place (or utility) in society let alone in a high school's curriculum.

Saturday Stories: Chess Robots, Man Flu, and The Best Restaurant in London

Albert Silver, in Chess News, with a fascinating piece on the world's best, wholly self-taught and given only the rules to start, chess robot.

Kyle Sue, in the BMJ's tongue in cheek Christmas edition, on the science behind the man flu.

Oobah Butler, in Vice, on how he managed to make his backyard shed the top rated restaurant in London on Trip Advisor.

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

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014 and this piece on juice.

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 water to children and washing it in BS "corporate social responsibility", food insecurity, and health, is incredibly misguided, and incredibly sad.

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

Teaching Your Kids To Cook Is More Important Than Teaching Them To Play Soccer Or Hockey

Source: USAG-Humphreys' Flickr

So this post, originally published at US News and World Report a few years ago, will be the last of this recent sled of in defence and support of home cooking.

Once upon a time, not so long ago, people ate out for a reason. Maybe it was in celebration of an anniversary, a birthday or a promotion. Maybe it was out of necessity to seal the deal with an important prospective client. Or maybe it was the understandable consequence of travel. But one thing's for sure — we didn't used to eat out simply because we could. Eating out was special.

Growing up in the 1970s, meals out were exceedingly rare for my family. Aside from our every-other-year family vacations, I'd bet we only ate out once every few months or so — and almost always to mark an occasion. I don't think we were atypical in how we spent money on food back then; as a society, the 1970s saw roughly 30 percent of our food dollars spent on food prepared outside of the home. Today North American society is over 50 percent.

Working in my office, I'd venture my average patient is eating out three to four times a week. And yet, it's not laziness that drives their frequent meals out. Regular meals out are simply North America's new normal. And it's a new normal that I think is a huge player in our collectively poor health.

While there is no one singular cause for our societal struggle with diet and weight-related conditions, one of the primary drivers is our unbelievably frequent use of restaurants, cafeterias and take-out food. Sometimes we justify these choices because there's a "low-fat", or "low-carb", option or something that sounds safe and healthful, and sometimes we convince ourselves it's due to a lack of time — that we honestly don't have the five or so minutes it would take each morning to brown-bag a lunch.

But I'd bet that most of the time we don't even think about whether we should or shouldn't be eating out. And we don't think about it, because the regular use of restaurants, or of supermarket take-out, or of nuking a box or assembling a jar of this with a box of that and calling it cooking, is just what we all do. And generally people don't question conventions that simply reflect regular behaviour.

I'd go further and say that families are often looked at with scorn when the vast majority of their meals are transformed from minimally processed and fresh whole ingredients. The "normal" of convenience has people seeing the cooking family as having an "obsession" with health or nutrition beyond what "normal" people consider to be healthy.

At the end of each day, we're all consumers of the exact same amount of time. While no doubt, there are those who have far tougher lives than others, and some work far longer hours, there was a time when each and every last family out there, regardless of how rough their circumstances, was obligated to find the time to prioritize cooking as part of day-to-day requirements, because there simply was no alternative. And while there are definitely people whose life circumstances truly make regular cooking an impossible and unreasonable goal, there are definitely others who have been convinced, or have convinced themselves, that it's not doable.

Now I'm not trying to romanticize the foods we all once cooked. I'm certain many a meal from those days would have turned many a dietitian white with horror. But I'd argue that the simple act of cooking — a health-preserving life skill — is a skill that risks extinction. In some families, regular home cooking is a phenomenon not seen for three generations.

My guess is that even the worst home-cooked-from-fresh-whole-ingredients meals from back then were likely to be lower in calories, sodium, and sugar than many healthy-sounding restaurant choices today. More importantly, those meals were far more likely to involve shared meal preparation and cleanup along with their consumption as a family ritual, around a table free from today's drone of kitchen-based TV sets and the pings and beeps of emails, tweets and Facebook updates from our electronic leashes.

So what have we prioritized in cooking's place? Kids' organized sports? Longer work hours? Our favourite TV shows? Text messaging? Social media?

Boiling it down to its essence, ultimately what we've prioritized as more important than cooking is convenience. Moreover, we go out of our way to convince ourselves (as does the food industry) that convenience can still confer health, that those boxes that claim they contain healthy nutrients and those menu items that include vegetables are in fact good for us. But looking around us — and given the urgency of the problem and the never-ending call to arms to fix it — it sure doesn't seem as though convenience is doing a very good job.

The inconvenient truth of health is that healthy living does require effort. There are no shortcuts.

And if you're looking for the one thing you can do that would most dramatically improve your or your family's health, my money would be on you prioritizing the regular, uninterrupted use of your kitchen. Prioritize it at the expense of your electronic tethers and, yes, even at the expense of your children's after-school sports, as teaching your children the life skill of cooking trumps their need to learn how to play soccer - and if you have time in your life for that, you definitely have time in your life for this.

And please don't misread this as if I'm suggesting that change need be absolute or all at once. Maybe commit to cooking one additional meal a week, and it certainly need not be complex. The goal is to cultivate love affairs with our kitchens, but that doesn't mean you'll be madly in love from day one, and while I don't think we should stop taking advantage of the miraculous times that we live in and should still enjoy and savour some wonderful meals out, we should be aiming at making eating out special again — a rare and exciting treat. In other words, aim to eat out for occasions, and not just because it's Tuesday.

Saturday Stories: Nutrition Conflicts, Cheap Food, And Genetic Horoscopes

Drs. Ionnidis and Trepanowksi, in JAMA, with their thoughts on conflicts of interest in nutrition science.

Tamar Haspel, in The Washington Post, with a fascinating explainer on why it's not farm subsidies we should blame when considering the low cost of junk food.

Angela Chen, in The Verge, with her own personal account of the genetic astrology that is the current state of direct to consumer genomics.

Introducing #15by15, My Wife's Life Skill Challenge For Our (And Your) Family

Our family's current week's meal plan as laid out by our 10 year old on Sunday (it's a magnetic whiteboard that lives on our fridge)

Today's guest post comes from my wonderful wife Stacey who has recently implemented a new challenge for us - she calls it #15by15 - where 15 is the minimum number of meals we want each of our kids to know how to make, entirely by themselves, by the age of 15.

“Fifteen by fifteen”. That’s what I told my kids when they recently helped to make our menu plan for the week, and this time were instructed to add in one meal each that they would cook from scratch, with or without my help.

I’m not going to lie, there was some whining. My three kids, now aged eight, ten and thirteen, have been helping to create menu plans that include breakfast, snacks, lunch, dinner and even treats for several years now (ht stands for "Halloween Treat" - they generally last them an entire year), as well as cooking with me and/or my husband. The kids take turns doing this from week to week because they recognize that we all have different favourites, and they want to make sure that theirs are included.

Our kids also recognize that for a household to run well, and for their mom to yell less (because, well, life is stressful enough without having to worry about each meal and snack that comes next), we all need to pitch in and help. This includes other household chores, like doing the laundry, loading and unloading the dishwasher, setting and clearing the table, taking care of the cat's food and litter, and taking out the trash, among others. My kids know that while these are not particularly fun activities, they are life skills, and that they aren’t likely to be taught how to do them anywhere but home.

In my mind, perhaps the most important of all of these life skills, is the skill of cooking.

From the time my kids were old enough to provide constructive criticism of mine or my husband’s cooking escapades, they have also been asking that we teach them how to make particular favourites before they move out. And so, with that, came our promise to them,

"When you leave home, you will leave with a cookbook of family favourite recipes, an Instapot (because they’re awesome), and a minimum of fifteen meals that you can make completely on your own from scratch."

And while there may have been whining when first announced (and perhaps even a bit of trepidation from me as I thought about the mess that would be my kitchen on at least a tri-weekly basis (I'm not including the nights my husband cooks, god-bless his mess)), my kids have fully embraced this new goal, reminding us that it is their turn to cook, with my older two kicking us out of the kitchen when they're up – which is beyond awesome, because they know that I have difficulty stepping back and allowing them to do their thing, and clearly they are more than capable.

While I can’t say that there hasn’t been an impact on the cleanliness of my kitchen, I can say that the mess has been worth making in reaching the goal of my kids becoming self-sufficient and capable of cooking with fresh, whole ingredients. They are well on their way to being able to cook fifteen meals by the time that they are fifteen years old, and, at least to date, they continue to be excited in finding and cooking new recipes, and full of pride as our family consumes them.

If you have a young family, perhaps you can consider taking on the #15by15 challenge too.

You'll Gladly Die for Your Children; Why Won't You Cook for Them?

Today the Heart and Stroke Foundation published a report by Dr. Jean-Claude Moubarac that found Canada's biggest consumers of ultra-processed food are our children. Canadian kids between the ages of 2-18 are consuming over half of their calories from ultra-processed foods, and kids aged 9-13, are closing in on 60%. When I read the report, one which clearly suggests that cooking is a lost art, it reminded me of this article which I first published in USNews and World Report in 2013 (and I'll have more on this subject from my wife on Thursday)..

I'm a parent of three. I hold no illusions that I'm a uniquely dedicated parent or that my love for my kids is greater than anyone else's. And like all parents, should the opportunity arise, I'd gladly, immediately and unquestioningly give my life for their's. And it's my firm belief in the incredible and powerful love of parents for their children that regularly leads me to scratch my head and wonder: Why it is that while most every parent would happily die for their children, it's an increasingly rare parent who will cook for them?

I've heard all of the explanations—time, cost, after-school activities, lack of cooking skills, picky eaters, etc. But ultimately, I think the real reason parents who would die for their children are comfortable feeding them from boxes and drive-thrus isn't due to a lack of love or concern. It's because society has been so firmly and conclusively duped into believing that doing so is both safe and healthful that it has become our new normal.

Remember that the foods we feed our children are, quite literally, their building blocks. Consequently, we are building a nation of children constructed from the food industry's deceptively and, at times, deceitfully marketed salt, sugar and fat offerings of convenience.

But more than that, the manner in which we feed our children is the model from which they're likely to draw upon to feed their futures. If fast and processed food assembly make up the bulk of their childhood "cooking" experiences, where actual cooking is a grumbling rarity relegated to holiday dinners, do you think your children are likely to take the time to cook and look after their nutrition as young adults or as parents themselves?

The statistics are ugly. Nearly half of our food dollars are being spent on restaurant and out-of-the-home convenience foods. In our homes, the percentage of food dollars being spent on processed foods has doubled since just the early 1980s. But again, we're not eating this way because we don't value health or love our children. We're eating this way because the food industry has festooned boxes of salt, sugar, fat and pulverized white flour with claims of added "nutrients" and health benefits; they've also convinced us that mixing, pouring, stirring and adding is "cooking."

The fact the food industry has succeeded in doing this in part may have to do with our species-wide desire for convenience, because, at the end of the day, it's simply not about time. Recent reports put the average American in front of a television for 34 hours a week and on the Internet for another eight–sure sounds like time's something of which we actually have plenty.

Fixing this problem will require more than just trying to make parents feel guilty. At this point, many parents have been led by lax front-of-package labeling and advertising laws to faithfully believe that the boxes they're feeding their children do in fact conveniently and healthfully replace fresh, whole-ingredient cooking. Plus, they themselves may have grown up in homes where actual home cooking was anything but the norm and may not know how to cook.

So what should we do? Here's a start:

• We need to take away the food industry's upper hand in the supermarkets. We need to change labeling laws and hamstring the ability of the food industry to hoodwink harried parents into believing that a sometimes-comfort food like mac and cheese can ever be a smart choice. Why should the onus be on the consumer to turn boxes over to study the nutrition facts panel to ensure that the claims on the front of the package are supported by its actual contents? Moreover, are consumers actually equipped to do this from a nutrition-education perspective?

• We need to bring back home economics. Sadly, there are many families in which regular home cooking was last seen three generations ago. I think children shouldn't be allowed to graduate high school without knowing how to cook 10 simple, healthful, fresh, whole-ingredient meals on their own. As well, we should consider using our schools' abandoned kitchens after hours to help teach basic cooking skills to families as a whole.

• We need to denormalize the reliance on convenience when it comes to feeding our children. As a society, we need to prioritize our kitchens as the healthiest and most important rooms of our homes. And we'll likely need hard-hitting public health campaigns that criticize the food and restaurant industry as well as nutrition education in schools.

The shift from regular home cooking to the mess we're in now didn't happen overnight, and it's going to take time to reverse. We need to rise up and reclaim our kitchens and shift the balance of power from the food industry to loving moms and dads who no doubt would die for their children and, if empowered to do so, I've no doubt would cook for them, too.

We need to champion produce and not products, and we needed to have started yesterday.

Saturday Stories: Professor Piffle, Opioids, and Weight Lifting

By U.S. Navy photo by Mass Communication Specialist 1st Class Brock A. Taylor [Public domain], via Wikimedia Commons

Ira Wells, in The Walrus, with a story more for we Canadians on Jordan Peterson, the Professor of Piffle.

Admiral James Winnefeld, in The Atlantic, on how no family is safe from the opioid epidemic.

Alex Hutchinson, with his new gig in Outside, on how if you want to delay death, you should probably be lifting weights.

[And thanks to the great generosity of friends, family, and readers, this year's Movember fundraising amounted to $4,553. If you'd like to watch my kids shave off my moustache, here's that video]

Picture Books Shouldn't Teach Toddlers To Be Self-Conscious About Weight

A patient brought in this picture book.

It's apparently from a series of picture books about "Pot Bellied Buddies"

It's about a bunny who as a consequence of eating too many carrots, no longer fits in his bunny hole.

And so what did the bunny do?

Well he decided to "cut back a little, and exercise"

Another patient brought in a Thomas and Friends book.

In it, kids are introduced to, "The Fat Controller"

And when exploring other Thomas and Friends characters I learned there's also a "Thin Controller". There are no other body based descriptors of any other characters. Weight is apparently an important distinction.

In the past I've noted weight biased messaging in:

A beloved and award winning children's author's book
Harry Potter
The Princess Bride
A kid's movie whose entire premise rides on the suggestion that being fat is horrific
The Muppets reboot
Scooby-Doo
Johnny Test
Max and Ruby

and

An attraction at Disney's Epcot Center.

That weight hate and stereotyping is so prevalent in children's books and movies speaks to how deeply ingrained weight bias is in society today. Parents, please be on the lookout for this sort of messaging, and when (not if) you come across it, use it as an opportunity to have a thoughtful discussion with your kids about why it's wrong.

Whether Or Not You Can Outrun A Bad Diet Depends On Your Finish Line

If you're trying to run away from weight, the likelihood of you succeeding without also addressing your diet is pretty darn low.

On the other hand, if you're trying to run towards health, well then my money's on your feet.

Exercise is, second only perhaps to not smoking, the most important health behaviour anyone can cultivate.

Whether you're running to reduce the risk or burden of most chronic diseases, or to preserve and improve your functional independence, or to reduce pain, live longer, improve sleep, bolster mood, gain strength, lengthen endurance etc., increasing and sustaining regular exercise, regardless of weight and independently of diet, is incredibly powerful.

And I'm not aware of there being any credible voices suggesting otherwise.

Saturday Stories: Window Girl, Graffiti Kids, And Iron Lungs

Lane Degregory in Floridian on the girl in the window (apparently an update to this 2008 story is imminent).

Mark McKinnon in The Globe and Mail on the graffiti kids who sparked the Syrian war.

Jennings Brown in Gizmodo on the last few people living in iron lungs.

10 Easy Non-Junk Food Rewards Teachers Can Dole Out

It happens in my kids' classes too. Teachers use junk food to reward academic accomplishments, good behaviour, fundraising and other social initiatives.

I'm sure the intentions are good. Rewarding desired behaviours reinforces the behaviour. Of course it also reinforces the rewards.

Teachers teaching their students, usually their very young students, that candy and pizza are rewards for every job well done no matter how small, might not be a great lesson for kids.

Moreover, there are so many better rewards that could be metered out.

In no particular order, here are ten (some whole class, some single kid), and please feel free to share this post and list with the your children's teachers. Honestly, they care about your kids, but they may not have thought about the issue much, and they're just doing what's nowadays considered to be normal.

1. An extra period of recess
2. An in class dance party
3. Dress up (or down) days (PJs, costumes, fancy clothes, whatever)
4. Class put in charge of school PA system for the day
5. Painting a hallway or classroom mural
6. Stickers or temporary tattoos
7. Sit wherever you want for a period (teacher's chair, floor, under desk)
8. Get out of one night of homework free card
9. Phone a kid's parents to tell them how terrific their kid is
10. Scrabble/boggle/other sort of educational game competition/hour

Of Course You Can Be Fit And Fat

Undeniably fit ultra-marathoner Mirna Valerio (from a 2015 Runner's World story (am quoted))

How about I pose a different question.

Can you be fit and have diabetes?

Of course you can. It'd be ridiculous to suggest otherwise.

So why doesn't the question of whether or not a person can be fit and fat sound equally ridiculous?

Why instead do we regularly see articles like this recent one from the New York Times that cover the "controversy" of the fit fat person?

In part it's because these stories conflate fitness with being free from other chronic diseases and/or from the risk of developing other chronic diseases.

But is that the average person's definition of fitness?

I don't think so.

I think most people think of fitness as the thing one gains as a consequence of regular exercise. That's why when it comes to the question of can you be fit and have diabetes, it sounds ridiculous as of course you can exercise and have diabetes.

Well guess what, you can also exercise and have obesity.

And in fact, that same study on which the New York Times based their article, didn't even try to quantify whether or not exercise provided health and/or quality of life benefits to people with obesity (of course exercise does). It simply looked at the heart disease risk of people with obesity, who didn't have other chronic medical conditions.

So basically the study concluded that obesity ups cardiovascular disease risk, not that those with obesity couldn't be fit.

And exercise mitigates, to varying degrees, the risks associated with virtually all chronic diseases, and obesity is no different.

Coming back to why we see stories in even the world's most reputable newspapers framing fitness and fatness as a controversy, well I think it just comes down to weight bias - specifically the trope that assumes that anyone with obesity must be lazy, because without that bias as a backdrop, there really isn't much of a story.

Saturday Stories: Gene Drives x 2, and The Uncounted

By Mariuswalter (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

Ed Yong, in The Atlantic, on how New Zealand's war on rats might change the world (and not necessarily for the best).

Carl Zimmer, in The New York Times, on why scientists believe gene drives (like the one discussed in Ed Yong's article) are too risky to employ.

Azmat Khan and Anand Gopal, also in The New York Times, with an incredible piece of journalism on the accuracy, or lack thereof, of America's bombing of ISIS.

And lastly, if you enjoy my blog, please consider a donation to my Movember fundraising for men's health initiatives. Thanks to the generosity of friends, family and readers, I'm 91% of the way to my $3,500 goal. You can give anonymously and it's fully tax deductible. Just click here! No donation is too small.