Attention Government of Guyana

Anyone out there know anyone high up in the Guyanese government? They need some help.

According to the Guyanese Minister of Health, Dr. Leslie Ramsammy, obesity is becoming a problem over there. An article in the Stabroek News has Dr. Ramsammy quoted regarding their new crisis as well as provides some context for it.

Context wise, turns out just as in North America, it is abnormal in Guyana for someone to have a healthy body weight with 53% of the population being overweight or obese. The survey also revealed that in urban areas 68% of the populace ate out daily.

Their survey also looked at calories. Apparently the Guyanese' average daily caloric intake is 2,849, up from 2,269 in 1963.

Perhaps not so surprisingly given what seems to be a global culture of fear surrounding the talk of calories the Guyanese government's response to their new found crisis is to ignore the calories and instead to promote two things:

1. Increased physical fitness
2. Consuming more than 400grams of fruit and vegetables daily

Um, Minister of Health Ramsammy, do you have an inkling how much exercise a person would have to do to burn the additional 600 or so Calories a day they're now consuming? That's of course also assuming that the estimates are correct, and given that 68% of your urban population eat out daily, and that restaurant food is pretty much always underestimated calorically, that's a stretch. So back to the question, 600 Calories burned = how much exercise?

Well, for mild exercise (walking, gardening etc) it'd be anywhere between 2 and 3 hours daily. Moderate exercise up to 2 hours and intense exercise between 1 and 1.5 hours daily.

Shame though that in your recommendations you've actually suggested to the population that they should strive in fact to eat more not less. Did you know that fruit had calories in it too?

If there were a way to buy obesity futures in Guyana, I'd be calling my broker as I type.

The World's Most Dangerous Pizza

I can't seem to get enough of this pizza as this is now my third (and I hope last) blog post on it. post.

Regular readers will remember the sausage stuffed crust scary looking pizza from Japan. Below is a commercial advertising it.

Well along comes a blog I've not been to before, Fitsugar, that with the help of a translator put together a caloric estimate for this beast.

Ready for it?

Per slice, 646 Calories and 1,344mg of sodium (5,164 Calories for the whole pizza and a perhaps literally brain swelling 10,752 grams of sodium).

Feel free to peruse their calculations here

Does Kellogg's think you're Stupid?

So here is the Nutrition Facts label from Kellogg's original flavour Special K cereal.

It says a serving contains 110 Calories and is 1.25 cups in size. (click it if you need to make it bigger)


Now let's look at the Nutrition Facts label from Kellogg's new Special K Fruit and Yogurt Flavour.

It says a serving contains 120 Calories, but now it's only 0.75 cups in size.



It's examples like this that drive home just how lax, misleading and easily exploitable our current labeling laws are.

Clearly here Kellogg's wants consumers to think that their wonderful new flavour has only 10 more calories than original Special K, when in fact by volume it has almost double the calories (81% more calories per cup of the Fruit and Yogurt flavour).

Let me ask you, how difficult would it be for Health Canada to push for legislation that for instance for cereals would require all cereals have a standard 1 cup serving size label representation? Of course, this is only one example - misleading labeling is everywhere, mainly because Big Food's able to get away with it and because most folks don't take the time to read labels carefully or to compare.

Shame on you Kellogg's for what to me looks like your obvious attempt at deception, and shame on you Canadian government for not having laws that would prevent this type of overt label deception.

So You Wanna be a Goalie?

It's hot in Ottawa. Sticky too.

So today for Funny Friday, I've got a clip to cool you off.

Steve Carell teaches you what it takes to become a great goalie.

Have a great weekend!

Obesity is "socially contagious"

The media will be all over this one.

A study came out today in the New England Journal of Medicine that showed that over a 30 year period people's weights were strongly influenced by the weights of their friends and spouses.

The study followed over 12,000 folks and mapped their weights against their "social networks".

Their research states:

If your spouse becomes obese, your chance of becoming obese rises by 37%

If your adult sibling becomes obese, your chance of becoming obese rises by 40%

If you're a man and your male friend becomes obese, your chance of becoming obese rises by 100%

Don't worry if your neighbours are obese

Don't worry if your opposite sexed friend is obese

Don't worry if you're a woman and your female friends become obese

It's actually a beautifully put together study - from the writing, to the methodology, to the gorgeous diagrams and slick video on the New England Journal website that demonstrates the social march of obesity over time.

So is it important? Does it tell us anything we don't already know?

I don't think so.

Friendships and marriages tend to be forged over commonalities, over shared pleasures.

What am I getting at?

Marathon running teetotaling vegans are far more likely to be friends with marathon running teetotaling vegans than they are with sedentary, beer swilling carnivores and they're probably alot less likely to marry them too.

I think what this study proves beautifully is that lifestyle dramatically impacts upon weight and that friends and spouses dramatically impact upon lifestyles.

So does this study help with prevention and treatment?

The authors think so,

"The relevance of social influence also suggests that it may be possible to harness this same force to slow the spread of obesity. Network phenomena might be exploited to spread positive health behaviors"

I guess what they're getting at is that skinniness may also be socially contagious if harnessed by social networks. Good news is, if the researchers want to, they can simply apply their same statistics and formulae to examine the effects of weight loss in social networks....only problem there is that sustainable weight loss for the most part is a pretty elusive beast.

Bottom line - your friends and spouses likely share your lifestyle more than your neighbours and coworkers, and your lifestyle obviously has a dramatic effect on your weight.

What this study should spur you to do is examine how you spend time with your friends and family. If socializing means going out to dinner all the time or hitting the bars, maybe you can suggest trying some less calorie dense, or even some calorie burning activities.

What this study should not spur you to do is put a sign outside your door that says, "You must be this thin to be my friend".

Another Dubious Honour for Obesity

Saw a press release from the Canadian Liver Foundation yesterday.

Obesity has overtaken alcohol as the number one cause of liver disease in Canada.

Over 1.4 million Canadians apparently have non-alcoholic fatty liver disease or NAFLD.

15% of obese children have NAFLD.

NAFLD can of course progress to non-alcoholic steato-hepatitis or NASH.

NASH can progress to cirrhosis.

Cirrhosis can progress to death.

Sorry, can't think of anything funny to say today.

Will Diet Coke make you fat?

Splashed over headlines and sound bites today will be articles and reports telling you that a new study suggests that if you drink any soft drinks, even diet ones, that your risk of developing high blood pressure, high cholesterol, diabetes and obesity rises dramatically.

Scary stuff, maybe you should immediately pitch your diet coke stash.

Don't throw out it out yet.

So this study, published yesterday in Circulation, looked at over 6,000 folks and their soft drink consumption with the authors reporting that they controlled for age, sex, physical activity index, smoking, saturated fat consumption, trans fat consumption, fiber, magnesium, total calories and glycemic index in asking whether or not consuming soft drinks (diet or otherwise) raised the risk of developing metabolic syndrome (the constellation of symptoms listed above).

The authors concluded,

"In middle-aged adults, soft drink consumption is associated with a higher prevalence and incidence of multiple metabolic risk factors"

and they found this to be true regardless of whether the soft drinks were of the regular or diet variety.

Problem is, there are too many inconsistencies and omissions in this study for it to have any value. Let's go through some of them:

They don't tell us how they tracked calories. They mention controlling for calories in their abstract but then fail to mention in their methodology how exactly they determined how many calories folks in this study were consuming. That's quite an important methodologic piece as if it turns out that folks who drink soft drinks (diet or otherwise) tend to consume more calories, it'll matter how they tracked calories since it's calories that lead to weight gain and weight that leads to metabolic syndrome.

The calories they did track are inaccurate. They reported that folks who drank no soft drinks consumed on average 1,800 calories daily and those drinking 2 or more daily 2000 or so Calories. In what alternate universe is the average per capita consumption of calories in America 1,800-2,000 calories daily? According to the USDA, the average American consumes around 2,700 calories daily and even back in 1970 was still higher than the calories reported in this study. The Food and Agriculture Organization of the United Nations actually thinks the average American consumes around 3,770 calories daily. Clearly if this study's calorie models are flawed, with calorie models based off of reported dietary intakes than dietary intakes are flawed in which case the conclusions aren't valid.

The authors did not control for type of carbohydrates. They kind of did, indirectly, by controlling for glycemic index, but frankly a more valuable control would be for whole grain consumption as its consumption has been shown quite conclusively to minimize the risk of developing metabolic syndrome while the converse is true from refined carbohydrates (the white stuff)

The authors did not control for sodium intake which of course would impact on the development of hypertension (one of the criteria above). Here actually is an argument that might be applicable as many diet beverages do still have salt in them

The authors did not control for meals out. If would certainly seem plausible to me that the folks drinking more soft drinks (diet or otherwise) are the folks eating out more regularly. Meals out have more calories and as a whole more dietary salt, less healthy fats and more refined carbohydrates - all of which contribute to metabolic syndrome development.

The authors could not come up with any commonality to explain the fact that diet soft drink consumption and regular soft drink consumption led to the same outcomes. Unfortunately, without commonality what they've failed to prove is causality and instead have proved association. They did mention "sweetness" of the beverages as a possibility leading people to consume more, but if you remember back to my criticisms on the study's calorie models, they concluded that in fact calories were not statistically different between groups. As well, if they did want to blame sweetness, another control would have to be juice consumption, because if both high fructose corn syrup and aspartame can have the same effect, so too should plain old fructose.

So to sum up, the study's calorie models are flawed at best, the authors didn't control for known confounding variables that have in fact been proven to be contributors to metabolic syndrome and they admit that they can't think of any similarities between diet soft drinks and regular soft drinks that would explain their results.

The ABA (the American Beverage Association) came out with a statement of their own and amazingly, I agree with their conclusions more than this study's.

The ABA states,

"This study doesn't prove any link between soft drinks and increased risk of heart disease. Its assertions defy the existing body of scientific evidence as well as common sense. Even the researchers acknowledge that their study can't support a link."

I couldn't (and didn't) say it better myself.

You may now enjoy your Diet Cokes.

Goodbye Supersize, Hello Hugo-size

In 2004, following the public backlash after the release of the movie Supersize Me, McDonald's discontinued their practice of promoting Supersized portions.

Well guess what? Starting this summer there's a new McDonald's Supersize in town and it's called Hugo.

A Hugo sized soft drink costs only 89cents, is 42oz in size (for us Canadians that means 1.25 litres) and contains over 400 Calories and 31.5 teaspoons of sugar.

Dayna Proud, a McDonald's spokesperson when cornered by the New York Times had this to say about the Hugo,

"People, I believe, tend to drink more during the summer"

and when asked if it were comparable with prior Supersized promotions stated,

"That’s not what this is about, you have to put it in context with the rest of our menu."

Certainly from the ad above, that context is meant to be to buy it alongside an ice cream sunday.

And why Hugo? Because it's meant to make you huge? Because it's so large it makes you want to give people hugs? Because of that character on Lost?

Lastly I wonder if McDonald's will offer apologies to all the Hugos of America whose respective "friends" and bullies now have a wonderful new way to make fun of them.

People will buy anything

Today's Funny Friday post was born in the 80s.

It's a clip from a workout video by Green Childers called Body Flex II.

I'm thinking of buying it myself - laughing's great for your abs.

Have a great weekend!

Big Food's Useless Gesture

Yesterday was awash with news reports of how Big Food is voluntarily planning to decrease advertising targeting children.

They're trying to throw government a bone so as to allow the government an easy out as to why they're not going to legislate any reforms.

So what has Big Food offered?

Well certainly not a blanket ban. Instead it's a company by company, product by product, voluntary (and therefore reversible and unenforcible) series of changes. And apparently it's a ban on advertising during children's shows, but not "family" shows like American Idol which according to a report in the New York Times is watched by 2.1 million children between the ages of 6-11.

For a complete list of the companies involved and their pledges, click here.

Pepsi-Co will only market two products to children - Baked cheetos and Gatorade. McDonald's will only advertise two type of Happy Meals one with four Chicken McNuggets, apple dippers with caramel dip and low-fat white milk, or one with a hamburger, apple dippers and milk. General Mills will stop marketing its Twix cereal, but Cocoa Puffs will remain A-OK to target to kids.

Let's see. Cocoa Puffs for breakfast, baked cheetos for a snack, four Chicken McNuggets, apple dippers with caramel dip and low-fat white milk for lunch, some gatorade while playing XBOX and then for dinner - maybe that rising crust pizza that was advertised last night on American Idol.

What a healthy day.

Thank you Big Food - you guys sure are a big help.

Should we ditch nutrition in schools?

That's what a recent non-scientific study conducted by the Associated Press would suggest.

In the study the AP examined 57 nutrition education programs conducted at schools and of them, only 4 showed anything even remotely resembling a positive result.

Some programs offered kids free fruits and vegetables, others gave prizes to students who ate fruits and vegetables, and most simply provided more in depth nutritional education. All programs were rather time and/or resource intensive.

Sounds discouraging, right? Kids will be kids and just won't change, right?

Maybe. However I can't help but wonder if the problem isn't with the kids, but rather with the programs. I've had the misfortune of being involved in the planning of some of these programs. I say "misfortune" because certainly in the cases where I've been involved the organizers involved in the programs' designs were often a hodge-podge of very well intentioned, but not necessarily expert folks who always want to promote the same old tired, overly simplistic and clearly useless messages of:

Eat more fruits and vegetables

Eat less fast food

Exercise more

Watch less TV

Play fewer video games

Eat less fat

If I was setting up school nutrition curricula, certainly the one thing I would ensure was front and centre was the concept of energy. Calories. People are afraid of talking about calories. I've often heard folks express concern that if we teach kids about calories, we'll promote eating disorders. Never mind that there's never been a study that suggests that teaching calories leads to any sort of disordered eating behaviour; never mind that by teaching calories you could argue you're providing kids with minimum calorie targets thereby perhaps reducing anorexic risks; and never mind of course that calories that are the currency of weight. It's only in calorie blind world where low-fat muffins, fruit juice and smoothies are healthy choices. Teach kids how many calories they need and how to find them and perhaps they'll make different choices.

Don't believe me?

It worked in Pennsylvania with zero additional guidance. Four schools there simply posted calories on their cafeteria menu board and then tracked cafeteria purchases and low and behold, immediately kids started choosing the lower calorie options - the study was published here in the Journal of Child Nutrition and Management. A followup study showed that when you combined school nutrition programs with point of sale nutrition information, students were happier with the school nutrition programs as a whole.

Schooling aside, regular readers of my blog will know that my belief is that the best way to combat childhood obesity is to walk the walk which is why when I counsel parents of overweight or obese children I always provide them with the same message,

"Live the way you want your children to live and then hope for the best"

As far as I'm concerned, the bigger problem here is the fact that adults aren't taught what's healthy or how to maintain a healthy body weight and consequently they're unable to walk the walk for their children. That's also why it's such a horrible shame that the Canadian government decided to put out a Food Guide that spent more time promoting industry in Canada than promoting an evidence-based approach to healthy eating with clear and useful guidance on weight management. I guess for now we should all just keep our fingers crossed that it doesn't take the government another 15 years to revise this one.

A Weight Loss Cult?

It's called the Weigh Down Workshop and since 1986 it has been held in over 30,000 locations around the world. Even more remarkable is the fact that out of this God based diet has grown an actual evangelical church.

I'll get back to the church in a moment, but first let me help you with the question, "How will God help me lose weight?"

Well according to the Weigh Down website,

"God is broken hearted over the fact that so many of His children have learned to run to the food instead of to Him for comfort, companionship, and acceptance."

"God does not care about what we eat, so we should no longer feel self-righteous about following any man-made rules. Instead, what God cares about is how much we eat; He cares very much about - and is displeased with - overindulgence."

"Typical diets have not worked because everyone is using man-made rules instead of God’s rules. God has never asked anyone to eat food off of a list, count fat exchanges, or take an appetite suppressant! Weigh Down doesn’t have any of those things. What we DO have is a future-a future to be filled and fulfilled. Hunger will be filled and appetites will be under control, given to God."

Ok, a little weird that these folks feel that God cares how much I eat, but to ask God to help them with weight loss, what's wrong with that?

Nothing.

Interestingly however, the Weigh Down Workshop actually spawned a church called the Remnant Fellowship (130 worldwide and growing) and on the Remnant Fellowship website they describe the role of the Weigh Down workshop as,

"The Weigh Down Workshop Productions creates the Bible material for its members and is the evangelistic arm to these Churches that are now scattered across the USA, Canada, Europe and Australia."

Now I'm no cult expert, but Rick Ross is and The Rick Ross Institute has a collection of articles regarding the Remanant Fellowship including some which detail how the church apparently teaches that over eaters court eternal damnation.

Oh, and did I mention that the Church was featured prominently in the beating death of an 8 year old by two of its members? Apparently the Church is a big fan of corporal punishment for children. They funded the defense of the two parishioners Joseph and Sonya Smith who were each given life plus 30 years for the death of their son who prosecutors said was kept locked in a wooden box and confined to a closet for hours at a time before he died in October 2003 from a blow to the head. The Church has stuck by the convicted parents and have set up a website to help pay for their appeal.

So let me get this straight, their version of God hates over eaters and damns them to an eternity burning in the fires hell but has a soft spot for child abuse?

I think I like my version better.

Stupidest Treadmill Ever

If you ever feel a need to look patently ridiculous, you need look no further than this treadmill by Oooms.

Called the Rollator, walking on it causes its wheels to turn thereby propelling you forward. What this means of course is that you can only use it outdoors and you can use it to get from one place to another.

You know what else does that?

Walking.

A video of this sublimely stupid product below.

Dizzy Boxing - my new Favourite Sport

This week has seen an influx of new subscribers to my blog thanks in part to its being picked up by CTV's Mednews Express blog (they grab the posts they want).

For those of you new here, Fridays are my day off indignation. Around here Fridays become "Funny Fridays" where usually I find some bizarre clip from YouTube to brighten up your day.

Email subscribers, you've got to log on to the blog itself to watch the video.

So without further ado, here's a video of perhaps my new favourite sport. It's called dizzy boxing and here's how you play. Get spun by a giant machine in a circle for a while, get released and run down a narrow plank towards your opponent (who for good measure, is wearing a dress), try to hit your opponent without falling off the plank because if you do you should know, the water surrounding you below is scalding hot. If you do fall off, hurry out of the water because just outside of the pool is a big bowl of ice that you can jump in.

I think we should petition the Olympics for inclusion.

Have a great weekend!

Are Antioxidants Dangerous?

Since the late 1980s antioxidants have been heralded as molecules that are dramatically important to our health. Multivitamins shout their antioxidant concentrations on their labels and food and beverages are promoted based on their antioxidant properties.

Antioxidants work by neutralizing free radicals, the byproducts of oxidative stress in the body - put simply, they are supposed to be working to protect us by neutralizing dangerous and damaging molecules that have been touted as being theoretical culprits in a myriad of disease processes.

This week a study was pre-released by the Annals of Internal Medicine that looked at the long term effects of selenium supplementation on the risk of developing diabetes. The reason researchers chose selenium is because it's a potent antioxidant and oxidative stress has been proposed as an important mechanism in the development of insulin resistance and diabetes and therefore researchers postulated that if they provided folks with more protection against oxidative stress, it might translate into protection against diabetes.

What the researchers found was that the more selenium provided to the study patients, the greater their risk (yes, I did say greater) of developing diabetes.

So what's going on here? I thought it was supposed to lower risk.

What's going on here is further proof that common sense does not dictate treatment response and that our bodies are big black boxes that don't always behave as predicted.

Interestingly that can be said about a few other heavily promoted antioxidants.

Beta-carotene, once expected to be a contender at reducing the risk of cancer development was actually shown to increase the risk and rate of lung cancer growth in Finnish smokers.

Vitamin E, once expected to help reduce the risk of heart disease, Alzheimer's, cancer and more, was shown in fact to be associated with increased rates of all cause mortality and increased risk of congestive heart failure.

At the end of the day, I'm not suggesting you should immediately stop your antioxidant containing multivitamin. The risks we're talking about here are far from astronomical and there may indeed be benefits to other disease processes. I do however think that consumers need to bear in mind that we really don't have nearly the understanding that folks think we have in terms of how individual micronutrients impact on our health and simply because something theoretically sounds healthy, doesn't make it a smart choice.

My recommendation is to remember that while we might still lack data about the individual components of food, where we've got a great deal of data is about food itself. Diets higher in fruits, vegetables, whole grains, nuts and fish and lower in red meats, refined carbohydrates and salts indeed have been shown to reduce the burden of chronic disease.

Focus on your food, not on your vitamins.

Menu Board Calories Arrive in New York

On July 1st, a new regulation passed by the New York Board of Health required chain restaurants to put calories on menu boards. The menu board above is the first to comply and not too surprisingly it comes from Subway, a chain that has long since been banking on nutritional disclosure.

The food industry as a whole however is not as welcoming of this regulation as Subway and in fact most chains are refusing to comply and in fact are busy suing the city in federal court.

In Canada a similar law was rejected by the House last year during its second reading following massive pressure by the food and restaurant industries to reject it.

If passed it would have certainly necessitated significant menu changes when shocked Canadians would have demanded lower calorie options as it doesn’t take a degree in dietetics to recognize that many of the foods that are out there have absolutely astronomical numbers of calories in them.

Back in 2005 I participated in a Think Tank on obesity in Toronto and I asked Sherry MacLauchlan, the Manager of Government Relations for McDonald’s Restaurants of Canada what McDonald’s position on menu board calories were and she responded that McDonald’s felt it would be too confusing to have all those numbers on the menu boards and that they would be impossible to read and navigate through.

It’s an argument that clearly has trickled over to the States as well and the Center for Science in the Public Interest has a great exhibit on it that includes a legal brief from Dunkin’ Donuts regarding New York City’s new regulations that included a mock menu board proving how difficult it would be to fit in calories (see below).


Indeed, in that mock up it is quite difficult.

The Health Department’s in house graphic artist caught wind of this and immediately whipped together a mock up of his own (see below)



Looks pretty easy to follow to me.

The restaurant industry is running scared because at the end of the day, industry, unlike government, responds to demand. In this case the demand will be for lower calorie items that actually taste good. For the industry that’s going to translate into money spent on research and development, and eventually for us it will hopefully be one more step towards a shrinking nation.

For the food industry, ignorance is business, for the public it might be bliss, but for your weight - ignorance is risk.

The Baconator

Heart attack waiting to happen.

6 strips of hickory smoked bacon, 1/2lb of beef, 2 slices of cheese, mayonnaise and a giant bun.

830 Calories, 50% of calories directly from fat, 2.5gr of trans fat and 1,920mg of sodium.

(Add a medium fries and a medium coke (a combo) and you're up to 1,470 calories, 71 grams of fat and 2,350mg of sodium.)

The Baconator

Thanks Wendy's.

How to Choose a Weight Loss Program

So let's say you have decided you want to try to lose some weight and that you've also decided that you'd like some help - who should you call?

Unfortunately I know of no country that regulates the weight loss industry. I say unfortunately because literally for centuries, weight loss scams and snake oil salesmen have been commonplace.

Some programs have celebrity endorsements - of course that doesn't mean that the celebrity has used the program or products. Just last week Rachel Hunter, new spokesperson for Slimfast admitted to Newsweek that she'd never even tried any and in fact the closest she could come to saying that she might try their product (though certainly her weight does not carry with it much in the way of medical risk) was this statement,

"I'm kind of more than willing to try their product."

Currently I'm working on a short set of questions to ask when considering a weight loss program based on some simple truths and principles regarding weight loss. As soon as they're done, I'll post them up here, but until then, there's a very extensive checklist/fill in the blanks document published by the FTC which you can print out and bring with you to any weight loss program you consider.

Some for sures:

1. Don't join a program that makes you pay up front and doesn't offer refunds
2. Don't join a program that makes you sign a contract or guarantees your weight loss
3. Don't join a program that requires the purchase of products of supplements
4. Don't join a program that has you eating fewer than 1,200 calories daily
5. Don't join a program that can't explain their success rates through a maintenance period.

To print up the FTC's checklist, click here.

Please Don't Let my Daughters Turn Out Like This

This one's another clip that's been floating around a long time.

It's so over the top I do wonder if it was staged.

It's about a teenager who's surprised by her family with her new Saab convertible as a birthday gift.

I should take this time too to wish our trainer Kelly a belated Happy Birthday and hope that this year affords her the time to train to the point of being faster than my wife.

Have a great weekend!

Is Avandia Safe?

If you're a diabetic and on a medication called Avandia (Rosiglitazone) and you read the news you're probably pretty scared. A few weeks ago a study came out in the New England Journal of Medicine that concluded, via a meta-analysis of other studies, that taking Avandia increased the risk of severe cardiovascular disease or death from cardiovascular causes by 8%.

I read the meta-analysis and I'll be honest, my knowledge of medical statistics was insufficient to truly decide how scary this all was. I chose to start taking my patients off Avandia and putting them on other medications figuring that until the issue is more firmly established one way or the other, I'd err on the side of caution.

This week the New England Journal of Medicine invited a diabetologist, a cardiovascular epidemiologist, and a drug-safety expert to give their opinions on the study and their views are available on the New England Journal's website for free here (scroll down to the editorial content and click on the free full text links).

Their conclusions?

Same as mine (but with their knowledge of statistics and study design backing them up) - given that there is certainly uncertainty regarding Avandia's safety and that alternative drugs for diabetics are readily available, it would seem prudent to consider switching patients off Avandia.

If you're a patient taking Avandia I would not recommend stopping it on your own. Go and see your physician and discuss it with them. If you were to stop it on your own without an alternative your sugars may climb dramatically high which certainly carries with it far more established and dramatic risks than staying on the Avandia for the extra few days it may take you to set up your appointment with your doctor.

Big Milk Hasn't Backed off Weight Loss Claims

Big Milk is still promoting the ridiculous concept that drinking 24 ounces of milk (the caloric equivalent of 27lbs a year of skim, 37lbs a year of 2% or 43lbs a year of chocolate milk) will magically help you lose weight.

If you remember, back in May Big Milk (specifically the National Dairy Council in the States), admitted that there was insufficient evidence to suggest that milk consumption has any benefit in weight control, and in response to pressure from the Federal Trade Commission agreed to back off on those advertisements.

Well it's now two months later and their obscene website is still up and running and going strong. The entire site is dedicated to the premise that milk causes weight loss as they state,

"The current body of research supporting dairy's role in weight management includes randomized clinical trials (considered the "gold standard" of science), observational, animal and cellular studies conducted by leading research institutions throughout the country."

This post is for the benefit of my American readers - if you'd like to petition the FTC to actually do something, please complain.

Click here to be linked to the FTC's online complaint form.

No Marijuana Weight Loss Drug Yet

So last week Sanofi-Aventis pulled their marijuana receptor based drug rimonabant from the FDA's application process.

It seemed that the drug, widely touted as the next great thing in medical weight loss, worked alright as a weight loss aid but had the nasty habit of inducing psychic side effects including suicidal ideation.

Rather than risk getting rejected from the FDA (I imagine that would hurt sales in the EU where the drug is in fact approved), Sanofi pulled the application.

Sanofi had sunk a tremendous amount of money into the research and development of the drug and shares dropped close to 5% on the news.

Sanofi had predicted over $3 billion per year of global sales of the drug and spent tremendous amounts of money marketing it even before its eventual non release in the States. I remember they were the only booth at the last Obesity Society conference with red carpets, plasma screen televisions, slick handouts and for some odd reason, frozen yogurt bars.

Bottom line here, while certainly I'd welcome a weight loss medication that was safe, effective with little in the way of side effects, it doesn't appear that we're too much closer.

Help Wanted

So no formal post today (it's a long weekend in Canada) but I thought I'd use the blog to advertise a job working with me and the other folks over at the Bariatric Medical Institute located in Ottawa, Ontario Canada.

Our great front desk person has decided to go back to school and consequently we've got an opening.

Knowing that I have a fair number of readers in Ottawa I thought I'd advertise the position here.

It's a full time position.

Here's our ad from the paper,

"We are looking for someone who loves working with people, is great at multi-tasking, is a team player and thrives off of challenge and responsibility. Our professional, holistic and unique medical office is looking for an office Administrator/Receptionist to join our team and our extremely positive and upbeat work environment. You will be responsible for answering 3 very busy lines, booking appointments, dealing with payments and most importantly playing an important role in overall patient relations.

Working with us you will have access to a full gym facility as well as shower and change rooms. Physical activity and healthy living are the primary focus of our work and therefore we view your active lifestyle as a great asset.

Our offered salary is highly competitive and includes a generous benefits package while the position has ample room for growth into an office management position.

We look forward to meeting with you."

If you or someone you know might be interested please send or have them send their resume to jobs(at)bmimedical.ca.

Thank you!

Grow Op Surprise

Hat tip to Jimmy Kimmel for this one - a clip from a local news channel's coverage of a burning marijuanna grow op. Stay tuned for the interview with the fire fighter at the end.

Have a great weekend!

(as always, email subscribers must head to the blog itself to watch the clip)

My Take on Body Fat Percentage Scales

Short version - don't buy one.

Here's the longer version.

You've all seen them, and I'm sure many of you have them - the scales where you take your shoes off and magically it tells you your body fat percentage.

The scales work via bioimpedance analysis which involves a small electrical current being passed through your body from foot to foot. The signal travels through the various components of our bodies (fat, muscle, bone) and the time it takes is measured by the scale. The more water there is in the tissue, the faster the transmission and because fat has less water content than muscle, the more fat you have, the slower the electrical current travels and the more fat is registered by the scale.

A good body fat percentage scale will have an error range of at least 4% and frankly you can affect more error by varying your hydration level.

So why don't I like them? Wouldn't it be a good thing to know your body fat percentage? Umm, why would that be a good thing? Would it change anything? Would you live any differently or choose any differently if you didn't see those numbers going down?

The answer to the above questions should be "no", because regardless of your body fat percentage what I'd be recommending you be doing is living the best lifestyle that you can enjoy.

What many folks don't know buying a body fat percentage scale is that body fat percentage changes slowly - very slowly and frankly aside from exercising and losing weight, there's really nothing for you to do to bring that number down. Add in the wide range of error that these scales tend to have and now you've got a tool in your bathroom with the potential of providing you with daily discouragement utilizing a number that you can't do anything specific about to change. Not so smart.

A good practice for a physician is not to order any test that you're not prepared to act on or where the results will not add to the person's health and well being. In my mind body fat percentage is just such a test.

I'll reiterate the goal that I tell everyone in my program is the only goal worth having,

"Live the best life you can enjoy, not the best life you can tolerate."

Sure there will be days with more calories and days with less exercise, but that's real life and in real life, if you're living a life you don't enjoy (a diet for example), eventually you'll decide to stop living that way. Knowing your body fat percentage will only confuse that goal.

Health Canada says Nachos are Healthy

Even for Health Canada, this is astounding.

So apparently for the past few years Health Canada has had a program called the Healthy Cafeteria Program, which according to an internal document from Statistics Canada involves a program that,

"promoted offering more healthy choices or alternatives to the foods regularly served in workplace cafeterias. Besides providing employees with an environment that supports healthy eating, the Healthy Cafeteria Program also gave employees easy access to information necessary for making better food choices."

Sounds good right? It gets even better. Lorne Murphy foods, the company responsible for the cafeteria at Jean Talon and Statistics Canada were awarded the Eat Smart! Award of Excellence from the City of Ottawa for their adoption and promotion of healthy eating in the Jean Talon cafeteria through the Healthy Cafeteria Program.

"One of the goals of the Healthy Cafeteria Program was being able to obtain the Eat Smart! Award of Excellence. This award certifies that Statistics Canada and Lorne Murphy Foods Ltd. have met (and in many places, exceeded!) the nutritional and food safety standards of the workplace cafeteria program."

I'll get into how useless Eat Smart! is another day, but today let's focus on the green checkmark in screen capture above.

If you look back at the picture at the top of the post you'll see a little green checkmark next to the Nacho Supreme (you can enlarge it by clicking on the picture). According to the Healthy Cafeteria Program and Lorne Murphy Foods, winner of the Eat Smart! Award of Excellence from the City of Ottawa that little checkmark represents the day's entree that is "low fat" and presumably is the "more healthy" choice and an example of the stellar work being done by the Healthy Cafeteria Program and their collaboration with Statistics Canada and Lorne Murphy Foods in the promotion of healthy eating and the provision of information to employees to enable them to make "better food choices".

So how much of a better choise are these nachos? I emailed Lorne Murphy foods and they were kind enough to provide me with the nachos' partial nutritional breakdown,

"In response to your inquiry, depending on the toppings you have, you are looking at approximately 1000 - 1200 calories and up to 2000 mg of sodium per serving of Nacho Supreme."

If promoting a 1,200 calorie lunch with more than a full day's worth of sodium as a healthier choice doesn't scream out to Health Canada and Eat Smart! give me an award of excellence, then I don't know what does.

Good Lord!

Unhealthiest Food Ever?

Hat tip to Julie over at her web log It Must Have Been Something I Ate for finding this informative video on what perhaps is the unhealthiest food I've ever seen - bacon dipped in batter, deep fried and served with gravy.

My favourite part of the clip is when the reporter states that the food's inventor Frank Sodolak is,

"force feeding America a much needed dose of of personal responsibility"

(Remember, email subscribers have to head to my actual blog to watch the clip)

Heart and Stroke Foundation's Fatal Trans Fat Flip Flop

In June 2006, the trans-fat task force, a joint undertaking between the Heart and Stroke Foundation and Health Canada, came out with their unanimous recommendations. They recommended that trans-fats be removed from Canada's food supply using a regulatory approach.

Not surprisingly given their lead role in the task force the Heart and Stroke Foundation (CEO Sally Brown was the task force's chair) has a position paper on their website dated November 2006 that states unequivocally,

"The Heart and Stroke Foundation of Canada recommends that the Federal government implement the recommendations in the Final Report of the Trans Fat Task Force (2006)†, which was co-Chaired by the Heart and Stroke Foundation of Canada and Health Canada."

In fact, over the course of the past year, the Heart and Stroke Foundation and CEO Sally Brown have made a very strong case for the implementation of a regulated approach to trans-fat elimination from the Canadian food supply. Here are a smattering of quotes and sources:

"Taking all the evidence into consideration, the task force agreed to a regulatory approach to effectively eliminate transfer in all processed foods"

Sally Brown, CBC News Jun. 28, 2006

The task force took many factors into consideration and was careful in choosing the limits and timeline that it did"

"When you're changing public policy, you have to come up with a solution that is doable, practical but meets your outcomes and that's what we very much tried to do"

"We believe if these regulations were promulgated, Canada would become a world leader in this area"

Sally Brown, Vancouver Sun Jun. 28th, 2006

"The problem is, without regulations, we won't get everyone on board and it's harder to get product changes. Unlike french fries, with something like doughnuts and chocolate bars, you have to take it out of the formulation which is more difficult. We needed regulations uniform across both sectors"

Sally Brown, Vancouver Sun Nov. 1st, 2006

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

"We know that the government is taking our recommendations very seriously, but we also know that they're getting some push back from industry who traditionally don't like regulatory approaches"

"Our argument is, if you don't regulate it, it'll be piecemeal"

"We also say that by regulating it, you're sending a signal to the marketplace to ... create healthier oils."

"We think we've given the government a great opportunity to implement what was a consensus report," she said. "[The food industry] supported all the recommendations, they're ready to act. Now we need the government to act."

Sally Brown, National Post Jan. 11th, 2007

"We don't understand why the federal government has not moved on this important health issue,"

"We want this toxin - which is what it is - removed from our food supply"

"Canadians are consuming on average 2.5 times the daily limit, and in some age groups, much higher than that"

Sally Brown, CNews, Apr. 5th, 2007

"could account for between 3,000 and 5,000 Canadian deaths annually from heart disease"

"The longer we wait, the more illness and in fact death will happen, so we know we have to get it out of our food supply"

"There is no safe amount of trans consumption, but many of these foods are well past recommended limits."

Sally Brown, The Windsor Star, Jun. 5, 2007

So to summarize Sally Brown and the Heart and Stroke Foundation's very clear position on trans-fat and Canada, they wants trans-fat, a toxin with no safe consumption level, responsible for thousands of deaths annually, removed from the food supply via regulatory means because if its removal is not regulated not everyone will be on board, removal will be piecemeal and the longer we wait, the more illness and death will happen.

So then please can someone explain to me why when on June 19th, Tony Clement reported that the government will be ignoring the clear cut recommendations of Sally Brown's trans fat task force, trading a regulatory approach to trans-fat removal for a two year, please, pretty please, request to the food industry to remove trans fat that Sally Brown, CEO of the Heart and Stroke Foundation came out with this press release,

"The acceptance of these expert, consensus recommendations moves us one big step closer to the elimination of processed trans fats from our food"

Sally Brown, Toronto Star, Jun. 21, 2007

Umm, Ms. Brown, didn't you say just two short weeks ago that the longer we wait the more illness and death will happen? Didn't you also express your genuine and valid concern that without regulation not everyone will be on board and that removal will be piecemeal and that there's no safe level for consumption?

Ms. Brown, why have you replaced what should have been indignation with accolades?

Contrast Ms. Brown's roll over and play dead response to Tony Clement's inaction press release with that of Mr. Bill Jeffery from the Center for Science in the Public Interest. He was also a member of the task force and felt just as strongly as Ms. Brown once purported to about the need for a regulatory removal of trans-fat from our food supply,

"Since the Trans Fat Task Force called for regulatory limits on industrial trans fat in foods in June 2006, at least 2,000 Canadians have died from trans-fat induced heart attacks. Yet, Minister Clement gave the entire food industry a two-year free-pass for voluntary action and says he will let all companies off the hook completely if, by June 2009, only 75% of certain products comply with the limits proposed by the Task Force. Minister Clement’s long inaction and flimsy standards for corporate responsibility pay a king’s ransom for the government’s relations with food companies."

Bill Jeffery, CSPI Jun. 20th, 2007

Shame he's not the CEO of the Heart and Stroke Foundation.

Introducing the iRack

This one's been floating around for some time.

It's MadTV's Michael McDonald as Apple's Steve Jobs presenting their latest product, the iRack.

Have a great weekend!

Health Canada Ignores Own Recommendations

On June 6th, 2006 Health Canada's trans fat taskforce published its recommendations to Health Canada.

They recommended,

"Foods purchased by retailers or food service establishments from a manufacturer for direct sale to consumers be regulated on a finished product or output basis and foods prepared on site by retailers or food service establishments be regulated on an ingredient or input basis.

For all vegetable oils and soft, spreadable (tub-type) margarines sold to consumers or for use as an ingredient in the preparation of foods on site by retailers or food service establishments, the total trans fat content be limited by regulation to 2% of total fat content.

For all other foods purchased by a retail or food service establishment for sale to consumers or for use as an ingredient in the preparation of foods on site, the total trans fat content be limited by regulation to 5% of total fat content. This limit does not apply to food products for which the fat originates exclusively from ruminant meat or dairy products."

Yesterday, one year later, Tony Clement provided the government's response,

"We are giving industry two years to reduce trans fats to the lowest levels possible as recommended by the Trans Fat Task Force. If significant progress has not been made over the next two years, we will regulate to ensure the levels are met."

Here's my non-spun version of this statement, "We've stalled for one year, now we're going to stall for two more years and hopefully by then all this hubbub on trans-fats will die down and we can avoid upsetting the food industry for a few more years".

So how is the food industry responding to this remarkable lack of action and incredible turn of luck for them? Here's the headline of the Canadian Restaurant and Foodservices Association of Canada's response to Tony Clement's gift to them,

"Foodservice industry applauds Minister of Health for action on trans fat"

and from Food & Consumer Products of Canada,

"Food Industry Supports Government of Canada's Trans Fat Elimination Plan"

Here's a basic rule of thumb. If the food industry applauds your recommendations they probably had a hand in shaping them.

Once again, shame on Health Canada.

Do you have Sleep Apnea?

I guess the first question should be, "Do you know what sleep apnea is?".

Amazingly, despite its clear causal association with hypertension, memory disorders, and obesity and the associated increased risk of sudden death, motor vehicle accidents and depression, many folks with sleep apnea don't know what it is.

Put simply, sleep apnea involves a person repeatedly stopping breathing during sleep which in turn causes them to not enjoy restorative sleep and to have low levels of oxygen in their bloodstream.

There are 3 types of sleep apnea: Obstructive, central and mixed with obstructive being far and away the most common and the one directly related to weight with the weight of a neck actually causing collapse or narrowing of upper airways during sleep.

Testing usually involves suffering through a terrible night's sleep at a sleep lab (though I'm sure some are lovely and don't involve trying to sleep through the chaos of a hospital) and then treatment usually involves sleeping with something called a CPAP mask that uses air under pressure to continually keep airways open.

Folks with successfully CPAP treated sleep apnea will almost always report that they can't imagine ever living without their CPAP machine because it has so dramatically improved their quality of life.

A person with sleep apnea might complain of NEVER feeling well rested, morning headaches, memory disturbances and daytime sleepiness. Their partner might complain of loud snoring (though snoring is not a must) or actual witnessed apnea events where they watch their partner stop breathing for up to a minute at a time.

The problem in Canada is that sleep labs are sometimes difficult to get to, especially in rural areas. Recently a company in Canada invented something they call a "Sleep Strip" which is actually a very sophisticated device that helps to screen for sleep apnea in your own home. It's the device pictured at the top of this post and it's available for sale at their website for $49.99.

[Hat tip: Robert]

UPDATE: Robert tells me that it's actually NOT a Canadian invention but rather an Israeli one.

90 Calorie Life-hacked Cupcakes

Lifehacker's a fabulous website that offers up "hacks" on how to do things better from day to day life and quite a ways back they posted what I felt to be a very interesting dietary substitution.

You know substitutions I'm sure - apple sauce for oil, Splenda for sugar etc., but this one was really quite unique and specific to of all things, cupcakes.

The recipe is simple:

1 box cupcake mix
1 can of your favourite diet soda

All done.

Honestly, the diet drink is supposed to substitute for the water, eggs and oil.

I've been meaning to try it, but haven't got around to it so thought I'd throw it up here (no pun, honestly, no pun) and hope that one of my readers might give it a go and give us a comment. Icing wise Lifehacker recommends light cool whip (with some food colouring)

Apparently the average box of cupcakes will yield about 2 dozen 90 Calorie cupcakes.

Let me know how it goes!

Make Up Your Own Mind

Ever wonder how McDonald's would answer questions like,

"Why do you target children with unhealthy foods when there is an obesity crisis already?"

and

"Isn't the high level of advertising aimed directly at children questionable and unfair on parents?"

Well then have I got the site for you: Make Up Your Own Mind is actually a McDonald's website run out of the UK where you're allowed to submit any question you want and McDonald's will "answer" it.

I put the word "answer" in quotations because the sites answers are just empty spin doctored responses.

For instance, here's McDonald's answer to the targeting children with unhealthy foods question,

"McDonald’s has always been aware of the context in which it operates and the need for it to meet the requirements of society and customers in the food and experience that it provides. That’s why over recent years, the company has added new choices to its menu, such as Organic Semi-Skimmed Milk, Orange Juice, Vittel Water, Fruit Bags and Carrot Sticks, changed the recipes of popular food items such as Chicken McNuggets to reduce salt, fat and sugar and introduced better nutritional information without undermining the great taste that people know and love. You may be aware that the Food Standards Agency has devised a nutritional model that profiles food by its fat, salt and sugar content and will inform which products can or can’t be advertised directly to children. The majority of Happy Meal items (with the exception of the Cheeseburger, Milkshakes and non-diet fizzy drinks) are all rated as not being high in fat, salt and sugar."

The site's actually a hoot. The questions certainly are candid and the responses really demonstrate the need to duck and bob. Try to think how you might, as corporate McDonald's, answer these questions (taken directly from the site):

How is it that the pictures above the counter in your restaurants look so much better than the food that you supply your customers with? Isn't this blatant misrepresentation?

did u know that your products contain too much salt, sugar and fats? and that all that is not good for our physical bodies?

if you ate McDonald's everyday could you die

On t.v a man ate McDonald's for a whole month and he died. I think it would just kill people if they ate it more than 1 every 2 days. Is it true that your food is full of badness?

Why is it that it has taken the rather large amount of bad publicity for your food to actually start you looking at your menu's? Isn't it just reactive? when surely you have a responsibility to be proactive?

Why do you think you have such a bad reputation - and I mean terrible, you are reviled, ridiculed and abhorred - among educated people int his country (UK)?

More people die each year from illnesses relating to obesity than those relating to smoking. Tobacco companies are banned from advertising but McDonald's are not, whats more the obesity is actively encouraged by way of the 'Make your meal bigger' promotions. How do you feel about this? Guilt?

Anyone know how I could submit, "Answer writer for Make Up Your Own Mind" as a suggestion for a feature on that Discovery Channel show Dirty Jobs? Those folks' arms must be pythons from slinging so much bullsh*t.

[Hat Tip: Stefan]

Best commercial ever

Marketing is a very difficult thing. Ads you think will do well often don't and ads you're not terribly excited by often shine.

Ads need to provide you with very specific messages and provide you with an emotional call to action.

I imagine this one filled night tables across Europe.

Have a great weekend!

Set Point Theory

Yesterday someone in the comments asked me what I thought about "Set Point Theory".

What set point theory suggests is that a person's body, metabolism and caloric drive strive to maintain a specific preset weight and therefore if your "preset" weight is high and you lose weight, your body will just try its darndest to gain it back.

I think it's an asinine theory.

Some obvious problems (one pointed out quite rightly by the comment yesterday):

1. Why have the world's setpoints gone up dramatically over the course of the past 50-100 years?
2. Why is the world getting bigger so much faster (are all of our setpoints 1,000lbs?)
3. Why do the setpoints of indiginous peoples (like the Pima Indians) seem to change the moment they step into North America?

Set point theory is something that allows folks and governments to take even less responsibility in treatment design and implementation.

Now it is indeed true that as the body loses weight it does compensate in multiple ways to try to preserve the weight it's losing. The body of course perceives weight loss as an environmental threat - an ice age or a flood or something, and so it jumps into action and changes the way the body handles certain processes, decreases something called the thermic effect of food and basically tries to hold on but it doesn't throw any magical switches to get folks to open their freezers and cupboard doors.

I don't completely discount the whole theory however. I do believe that there is a range of weight within which a person can comfortably live, but I also believe that range is very wide and it depends not only on the genetic makeup of the individual, but also his or her learned and fixed environment.

You might even stretch and say that I do believe in set point theory, but in my own version of it - I'll call it Life-Set Theory with weight being primarily lifestyle related.

People regain their weight as they regain their old lifestyles.

I say this to new patients daily,

"The more weight you'd like to permanently lose, the more of your lifestyle you'll need to permanently change"

The problem is, most weight loss efforts don't really do much to address lifestyle. Weight loss usually involves a food regime - either overt overall restriction and hunger or the magic food approach of this food's good and that food's bad. Those approaches are of course non-sustainable becase they invoke the suffering of hunger or of blind, thoughtless restriction. Any weight lost through suffering will be gained back when the suffering stops and the person reverts back to their prior life that might have led them to have weight to lose, but was easy to live.

The environment also of course matters. Look at the Pima Indians - heaviest people in the World in Arizona and healthy weights back home in Mexico. I'd imagine this would work in reverse too. For example, take someone who's lost weight with a restrictive approach while working a sedentary job in an urban environment and plop him or her down on a farm where they've got to work all day long and there's no access to food other than what they cook and grow themselves. Do you think their "set point" will have them magically gain? Of course not, because their environment no longer allows for their prior calorie rich lifestyle.

So to sum up this rant. For me lifestyle dictates set point. Change your lifestyle and eating patterns (combining hunger prevention strategies like frequent eating and increased protein with calorie awareness and an explicit lack of forbidden foods) and you've definitely got a shot, but do remember with lifestyle change it's not necessarily the changes that are difficult, it's change itself.

More Weird Searches

A while back I posted a top ten list of weird searches that landed people on my blog. I decided this morning after seeing someone found me by searching for, "How many people die from choking on bacon?" that it was time for another list.

Here are ten more very strange searches:

1. Mcdonalds "snack wrap" diarrhea
2. Does red meat stay in my stomach?
3. Safe to give toddlers coke chocolate?
4. Calories in smell
5. This dog won't hunt overweight kids
6. Uses of coca cola as medicine
7. Rejoice underwear canada
8. How to quit atkins?
9. "coke plus" diarrhea
10. Space alien medicine.

So if those folks are still trolling around here...diarrhea guy, I hope you're feeling better. Please don't give your toddler coke chocolate. Don't worry about calories in smell (there aren't any). Coca Cola is not a medicine. I'm glad someone really likes underwear. And if you want to quit Atkins please try eating some bread.

Big Milk - Fastest Spin Doctors in the West

That sure didn't take much time.

Just last week a study was published in the American Journal of Clinical Nutrition that looked at vitamin D and calcium supplementation and risk of cancer. The study was fairly short at 4 years and somewhat small with only 1,179 total subjects. Subjects were randomized to receive either a calcium supplement or a calcium supplement plus vitamin D or a placebo. The results suggested that calcium and vitamin D supplementation in post menopausal women slightly lowered the incidence of cancer.

So fantastic let's all drink milk right?

But wait a second here, the study didn't look at milk did it? This small, short study looked at vitamin D and calcium supplementation.

And wait another second, weren't there in fact studies that looked specifically at dairy consumption and cancer risk (rather than calcium and vitamin d supplementation and cancer risk)?

If I remember correctly, didn't those studies actually show increased risk of cancer development with increased dairy consumption? There was the meta-analysis that suggested higher dairy consumption was actually associated with increased risk of aggressive prostate cancer and another showing that consuming the equivalent of 3 glasses of milk daily led to a 25% increase in the risk of ovarian cancer.

Did that stop the Big Milk spin machine? Absolutely not.

Yesterday there was a Big Milk press release that originated from the global PR firm Weber Shandwick. In it their press release entitled, "Boosting key milk nutrients may protect against cancer" Big Milk suggests, guess what, that you should drink more milk to get more vitamin D to prevent cancer.

The press release explicitly recommends that you drink 3 cups daily which even if it were skim milk would provide you with 24lbs worth of skim milk Calories a year and lead you to consume a beverage linked to prostate cancer, ovarian cancer, and if you remember from a recent post, Parkinson's disease.

Don't you think it might be smarter to just take a zero calorie 1000IU Vitamin D supplement instead?

You Know you're Hardcore When....

You know I like exercise.

A few weekends ago we had 64 patients run the Dr. Freedhoff Challenge triathlon through Somersault. Two weekends ago we had 4 patients run the National Capital Marathon, 2 run half-marathons and a whole bunch run a 10km run.

One of my fondest exercise memories is hiking from Lichtenstein to France across the Swiss Alps (a route called the Alpine Pass Route - absolutely breathtakingly fabulous hiking). I decided to hike it because it was billed as one of the 3 most difficult hikes in Europe that didn't require specialized equipment.

During that hike I remember it being a positive thing when a few of my toenails decided to fall off in protest of the beating they were taking.

People have said I'm crazy for having that sentiment, but I'll tell you, I'm not nearly as crazy as someone named Jan Ryerse. Jan is an ultrarunner - someone who likes running over 100 miles at a stretch. He also kind of designs jewelery.....made from toenails.

Like I said, you know you're hardcore when.

Click the picture above, I dare ya.

Mom my Ride

I can't believe that his been floating around the internet for as long a time as it has and I haven't seen it.

Hat tip to my sister.

Have a great weekend!

Does Agriculture Canada Promote Health?

Readers of my blog will know I've got a bit of a penchant for slamming what I see to be the inadequacies of Health Canada and their involvement in our national dietary recommendations.

So how about Agriculture Canada? Does our Department of Agriculture do any better than Health Canada in the promotion of our national diet?

Apparently not.

NOW Magazine in Toronto had a very interesting article written by Wayne Roberts detailing just how woefully bad our agriculture policies are in the promotion and protection of health.

Wayne looked at three separate Statistics Canada agricultural reports.

The first report worried him because it reported to him that most independent farms are money losers. The report, The Financial Picture Of Farms In Canada, notes that 44.2 per cent of farmers lost money last year and that less than half of the farms that didn't go out of business since 2001 make enough money for the farmer that he or she can be working full time on their land.

The second report worried him because it reported that most Canadian farmers are old. The report, Snapshot Of Canadian Agriculture, notes that the average age of a farmer in Canada is 52 years old, up 5 years from the report in 2001, and that there's been a 25% drop in farmers under the age of 35. For NOW Magazine's Wayne Roberts, that suggests that the days of the family farm are indeed numbered.

Wayne's also worried that fewer than 6,000 farms account for roughly 40% of farm gate sales. His worry is that should there be any type of crisis, much of Canada will be left without any local food supply,

"This is not a system designed with any regard for resilience, surge capacity, robust response to crises or due diligence by politicians and health officials."

Wayne's also concerned by what he sees to be a disconnect between Health Canada and Agriculture policy. To quote Wayne,

"Alert health officials might also be alarmed by another trend. There's little relation between what Canadian farmers grow and what Canadian health guidelines say people should eat. The government puts $4.8 billion a year into programs that fund farmers, but there's no sign that one of those dollars is attached to any directive about enviro or dietary health goals. About half of Canada's farms raise livestock of various kinds, beef cattle way out ahead, and about 40 per cent raise field crops (wheat, hay, canola, feed corn, etc), much of which goes to feed livestock or, more recently, to fuel cars.

Only 5.5 per cent of farms produce fruit and veg. Sweet corn, tasty but devoid of many nutrients, takes up a quarter of the land devoted to fruit and veg, and potatoes, most destined for heart-dumb French fries and potato chips, take up much of the rest. The best fruit lands are devoted to grapes for wine, said to be good for the heart but bad for cancer, and displace apples and tender fruit, good for both.

You'd never know, in short, that Canada's Food Guide was drawn up by the same government and paid for by the same taxpayers who fund and support contrary products in agriculture. I think "two solitudes" was the phrase a novelist once used to describe this Canadian trait."

It's an interesting argument and one that I'm not sure I'm qualified to weigh in on as I'm not someone well versed enough in what our soils are good at producing and the economies of scale of which crops are the smartest to produce and subsidize.

But it certainly wouldn't surprise me to learn that our government's out to lunch on Agriculture policy due to the enormity of the industry we're talking about and the nature of politics and its catering to the folks with the deepest pockets.

The Oxymorons at White Hat Brands

Pop quiz time (let's see if you've been paying attention):

1. Would recommending that children consume an additional 80 Calories per day help combat childhood obesity?
   
   
2. Would recommending that children consume an additional 4 and 3/4 teaspoons of sugar per day help combat childhood obesity?
   
   
3. Would recommending that children take a daily multi-vitamin help combat childhood obesity?

The answer of course to all of those questions is a most emphatic, "NO!".

Perhaps someone should tell that to the oxymorons over at White Hat Brands, a new corporation trying to hitch itself to the childhood obesity prevention/treatment bandwagon.

Amazingly the thing they're trying to hitch is in fact an 80 Calorie, 4 and 3/4 teaspoons of sugar containing, vitamin enriched juice which according to the quobesity that is their press release is,

"specificially formulated to help combat childhood obesity and type 2 diabetes among preteens".

Really? Pushing sugar and Calories into children by using cartoon logos and a website targeting children who can't discern truth from advertising will help combat childhood obesity and type 2 diabetes?

Hopefully discerning Mom's and Dad's will use Google to help them find this blog's commentary on this atrocious product and its parent company's shamelessly misleading statements about their Dog on it! fortified juice beverages.

National Action Against Obesity - An organization I will NOT join.

Here's an example of something terribly wrong. Out there is an organization entitled, "National Action Against Obesity". Sounds like a group for me, no?

No.

As far as I'm concerned, NAAO is as biased and backwards an organization as you can get and while I may indeed agree with some of their positions (such as governments doing too little to help with this major public health concern), I'm absolutely appalled by the virulence and vitriol of their arguments.

To see what I mean, click the video below (remember email subscribers need to head to my blog to see videos) and watch as the organization president Meme Roth espouses her asinine, biased, offensive and disturbing view that the most recent winner of American Idol is not worthy because her BMI doesn't fit Meme's ideal.

When I watched this video the words contemptible and loathsome leaped to mind. How about you?

The Weight of the World

Hat tip to the web log rightsizingamerica that pointed me to this pictorial representation of global obesity rates (click it for a larger view).

The picture comes from a generally non-weight related web log entitled Wellington Grey.

If there are educators out there who want this as a poster, the graphic's designer has opened up a webshop selling them.

$20.69 for a large poster.

(Sorry for the late post - I moved on Friday and don't have an internet connection at home yet)

The Sick Call

I know one of the readers of my blog keeps her own blog and every once and a while she blogs about taking a sick day sorta just like that. I wonder if her employer reads it?

I wonder how many fewer sick days there would be if every employer were like Conan O'Brien?

Have a great weekend!