Eating Well with Canada's Food Guide at McDonald's!

Ever wonder how many, "Canada's Food Guide" servings you'll get from a Happy Meal?

Well wonder no more!

On McDonald's website is a handy dandy page called Canada's Food Guide Facts.

It'll help teach you how the juice you order for breakfast at McDonald's is really 2.5 servings of fruit; how their refined white flour, processed cheese, red meat based cheeseburger counts as 2 servings of grain, 1/4 serving of milk and 1/2 a serving of meat; and how consuming Newman's own caesar salad dressing (with 480mg of sodium per tablespoon) helps you to get the recommended daily servings of unsaturated fats.

Of course it'll also help teach you just how nutritionally weak our Food Guide is given how easily McDonald's can describe how well their food fits into it.

Certainly were there in fact stringent and evidence-based guidelines backing up the Food Guide, there'd be explicit limitations on such things as juice consumption, refined grains, red and processed meats and high calorie, high sodium salad dressings and likely no McDonald's hearts Canada's Food Guide webpage.

Which "Natural" Weight Loss Supplements Really Work?

Simple.

The ones laced with prescription weight loss drugs.

You see the thing is, there is far less regulation with nutraceuticals than pharmaceuticals.

With real drugs potency and ingredients are tested, studies are conducted to determine efficacy and safety and mandatory reporting of serious adverse effects exists.

The same can't be said about "natural" products.

Perhaps this is why on a weekly basis I get a report from Health Canada detailing the week's latest recalls.

This week?

This week's lineup includes:

Dan Bai Shou Shen Su (Found to contain undeclared thyroid hormones and sibutramine)

Karntien (Found to contain undeclared sibutramine and N-desmethylsibutramine)

Karntien Easy to Slim (Found to contain undeclared sibutramine and N-desmethylsibutramine)

More Slim (Found to contain undeclared sibutramine)

Soloslim (Found to contain undeclared sibutramine and illegal in Canada synephrine)

Honestly, if there really was a natural product that was both effective and safe for weight loss, do you think it'd be a secret? Of course not, quite the opposite as the company that made it would ensure that a copy of the studies proving the product's safety and efficacy were on every single physician's and reporter's desk in the world.

Bottom line?

When it comes to "natural" weight loss products. If your doctor doesn't recommend a particular weight loss aid it's safe to assume that to date it hasn't been proven to be safe and effective and therefore also safe to assume it's probably a waste of your money and potentially a risk to your health.

Oh, and if you think that doctors don't recommend "natural" products because of a global conspiracy to keep people ill, may I suggest you go to see the new X-Files movie.

Obesity is Still not about Exercise!

You need more proof that we're not going to put a dent in childhood obesity with exercise?

Fine.

Published ahead of print in the Archives of Diseases of Childhood is a simple study that looked at 300 children from 54 different schools in the city of Plymouth in the UK.

Dr. Brad Metcalf et al. followed the children for 4 years (from the age of 5 to 8) and looked for associations between the variables of physical activity, body mass index, body fat percentage and some metabolic blood parameters.

Guess what?

There was no association found between the amount the children exercised and their body mass indices or body-fat percentages over time despite the fact that amongst the children there was a ten fold difference in the amount of physical activity that did not in fact change over the course of the study.

That finding is so powerful I'm going to rewrite it big and bold:

Despite the fact that some kids were ten times more active than their peers, their 4 year long, ten-fold increase in exercise did not help them maintain healthier body weights or body fat percentages!

The exercise wasn't all for naught however as metabolic parameters were in fact better in the exercisers.

I wonder how many more studies need to come out before it becomes mainstream to know that exercise as a component of obesity is minor at best?

The Olympics have nothing to do with obesity

Maybe someone should mention that to Canadian Olympic gold medalist Silken Laumann.

Silken, when criticizing Canada for not funding amateur athletics as an explanation for our early dearth of medals, jumped onto the obesity horse to try to ride her point home,

"We have this perception that we are into sports, that we're a sports-minded country, but when you look at it, inactivity and obesity are a real challenge to this country"

Her comments spurred the Ottawa Citizen editorial board to readily agree and they stated that increasing funding for amateur athletics,

"not only would it increase the pool of future Olympians, but it would make a dent in rising obesity and diabetes rates."

Well I've got news for Silken and the Citizen - the country with the most medals of the games also holds the global gold medal for the highest national obesity rates (USA) while the country in second (China), holds the gold medal for gaining weight faster than any other nation in the world.

As I've blogged about over and over and over again, energy-in matters far more to obesity rates than energy-out.

I'd love to chat with Silken about this one day, as over the course of the past two years she's been quoted over and over and over again linking Canada's childhood obesity problem with a lack of sport. Unfortunately in so doing, Silken, whose voice carries a great deal of weight with Canadians, is perpetuating a belief that if acted upon (through the establishment of obesity prevention programs focusing on energy-out) will waste valuable time and resources that could instead be spent on helping Canadians with understanding and modifying their energy-in.

Menu Board Calories Hit the Funny Pages

I love it when Funny Fridays involve nutrition but today it's an extra special Funny Friday as today I've got a double header and both items are about menu board Calories.

First up we have Doonesbury. Amazingly, Gary Trudeau has now been writing his often biting, left leaning, comic strip Doonsebury for 40 years giving us his view of the world. This past week menu board calories hit his strip with Trudeau detailing how the posting of menu board calories at "McFriendly's" is affecting customers and regular pothead character Zonker. The series is remarkable too in that it means that menu board calories have hit the big time with the issue reaching a level of social conscious high enough to make the strip understandable and comical to its readers. Click the picture above to enlarge the strip enough to read.

Next up we have a youtube video that Marion Nestle posted a few days on her fantastic blog What to Eat. It was put together by the California Center for Public Health Advocacy and it involves them asking folks to figure out fast food calories using Big Food's answer to menu boards - brochures.

Have a great weekend!



[Hat tips to my mom and Cynthia for sending along the Doonesbury works]

Seriously? Deep Fried Green Beans?

Rob, BMI's fitness director, picked them up from me from a local supermarket.

According the the package they're called, "Mixed Vegetable Chips" and ingredients include sweet potatoes, squash, carrots, green beens, taro, non-hydrogenated canola oil, dextrin and salt.

I took the photo with the gum beside it to provide some perspective as to how small the container actually is.

Care to venture a guess as to the calorie content?

Would you be surprised if I told you that little container has just a hair fewer calories than a large supermarket bag of potato chips?

Having tasted them, if I'm going to spend the calories, I'll take the chips.

I wonder how many people out there buy them to be, "healthier"

(The label below - it's not for the whole container, it's for 100g. According to the top of the container, the net weight is 222g for 999 calories)

What Does the Greatest Olympian in History Eat?

Can't tell you how many people have been forwarding Michael Phelps' meal plan to me.

In case you're incredibly disconnected with the Olympics, Michael Phelps is a swimmer who has now won more gold medals than any Olympian in history.

NBC's coverage of Mr. Phelps is almost as prodigious as his breakfast and as part of their coverage they covered, you guessed it, his breakfast.

So what does a 23 year old swimming phenom eat?

Apparently nothing he cooks for himself.

He's been instructed to eat between 8,000 and 10,000 Calories daily.

Breakfast as reported by Bob Costas consists of,

"Three sandwiches of fried eggs, cheese, lettuce, tomato, fried onions and mayonnaise, add one omelet, a bowl of grits, and three slices of french toast with powdered sugar, then wash down with three chocolate chip pancakes"

You can eat like Michael Phelps too....provided you're 23 years old, 6 feet 4 inches tall and have been swimming 5 hours a day since the Athens Olympics in 2004. If that doesn't sound like you, I'd recommend cutting back some on the calories.

Thanks to everyone who sent this in - here's a clip from NBC.

The Oreo Episode of 7th Heaven

Can't say I've ever watched the show, but thanks to a post by Parke Wilde on his wonderful blog US Food Policy, I'm pretty sure I don't want to.

His post was about their 218th episode entitled, "Secrets" - an episode whose entire premise is that eating cookies leads people to tell each other their secrets. The thing is, it's not just any cookie that loosens lips, it's specific to Oreos due to presumably paid product placement.

I've included Parke's clip below, along with one other, but some background before you watch the clips.

Oreos are owned by Kraft.

Kraft is one of those corporations who have managed to appease critics and politicians by crafting their own voluntary guidelines regarding targeting children with junk food advertising.

They pledged not to target children back in January 2005 and specifically made mention to Oreos.

So when was that 7th Heaven episode aired?

April 17th, 2006.

Of course Kraft will say that 7th Heaven is a "family" show and therefore they're not exclusively targeting kids. Gee thanks Kraft.

The FCC is investigating but of course without any regulatory teeth, I'm not sure what they expect to be able to do.

Still think "voluntary" is a good idea?

Stupidest Obesity Headline Ever?

Not the one above this post, but rather one by Reuters published on August 6th, 2008.

The article had to do with a study recently published in Obesity that looked at predictions for overweight and obesity in the US for the coming few decades.

The hypothetical study wanted to address the question of what might happen to healthcare expenditures attributable to weight and weight related disease if rising rates of obesity continued unabated.

Certainly if you simply draw a straight line on a graph eventually everyone on the planet will be overweight or obese, but natural phenomena do not occur in straight lines and natural distribution will ensure that eventually we will hit a zenith.

The authors knew this too and simply put it together as a hypothetical question.

Reuters perhaps took it a little too seriously with their alarmist headline,

"All U.S. adults could be overweight in 40 years"

For their efforts Reuters has earned my first quobesity post in some time.

Don't Watch on a Full Stomach

Today for Funny Friday, an absolute classic Saturday Night Live skit with Will Ferrell and Juliana Margulies.

How they manage to keep straight faces for the few moments they do before cracking up is beyond me.

Have a great weekend!

See more funny videos at Funny or Die

Leslie Beck Bashes Juice

And rightly so!

In her (for my non-Canadian readers, Leslie is a prominent Canadian registered dietitian) most recent column Leslie reviews a number of studies that rolled out of the Archives of Internal Medicine.

Her conclusions, while certainly not shocking, are bang on,

"You need to count calories (not grams of fat), lay off sugary drinks and increase your consumption of fruits and vegetables if you want to ward off Type 2 diabetes"

and,

"Soft drinks, fruit drinks and even fruit juice supply extra calories that can promote weight gain. Research suggests we don't register the calories we drink as well as the calories we eat. Liquid calories don't fill us up, so we don't compensate for them by eating less food."

So why am I bothering to post about this?

Because unfortunately too many allied health professionals are still snowed by the juice industry and fewer still are willing to openly call for the limitation of juice despite the fact that evidence-based nutrition would encourage you to consume your fruits and vegetables, not drink them.

Kudos to Leslie for publicly bucking that trend!

Update on Hospital Cafeteria Food

Just thought I'd bring you an update on what's gone on with the hospital food issue.

Following Don Butler's excellent piece on my hospital food adventures in the Citizen the Canadian Medical Association Journal invited me and that doc I've blogged about from the East coast Rob Stevenson, to co-author an editorial about our experiences.

That editorial, available online was posted last week and in turn that led to a flurry of activity and potentially even some change.

The day after the editorial was published the Quebec Minister of Health Dr. Yves Bolduc announced (link is in French) that he would see to it to ensure that healthy foods would in fact be served in Quebec hospitals. There were also a myriad of articles across the country covering what to most allied health professionals is a no-brainer issue and I was thrilled to see in the comment sections for these articles, it's a no-brainer for most Canadians too who see improving hospital cafeteria options as an obvious, necessary and medically responsible thing to do.

A few days ago I was invited onto Steve Madely's show (hosted by Mark Sutcliffe) to talk a bit further and I was pleasantly surprised that the interview was pretty lengthy and really allowed me to flesh out the issue for the listeners. If you're curious, you can click the player below to hear it (if you're an email subscriber and the player doesn't work, just head over to the blog):

Lastly this coming weekend Dr. Barry Dworkin has invited me onto his now nationally syndicated show Sunday Housecall to discuss this an other issues (you can listen online by clicking here at 3:30pm Sunday August 10th or tune into CFRA in Ottawa).

Who says a few loud voices can't affect change?

Shocker - Kids' Meals in Restaurants have too many Calories!

Apropos to my post from yesterday is a story that broke embargo at noon and honest to goodness, I had no idea it was going to hit.

It was from one of my favourite groups, the Centre for Science in the Public Interest (CSPI), the non-profit nutritional advocacy group who also publish the informative and surprisingly affordable monthly newsletter Nutrition Action (ad free and only $24 per year).

What did they do this time?

They calculated the Calories in 1,474 different kid meals available at big chain fast food and semi-fast food restaurants.

The results?

93% of them had more than a third of the Calories an average child would need in a daytime and 86% were too high in sodium.

So going back to yesterday...if activity rates haven't changed in the past 30 years and obesity rates have tripled.....and if restaurant meals for kids have too many calories as do restaurant meals for adults....and if eating out Calories now account for a full 1/3 of daily kid Calories ya think there be a connection?

Darn tootin'!

Oh, and about the recommendation that when you eat out you should just substitute for healthier fare - two comments. Firstly, healthier does not mean lower in Calories and many foods thought of as healthy may in fact be surprisingly unhealthy. Case in point, substitute chocolate milk for soda and you might well be providing your children with more Calories, saturated fat and sugar than the small soda had in the first place. Secondly, how many of you think your kids will let you get away with ordering Burger King's new apple fries in place of real ones? In addition to? Maybe. In place of? Forget about it.

Easy bottom line here. Worried about your kid's weight? Don't (or only very rarely) take them out to eat.

[BTW, if you live in Ottawa, check out CJOH at 6:25pm where I may well be chatting about this and potentially other nutrition news]

Obesity is NOT about inactivity

I've been saying that forever - the math just isn't there.

Thankfully other people have been out there proving it.

People like Drs. Westerterp and Speakman who in May of this year published a fascinating paper in the International Journal of Obesity.

The paper looked at energy expenditure experiments conducted since the 80s. The experiments were gold-standard style as they used doubly labeled water to track results. Many health professionals, the media and the general public might assume that since obesity rates have risen dramatically since the 80s, energy expenditure (the scientific term for activity) must have declined in turn.

Imagine their surprise to read this paper which showed that not only has the developed world's average daily energy expenditure remained the same, it does not differ significantly from that of the third world (a conclusion also reached in that paper I blogged about that compared the energy expenditure of suburban Chicagoans to Nigerian subsistence farmers).

Given that there are ultimately only two components to energy balance (in and out), and given that "out" over the course of the past 30 years has remained the same, once again I'm going to say if we want to see any progress in the war on obesity it's going to have to come from shifting the focus to "in".

I've Seen this Look Before

It was back in 2006 in the Canadian House of Commons.

Granted the look then also included some anger.

It came from Health Canada officials who were called back by the Standing Committee on Health following my testimony on the Food Guide's inexcusable shortcomings.

About a minute or two after I sat down in the gallery all of a sudden all 4 Health Canada folks turned around and gave me a withering glare.

Can't say I blame them either, I certainly hadn't made their lives any easier.

Fortunately for me, I don't wither easily.

So today for Funny Friday I bring you the dramatic kitty in what I'm sure will end up being a viral internet classic (the video, not this post).

Have a great weekend!

Google Walk

Two Google Map mashups in two days!

This one's by Google themselves.

Basically in North America, if you go to Google Maps and put in two locations you've now got the options for driving directions or walking directions!

Google states that their walking directions will try to be direct, flat, and if available, uses pedestrian walkways.

Of course you'd better hope that Mr. T.'s not driving around your neighbourhood as evidenced in this fabulous ad for Snickers.



Thanks Google!

I Have Something Nice to Say about the Heart and Stroke Foundation

My internal sources over at the Heart and Stroke Foundation tell me that the higher ups over there think the reason I'm so critical of their atrocious mis-information program (Health Check) is due to the Foundation's vocal support of another mis-information program - Canada's Food Guide.

While there's no doubt that the Foundation's support of the Food Guide wasn't an evidence based move, my disgust with Health Check isn't personal - it's professional.

Proof comes here where I've got something nice to say about the Heart and Stroke Foundation as they've cofunded (along with the University of British Columbia) a fantastic new google mashup for Vancouver that helps cyclists pick the best routes.

The mashup, allows google style directions but includes information pertinent to cyclists including:

Major streets vs. alternative streets and dedicated cycling paths

Least traffic pollution

Least elevation gain

Most vegetated route

Shortest path route

Restricted maximum slope

If you're in Vancouver and you're a cyclist be sure to check it out by clicking here. If you're in the rest of the country, let's hope the Heart and Stroke Foundation helps roll it out to the rest of us.

Thanks Heart and Stroke Foundation

Is Exercise Necessary for Weight Maintenance?

Yes, but the much more important question really is why?

Today a new paper in the Archives of Internal Medicine again suggests that exercise is crucial for long term weight maintenance, but I think misses the boat on why.

The paper, written by one of the giants in exercise and its role in obesity treatment and prevention Dr. John Jakicic and colleagues, follows 201 women for 24 months randomizing them into one of 4 different exercise arms (having to do with intensity and duration) and giving all of them Calorie reduced diets.

They then subdivided the results into groups representing percentages of maintained weight loss at 24 months and analyzed scads of data.

Their results and conclusions?

The folks who maintained a weight loss of greater than 10% of their starting weights exercised more minutes per week than those who did not. The authors concluded that the magic number of weekly exercise minutes for weight maintenance therefore were 275 (an average then of 40 minutes daily or an hour 5 days a week).

The thing is, I don't think that's the whole story.

Looking more carefully at the data we can see that on a weekly basis the folks who exercised the most burned only 1,145 more Calories than the folks who exercised the least (illustrating that exercise really doesn't burn boatloads of Calories given that to burn those additional Calories those folks on average exercised 3.5 hours more a week). That's only an average of 163 Calories more burned daily - not much to write home about.

No, for me the story is elsewhere in the data.

Looking at those who exercised the most, on a daily basis they were consuming 444 Calories less than those exercising the least. Extrapolating that and those folks were eating 3,108 fewer Calories a week! That's almost a full pound of Calories less a week! They also had much better scores on an eating behaviour inventory meant to assess weight control eating behaviours.

Translation?

The folks who exercised the most, ate the least and controlled their eating the best and in fact the magnitude of their dietary interventions at 24 months were 3 fold higher in Caloric impact than their exercise interventions.

My conclusion?

Exercise works and is integral to most for weight maintenance, but not via its direct Calorie burning capacity (which is small), but rather through its remarkable ability to cultivate healthy attitudes about weight management and in so doing, support dietary restraint and thoughtfulness for the long run.

Therefore to truly harness the power of exercise, we need to explore how exercise leads these folks to consume less Calories and stick to weight control eating behaviours. If we can figure that out, perhaps we can create interventions that do not in fact necessitate seemingly other-worldly amounts of daily exercise.

Proof NYC Menu-Board Calories Change Behaviour

No, it's not the incredibly quick publication of research - it's a buried statement in an MSNBC news story.

The story of course is about Calories on NYC menus and the "sticker shock" many patrons have when realizing their beloved meals out contain enough Calories to feed a family (as evidenced by the insane numbers in the IHOP menu posted up above).

While certainly many of these stories talk of individuals who will no longer consume their more-Calories-than-a-BigMac muffins and fancy coffees, this piece included another important piece of information.

People are choosing lower Calorie options.

The part that leads me to believe that?

The part where the story reports that T.G.I. Fridays had run out of the "suddenly popular" 290 Calories Bistro Sirloin Salad (the article states it's the "Classic Sirloin" but that's not possible as the Classic Sirloin without sides contains 520 Calories) even before the dinner rush had arrived.

MSNBC also had another tidbit on their site I found interesting.

It's a vote where the question asked was,

"Do you want to know the calorie counts of every cookie, muffin and morsel at the restaurants you go to?"

The politicians who read my blog may find these results particularly interesting.

Out of the 28,587 responses at the time of my visiting the poll an overwhelming 79% said,

"Yes. More information leads to smarter choices."

Sad News - Randy Pausch has Died

I blogged about him back in April.

He's the computer scientist who inspired the world with his moving, insightful and surprisingly positive approach to dealing with a terminal diagnosis.

Unfortunately he died on Friday.

Rest in peace Dr. Pausch, and thank you.

[If you're so inclined, his family has suggested the Pancreatic Cancer Action Network for donations as a tribute to Dr. Pausch. You can donate by clicking here]