bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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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.


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Throwing the fish out with the oil

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For the most part I love Fooducate; however, I was a little surprised by this recent blog post on their site. The post referenced a recently published study that suggested our touting fish oil supplements (or even the recommendation to consume fatty fish twice a week) is faulty. They did not offer any thoughts or critique on the new “study”.

The study was actually an analysis of previously published research. They claimed that our recommendation to consume fish (or fish oil) was based solely on a research study of Icelandic Eskimos conducted in the 1970s. They assert that the findings of this study were misinterpreted and that the researchers did not even look at the prevalence of cardiovascular disease in the population they studied. They then looked at the other research on diet and CVD in Eskimo and Inuit populations. They only found one study that performed direct measurements on the Greenland Eskimo
population for assessing the presence of CAD or CAD risk factors”
. They state that this study, conducted before the Eskimo population had adopted a Western diet, found no difference between incidence of CAD in the Inuit population in comparison to American and European populations. Interestingly, I took a look at the original research study and the researchers actually found a lower risk of CVD in the Inuit population as compared to the Western population. Essentially the opposite of what the current researchers are claiming.

So… “What the heck does this all mean??” you may be wondering. Should you be eating fish twice a week? Should you be taking fish oil supplements? Well, unless you are a Greenlandic Inuit then this research may not apply to you at all. We can’t say that what’s healthy for the Inuit population is healthy for other populations. We also can’t be certain that it’s the consumption of fatty fish that reduced their risk of heart disease. It may be any of  number of other lifestyle factors that placed them at lower risk for CVD. Recent research into the benefits of fish oil has yielded mixed results. Some studies show benefits of fish oil consumption, others show negative effects of its consumption. As always, the best advice is that variety is the spice of life and it’s best to obtain your nutrients from whole foods. Yes, eat fish (limit the larger saltwater fish you consume though as it can be high in mercury), choose a variety. If you don’t eat fish, you might want to consider consuming a fish oil supplement. There may be benefits other than lower CVD risk associated with consuming omega-3s from fish/fish oil (such as mental and cognitive well-being, bone and joint health). Research is ongoing and you might want to wait before you turf your fish oil supplement or grilled salmon.


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Sugar and obesity

Letsblameobesityon

I don’t dispute the fact that most of us likely consume too much sugar. As with too much of anything it’s also likely doing more harm than good. However, I do take exception to the sentiment I’ve seen from some vocal supporters of Action On Sugar on twitter. There’s the dichotomy that you’re either with them or against them. Along with that, there’s the implication that any dietitians questioning the assertion that sugar is toxic must be in the pocket of the food industry.

Why can’t it be possible that some of us think there’s a middle ground? That perhaps, as with other nutrients before (e.g. fat, salt, carbs) it will turn out that there is nothing intrinsically harmful about sugar, and that some dietary sugar is perfectly safe as part of a healthy diet.

I resent the implication that if I dare to question the sensibility of demonizing sugar that I must be brainwashed by the food industry. After the harm we’ve seen done by demonizing nutrients in the past, you would think that we would have learned our lesson. The likelihood that a single nutrient, such as sugar, is the cause of the obesity epidemic is extremely unlikely. Reformulating products is not the solution. We’ll probably just end-up replacing sugar with something that will turn out to be even worse for us. Instead, we should be teaching people to cook and to consume fewer highly processed calorie-dense, nutrient-light foods.


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What’s the *BEST* diet?

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There are so many diets out there; from low-carb (and its many iterations), vegetarian, vegan, low-fat, paleo, gluten-free and on and on. The one thing that many of their followers seem to have in common is the absolute certainty that their diet is the best diet. It amuses me when I see back-to-back tweets from people praising their chosen religion diet.

I’m sick of seeing people (especially my fellow dietitians) passing judgement on the diets of others, presuming that their chosen diet is superior. Power to you if you are healthy and enjoy following your diet of choice. That doesn’t mean that the diets followed by others are inferior. It doesn’t mean that only you (and others following the same diet) are eating “real food”. What the heck does that even mean?? I’m fairly certain that I didn’t imagine my last meal, that I didn’t consume “fake” food. Just because it works for you doesn’t mean that it’s going to work for everyone. This isn’t Mormonism, you’re not going to secure your place in foodie heaven by converting more people to your way of eating.

Each diet has its drawbacks and nutrients of concern. Each of these diets has its benefits. I could go through many of them and list out the pros and cons but that would be tedious for me to do and tedious for you to read. So which one is the best? The one that you are happiest and healthiest following. The one that you can easily follow for the rest of your life without feeling like you’re on a “diet”. Yeah, sorry, I sucked you in with that title. It’s the truth though. Me, I don’t follow a diet with labels. I enjoy a variety of foods. I eat meat, but I have been known to go weeks without it. I eat grains, but I try to vary them and may not have them at every meal. I’m an agnostic eater.


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Will canned fruit really kill me? Lessons from epi research

 

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One of my twitter friends retweeted the above tweet yesterday (identifying info removed to protect the guilty). I asked if they had a link to research to support this claim and received a link to this article in Science Daily in response. Dutifully, I followed-up with reading the full journal article. I just couldn’t fathom how eating canned or frozen fruit and vegetables could increase your risk of cancer.

For one thing, right off the bat, the authors are make no mention of frozen vegetables, they refer only to frozen fruit. Just to be clear, that was not a claim they were making.

It’s important to note that the study is observational epidemiological research. It’s impossible to infer causation from such research. At best we can say that there is a correlation between fruit and veg consumption and cancer diagnoses. We can’t say that fruit and veg consumption, or lack thereof, is causing the cancer.

The researchers questioned the participants regarding their fruit and vegetable consumption on the previous day, once a year, for seven years. This data was then linked to all-cause mortality up until 2013.  A few points to make here: 1. fruit and vegetable consumption included fruit juice and dried fruit, as well as pulses (e.g. lentils, beans, legumes) which many would categorize as meat alternatives; 2. dietary recall is notoriously inaccurate… can you remember everything you ate yesterday, including the quantities? 3. we are operating under the assumption that one day is truly representative of most days for the study participants, rather a large assumption.

Some potential confounding variables were controlled for; such as, physical activity, education, socioeconomic status, and BMI. However, it is not outside the realm of possibility that some variables were overlooked. As the researchers themselves point out, they didn’t look at total calorie consumption or other specific aspects of diet (e.g. sodium intake, macronutrient composition, consumption of fast food, timing of food intake, changes in diet, sedentary time, etc). Any of these things could have affected the apparent relationship between fruit and vegetable consumption and mortality from cardiovascular disease (CVD) or cancer.

As someone else on twitter pointed out, it’s also worth noting that the relative risk of dying was quite small. Out of 85, 347 participants, 1, 336 died from cancer and 1, 482 died from CVD. That’s a whooping 3.3% of all participants. Although the researchers found an inverse relationship between fruit and vegetable consumption (except for canned and frozen fruit for which they found a positive relationship) and all-cause mortality I question how meaningful this is. After all, suicide was the leading cause of death in both men and women between the ages of 20-34 years, accidental poisoning was second, and car accidents were third in England and Wales in 2012 (1). Is diet that much of a factor in such deaths? Why look at all-cause mortality? Why not focus solely on lifestyle related deaths?

Yes, it would appear that consuming more fruit and veg is correlated with reduced risk of dying, particularly from CVD. It’s certainly not going to harm you to eat more fruit and veg, unless you’re eating more canned and frozen fruit. So, why would that be? Well, remember the researchers didn’t examine the entire diet, nor did they distinguish between fruit packed in syrup and canned fruit packed in water, or frozen fruit without additives. It’s quite possible that other aspects of the overall diet (or the type of canned/frozen fruit) is responsible for the apparent increase in all-cause mortality in canned/frozen fruit eaters.

That brings me back to the tweet that started all of this. It came from someone who promotes health and fitness and who has a number of followers. Personally, I think that it’s irresponsible to tweet something like that. The tweet misinterpreted the findings by lumping frozen and canned fruit and vegetables together. It also sent a terrible message: if you can’t/don’t eat fresh fruit and veg you may as well not bother; you’re probably going to get cancer if you eat canned/frozen so you’re likely better off polishing off that box of Oreos. Sigh. Many people can’t afford, or don’t have easy access to fresh fruit and vegetables. Frozen and canned are preferable to none, especially if you make good choices. Frozen fruit and vegetables (without added sauces or syrups) are often more nutritious than their fresh counterparts as they are picked and frozen at peak-ripeness rather than under-ripe and spending time in transit, warehouses, on grocery store and fridge shelves. I would also argue that canned are preferable to that box of Oreos. If possible, choose fruit packed in water or juice, not syrup. Choose veg that are packed without added salt. If you can’t find vegetables without added salt, drain and rinse them well before using; you can get rid of up to 40% of the added sodium by doing this.

Don’t be discouraged if you feel that 7+ servings of fruit and veg are beyond your reach. Remember that every little bit helps; fresh, frozen, or canned.