bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Should moderation have a place on your plate?

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I found myself getting annoyed by this article as I was reading it. While I agree that “moderation” is not the best term to use when referring to eating habits, I don’t agree with the way that this article characterized it.

According to the article, “moderation” should be done away with because there are some foods that we should eat lots of and other foods that we should avoid. I’m more inclined to think that we should do away with “moderation” because it’s not clearly defined in terms of a balanced diet. I see nothing wrong with the sentiment that all foods can be a part of a healthy diet. However, instead of “moderation” we should probably be talking about “every day” foods and “sometimes” foods.

As the article states, we should be eating plenty of vegetables and fruits. Few would dispute that. Where the article and I disagree is about the inclusion of “sugary treats” in a healthy diet. The article states that “none” is better than “moderate” amounts. Well, sure if you’re treating all foods equally in terms of “moderation”. Of course you shouldn’t consume equal quantities of doughnuts and brussels sprouts. I don’t think that doughnuts (or whatever sweet treat it is that you enjoy) have to be entirely eliminated from your diet in order to be healthy. What good is a healthy diet if you’re miserable and hate it? If you’re happy never eating doughnuts, that’s cool. I’m happy for you. Most of us aren’t.

The main study cited to support Ludwig’s argument against moderation is not as cut and dry as he’d have us believe. Ludwig wants us to think that the study was stopped short because those in the control diet (who were advised to eat a low-fat diet) were at greater risk of death than those in the experimental groups (i.e. one assigned to a Mediterranean diet high in extra-virgin olive oil and one assigned to a Mediterranean diet high in nuts). The study was actually concluded early because the researchers had sufficient data to draw conclusions. Continuing it would be unnecessary for their purposes but it wasn’t putting participants lives at risk. Indeed, there was no significant difference in mortality between the groups. Although there was slightly greater risk of stroke among the control group.

This study has been highly criticized for a number of reasons. One reason being that the diets followed by each group weren’t actually all that different from each other; the low-fat control group didn’t actually consume a low-fat diet. However, the Mediterranean groups were given regular counselling sessions while the control group was not. It’s possible that this counselling alone could have accounted for the slightly lower stroke risk in the experimental groups in comparison to the control group. The study allegedly only included participants at high-risk of cardiovascular disease. As no difference in mortality was seen between the groups what are the chances that following any of these diet conditions would improve health outcomes for the general population?

Besides the study mentioned by Ludwig, the article mentions a few other studies which I don’t feel it’s quite as worthwhile to examine closely. Primarily because they’re like “duh Captain Obvious”. Although it’s quite possible that their designs were also not great, as we so often see with nutrition research. Anyway… They tells us of a study that found that people who eat a high variety of sweets and condiments but a low variety of vegetables “made people fatter”. Another study found that eating “plenty” of vegetables lowered the risk of developing Type 2 Diabetes.

The conclusion of the article:

The takeaway? The quality of the foods you’re eating matters more than the relative quantity. In other words, what you eat matters – not just its amount.

It’s probably time to stop saying, “everything is OK in moderation.” Some things just aren’t.

My conclusion: eat plenty of vegetables, whole grains, nuts, seeds, legumes, and fruit. These foods should be the foundation of any healthy diet. However, there are other foods that we eat for pleasure like pastries, chocolates, and potato chips. You don’t have to eliminate these foods from your diet to be healthy. Treat them as treats. The occasional cookie won’t kill you.


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Is slow chewing a way to prevent obesity or foster disordered eating?

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Image by Meliblair on Visually

A few weeks ago results of a study reportedly showing that chewing food slowly might prevent excessive weight gain in children hit the news. While it’s not exactly news that practicing mindful eating is healthy and can help with weight management I still had to check out the original research.

According to the authors: “The study’s goal was to test the feasibility of reducing body weight by teaching how to eat at a controlled pace and stop eating at satiety”. They did this by recruiting children and adolescents (between the ages of 6-17 years) through an open invitation to parents of children at a school in Mexico. 54 children were placed in the study group while 36 were in the control group.

There was no weight criteria for participation in the study and parents were advised that the study was not intended to alter diet or meal size.

All participants were given an hourglass to time their bites (30 seconds per bite) – it’s unclear whether or not this means that the control group was given an hourglass. They, and their parents, were also given a guide on how to follow the program,

appropriate weight by age, main causes of obesity or dyslipidaemia in children and adolescents, complications of obesity such as diabetes and which foods are recommended and not recommended for healthy growth. Instruction also promotes eating a home-cooked meal at the table.

Additional instructions to participants included:

eat slowly, using the hourglass as a guideline; drink water before starting to eat (possibly avoiding sugary drinks); do not talk and eat at the same time; no repeated portions; no overfilling; no eating or snacking between meals; and no eating off the table. The control group did not receive any instructions.

Children who stuck to the programme at least 50% of the time each week were referred to as the “adhering group” (16 at baseline and 14 after a year) for analysis. Students who didn’t stick with it at least half the time were referred to as the “non-adhering group” (26 at baseline and 20 after a year).

The average weight and BMI of the children in the adhering group decreased over the 12-months of the study while both measures increased in the non-adhering group. Weight of the control group increased, however BMI decreased. Somehow this was interpreted to mean that counselling children to chew each bite for 20 seconds can prevent obesity.

Here’s where my concerns come into play. I found it interesting that the average height of the non-adhering participants actually decreased during the first six months. This suggests to me that the sample sizes are far too small to provide any meaningful reliable data. These are growing children and can’t shrink. If the average height was shown to decrease during the study this means that the average weight and BMI results could also be easily affected by the attrition of just one or two participants. That is, we can’t say with any degree of certainty whether or not the weight reduction seen was a result of the intervention or just a lucky coincidence.

I’m also not so sure that it’s positive for us to see a weight reduction among these participants anyway. These were not obese or even overweight children. The average BMI of the children in the adhering group was 23.7 to begin with. This is perfectly healthy. Yes, we want to look into measures to prevent obesity but I don’t think that we can say that weight loss among a group of healthy weight children is prevention of obesity. The non-adhering group and the control group were already at lower BMIs to begin with (20.5 and 21.5, respectively). Despite both of these groups gaining weight, they were still at healthy BMIs after a year (21.3 and 20.3). Interesting that the non-adhering group fared “worse” than the control group. While likely not statistically significant, this does bring me to my greatest concern about this research.

Rather than teaching children healthy relationships with food, I fear that studies such as this only serve to promote disordered eating among children. Sure, family meals are great, as is mindful eating. However, timing each bite and scaring children with the consequences of obesity, labelling foods as “good” and “bad” does not foster a healthy relationship with food. While I’m sure that the researchers meant well, I truly hope that we don’t see this study expanded and replicated as the authors are aiming to do.


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Of strawmen in food swamps who exclusively eat carrots

The Statist Guide to Healthy Eating in the National Post last week had me all like:

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Maybe the author, Soupcoff, was trying to be inflammatory. In that case, she certainly succeeded.

Recent news has come out about so-called “food swamps” in Toronto. These swamps are areas that are plentiful in less nutritious food options and lacking in things like grocery stores and farmers markets where fresh, minimally processed foods can be purchased.

Soupcoff argued creating policies and zoning to promote healthy eating is ridiculous; as is the notion of a “food swamp” in the first place. Instead of creating places where the healthy choice is the easy choice we should just be teaching people how to make healthy choices.

According to Soupcoff, “If we want people to eat healthier, treating them as grown-ups and giving facts is probably going to be far more effective than elaborate zoning plans to engineer equal kale distribution.” Sorry, nope. If people are surrounded by food options that aren’t very nutritious then they’re far more likely to choose those options on a regular basis than if they’re surrounded by healthy food options. I certainly believe that most people could benefit from greater nutrition education. However, for people to make healthier choices we need to be redesigning our environments so that those healthier choices are easier to make. Kale or no kale.

Soupcoff then goes off on a tangent, bringing in a strawman, to tell us that people who exclusively consume carrots are less healthy than people who consume a balanced varied diet and an occasional chocolate bar. As if this has anything to do with making healthy food choices easily available to all.

Interestingly, Soupcoff is the National Director for the Canadian Constitution Foundation. A far-right-wing organization that supposedly fights for the freedoms of Canadians. Apparently, creating environments which promote food security and provide healthy food options is somehow infringing on our basic rights and freedoms. Go figure.

 


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Burger King rules in New Brunswick schools

Burger King image by Mike Mozart on flickr used under a Creative Commons Licence.

Burger King image by Mike Mozart on flickr used under a Creative Commons Licence.

A few weeks ago it hit the news that Burger King has the contract to provide hot lunches for the Anglophone East School District in New Brunswick. Some people were upset that a fast food restaurant is being paid to provide children with lunches. Others defended the program by stating that the foods provided meet the provincial school nutrition policy.

Without knowing exactly what foods are being provided through this program, I would be remiss in dismissing the program as unhealthy. The article simply states that burgers can’t be served more than twice a week, fries aren’t served at all, and they also offer salads and apple sauce. I admit that these claims don’t instil me with much confidence that the offerings are truly healthy, balanced, varied choices. After all, a healthy diet isn’t the absence of the least healthy foods. Offering burgers “only” twice a week isn’t exactly a paradigm of health. Nor is apple sauce and what I’m speculating would be an iceberg lettuce-heavy salad. But that’s just speculation. Perhaps BK is offering a variety of nutritious salad options.

I do think that it’s unfortunate that the decision as to which company receives the RFP to provide schools with lunches is made based on what company can meet the guidelines for the lowest price. Instead of looking at what other hot lunch providers can offer by way of variety and nutrition above and beyond foods permitted, it’s all about the money. Far be it for schools to consider the import of good nutrition on health, behaviour, and the ability of students to learn.

The issue goes beyond the nutritional value of the food being served. Having Burger King provide the hot lunches also allows them to advertise within the schools and build life-long customers out of young children. BK may be providing the food at a lower cost than other providers could but that’s because they’re a huge corporation that sells relatively inexpensive mass-produced food products. They’re also getting more than their money’s worth by being allowed to advertise in schools in this manner, and don’t think for a second that this isn’t exactly why they’re doing it.

In an ideal world, schools would have their own cafeterias with staff and nutritious food prepared for all students at lunch. Unfortunately, our world isn’t ideal. At the very least, school boards could be ensuring that RFPs give preference to local companies rather than large multinational fast food conglomerates.


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Protein: the latest killer lurking in your food

Image by noodles and beef on flickr. Used under a Creative Commons Licence.

Image by noodles and beef on flickr. Used under a Creative Commons Licence.

Oh good, just what we all need, more fear mongering. That’s one thing we certainly don’t get enough of as part of our current diet. So, what’s the latest to spark fear into the tummies of eaters everywhere? Protein. Yep, apparently, our “obsession” with protein is actually making us sick. This according to Garth Davis, a surgeon, and author of the forthcoming book Proteinaholics. Cute name, no? Right up there with Grain Brain and Wheat Belly.

Davis proposes that we’re all eating too much protein and that it’s having dire health consequences. According to the article an average 150 lb adult in the US consumes the equivalent of more than 6 eggs worth of protein in a day. I’m not sure how the math was done to obtain this conclusion (I guess that “more than” must be integral) as I have six large eggs clocking in at 6 grams of protein a piece which would be 36 grams of protein for the day which is actually less than the recommended 0.8 g/kg of body weight per day. In fact, it leaves our “average adult” about 18 grams of protein shy of the recommended adequate intake. Not to mention the fact that while the AI is expected to meet, or exceed, the needs of most individuals, it doesn’t account for those who have increased nutrient needs such as athletes, those who are injured (particularly people suffering from burns), pregnant women, the elderly, etc. To the article author’s credit, she does go on to mention that there are some researchers who believe that the AI for protein should be increased, providing some balance to the article if you manage to read the whole piece.

Another good point made in the article is that we get protein from many foods, particularly foods that people don’t think of as protein sources. Things like grains and vegetables. However, this is undermined by the example provided comparing the protein content of a packet of Mr Noodles with the protein in a Clif Bar. An unfortunate choice because your standard Clif Bar isn’t a protein bar, it’s an energy bar. This may sound like a minor quibble but when most protein supplements provide around 20 grams of protein per serving, comparing an energy bar with 11 grams of protein (still nothing to sniff at) to Mr Noodles (which have 10 grams in the chicken flavour used for comparison but as few as 4 grams in some other flavours) is rather foolish. To digress from protein for a moment… While the Clif Bar is also high in sugar (about 5 teaspoons!) it does contain other vitamins and minerals and fibre while your packet of Mr Noodles will give you more than half a day’s worth of sodium. I know that the focus of the article was protein but it’s important not to make the focus of nutritional comparisons single nutrients.

Onto the dangers of our proteinaholic diets. Ketosis. Which, based on the article, you would think occurs after consuming a single protein supplement (sans carbs) and leads to nausea, fatigue, and headaches. Apparently feeling miserable is why you lose weight, you’re simply less inclined to eat. While I’m not a supporter of ketosis for weight loss (I love carbs and I don’t think that very-low carb diets are sustainable) I think that there may be some confusion between ketosis and ketoacidosis here. Ketosis is the result of following a low-carb diet (not necessarily a high-protein diet) and may initially result in symptoms such as frequent urination, dry mouth, and headache. People who are in ketosis often report a sense of euphoria and a lack of hunger once these initial symptoms pass. Nausea and vomiting may occur in the case of ketoacidosis which is when ketones build-up in the blood, making it acidic. This can happen to people with diabetes, during starvation, and in conjunction with other medical condition, not on a low-carb diet.

Animal proteins apparently also make you fat, cause cancer and diabetes. Also, the amino acids (which are building blocks of proteins) leach calcium from muscles and bones. To address the first statement: animal protein might cause you to gain weight, if you consume too much of it. So might cookies. Consuming excessive calories from any source can lead to weight gain. Animal protein might be a factor in cancer development, certainly processed meats and burnt meat have been identified as risk factors. As for diabetes, there has been an association noted between higher consumption of meat and type 2 diabetes; however, there has been no causal link made to date. To address the second statement: this myth has been around for a number of years. Recent research indicates that protein consumption does not reduce bone density, in fact, it may actually help to boost calcium retention.

“Although it’s necessary for us to grow, it also helps grow cancer cells. It’s instructive that breast milk, which humans consume during the fastest growing period of our lives, derives just five per cent of its calories from protein.”

Funny, I thought it was sugar that was feeding cancer. If you believed all of the fear mongering out there you wouldn’t be able to eat anything. Do I really need to tell you that infants are different than adults? If breastmilk was the optimal way for humans beyond the age of 2 years to obtain nutrition then we’d all be drinking breastmilk on the daily. As we age, our nutrient needs change; in connection with increased caloric needs we also see increased protein needs.

We’ve seen so many diets purporting that this or that macronutrient is evil. I’m not saying eat more meat, most Canadians could certainly benefit from consuming less. However, it seems to me that people like Davis are conflating protein with meat. You can’t paint all protein-containing foods with the same brush and his message only serves to scare people away from protein in general. In my mind, this is not promoting a healthy way of eating. Nor am I saying that protein supplements are necessary, sorry Vega, they’re really not.

Davis says, “If I can’t convince you that protein is bad for you, I can’t convince you that water is wet.” Awesome. I’m looking forward to no longer having to towel off after I shower.