bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Food as medicine

How many of you have seen memes like these?:

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imgres-1The sentiment is nice and all. Obviously a healthy diet is a huge factor in preventing and treating many illnesses. But to be honest, I loathe these sorts of memes. To me, they suggest that it’s your fault if you get cancer because you ate a bag of potato chips. It’s not. There are many factors that contribute the development of diseases. They suggest that that treats don’t have a place in a balanced diet. They do. Healthy food can be delicious but what’s a life without the occasional ice cream cone? They also imply that somehow you can cure any disease with food. I’m sorry, but eating more broccoli is not going to cure lupus, you can’t cure AIDS with apples. While food plays a role in health, medicine does as well. We shouldn’t consider replacing essential medications with food. Medicine is medicine. Food is food.


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Stephen McNeil gets a failing grade for his response to Nova Scotia’s poor health report card

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Provincial Health Report Card from the Conference Board of Canada

I was driving home from work a couple of weeks ago, listening to the CBC (as per usual), when a segment came on about the recently released provincial health report cards. Nova Scotia did not fare well. We received an overall “D” grade, brought down by our “D” grade for cancer mortality. We also scored poorly on ratings for infant mortality, mortality due to respiratory diseases, and overall life expectancy. Our Premier, Stephen McNeil, made a statement to the effect that while the government does play some role in the health of Nova Scotians, we need to take more ownership of our heath. He said that we should eat better, exercise more, and drink less alcohol. WHAT?! 

I suppose I shouldn’t be all that surprised after the ill-informed op-ed piece by our Minister of Health last year. Really, though, has our Premier never heard of the social determinants of health? How is it possible for someone in such an important governmental role not realise the impact of government on the health of citizens? It’s hard for people to be healthy in our society. In a province where working longer hours is expected, where unhealthy processed foods are more widely available and affordable than nutritious foods, where the weather and poorly cleared sidewalks make even going for a walk difficult, where urban sprawl limits active transportation, where doctors are in short supply and wait times for specialists are outrageous, where many health care plans don’t cover dietitian’s services, where the government profits from the sale of alcohol, where jobs are scare and pay dismally, and so on, the onus should not be placed on the individual to improve population health. It’s the government’s job to make healthier choices more accessible for citizens and to provide us with the services and opportunities we need to be healthy. It’s embarrassing that our Premier would place the blame for our collective poor health on citizens of Nova Scotia when the environment we live in so clearly sets us up for illness.


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Will an avocado a day keep the doctor away?

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Avocado photo by Paree on Flickr. Used under a Creative Commons Licence.

Last week everyone was all excited about new research touting the health benefits of avocados. The gist of it being that everyone should eat an avocado a day to lower improve their cholesterol profile. Now, I love avocados, but I still had to take a look at the study myself.

The first thing I noticed was that the research was “supported by a grant from the Hass Avocado Board” and that the lead author, Dr Kris‐Etherton, is a member of the Avocado Nutrition Science Advisory. According to one of the news items I heard, she insisted that she still would have published the research if it had not shown avocados to impart special benefits on cholesterol levels. Despite this, it’s still a significant red flag to me that the research was supported by the Avocado Board.

This was also a rather small study, looking at 45 individuals over five weeks. While the results were interesting, a larger study would be needed to draw any definitive conclusions. What were these interesting results? Bearing in mind that dietary adherence was self-reported, 90% allegedly stuck to their prescribed diets, and all participants maintained their starting weights. Participants were assigned to one of three treatment diets: low-fat, moderate-fat, or avocado. All three diets were found to lower LDL-C and total cholesterol. However, the avocado diet decreased both (LDL-C and TC) significantly more than the low- and moderate-fat diets. The avocado diet was also the only diet found to decrease the number of small, dense LDL particles (the really bad guys).

Okay, so avocados may impart health benefits. Does this mean we should all exponentially increase our grocery bills and start eating an avocado a day? Probably not. The participants in the study were predominantly white, overweight and obese, healthy Americans. If you’re not part of that group, the results may not apply to you. The study also only ran for five weeks and did not incorporate other life style changes such as exercise and weight loss. We can’t say if eating an avocado a day would impart the same health benefits to someone of a lower weight, different ethnicity, or disease state. We also don’t know if the benefits would continue beyond five weeks or if eating an avocado every day would be more beneficial than increasing exercise and/or losing weight. What about the effects of all three of these together?

Avocados are delicious and full of good nutrients. I don’t want to discourage anyone from eating them if they enjoy them. However, they are expensive, and their use in the treatment of conditions such as elevated cholesterol needs further investigation before we start prescribing an avocado a day.


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I guess some RDs are sexy

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Eat big meals… Fat goes quick! Photo by L’imaGiraphe (en travaux) on Flickr. Used under a Creative Commons LIcence.

Right on the heels of my post about we dietitians not being sexy, this article comes out in the Daily Mail, and I’m forced to eat my words (good thing there are no forbidden foods!). Dietitian Trudi Deakin is proclaiming a high-fat, low-carb diet to be the be all and end all, and she’s written the book to “prove” it. Sigh.

Now, as you (my regular readers) know, I’m certainly not one to shy away from fat. New readers, My original by line was “real dietitians eat butter”. However, I also subscribe to the school of thought that says too much of anything is bad for you. Be it fat, salt, sugar, or carrots. You can have too much of a good thing. According to Trudi, saturated fat is the key. While it’s become widely accepted that saturated fat is not the demon it was once believed to be, that doesn’t mean that it’s suddenly a dietary super hero.

Trudi claims that her diet is 82% fat, and she’s never felt healthier. She alleges that high-carb diets are fuelling the obesity epidemic. The gist is that low-fat was wrong so low-carb must be right. Why do we have to go from one extreme to another? I’ll say the same thing about this that I said about demonizing sugar: blaming one nutrient for obesity or chronic disease isn’t getting us anywhere. These are complex problems that aren’t going to be remedied with simple solutions.

This 82% fat has me curious though. What would a diet that’s 82% fat look like? According to Trudi:

BREAKFAST: Three eggs cooked in the microwave with butter and cheese, like a souffle, served with oily fish – smoked salmon or mackerel – or avocado.

LUNCH:A bowl of berries with double cream or a homemade walnut scone, made with ground almonds rather than flour, served with double cream

DINNER: Meat or fish with a serving of vegetables cooked in butter 

Just for fun, I entered this meal plan into my fitness pal to find out the breakdown. Obviously without quantities, it’s near impossible to say exactly what caloric and macronutrient totals would look like. Based on one serving of each of the items listed above, I would only be consuming 995 kcal, and fat would account for roughly 40% of these. If Trudi’s diet is being accurately reported, she’s obviously consuming greater quantities than I recorded, particularly of the high-fat foods. Regardless, it doesn’t sounds overly appealing to me. I’d rather be a few pounds heavier and die a couple of years earlier than never have cereal for breakfast, never snack, and put butter on everything (as much as I love butter).

While Trudi may be content with this restrictive diet for now, it will be interesting to see what will happen with time. Most people following low-carb diets find them to be extremely difficult to follow over the long-term and usually relinquish them. Aside from the difficulty adhering to these low-carb, high-fat diets, there are other risk factors to consider.

Children with epililepsy following ketogenic diets provide us with some insight into the long term effects of a ketogenic diet. A study of children following a ketogenic diet found that poor growth was common. Other side effects were kidney stones and bone fractures.

There’s some other misinformation in the article. Trudi states that she consumes 30 grams of protein at breakfast because “your body doesn’t store it.” Um… I don’t know where this is coming from. While 30 calories at breakfast is certainly reasonable, excess calories, regardless of macronutrient, will be stored as fat.

The unfortunate thing about most weight management research is that “long term” equals several months to a year. While someone might experience weight loss, and find a high-fat diet relatively easy to adhere to for a few months, years, or a lifetime, are a far different story. Trudi’s been following this diet for less than year. Let’s see the tune she’s singing in a decade. Until then, you might want to take her high-fat diet with a grain of salt, or better yet, a baked potato.