bite my words

Dispelling nutrition myths, ranting, and occasionally, raving

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Book Review: The Diet Fix


I should start with a disclosure: I briefly worked with the author, Dr Yoni Freehoff at his weight management clinic in Ottawa, and I consider him a friend. That being said, I no longer work with him, he didn’t ask me to read or review his book, I didn’t even get a free copy! Okay, well, I kind of did, I borrowed one from the library. The book in question is The Diet Fix

Having worked with Yoni, and being a dietitian, there wasn’t anything in the book that was new or surprising to me. Basically, it was a refresher of everything we would cover with clients, minus specific nutrition information and individual concerns. In addition, I’m not someone who struggles with weight so it wasn’t of personal benefit to read the book. It’s hard to set aside my personal lens when writing about the book. However, as I was reading, I could think of several people I know who would likely benefit from reading The Diet Fix.

Yoni provides a great overview of the information that’s imparted at his clinic in the book. For anyone who doesn’t have access to services provided by a place like the Bariatric Medical InstituteThe Diet Fix is a decent stand-in. There’s a valuable emphasis on living the best life that you can and de-emphasis on the numbers on the scale. Many of us have developed unhealthy relationships with food and this book does its best to help the reader (re)gain a healthy relationship with food.

While there is a section about “resetting” various diets, the book is not a diet book. It’s a lifestyle guide book. The problem with diets is that they always have an end date, and then what? Yoni doesn’t harsh on Paleo (even though it’s so easy and tempting) or Clean Eating or any other money-making diet out there. As long as you’re able to happily and healthily live the rest of your life adhering to whatever style of eating you’ve chosen that’s okay. There are tips for how to make the most of any diet style.

Honestly, the only thing in the book that really bothered me was how often he says “folks”. And that’s probably just because I know someone else (who I can’t stand) who calls people “folks” all the time and it’s become like nails on the chalkboard to me. But I digress… The only statement in the book that I took any exception to was this:

Fruits and vegetables also fall into the carbohydrate catchall. For the most part, they’re all wonderful. The only possible exception is the potato. Dr. Walter Willett, Harvard’s chair in nutrition  since 1991 and the world’s second-most-cited scientist in history, once suggested that consuming one was akin to spooning pure white table sugar into your mouth.

Who am I to question the wisdom of Willett? I will anyway though. Sure, many people consume potatoes far too frequently and in less than nutritionally optimal forms (i.e. chips and fries), however, it’s my belief that the potato is an under-rated vegetable.

Minor quibbles aside, I enjoyed the last sections of the book the best. They addressed a number of issues, such as medications and raising healthy eaters, that most “diet” books would never touch. This makes it a great resource for anyone who wants to take charge of their health, impart healthy habits on their children, or who works with people who do. If you want to lose weight and don’t know where to start, if you’re a doctor or a dietitian, I definitely recommend giving this book a read.

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A bit more about food combining

PB&B sandwich photo by Kevin Reese. Used under a Creative Commons Licence.

PB&B sandwich photo by Kevin Reese. Used under a Creative Commons Licence.

After I wrote about the utter nonsense of food combining last week I had a reader contact me to suggest that perhaps I could elaborate on the positive side of food combining. To be clear, this is not what is traditionally meant by “food combining” which is a complicated way of eating which erroneously is believed to aid digestion and is more based on not eating certain foods in conjunction with others than with eating a variety of foods together.

I mentioned in my previous post that combining some foods can be beneficial in terms of absorption. Fat soluble vitamins (ADEK) need to be consumed with fat in order to be absorbed. This is one of the many reasons that a low-fat diet has been decried by dietitians. Skimmed milk with added vitamin D? No sense to it unless you’re washing down a croissant (or an avocado, nuts, or other fat-containing food of your choice).

In addition to aiding absorption of fat-soluble vitamins, certain foods can help with the absorption of other nutrients. Foods containing vitamin C can help with the absorption of iron, particularly from plant foods in which the iron is less bioavailable than in meats. For example, eating peppers with your spinach salad can help you to absorb more iron. Or having an orange with your oatmeal, tomatoes and beans, etc. Of course, there are also instances where nutrients can hinder the absorption of other nutrients. Tannins and fibre may decrease the absorption of some minerals and medications. Oxalate (found in spinach and some other fruits and vegetables) can impede the absorption of calcium.

As my astute reader pointed out, there’s also the benefit of glycemic control imparted by eating certain foods together. As any reader of Wheat Belly can (and likely will) point out to you, whole wheat bread has a higher glycemic index than white sugar. The thing that’s not taken into consideration when latching onto that fact is that we rarely eat whole wheat bread in isolation. Turn your bread into a peanut butter and banana sandwich or chicken salad sandwich and you’ve altered the glycemic load of the meal because you’ve added other macronutrients. Consuming fat, protein, or fibre can all help to mitigate the effect of carbohydrates on blood sugar. This is why, if someone with diabetes is experiencing low blood sugar it’s much better to give them candy or juice than a chocolate bar. On the flip-side, this is why most dietitians will recommend that you consume two food groups at snacks. Having a piece of fruit and a few nuts or cheese and crackers, berries and yoghurt, veggies and hummus… will help to prevent a spike in your blood sugar and keep you feeling full for longer that if you were to just have a piece of fruit. It also helps you to meet your nutrient needs if you include a vegetable or fruit as part of your snack.

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Follow Friday: #Elf4Health


I saw a bunch of my social media RD friends participating in this challenge last year and I thought it looked like fun. So, this year, when I saw one of them tweet about it, I immediately signed up. You can too! You can sign-up to participate with and as a buddy or just go it alone depending on how much involvement you want to have.

Each day of Elf for Health yields a new challenge. Starting with going meatless on Monday, November 24th, and finishing with making a donation on December 21st. It’s a great way to focus on health during what can often be a stressful time of year.

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Food combining

Photo by Tom Ipri on flickr used under a Creative Commons Licence

Photo by Tom Ipri on flickr used under a Creative Commons Licence

Not long ago I had the pleasure(?) of overhearing a conversation about digestion over a meal. One woman was explaining why she wasn’t having carbs at her her meal (this despite the fact that the hummus she ate certainly contain carbohydrate, as did some of the vegetables with her meal). Her logic was that to aid digestion it’s better to consume food groups separately. Hence, she was just eating vegetables and meat. Someone else piped in that this made sense and added that eating foods in a specific order must also be beneficial. I did my best not to bite off my tongue and eat it along with my vegetables, meat, and (gasp!) rice.

Not everyone knows about how digestion works and I can see how these myths perpetuate. But please give your body some credit; it can handle more than one macronutrient at a time.

I’ve addressed the issues of food “layering” and combining before. Just a quick reminder: digestion starts in the mouth with amylase breaking down starches. Your stomach does an excellent job of churning all of the food you eat, breaking it down, and making it into an acidic stew. Believe me, nothing is sitting in there on top of everything fermenting. Most of nutrient absorption occurs in the intestine. Consuming more than one food at a time may actually aid in nutrient absorption as some nutrients, such as the fat soluble vitamins ADEK, need other nutrients to be absorbed (in this case fat).

This doesn’t even address the fact that many foods taste better together. Think: chocolate and peanut butter, apples and cheese, bread and butter. There’s no need to deny yourself the pleasure of these foods. Variety is the spice of life and choosing healthy foods is complicated enough without adding the element of what to eat with (or without) something else.

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Do you need a testosterone boost?


A friend recently sent me a link to this article Why Testosterone Is Your FriendMy first question was: is testosterone deficiency a common problem. This study puts the prevalence at roughly 10% in males aged 20-79. However, deficiency was much more common among the older males. Testosterone deficiency may also be a problem for women. Naturally, the research in this area lags far behind that of the research on men so it’s impossible for me to comment on the need for testosterone boosting efforts in women.

The article is correct in stating that testosterone plays an important role in the body. It plays a role in sex development and libido, bone mineralization, weight and body mass composition, and energy levels (1). That being said, it’s relatively unlikely that a fit young person suffers from testosterone deficiency. If you do suspect that you suffer from testosterone deficiency, then you should visit your doctor. She or he will be able to measure you testosterone levels through blood tests. Pending the results, appropriate treatment efforts can be determined. Please don’t self-diagnose or take the advice of a fitness blog written by a personal trainer (or anyone, regardless of credentials as gospel).

Much of the advice in the post is solid advice for anyone regardless of testosterone levels. Indeed, obtaining an adequate nights sleep and reducing stress could benefit most of us. Let’s just quickly go through each of the suggestions…

1. Get deep sleep. Everyone can benefit from getting a solid nights sleep. Yes, this may help to increase testosterone.

2. Lift heavy things. Strength training is important for everyone to maintain muscle mass and bone density as we age. This may help to increase testosterone levels in people who are slightly low, but it’s unlikely to make much of a difference for anyone who’s deficient (2).

3. Don’t run too much. As someone who loves to run, I have a bit of a personal bias against this one. Run too much? Does not compute. Apparently, those who over-train, or elite athletes, may actually see a drop in testosterone levels. However, it would certainly take more than running a few times a week to have such an effect. If you enjoy running, don’t stop.

4. Eat fat, especially saturated fat. This is quite a vague recommendation. I certainly thing that fat has been unfairly vilified in the past (and sometimes, in the present). It is also possible that consumption of fat, and saturated fat may impact testosterone levels (3). However, these findings are based on a very small correlational study which makes it impossible to draw widespread recommendations from them. That being said, fat is an essential nutrient and (aside from man-made trans-fats) should not be avoided. There’s a good review of the research here. The AMDR for dietary fat is 20-35% of total calories for adults. Of course, our needs vary so you may fall on the low or high end of that scale depending on your genes and activity levels. Ignore the recommendation in the article to eschew plant oils. Use a variety of oils and fats.

5. Eat enough protein. Most of the research on protein and testosterone focuses on the inverse relationship. Again, a very small study found that ingestion of whey protein following a workout increased testosterone and androgen receptors in men (aged 57-72) while a placebo had no effect. Interesting. However, I would caution against extrapolating such a small study to younger men and women and even to all middle-aged men. While most of us consume more protein than we need, we may be well-served by consuming more consistent amounts at meals and snacks. Focus on getting more than 15 grams of protein at breakfast, protein at all meals and snacks, and meet with a registered dietitian if you have questions about adequate consumption of protein.

6. Keep stress levels low. Low testosterone and symptoms of stress may manifest in the same manner but there’s little evidence to support the assertion that stress will lower testosterone (4). Of course, stress is not good for us so taking steps to reduce stress in your life will likely serve you well regardless of your testosterone levels.

7. Don’t binge drink. Duh. Binge drinking is bad for your liver, your brain, and every other organ in your body. Animal studies suggest that chronic alcohol consumption may lower testosterone levels. It makes sense that if heavy alcohol consumption impairs bodily functions that it would also impair testosterone production. Despite the lack of human evidence, I’m not going to argue with this one. Don’t drink to excess, regardless of your testosterone status.

8. Get enough zinc and magnesium. There may be benefits to getting more zinc if you’re not getting enough in your diet. If you’re already getting enough, more is not going to help (5). Many of us don’t get enough magnesium in our diets so aiming to consume more magnesium-rich foods (e.g. nuts, seeds, beans, dark leafy greens, dark chocolate) is worthwhile. I wouldn’t recommend supplementing with zinc without first discussing with your doctor as zinc can interfere with the absorption of other minerals, like copper, and unnecessary supplementation could lead to deficiency in another mineral.

9. Make sure to get enough carbs. Personally, I love carbs. I’d never suggest anyone cut carbs from their diets. However, there’s no reason to believe that insufficient carb consumption will lead to testosterone deficiency.

10. Get enough vitamin D. Research on vitamin D has been mixed. Most of us can get enough from the sun in the summer months. We may benefit from supplementation of 1000 IU during winter months. Vitamin D may slightly increase testosterone in deficient males (6). As with most things, just because some is good, doesn’t mean that more is better. While uncommon, it is possible to consume toxic levels of vitamin D so don’t go mega-dosing.

11. Stay away from soy. Research looking at testosterone levels and soy consumption has focused on soy protein supplements. Results have been mixed. It’s quite unlikely that consuming soy in “natural” states (such as tofu, edamame, soy beans/nuts, or tempeh) is going to have any impact on your testosterone levels.

12. Eliminate wheat and gluten grains. Now we’re really going off the rails. There is no link between wheat and gluten and testosterone deficiency. There is no reason to eliminate gluten from your diet unless you have celiac disease or an allergy.

13. Limit all medications/birth control pills. Some medications may affect hormone levels. Some will not. Don’t stop taking essential medications and don’t take unnecessary medications. If you have any concerns about any medications that you’re on discuss them with your doctor.

There are also potential risks associated with high testosterone levels. Let’s not get carried away with focusing on low testosterone without first learning that our testosterone is indeed low.