bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Can yoghurt prevent diabetes?

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A friend of mine recently shared the news of a new study reporting an association between yoghurt consumption and decreased risk of type 2 diabetes.

The study was actually a meta-analysis of three large studies. Meta-analyses always make me a little nervous due to the ease of cherry picking and interpreting the results to yield the desired effect. The results of a meta-analysis can only be as good as the results of the original studies on which they’re based. I’m not saying this was the case here, just that it’s something to bear in mind when reading about meta-analyses. The researchers do have on their side the fact that all three studies had large sample sizes. After examining the results of these three studies, they added an additional 11 prospective-cohort studies for their meta-analysis.

The researchers controlled for a number of potential confounders. However, there’s always a remaining risk that an unaccounted for confounding variable might be the true reason for any observed effect. While the researchers reported a significant decreased risk of type 2 diabetes in regular yoghurt consumers they were also quick to acknowledge that this does not indicate causation. Yes, people who consume yoghurt appear to be less likely to develop type 2 diabetes than people who don’t. However, the studies all relied upon self-reported food frequency questionnaires and they were observational. It is possible that there is some unaccounted for variable that’s reducing the risk of type 2 diabetes in yoghurt consumers other than the yoghurt.

The researchers do make an interesting suggestion that the probiotics in yoghurt may be responsible for the decreased risk of type 2 diabetes. I do wonder about the validity of this as many yoghurts contain limited live bacteria due to their processing. In addition, it’s unlikely that many probiotics in yoghurt survive the acidic stomach environment to make their way to the intestines. Perhaps it’s the by-products of the bacteria in the yoghurt (e.g. vitamins, lactic acid) that are responsible for decreased risk of type 2 diabetes. Just postulating here. I would love to see a study in which participants are prescribed diets containing either yoghurt with live bacteria, yoghurt without live bacteria, and no yoghurt. Yes, it would take a long time to determine if the yoghurt reduced the risk of type 2 diabetes but other effects could be examined as well and it would be interesting to see what the true effects of  regular yoghurt consumption are on health.


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Follow Friday: the Dartmouth Community Health Board

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My apologies to non-Dartmouth residents. However, if you live in Nova Scotia, you’ll have a community health board for your district. Other provinces and places in other countries may have equivalent bodies and it’s worth checking into.

I’m shamelessly promoting the DCHB, of which I’m a volunteer member, as I think they’ve done (and we’re doing) great work in the community. We’re here to work toward improving the health of Dartmouthians and to act as the liaison between residents and Capital Health. We do this through advocacy, education, events, various other activities, and reporting to Capital Health.

Did you know that we offer grants to non-profit organizations in Dartmouth? We do this twice a year, once in the fall, and once in the spring. Find out more here. We also give a monthly award to an outstanding volunteer in our community. Do you know someone who is making a difference in Dartmouth through volunteer work? Just send off a quick email to info@dchb.ca with the name of the person you’d like to nominate, where they volunteer, and why they’re so great.

Connect with us on facebook.

Free Community Skate – December 2014


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Follow Friday: #Elf4Health

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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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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/


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The other evening I was out with my brother and his girlfriend and she stopped at Starbucks to order an iced coffee. I haven’t ordered an iced coffee in years but it reminded me of the first time that I did from a Starbucks. I ordered my iced coffee, black, got a straw, took a sip, and was surprised to find that it was sweet. I went back up to the counter, thinking that there had been some mistake, apparently there was. It was my mistake for not specifying “unsweetened”. Since when did sweetened iced coffee become the default for iced coffee? They wouldn’t automatically put sugar in a hot coffee, latte, or espresso, so why assume that customers want their cold coffee sweetened?

This is a great example of what’s wrong with the food system in North America. The healthy choice is not the easy choice. I should have to ask if I want sweet coffee. Or add the sweetener myself. It shouldn’t be the default. That sweet coffee left a bitter taste in my mouth.