bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Why obesity prevention is not the answer

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One of my twitter friends recently shared a link to this article: How Early Should Obesity Prevention Start?ย My immediate reaction was that they’re asking the wrong question. They should be asking how earlyย health promotion should start.

While I think that the authors make some good points about obesity influences beginning in the womb, I stand by my initial reaction. No one likes to hear the term obesity. No one wants to be told that they’re obese or that their weight may cause their children to become obese. Is an obesity intervention really going to make much of a difference? I’m doubtful. Framing such an intervention as health promotion, and not only targeting overweight and obese women might be slightly more effective. However, these interventions are still putting the onus on the individual. Interventions targeting individuals and groups serve a purpose in the battle against obesity in the same manner that food banks serve a purpose in the battle against food insecurity and poverty. They are bandaid solutions for gaping wounds.

As I’ve said many times before: we need systemic change. The only way that we’re going to truly see a decrease in obesity rates is if we, as a society, change. We need to put more emphasis on food preparation and incorporating physical activity and exercise into our daily routines. We need to stop wearing long workdays and sleep deprivation as badges of honour. The best way to address the obesity problem is to not talk about obesity.


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Hyperemesis gravidarum: beyond morning sickness

With Kate Middleton’s recent hospitalization, hyperemesis gravidarum (extreme nausea and vomiting during pregnancy) has been thrust into the spotlight. Coincidentally, I’ve had several friends suffer from it recently as well (supposedly it only affects 1-2% of pregnant women). It’s much more severe than the “normal” morning sickness (which itself is a misnomer as it can occur at any time of day) and often lasts throughout much of the pregnancy.

Frequent vomiting during pregnancy can lead to weight loss, dehydration, and electrolyte imbalances. Women who suffer from hyperemesis, and who do not gain as much weight as hoped during pregnancy, are at risk of delivering small infants.

Essentially, women suffering from hyperemesis should consume foods that they best tolerate in an effort to gain a healthy amount of weight. Different foods may be better tolerated, or may trigger nausea, depending on the woman. However, oftentimes starchy foods are best tolerated. Trying to consume energy dense foods that us dietitians would normally be advising people to limit intake of may be beneficial for women suffering from hyperemesis. Things such as dried fruits, nuts and nut butters, granola, crackers, even chips may be good choices for these women. Ginger is a natural anti-nausea agent that may also be helpful.


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Pregnancy, a licence to eat?

Myth 32: When you’re pregnant, eat up! You are eating for two.
What Dietitians of Canada says:
“Pregnant women are commonly told they are “eating for two.” In reality, you need just a little more food, during the second and third trimesters, to get enough nutrients and calories to support a growing baby…”
What I say:
This is a good myth! The people who seem to spread this myth the most are pregnant women themselves. I think it’s often used as a licence to eat as much of whatever you want. While I am not at all opposed to the occasional indulgence, I don’t think that eating unhealthy foods to excess is a good plan during pregnancy. Your unborn child is pretty small, especially during the first trimester, they don’t need a whole lot of calories. As DC says, you don’t need any extra calories during the first trimester, and only about 340 per day during the second, and 452 per day during the third. That’s just a couple of extra snacks a day. It’s not about quantity, it’s about quality. You have a responsibility to give that baby the best possible start possible. As the fetus cannot control the nutrients that are being provided to it, the pregnant woman shoulders the responsibility of providing their child with a healthy diet. More calories are actually needed to support breastfeeding than pregnancy. It takes at least 500ย extra kcal/day to support lactation. If you want to use your pregnancy as an excuse to change your diet try to use it as an excuse to choose healthier nutrient-dense foods, not as an excuse to double your calorie intake.


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Baby making

What with all this talk about babies, I thought that I should talk a little bit about related nutrition. Let’s start with preconception. Provided you’ve actually made the conscious choice to conceive, both of you need to think about your nutrition. It’s not just about cutting out alcohol and it starts months before conception. What a man eats affects sperm production quality. If you want a good product, it just makes sense to use the best ingredients. There’s enough pressure on the woman to do things right, the man needs to assume some responsibility here too. Potential dads: if you want to make a better baby then make sure your diet includes lots of fresh vegetables and fruits and consider cutting out alcohol. Exercise is also important. The healthier you are, the healthier your baby will be, both at birth and years down the road. The other thing that really annoys me is hearing women say that they’re “eating for two.” Or using pregnancy as an excuse to eat loads of high calorie, low nutrient foods. You’re not eating for two! Your foetus is tiny. You do not need to double or triple your caloric intake during pregnancy. Sure, if you have a craving, go ahead and indulge yourself, but do so with the same restraint that you would if you were not carrying a small person around inside you. Also, there is an increasing body of research showing that what you eat during pregnancy can affect your child’s health throughout their entire lives. Check out the study of nutrigenomicsย if you’re interested in learning more about how nutrition can affect gene expression. Sure, it’s a lot of pressure, but you are responsible for this unborn person’s future. It is a lot of pressure.


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Safe strollering

This isn’t exactly nutrition related, although it is about weight loss. It’s something that I learned about in one of my nutrition classes though so I’m going to just go ahead and rant about it… I recently read an article in Chatelaine magazine about losing post-pregnancy weight by running with your baby in a stroller. This article really bothered me because in it they make no mention about how young a baby can handle this weight loss plan. The author only addresses the concerns of the new mum. I recall learning that it’s unsafe to run with a baby in a stroller until they’re at least 6-months of age as there’s a risk of shaken baby syndrome. I did a little research into this and it seems that recommendations around this vary (some say there is no minimum age, while others say three to six months) so make sure that you consult with your doctor and read the manufacturer’s instructions carefully before taking your baby out for a jog. Note that I said “jog” and not “run.” You’re much less likely to cause harm to your baby if you’re cruising along at a moderate pace. The article author used these terms interchangeably but I would argue that jogging is generally more leisurely than running. The author also mentions that she had a “jogging stroller”. This is important information, but she fails to notify the reader that this equipment is important. A good jogging stroller should be designed to provide neck support for your baby. Your regular stroller is unlikely to offer this feature. Now, I don’t want to discourage new mums from getting out there and exercising. I think that exercise is important for everyone to feel their best both physically and mentally and this can be especially important post-pregnancy. I just want to encourage new mums to be informed when choosing their exercise plan.