bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Have a merry Coca Cola Christmas

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Today I just want to have a little rant about the obesogenic environment we live in.

The other day I had to go to Walmart for something. I know, I know. It’s a store that I normally avoid like the plague but knitting emergencies do strange things to people. Anyway… Christmas is popping up all over the place despite the fact that it’s obscenely early and one of the first things I saw upon entering Walmart was a huge bin of Coke Christmas ornaments. These weren’t just ornaments though, they were bottles of Coke shaped like Christmas balls. Beside the fact that they’re completely impractical, they’d break pretty much any branch, why on earth do we need to put pop on a Christmas tree? I truly hope that this is a sign that the mighty are falling. If Coca Cola are becoming so desperate in their marketing that they’re resorting to make ornaments filled with pop maybe they’re not doing so well. Honestly, there is more than enough celebratory eating over the holidays is it really necessary that people adorn their trees with Coke???

Later that same day I went to Starbucks for coffee with a friend. I know, more corporate shame. Would you believe that there are no other coffee shops in the city open past 6 pm? I would choose somewhere local in a heartbeat but without that option I found myself ordering one of the new chestnut praline lattes. Because it was night time and I’m an old dietitian I ordered it decaf, half sweet, with 2% milk. Silly me, because I failed to request no whipped cream or sugary sprinkles. I’ve ranted about the use of sweetened coffee as the default for their iced coffees before but really, this is just a crime against coffee. No coffee shop beverage, aside from an espresso con panna, should automatically come with whipped cream and sugary sprinkles. A latte by definition is espresso, steamed milk, and a little bit of foam. Not whipped cream. Not sprinkles. If customers want those options they should have to specially request them and pay a little extra. Why must the unhealthy option be the default? Even at half sweet it tasted very sweet. According to the Starbucks website there’s 31 grams of sugar in a tall chestnut praline latte. That means in my half sweet version (which I scooped the whipped cream and sprinkles off of) there was still nearly 4 teaspoons of sugar! If I ever get it again I’m going for 1/4 sweet, which, at 2 teaspoons of sugar is still too sweet. Screw it, I’ll just have an herbal tea.


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Get a haircut and get an unpaid job

Image from Pink Elephant

Image from Pink Elephant

I had a post percolating when the Bank of Canada Governor made the remark that students should work for free in order to gain experience. No. No. No.

In order to become a registered dietitian I had to complete three, 16 week unpaid internship placements. Not only were they unpaid, I actually paid tuition to my university to complete them. We were not supposed to work during our placements as they were essentially full time jobs (plus homework and documentation for the internship program). However, I had to pay rent, and eat, and all of those other annoying necessities of life, so I worked at a part time job on the evenings and weekends. While I’m a little bit resentful about the process, it wasn’t intended to be regular work. As interns we were meant to be learning from other dietitians in the field. We were not supposed to be completing work that should be completed by a paid employee. In some cases, this was how it went. In other cases, unfortunately, it doesn’t. In one of my placements the person who should have been my supervisor had left so I essentially did that job as well as assisting in finding their replacement. This was atypical and not intentional. However, I know of other internship placements at which organizations “save-up” work that should be done by a dietitian for the months in which they’ll have a dietetic intern.

Yes, we all gain invaluable experience as interns. However, we do still have expenses and it’s unreasonable to expect people to work at an unpaid internship without a source of income. It also doesn’t actually help when it comes time to finding a job. Trust me. Nearly every dietitian I know is working several part time jobs, is looking for work, is working in a position only vaguely related to our educational background, or some combination of these three. You can give students all the unpaid experience in the world but if there are no paid jobs after they graduate then it’s not going to help them.

I’m not sure how much this relates to other fields, but in nutrition I also find that because we are so hungry for experience and opportunities that many people and businesses expect us to give away our expertise for free. I can’t tell you how many times I’ve been asked to give talks to groups without being offered any compensation. This just leads to a vicious cycle of dietitians working for free.

This is not a case of students needing to spend time volunteering. In order to be accepted to the dietetic internship program we had to have volunteer experience. More than one was the norm. I think that this is the case for many students. On top of full time course loads, and part time jobs, are memberships on committees and volunteer positions.

Even many people who are employed full time should take heed. While there are many wonderful employers out there there are also others who will milk employees for all that they can. I know a lot of people whose salaries would almost certainly be less than minimum wage if they calculated all of the unpaid overtime and lunch breaks they worked through. I think that the trend of judging how hard a person works by the number of hours they put in is dangerous and ridiculous. In most cases, work should be completed during working hours and if extra time is necessary, employees should be compensated. I know that my personal work motto aligns closely with that in the image above.

Everyone should be appropriately compensated for work. Forcing young people (and even not so young people) to work for free isn’t going to solve the problem. The problem is that there are just not enough good jobs.


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Are apples the key to curing obesity?

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A few weeks ago the media was reporting that apples may provide the cure for obesity. I was a little more sceptical. I mean, how many overweight and obese people do you know who eat apples? Probably lots. If apples were capable of curing obesity everyone would be thin.

My first concern was that this research was conducted on mice. That means that it may (likely) is not translatable to humans. A couple of things to consider: these mice were fattened up by being fed a very specific high-fat diet. Obesity is a complex condition with myriad factors. Unless the reason for people being overweight is due to consuming a similar diet to these lab mice, it’s quite likely that they will not respond to this weight loss treatment in the same manner as the mice. I also wondered how much apple the mice were fed. How much apple would humans need to consume to see similar results? Here’s where it gets crazy: the mice did not eat the apples. Yep, that’s right. We have no idea how much apple would be beneficial to humans as we don’t know how much would be beneficial to mice. Rather than feeding the apples to the mice, the researchers made a slurry of apple compounds and mouse faeces. They found increased levels of certain bacteria that are commonly found in the faeces of slim mice in the cultured faeces of obese mice. Their results were not statistically significant. They showed a trend toward increased levels of some bacteria and butyric acid, and decreased levels of other bacteria in the faeces-apple slurries of obese mice but none of the changes (save the decreased bacteria) were large enough to be statistically significant.

It’s impossible to say whether or not eating apples (how many, how frequently) would have similar effects on the fecal microbiomes of mice or humans. We also don’t know if these microbial changes do occur if they would result in weight loss. Without knowing this, it’s a ridiculously huge leap to suggest that consuming apples could be a treatment for obesity. This didn’t stop the authors from concluding that:

These results suggest that dietary fibre and phenolic compounds remaining in apples after IVD might help to prevent metabolic disorders driven by an altered microbiota in obesity, and potentially protect from an obesity-disturbed balance of microbiota.

It also didn’t stop the media from publishing articles with headlines like: “An apple a day could keep obesity away: Granny Smiths promote friendly bacteria helping us feel fuller for longer” and “Granny Smith apples can help prevent the damage of obesity“.

I do think that research into our microbiomes is going to provide insight into many illnesses and conditions. However, our individuals microbiomes are extremely variable. Suggesting that this research using mice will translate to obesity treatments for humans. It’s also extremely unlikely that consuming one healthy food will negate the effects of an overall unhealthy diet. That being said, apples are nutritious and it’s certainly not going to hurt you to have an apple a day.


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Book Review: Health at Every Size

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Thanks to Helen at Food & Nonsense starting the RD book club I finally got around to reading Linda Bacon’s Health at Every Size. Unfortunately, due to time differences, the tweet-up to discuss the book is taking place at 6 am on a Sunday morning for me. I’ve scheduled this post to go live at that time as my feeble attempt at participating in the discussion without waking up ;) If you’d like to check out the discussion just search for the #RDBookclub hashtag (was that redundant? Probably) on twitter.

Helen was also kind enough to post some discussion questions so here goes…

1. Do you agree with the HAES assertion that health not weight should be the focus of nutrition interventions?

Absolutely. The focus should be on health and well being, never on numbers on a scale. That being said, weight management is one of the main reasons that people seek out advice from dietitians. I don’t think that we can just ignore this fact. As health care professionals it’s our job to help people to understand that the numbers on a scale don’t necessarily matter all that much when it comes to health. That being said, weight is often inextricably intertwined with health and nutrition.

2. Is a health approach practical in todays aesthetic focused society?

This is an excellent question and one that I found myself thinking about quite a bit as I was reading the book. It’s all well and good that we know that people can be healthy at many different weights but how do you translate that into acceptance and understanding? As much as we tell someone that they are healthy at their current weight, if they’re unhappy with that weight should we help them to lose weight or help them to accept themselves as they are? Oftentimes, neither of these options is feasible.

3. Do you feel that the main concepts in the book were adequately backed up by the research presented?

For the mist part I did. Although I must confess that I didn’t take the time to seek out all of the research Bacon used to back-up her arguments. A couple of things did bother me: One, I didn’t like how much she mentioned that if you do this or that you’ll probably end-up losing weight. If your book is about being healthy no matter what your size, and you’re preaching fat acceptance, then I don’t think that weight loss should be a frequently touted benefit of your approach. Two, I’m not sure how credible her evidence to support that overweight and obese people generally live longer than their lower-weight counterparts is. Weight loss is an extremely common side effect of many serious diseases. Thus, thinner people may be more prone to dying than larger people as a result of an underlying illness causing weight loss, not as a result of being thin. If we’re talking health at every size we need to be careful not to tip the scale in the other direction. People who are overweight, obese, average, or underweight may all be healthy. Also, death is not the only thing to look at. Obese and overweight people may be living for longer but how many of them are healthy during these extended life spans? Health span may be a more important consideration than life span.

4. How should nutrition professionals use this information in their day to day practice?

I think that nutrition professionals should use this information to help themselves overcome their personal biases and to educate their clients that weight is not the be all and end all when it comes to health. We should also use it to help clients realise that our own weight is not an indication of our health nor of our ability to do our jobs well. I can’t tell you how many people I’ve had tell me that I’m a dietitian they might actually listen to because I’m slim, as though larger dietitians don’t have exactly the same knowledge and education as I do. As with any field, our weight is not an indication of our ability to perform our jobs well.

5. Were there any ideas in this book that you reject or find difficult to accept?  Why?

I think I covered this in question three. Oops! I was also bothered with a very small point in which Bacon was advising people on how to choose whole grains (p.79). She says, “Look for the word “whole” in the ingredients list.” Not entirely accurate. This is the point where I pondered whether or not it was okay to write in a library book. You need to see the words “whole grain”. Unfortunately, “whole” on its own is not sufficient. Anyway… This is a very small quibble in the scheme of things.

I did also find it difficult to accept that there is no relationship between obesity and disease states. While I absolutely believe it’s possible to be healthy (and conversely unhealthy) at any weight I do still believe that there is increased risk of developing certain conditions such as heart disease, some cancers, type 2 diabetes when you’re obese.

6. What is the main thing you took from this book? How has it been helpful to you?

The main thing I took from this book is the importance of self-worth and acceptance. We all need to stop aspiring to look like other people and learn to be happy being ourselves. Many of us also need to step away from the scale and stop letting the numbers on it define us. I also really enjoyed the chapters on food and fat politics.

For some more interesting perspectives on the HAES movement check out the following links:

http://www.weightymatters.ca/2013/12/guest-post-why-i-am-walking-away-from.html

http://www.weightymatters.ca/2012/03/why-haes-may-never-go-mainstream.html

http://www.drsharma.ca/obesity-the-science-behind-health-at-every-size-haes.html

http://www.sciencebasedmedicine.org/does-weight-matter/