Teachers, Stop Teaching Kids To Reward Anything and Everything With Junk Food And Candy!

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016.

The past 50 years of so have seen scads of unhealthy societal changes to how we use food, and near the top of that heap lies our now normalized use of junk food to reward, pacify, and entertain our children at every turn.

Take the jelly bean prayer up above. That was sent home with RD Nadine Devine's Junior Kindergartener in honour of Easter.

WWJD? Not that.

Or this needs-to-be-seen-to-be-believed note that was sent home with another friend's 5 year old.

I imagine that the teachers responsible for those two examples don't see either as unwise as why question normal behaviours? If everyone does them, they must be ok.

Yet I'd wager that if those same two Kindergarten teachers reflected on the lesson their use of classroom junk food is teaching their incredibly impressionable, young, students, they would recognize that teaching incredibly young children that it is normal to reward even the smallest of victories or celebrations with junk food is not in their students' best interests.

Teachers, if you're reading this, so far as rewarding kids go, it's not difficult to do so without candy. Extra-recess, dressing your teacher up in funny clothing, being in charge of school announcements, a classroom dance party, have a class outside, hand out "no-homework" passes, stickers, bookmarks, etc...

I know that teachers care deeply about their students, which is why I genuinely believe that putting an end to junk-food classroom rewards is something that society, and teachers, can fix.

[And for some suggestions as to how you might begin to approach this with one your children's teachers, coaches, whatever, here's something I wrote a few years ago about shutting down your children's sugar pushers]

It's More Important To Teach Your Kids to Cook Than to Play Soccer

Photo courtesy of yoshiyasu nishikawa 

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016.

Yes, I know there will be people whose challenges and circumstances are real and severe enough that they genuinely can't ensure their kids learn how to cook before leaving home. This post isn't for them. This post is for everyone else.

For the first time in history the average American family is spending more money in restaurants than they are in grocery stores.

Kids are leaving home now knowing more about how to play soccer or hockey than they do about how to cook meals from fresh whole ingredients.

That's so incredibly unfortunate, not only for those kids, but for their future families.

Cooking is a life skill and it's a parents job to teach those before they leave home. If you aren't comfortable with cooking yourself, take the opportunity to learn with your kids. Your kids learning how to cook will serve not only to help them in providing themselves and their futures with healthful meals, but will also save them money during their lean years and will likely reduce their risk of developing a myriad of diet-related, chronic, non-communicable diseases.

Whether by way of the ridiculous amount of online recipes and resources, or enrolling in a cooking course or supper club, cooking, like any skill, is obtained by way of practice. It doesn't matter if you're not good at cooking now. Take the time, and there's no doubt you'll get there.

Saturday Stories: Snowflakes, Forgetting, And Fat Shaming

James Hatch, in Medium, on going back to College at age 52 and his semester with Yale's snowflakes.

Alvin Rosenfeld, in Tablet, on the perils of forgetting the Holocaust as the age of survivors draws to a close.

Latoya Shauntay Snell, on Huffpost, on marathon running, fat shaming, and concern trolls.

The Food Industry Spends A Cancer Moonshot On Advertising Every 3 Weeks

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016.

Some perspective.

Did you hear about the "Cancer Moonshot 2020"?

In their words,

"The Cancer MoonShot 2020 Program is one of the most comprehensive cancer collaborative initiatives launched to date, seeking to accelerate the potential of combination immunotherapy as the next generation standard of care in cancer patients."

And so what's the cost of this ambitious program over the course of the next 5 years?

$1 billion.

Sound impressive?

Maybe less so when you consider that according to AdAge, in 2014 alone, the top 25 US food industry brands spent just shy of 15x that amount advertising their products.

That's a moonshot worth every 3 weeks!

Spread that out over the billion dollar moonshot's 5 year duration and suddenly you realize that through 2020 the food industry will spend 75 times more money trying to get you to buy Coca-Cola, KFC, Cheerios, Dunkin, etc., than the government will be spending on their "MoonShot" to cure cancer.

If we want to see population level improvements to diet, no doubt that part of the requirement will be food industry advertising reform. Banning advertising that targets kids altogether, reforming front-of-package claims, cracking down on deceit, and more, because with a cancer moonshot of food industry advertising every three weeks, consumers don't stand a chance if we don't.

[And of course the other issue worth noting is how incredibly irresponsible it is to promote a 5-year, billion dollar investment as a cancer moonshot.]

School "Hot Lunches" Are Beyond Awful. How Did We Let Them Happen?

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016.

A friend on Twitter sent the photo up above to me. It's this week's hot lunch offering for his kid's school's kindergartners through Grade 6ers.

Hot dogs, donuts, and juice.

Really?

And then of course there's pizza days, sub days, and various other awful food days that not only serve kids literal fast food, but in so doing also teach kids that it's a totally normal/alright to have fast food each and every week.

Parents would jump in front of buses for their children, and yet packing them a healthy lunch everyday isn't doable? Clearly it's not a money thing as $5 for a hot dog, a donut and a juice box certainly doesn't make this hot lunch a value proposition.

How did we get here as a society?

More importantly, how do we leave?

Why You Should Probably Just Ignore All Breakfast Studies

By Evan-Amos (Own work) [CC0], via Wikimedia Commons

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016.

Ugh, breakfast stories.

Such a frustrating topic in nutrition as for both health reporters and diet gurus it would seem that there is no middle ground, breakfast is positioned either as essential or pointless.

Well I'll tell you what's pointless - "breakfast" studies.

I'm putting breakfast in quotations because virtually all the is it good for you or not breakfast studies seem to study breakfast as a whole.

Seems to me that regardless of your chosen end point (be it weight, appetite, hunger, adiposity, heart disease, insulin, school performance, whatever) what a person eats for breakfast will matter a great deal, and just studying whether or not a person ate breakfast, will lump together bowls of Froot Loops with almond topped steel cut oats, and Pop Tarts with summer vegetable omelettes.

My experience, born out of a dozen years of working with thousands of patients on weight management, has been that for most, a protein rich breakfast benefits all-day satiety, whereas a bowl of ultra-processed, sugar-fortified carbs, doesn't. And please note, I said most, not all.

Ultimately breakfast matters for some and not for others, and if you're curious whether or not it's important for you, what you choose to eat for breakfast is going to play a big role in your answer.

And for the love of everything holy, please, please, stop reporting on "breakfast" studies, whether you or they are pro or con, as if they're able to make conclusions about the utility of breakfast as a whole.

No Diet Works For Everyone, And Every Diet Works For Someone

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016

Two weeks ago Kevin Hall and I had our diet commentary published in The Lancet. Not surprisingly, we upset some folks - primarily low-carbers. Some accused us of being low-fat cheerleaders. Others that we fostered an "animus" towards low-carb diets.

While I can't speak for Kevin, I can honestly state that I'm totally fine with low-carb diets. For some people they're a life changer and our office is happy to work with patients on them. I've also got nothing against low fat, Paleo, intermittent fasting, vegan, gluten-free, or any other diet that has a name.

What matters most to me, and what was also the crux of our commentary, is whether or not a person likes their chosen diet enough to sustain it. Food is not simply fuel. Food is comfort, food is celebration, and food serves as the foundation of a huge part of our social lives. Regardless of whether or not one diet vs. another diet affords a person an additional few pounds of loss (or even whether or not it confers specific health benefits) pales in importance to whether or not a person likes that diet's style of eating enough to live with it for good

As noted in our piece, every diet out there has its long term success stories, and so moving forward, if you see anyone out there suggesting their diet is the best (or that your diet is the worst) rest assured they have an agenda. Their agenda might simply reflect an n=1 mentality of, "it worked for me therefore it's what you should do", it might reflect basic post-purchase rationalization, or it might reflect genuine science and studies that infer greater short term losses or potential health benefits. But if they can't wrap their heads around adherence (which on an individual basis is an expression of whether or not you like what you're eating and don't miss what you're not) as any diet's long term's most critical component, their ideology is showing.

Temporary efforts will only yield temporary outcomes no matter how exciting the outcomes might be in the short run.

Saturday Stories: Statistical Lies, Cell Phone Location Tracking, and Survivors

Stephen Senn, in Error, on lies, damn lies, and statistics (ok, really just on statistical lies) as they pertain to personalized medicine

Stuart A. Thompson and Charlie Warzel, in The New York Times, with what will surely win them a Pulitzer, on how cellphone tracking companies probably know everything about your life. Then read this incredible follow up story on tracking President Trump. And finally this piece on how to protect your own data somewhat.

Avital Chizhik-Goldschmidt, in Forward, interviews and photographs 5 inspiring women survivors of the Holocaust

Why Every Holiday Season Should be All-You-Can-Eat!

Ok, yes, the headline is very clickbait-y as there's a crucial qualifying word missing.

Thoughtfully

This holiday season should be all-you-can-thoughtfully-eat, where thoughtfully means asking just two questions before each and every indulgence.

1. Is it worth it?
2. How much do I need to be happily satisfied?

As I've said many times before, food isn't just fuel. As a species we use food for comfort and for celebration and no doubt for most of us, the answers to those two prior questions will be different in December than in January.

And here's a promise. If you don't ask those questions every indulgence will be worth it and you'll have far more of each than you need to be happily satisfied.

(this post was first published back in 2014)

Saturday Stories: Judaism's Executive Order, Reunited Lovers, And The Benefits Of Weight Loss

David Schraub, in The Atlantic, discusses, with great nuance and balance, the issues surrounding Trump's executive order regarding Jewish identity.

Keren Blankfield, in The New York Times, on lovers reunited 72 years after their affair in Auschwitz.

Kevin Bass, in his blog Nutritional Revolution, reviews how not only is long term weight loss possible, even small losses have been shown to markedly reduce the risk of death, and how those benefits are treated very differently than lesser benefits from medication and screening.

#IfYouServeItWeWillEatIt Vegetarian Conference Food Nudge RCT Edition

As I've noted before (usually in the context of soda and junk food) if you serve it, we will eat it, even if the 'we' are a bunch of medical or dietetic professionals.

But what happens if you serve healthier fare? And what happens if you give people a little nudge towards it?

A recent study sought to explore that and prior to 3 conferences, randomized attendees into receiving one of the following two options to consider for their lunch choices

Group 1 (this was the non-vegetarian default ask): At the conference a non-vegetarian buffet will be served for lunch. Please state here if you would like to have a vegetarian dish prepared for you: __________________________________.

Group 2 (this was the vegetarian default ask): At the conference a vegetarian buffet will be served for lunch. Please state here if you would like to have a non-vegetarian dish prepared for you:__________________________________.

You know what happened next.

At all 3 conferences, whatever was highlighted as the default lunch option was chosen by the vast majority for lunch.

At the first conference, the vegetarian choice increased from 2% to 87%. At the second conference it increased from 6% to 86%. And at the third conference it increased from 12.5% to 89%.

You know what would have certainly led to even higher numbers? No non-vegetarian options. And to be clear, I'm not suggesting vegetarian diets are a panacea, there are plenty of unhealthy vegetarian foods, but this simple study illustrates the power afforded to conference organizers in terms of what's being served and how it's being presented to attendees. The same of course would be true of any venue where meals and/or snacks are presented.

Given we eat what we're served, it seems to me to be a straightforward expectation, at least for medical and dietetic conferences, that we're served healthy options.

[Thanks to my friend and colleague David Nunan for sharing this study with me, and you should follow him on Twitter if you don't already]

Saturday Stories: Chaos, Hatred, And Ethos

Joshua Hammer, in GQ, writing on chaos at the top of the world.

Bari Weiss (and whether you loathe her or not everyone should read this harrowing article), in the New York Times, on how the global surge in Jew hatred should not be written off as isolated incidents of bigotry.

Rachel Laudan, in The Hedgehog Review, on the establishment of a modern culinary ethos.

(photo source)

Dear @OttawaCitizen, Your 83 Word Byline Free Drink Milk "Artice" Isn't Journalism And It Contributes to Scientific Illiteracy

Now to be clear, I'm not a journalist, though I have written my fair share of articles for various publications (including the Ottawa Citizen).

What I would never have submitted, let alone gotten away with, would be an 83 word (truly, that pic above is all there is), byline free, advertorial replete with a large photo promoting milk consumption in the name of Vitamin D and calcium citing a "report" that urged Canadians to drink milk, and mentioning "experts" three times, without actually naming the report or the experts.

Though I'm not sure which report the 83 words is referring to, my friend and PhD/RD Dr. Kevin Klatt (who you should absolutely be following on Twitter) was able to steer me to this study looking at non-dairy milk consumption and vitamin D levels in Canadian children which clearly demonstrates drinking non-cow's milk leads to lower, but still fine, vitamin D status markers.

He noted, as actually cited experts should, that vitamin D's daily recommended intake (DRI) levels were derived from intake studies performed in very high northern latitudes so as to remove the confounding issue of sunlight, and that consequently daily recommended intake levels are far more than are necessary to maintain safe vitamin D levels for everywhere but the far north. He also pointed out,

"there's not very strong evidence to suggest that not consuming milk places one at risk of having Vitamin D status in the range of insufficiency."

And though it may surprise you given the certainty of the 83 words up above, the data on dietary intake and Vitamin D are so limited that anyone who has concerns about their vitamin D status, regardless of whether they drink milk or not, should have their levels checked and not simply assume milk will be magical. Or better yet, not try to drink their way to higher levels of Vitamin D if they're concerned and simply take supplements (with meals if this is your plan as Vitamin D is a fat soluble vitamin)

Given the full court press the Canadian dairy industry has been making since our new Food Guide rightfully relegated dairy to simply a source of protein rather than suggest it is a unique food group, I can't help but wonder if this published seeming advertorial is consequent to their efforts and overtures, and while it might play to at least 50 years of Canadian dairy marketing, the Ottawa Citizen should know better than to simply pass along uncritical food takes suggesting magic benefits to specific foods to a population primed to believe them.

(Thanks to my friend and colleague Andrew Kujavsky for sending the photo of the article my way)

Saturday Stories: Labour's Shameful Supporters, Notre Dame, and Supermassive Black Holes

Stephen Daisley, in The Spectator, on the shame Britain's liberal Labour supporters should feel.

Pauline Bock, in Wired, on how Notre Dame is being reconstructed by way of 50 billion scraps of data.

Phil Plaitt, in ScFy Wire, on the star-making winds emanating from supermassive black holes.

And finally, today is the last day of #Movember, thanks to those who have already donated, and if you haven't, you still can by clicking here. You can give anonymously, and of course, your donation will come with a charitable receipt.

Toronto's SickKids Hospital New Oreos Fundraising Campaign

Because of course they are.

SickKids hospital has never shied away from junk food fundraising and their latest campaign sees them working with food giant Mondelez to promote the sale of Oreo cookies.

Mondelez of course is thrilled and sees this partnership as,

"a first step in a long-term partnership that will “allow for even more collaborative opportunities across portfolios and brands"

The partnership also benefits Dairy Farmers of Canada who are likely running damage control following the release of a Food Guide that rightly de-emphasized milk's unique importance in our diets and removed  our prior Guide's explicit recommendations around its consumption and instead simply included dairy in the protein foods grouping.

Dairy Farmers are likely worried about the impact the Food Guide's changes will have on their lucrative school milk programs and perhaps that's what underlying their stated campaign rationale of "helping kids reach their full potential”, which no doubt will have more weight with SickKids' push.

Apparently the campaign will include, "TV, cinema, digital, social media and public relations", and there's zero doubt that industry's expectations are despite the campaigns likely huge costs, they'll enjoy a return on their investment, either by way of direct sales, or by protecting current initiatives (like school milk programs).

As to what's in it for Sick Kids, of course it's just money. No doubt too that the amount of money SickKids is likely to get by way of fundraising with cookies, will be a fraction of what will be spent on the campaign to which they're lending their name and integrity to market them.

No doubt too, if this were about altruism for the Mondelez and Dairy Farmers, they'd just cut cheques.

Saturday Stories: Sacha Baron Cohen, Hiding Judaism, And Tianna Bartoletta

Matt Wilstein, in The Daily Beast, on comedian Sascha Baron Cohen's must see/read (really, watch it, the video's in the link) award acceptance speech where he explains why he thinks Facebook is the greatest propaganda machine in history (and he isn't complementing them).

From the Forward Staff, in The Forward, with 27 Jews very briefly sharing their fears of being Jewish - fears I can honestly say I have at times felt myself. It's a short read. And it's heartbreaking to me.

Tianna Bee, on her own blog, on Mary Cain, Nike, abuse, abusers, and elite sport. Do read this. It's great.

By Agência Brasil Fotografias - Provas de Atletismo nas Olimpíadas Rio 2016, CC BY 2.0, Link

The Corollary To If You Serve It We Will Eat It (If You Don't, We Won't)

I've written before how as human beings, if you serve it to us, we will eat it, with examples from medical conferences, medical resident events, and dietetic conferences, and published recently in JAMA Internal Medicine is it's corollary, if you don't serve it, we won't eat it, or at least we'll eat it less.

The paper, Association of a Workplace Sales Ban on Sugar-Sweetened Beverages With Employee Consumption of Sugar-Sweetened Beverages and Health explores what happened to sugar-sweetened beverage (SSB) consumption in the 10 months after the University of California at San Francisco banned their sale from campus and medical centre venues (including in their cafeterias, vending machines and retail outlets). People were of course still free to bring whatever beverages they wanted to work or school. Specifically researchers were interested in the impact the sales ban would have on those with heavy SSB intake (defined as a pre-intervention consumption of more than 12 fl oz daily for the prior 3 months).

For two months prior to the intervention, they canvassed for heavy intake participants, and once the SSB sales ban was enacted, half were randomly assigned to receive a 15 minute motivational intervention targeting SSB reduction, half were not, and 10 months later, all of their intakes were again explored.

The findings weren't particularly surprising. When SSBs aren't sold, fewer are consumed.

How much fewer?

Half as much overall, with those receiving the brief motivational intervention seeing their consumption decrease by roughly 75%, and those who didn't by 25% (though it should be noted, especially among those who received the motivational intervention, social desirability bias may have influenced their self-reported consumption reductions).

Bottom line though, it certainly stands to reason that if you don't serve or sell it, we won't eat or drink it, or at the very least, we'll eat or drink much less of it, and so as far as public health interventions go, likely wiser to reduce access to hyperpalatable and indulgent fare rather than simply encouraging people to just eat less of them.

Saturday Stories: Campus Antisemitism, Campus Conservatism, Bernie Sanders' and The Left's Antisemitism

Blake Flayton, in The New York Times, on his experiences being a young, gay, left-wing Jew, and how University's progressive spaces are for non-Jews only.

Jane Coaston, in Vox, on the "Groyper Army" and the war over college campus conservatism

Yair Rosenberg, in Tablet, on whether Bernie Sanders is the man to fix antisemitism and the left?

Photo By Lorie Shaull - https://www.flickr.com/photos/number7cloud/30924024642/, CC BY-SA 2.0, Link

New Systematic Review Concludes No One Will Ever Successfully Maintain Their Lost Weight. Or Does It?

From the Journal I Can't Believe This Ever Got Published (ok, in this case from Obesity Reviews) comes The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments.

The paper apparently is meant to be a counterpoint to other systematic reviews of long term weight loss where,

"conclusions are generally positive and give the impression that weight loss interventions work and that weight loss can be maintained"

Well we can't have that now can we?

It appears these authors sure couldn't because here are the criteria they used in selecting papers for their systematic review that concluded long term weight loss is impossible:

1. Studies must have follow up periods of at least 3 years
2. Patients must not have had any continued interventions during the follow up period
3. Medications approved for weight management aren't allowed

So what they ended up with were 8 studies of varied protocols being administered temporarily for a chronic medical condition where half provided what by definition were only temporary interventions (3 with very low energy diets, and one with hospital provided food). But guess what, chronic medical conditions require ongoing treatment, and what happens when you actually provide it? Well you get studies that would spoil the impossible narrative as noted by the authors of this paper,

"several of the non-included studies report a majority of participants achieving satisfactory weight loss and little regain, especially among studies with continued interventions during the follow-up period."

Imagine that! Appropriately treating a chronic medical condition with continued interventions works!

And this notwithstanding the fact that many (most? all?) of those studies that provided ongoing interventions likely did not include the appropriate prescription of medications to either help with losses or to prevent regain (just as we would with any other chronic condition) because weight loss medications are almost always excluded from use in weight loss diet studies. Which is odd by the way. Consider hypertension for instance. Sure some people might be able to resolve theirs by way of such things as lower sodium diets, increased exercise, and weight loss, but there's zero doubt that patients with hypertension will receive regular ongoing follow up visits with their physicians, and where appropriate, will be prescribed medications to help. Why? Because that's how chronic condition are managed! Which is why we'll never see a systematic review of hypertension treatments demonstrating that brief lifestyle counselling and the explicit exclusion of medications didn't lead to lower blood pressure 3 years later.

Leaving me to wonder, why publish a paper with the literal conclusion,

"that the majority of high-quality follow-up treatment studies of individuals with obesity are not successful in maintaining weight loss over time"

when really all your systematic review (of just 8 papers all with different dietary/lifestyle interventions) has proven is that delimited, lifestyle counselling doesn't miraculously cure a chronic medical problem, and where you admit in your paper that the appropriate provision of ongoing care might well in fact lead to sustained treatment benefits?

But I don't really need to wonder. Because the only reason that this paper was conceived and published is because of weight bias, whereby obesity has different rules applied to it, in this case, the notion that unlike so many other chronic medical conditions that are impacted strongly by lifestyle changes (eg. hypertension, type 2 diabetes, GERD, heart disease, COPD, gout, osteoarthritis, osteoporosis, kidney stones, and many more) people believe that for obesity some brief counselling should be enough to do the job, because that in turn plays into the trope of obesity being a disease of willpower and a deficiency of personal responsibility.

(Thanks to Dr. Andrew Dickson for sending my way)

Thanks to your generosity I'm over 2/3s of the way to my $3,000 Movember fundraising goal. While I'll never monetize this blog, this is my annual fundraiser and if you find value here, consider a donation! Remember, every dollar counts, it's tax deductible, and you can give anonymously! To donate, simply click here

Saturday Stories: Mary Cain, Fatal Powerpoint, And Echo Chambers

Mary Cain, in the New York Times, tells her story of the intersection of abuse and elite sport.

Jamie, in McDreeamie Musings, on the Powerpoint slide that killed 7 people.

C Thi Nguyen, in Aeon, on the dangers of echo chambers

And if you haven't had a chance to donate yet to my lipterpillar, and you find some value or enjoyment from this blog, please consider and remember, every dollar counts. So far this year the generosity of friends and family have helped to raise $1,640. Movember is a tax deductible charity and you can give anonymously if you'd prefer. And of course, as I've mentioned, Movember funds multiple men's health initiatives including mental health, suicide, body image, eating disorders, substance use disorders, & testicular cancer. To donate, simply click here

"Severe" Energy Restriction Better For Weight Loss Than "Moderate" Energy Restriction?

Well according to this new RCT it is - in it they found that patients randomly assigned to 4 months of severe energy restriction (65-75% restriction of energy by way of total meal replacement/all liquid diet) followed by 8 months of moderate energy restriction (25-35%), at 12 months, lost significantly more weight than those assigned from the get go to the same degree of moderate energy restriction.

Hurrah?

So first off it's not remotely surprising that putting two groups on the exact same diet (25-35% energy restriction) but starting one group off with 4 months of extreme energy restriction sees those who had the extreme jump start lose more in total.

Secondly, it would appear that the extreme folks have a weight gain trajectory that may well erase the differences over time.

And thirdly, this got me thinking. Behavioural weight loss programs, because they don't involve products (unless medications are being tested, and here they were not), have outcomes that are likely significantly dependent on both material, and perhaps more importantly, on the service providers. Consequently I do wonder about the ability of any of these sorts of studies to be applicable to other offices or programs. Meaning here at least, it would appear the extreme folks did better, and the moderate folks dropped out more often (perhaps consequent to slower than desired initial losses), but would the same necessarily be true at a different site, with the same restrictions but with different service providers, collateral materials, attention and support?

I'd venture those things matter a great deal more than is generally ever mentioned in the medical literature.

And a Movember update! If you enjoy these posts (or even if you don't but you hate read them for something to rage about thereby adding some extra meaning or identity to your life) would love your tax deductible donation to my lipterpillar's growth (and remember, you can give anonymously too). And though I have a family history of prostate cancer (hi Dad!) I think it's important to note that beyond prostate cancer Movember funds multiple men's health initiatives including mental health, suicide, body image, eating disorders, substance use disorders, and testicular cancer. And while I will never charge a penny or host an advertisement on this site, I will, on an annual basis, ask for your donation to this cause. To donate, simply click here

Just Because Your Cafeteria Has A Salad Bar Does Not Make It Healthy

A few months ago I visited the Ottawa Hospital's Civic campus and decided to have a peek over at the cafeteria.

It won an award you see, an "Award of Recognition" to be exact, which according to the plaque was for,

"significant achievement in creating a supportive, healthy, nutrition environment across hospital retail food settings"

A supportive and health nutrition environment you say?

Um, about that:

Sigh

Saturday Stories: Bad Nutrition Advice, Nell Scovell, And The Memo Method Of Fitness

Shauna Harrison, herself both a fitness instruction and a Ph.D. in public health, in Self, is begging you to stop taking nutrition advice from your fitness instructors.

Nell Scovell, in Vanity Fair, with an amazing piece of writing about her pre-#MeToo era interactions with David Letterman, and what it was like to sit down with him a decade later to discuss it.

Lindsay Crouse, Nayeema Raza, Taige Jensen and Max Cantor, in the New York Times, with just a lovely video on Guillermo Piñeda Morales, a.k.a. Memo, and his fitness methodology.

Lastly, I've had many people write to me over the years about their enjoyment of Saturday Stories in particular. If that's you, and if it moves you, today is #Movember 2nd! and your donations  are my ෴'s fertilizer! You give, I grow. And beyond prostate cancer Movember funds multiple men's health initiatives including mental health, suicide, body image, eating disorders, substance use disorders, & testicular cancer. To donate, simply click here

Photo by Pete Souza - Cropped from https://www.flickr.com/photos/whitehouse/3994558942, Public Domain, Link

Ideally Only Donut Conferences Should Be Handing Out Free Donuts #FNCE #RDChat #IfYouServeItWeWillEatIt

Lots of hoopla on nutrition Twitter this week because RD Tracey Fox questioned the wisdom of serving donuts at the Academy of Nutrition and Dietetics (AND) annual Food and Nutrition Conference and Expo (FNCE).

Hyperbole and fallacious arguments from both sides ensued.

The people hating on the donuts predictably likened sugar to *checks tweets, sighs* heroin and cigarettes, while the people defending them, their arguments are probably fairly summed up in this tweet:

It's these arguments that I want to very briefly address.

1. Dietitians, and everyone else, are allowed to eat donut holes whenever they want, and criticizing the provision of donut holes at a dietetic conference does not suggest otherwise.
2. No, the *giant eye-roll* consumption of one donut hole doesn't cause chronic disease, nor does criticizing the provision of donut holes at a dietetic conference suggest otherwise.
3. No, donuts were not the only food served at FNCE, nor does criticizing the provision of donut holes at a dietetic conference suggest otherwise.
4. Criticizing the provision of donut holes at a dietetic conference isn't shaming colleagues (but that tweet up above using sneering straw men to call out the RD who doesn't think donuts should be served at a dietetic conference sure is)

As I've written before in reference to a physician conference I attended where they were serving soda, Clif bars, and potato chips as a snack, human beings, including MDs and RDs, when faced with freely provided indulgent choices, tend to choose them, and I can't help but wonder had they not been offered how many RDs would have gone for a donut or cookie run?

And of course it's not "just one". We are all constantly faced with indulgent choices being offered to us freely to christen every event no matter how small, and we've created a food environment whereby we have to go out of our way to make healthy choices and to actively, regularly, say no to indulgent ones. Now I think indulgent choices are part of life, an enjoyable part at that, and ones that I even actively encourage my patients to make, but I also think it would be in everyone's best interest were that food environment reversed, where the healthy choices are the defaults and indulgent choices are readily available for anyone who wants to go out of their way to get them.

And by the way, at FNCE this year they were certainly readily available. The decadent Beiler's Bakery was 92ft away from the Pennsylvania Convention Centre, while more pedestrian Dunkin' was 135ft away.

Yes, the constant provision of junk food is a societal norm, but it certainly need not be.

And honestly, if even the Academy of Nutrition and Dietetics enables and encourages poor dietary choices at RD events, why would anyone expect better from others?

Until we stop leaning on the theoretical ability of people "just saying no", or that the provision of healthy choices somehow erases the provision of junk, as the primary means to address a food environment that incessantly offers and pushes nutritional chaff at every turn, we're not likely to ever see change, and frankly this is a charge that AND should be leading.

Yes, My Kids Eat Candy On Halloween And So Should Yours

(A variation of this post was first published October 24th, 2013)

It's coming.

And I'm not really all that worried. At least not about Halloween night.

The fact is food's not simply fuel, and like it or not, Halloween and candy are part of the very fabric of North American culture, and so to suggest that kids shouldn't enjoy candy on Halloween isn't an approach I support.

That said, Halloween sure isn't pretty. On average every Halloween sized candy contains in the order of 2 teaspoons of sugar and the calories of 2 Oreo cookies and I'd bet most Halloween eves there are more kids consuming 10 or more Halloween treats than less - 20 teaspoons of sugar and the calories of more than half an entire package of Oreos (there are 36 cookies in a package of Oreos).

So what's a health conscious parent to do?

Use Halloween as a teachable moment. After all, it's not Halloween day that's the real problem, the real problem are the other 364 days of Halloween where we as a society have very unwisely decided to reward, pacify and entertain kids with junk food or candy (see my piece on the 365 days of Halloween here). So what can be taught on Halloween?

Well firstly I think that if you'd like, you can chat some about added sugar and those rule of thumb figures up above provide easily visualized metrics for kids and parents alike.

Secondly it allows for a discussion around "thoughtful reduction". Ask your kids how many candies they think they'll need to enjoy Halloween? Remember, the goal is the healthiest life that can be enjoyed, and that goes for kids too, and consequently the smallest amount of candy that a kid is going to need to enjoy Halloween is likely a larger amount than a plain old boring Thursday. In my house our kids have determined 3 treats are required (and I'm absolutely guessing likely a few more on the road) - so our kids come home, they dump their sacks, and rather than just eat randomly from a massive pile they hunt out the 3 treats they think would be the most awesome and then silently learn a bit about mindful eating by taking their time to truly enjoy them.

The rest?

Well it goes into the cupboard and gets metered out at a rate of around a candy a day....but strangely....and I'm not entirely sure how this happens, maybe it's cupboard goblins, but after the kids go to sleep the piles seem to shrink more quickly than math would predict (though a few years ago my oldest told me she believed it was her parents eating them and that she was going to count her candies each night). I've also heard of some families who grab glue guns and make a Halloween candy collage, and dentist offices who host charitable Halloween candy buy-backs.

Lastly, a few years ago we discovered that the Switch Witch' territory had expanded to include Ottawa. Like her sister the Tooth Fairy, the Switch Witch likes to collect things and on Halloween, she flies around looking for piles of candy to "switch" for toys in an attempt to keep kids' teeth free from cavities for her sister. The joy and excitement on my kids' faces when they came downstairs on November 1st that first Switch Witch year was something to behold, and is already a discussion between them this year.

And if you do happen upon our home, we haven't given out candy since 2006 and we haven't been egged either. You can buy Halloween coloured play-doh packs at Costco, Halloween glow sticks, stickers or temporary tattoos at the dollar store (glow sticks seem to be the biggest hit in our neighbourhood), or if your community is enlightened, you might even be able to pick up free swim or skate passes for your local arena or YMCA.

[Here's me chatting about the subject with CBC Toronto's Matt Galloway]

Saturday Stories: Meat, Diets, and German Antisemitism

James Hamblin, in The Atlantic, with his typically insightful thoughts, this time about whether meat is good or bad for you.

Kim Tingley, in the New York Times Magazine, asks why isn't there one best diet for everyone?

Andrew Mark Bennett, in Tablet, on modern day German antisemitism and what German Jews are doing about it..

[And if you don't follow me on Twitter or Facebook, had a chat with the ladies from The Social yesterday about vaccinations]

Elementary Teachers Union (@ETFOeducators) Misleads Its 83,000 Members When Explaining Cutting Benefits' Actual Dietitian Coverage In Place Of Dial-A-Dietitian

Thanks to a person who wishes to remain nameless, I was recently alerted to the fact that the Elementary Teachers Federation of Ontario, a union representing 83,000 elementary teachers and education workers, have removed coverage for Registered Dietitians (RDs) from their benefits plan.

By way of background, here in Ontario, RDs are one of a limited number of regulated health professionals, and of course are the only profession dedicated exclusively to nutrition. Also here in Ontario (and pretty much everywhere), diet and weight related diseases have long since reached epidemic proportions.

As to why ETFO has delisted RDs, the province's only regulated nutrition professionals, according to a document distributed to their members it's because,

"these free services are now available through Ontario Telehealth"

But are they?

Telehealth RDs answer one-off nutrition questions by way of phone calls. They are most assuredly not there to provide individual counselling or comprehensive ongoing care.

Plainly, cutting RDs from ETFO benefits is shortsighted, and suggesting that actual RD services are the equivalent of a Dial-A-Dietitian service designed to answer simple questions is an outright lie.

If you're an ETFO member I'd encourage you to share this post, and to contact the ETFO ELHT Board of Trustees to ask that RD coverage be reinstated.

The Journal of Nutrition Describes Gut Bacteria Prevotella Abundance As "The Key To Successful Weight Loss" Following Short Study Where Subjects With No Prevotella Lost Comparable Amount Of Weight

Hype around preliminary findings, animal studies, cell culture studies, underwhelming studies, and more is the clickbait that sells papers and likes. Some of the time hype comes from journalists, sometimes from press-releases, and sometimes from the authors themselves. Today's blog post sees the hype coming from an invited oped published by the American Society of Nutrition's flagship The Journal of Nutrition.

The oped, entitled, The Key to Successful Weight Loss on a High-Fiber Diet May Be in Gut Microbiome Prevotella Abundance, was written in reference to the results of the study entitled, Prevotella Abundance Predicts Weight Loss Success in Healthy, Overweight Adults Consuming a Whole-Grain Diet Ad Libitum: A Post Hoc Analysis of a 6-Wk Randomized Controlled Trial.

The op-ed described the "key" to successful weight loss on a high-fiber diet as gut microbiomes containing an abundance of the bacterium Prevotella, and was written to amplify the - hold onto your hats now - findings from a very small, very short study that was not originally designed to test the relationship between Prevotella abundance and weight, that found a whole 3.5lb greater weight loss among the 15 study subjects with the highest Prevotella abundance vs. the lowest (but still present amount) when consuming a whole grain (WG) diet.

But wait, there's more!

Though it's confusing because of the way they reported weight loss, the same study found that particpants with microbiomes containing no Prevotella also lost weight on a WG diet. In fact, looking at the study's diagram detailing the losses between groups it sure appears as if subjects whose microbiomes contained no Prevotella (0-P) lost statistically comparable amounts of weight as those whose microbiomes contained the most Prevotella (High-P).

So to summarize, people with microbiomes containing what The Journal of Nutrition called, "the key to weight loss on a high-fibre diet" lost pretty much the same amount of weight as people with none of it on a high-fibre diet. Oh, and that key that worked as well as not having a key at all? If we make the enormous leap that it was causal, it led to a 3.48lb weight loss. Whoop whoop?

Bottom line I guess is that if you're going to describe something at the "key" to successful weight loss on a whole grain diet in the title of an op-ed in a prominent journal, and where we're talking about a 4lb weight loss, but having none of that key leads you to lose pretty much the same amount of weight, not only is that not much of a key, but it's incredibly irresponsible as it blatantly contributes to the ongoing erosion of societal scientific literacy and promotes the harmful and erroneous belief that magic exists when it comes to weight loss.

[Also, unless I'm misreading the very small amount of actual data provided, it would seem that the authors of the study also reported the difference between high Prevotella and low Prevotella groups wrong whereby the high group was found to have lost 4lbs (-1.8kg), and the low 0.5lbs (-0.22kg), but rather than report a -1.58kg (3.48lb) difference between the two, they added their losses and reported a -2.02kg (4.45lb) difference.]