bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Craisin a little hell #craisingate 2016

Earlier this week Dr. Yoni Freedhoff wrote about why he considers craisins to be better classified as candy than as fruit. I retweeted his post and posed the question on twitter: Should craisins be considered candy or fruit?

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As you can see from the results, people were overwhelming in favour of treating craisins as candy rather than as fruit. However, the results don’t tell the full story.

There was a surprising amount of vitriol expressed by some of my fellow dietitians. Apparently this topic touched on a nerve. Personally, I don’t feel all that strongly about the subject but I do take exception when people suggest that I’m causing eating disorders by daring to suggest that we should treat craisins (and perhaps other dried fruit) as we would candy, and not as we would fruit. I don’t see the need to attack each other’s professional ability over such a minor disagreement. Just because I disagree with dietitians who believe that craisins should be treated as fruit doesn’t mean that I think they’re incompetent. We don’t have to agree on everything and in the big scheme of nutrition this is pretty minor.

Anyway… A loaf of other strawmen brought to the party. Apparently I also hate camping because I think craisins are like candy. Somehow I was also implying that craisins are causing obesity (yes, I don’t get it either). I was “demonizing” craisins. Really? Really? I had no idea that people were so passionate about dried up sugary cranberries.

Let’s look at the facts. While Yoni drew some comparisons between craisins and candy, I think we should also take a moment to compare craisins and cranberries.

Dried Cranberries (60ml) Fresh Cranberries (125ml)
95 kcal 23 kcal
25.32 g carbohydrate 6.12 g carbohydrate
1.8 g fibre 2.3 g fibre
19.98 g sugar 2.03 g sugar
3 mg calcium 4 mg calcium
0 mcg vitamin A 18 mcg vitamin A (beta carotene)
0 mcg folate 1 mcg folate
0 mcg vitamin B12 0 mcg vitamin B12
0.1 mg vitamin C 6.7 mg vitamin C
1.2 mcg vitamin K 2.6 mcg vitamin K
4.92 g moisture 50 g moisture

As you can see, craisins do lose some nutrients when they’re dehydrated. They also gain a whole lotta sugar (both because the sugar is more concentrated and because a lot of sugar is added to make them tasty).

The sugar is certainly one of the reasons that I think we should treat craisins more like candy than like fruit. It’s like any sweet treat, apple pie, chocolate milk. Sure there are some redeeming qualities but just because it was once a berry, fruit, or white milk doesn’t mean that it’s equal to what that food was in it’s original state.

Why else should we consider craisins to be more akin to candy than to fruit? They’re lacking the water that’s present in whole fruit. This has three effects: 1. you’re not getting the water that you would eating whole cranberries that you do from dried, 2. the calories are far more concentrated so you only need a small portion to get the same calories that you would from eating fresh cranberries, 3. craisins are very sticky which makes them excellent contributors to the formation of dental caries.

After I had written this post, another RD (who wisely chooses to remain nameless, wanting to avoid getting caught in the fray) shared this with me:

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Sorry, for the poor resolution. Hopefully it’s clear enough for you to see that these national guidelines recommend dried fruit be included as “sometimes” foods. Which, as you can see below, is exactly what I’ve been saying.

I’m not saying that craisins are bad. Heck, I sprinkled some in my pancake batter for Pancake Tuesday (much as I might chocolate chips). I don’t think that candy is “bad” either. I don’t believe in labelling foods as “good” or “bad”. All foods fit. We should simply consume some more regularly than others and I would put craisins firmly in the “sometimes” food category.

*Thanks to my friend and fellow RD Mark McGill for the title suggestion and tweep Amanda McLaren for coining the now infamous craisingate hashtag


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Does that tub of yoghurt contain toxic levels of sugar?

Last week my twitter friend Stacey asked me for my thoughts on the mention of “toxic levels of sugar” in this article by Aviva Goldfarb: My healthy eaters are consuming toxic levels of sugar. Your kids probably are too. 

Before I go any further I think that we should stop and have a quick refresher on what toxic means as it seems to be a term that’s bandied about all too often these days. A toxic substance is a poisonous substance. There are a couple of ways in which something can be toxic. The effects of acute toxicity are fairly immediate adverse reactions to a substance. The effects of chronic toxicity are a result of long-term low-level exposure to a substance. Of course, the dose makes the poison. Large enough quantities of pretty much any substance can be acutely toxic. We need oxygen to survive but pure oxygen will kill us.

Now that, that’s out of the way, let’s take a look at the claims in the article at hand. According to Aviva, her children are consuming above the level of sugar recommended by the American Heart Association. The recommendation is no more than 3 teaspoons (or 12 grams) of added sugar a day. And she’s right, it’s easy for children, even children who snack on kale and edamame, to consume well over that amount of sugar in the course of a day. I mean, many cookies contain more than that amount of sugar. You can easily consume 3 teaspoons of added sugar from a bowl of cereal, a glass of juice, or a bowl of pasta with jarred tomato sauce. One meal or one snack and you’ve met your limit for the day. Does that mean that you (or your child) is consuming a toxic amount of sugar though? Probably not.

To my knowledge, there is no known dose of sugar that is toxic. Oh yes, I know that many of you, like Aviva will point to Dr. Lustig’s research and say that many MDs believe sugar to be toxic. I will argue that there are many MDs (and RDs and other critically-minded individuals) who dispute Lustig’s findings. I’d also like to remind you that Lustig has a serious conflict of interest. He’s built his entire career on convincing people that sugar is poison and written several books on the subject. If his study were to find that sugar was innocuous can you imagine the damage that would do to his career? He’d be finished. I’d also like to take the time to point out that, despite many others who have been fingered by the anti-sugar crusaders I have no conflicts of interest. I do not receive money from any industry groups, I have not made a career on pushing sugar, I don’t even like pop.

While it may well be that sugar is chronically toxic, there is not sufficient quality evidence to support a specific consumption recommendation. The number chosen by the AHA, the WHO, and others is completely arbitrary insofar as I can tell. What makes matters even worse is that these recommendations pertain only to added sugars. Despite our desire to believe that there is something inherently superior about the sugar in an orange, the fact is that it’s structurally identical to those vilified added (or “free”) sugars.

Sure, an orange comes with loads of excellent nutrients like fibre, vitamins, and minerals but that doesn’t change the fact that when it goes through your digestive system, the sugar in it is broken-down in just the same way as the sugar in a candy. If we are going to say that sugar is toxic then we can’t give “naturally” occurring sugars a pass. Surely we can easily consume more than 3 teaspoons worth of sugar from fruit, vegetables, grains, and dairy products in the run of a day. One glass of white milk and you’re already at 12 grams. Boom, done. Off to die.

Okay, I’m being a bit dramatic. But really now, enough with the fear mongering. Yes, most of us could stand to improve our diets by some measure or another. Undoubtedly, many of us would be well-served by eating fewer sweets and more leafy greens. That doesn’t mean that we need to start policing our children’s diets and denying them ketchup with their (gasp) fries. Honestly, I’d worry more about the negative effects of my children finding me surrounded by empty marshmallow bags and spent containers of Nutella than I would about enjoying the occasional sweet treat. I’d also worry more about the effects of counting grams of sugar they’re consuming and instilling the notion of toxic food choices than I would about a cookie.

Yes to more mindful food choices. Yes to preparing more meals at home using basic ingredients. Yes to more sitting down and eating as a family without distractions. No to more fear mongering and demonizing of single nutrients.


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Jamie Oliver and the hypocritical sugar tax

Jamie Oliver's Apple Berry Crisp contains over 5 tsp of sugar in a teensy tiny 100 g serving (i.e. 1/10th of this box)

Jamie Oliver’s Apple Berry Crisp contains over 5 tsp of sugar in a teensy tiny 100 g serving (i.e. 1/10th of this box)

This opinion piece about the proposed sugar tax in the UK left me with mixed feelings. On the one hand, I agree, Jamie Oliver is an hypocritical patronizing bully (remember that time he said “poor people” could well afford to cook better meals if they all have tellies?). On the other hand, the alternative solutions to the sugar tax offered in the article are quite likely to be even less effective. And I’m not being instilled with confidence by the author’s bio: “Alex Deane is an Executive Board Member of the People Against Sugar Tax campaign. He has a spare tyre, because he’s freely chosen to eat too much.” 

According to their website the PAST don’t receive any funding from food and beverage companies, only from private individuals. Of course, there’s no telling precisely who those individuals are and whether or not they have any ties to the food industry. PAST states that by not seeking money from food or drinks companies, “It means that people can be confident that our campaign has no conflicts of interests, and that we are the voice of the people”. Assuming it’s true, that all their money comes from people who just really don’t want to pay extra for pop, I’m still not sure that makes them the voice of the people. People who have money to burn on campaigns against campaigns against sugar certainly aren’t likely to be your average citizens. Interesting, considering that their central argument against the sugar tax is that it will be most damaging to people living in poverty. Since when do a bunch of conservatives and libertarians care about people who are struggling to make ends meet? I guess when it’s convenient to use them to make their argument sound noble.

I too have said that a sugar tax will unfairly hurt people living on limited incomes. I too don’t believe that a tax on sugar is the answer. However, I don’t think that the so-called solutions proposed by the PAST are any better, in fact, I think they detract from the real problems. Suggesting that improved nutrition labelling and “encouraging children to do more exercise” are far more patronising “solutions to obesity” in my mind than a sugar tax would be. Come on. These solutions once again place the onus on the individual and as a result imply that we all just need to make better choices. If only we could understand nutrition labels and get off our fat lazy asses a little more we would all be slim and fit and healthy. No matter that neither of these solutions addresses their central argument. You think that people living in poverty are going to benefit from improved nutrition labels and being told to exercise more as long as they don’t have to pay extra tax on pop and candy? This makes no sense at all.

The onus needs to stop being placed on the individuals. Sugary treats should be more expensive. Not because a higher tax is placed on them though, but because the food industry is no longer subsidized and offered tax breaks to create these products. Grocery stores could also stop selling these items as “loss leaders”, stop accepting money from the companies making these products to place them in prominent displays, stop giving them the prime eye-level shelves, and selling them at checkouts. Other stores that by all rights should not be selling food (I’m looking at you office supply stores, house-ware shops…) could stop selling candy and other food. Until we start realising that profit is not the be all and end all, and that the abundance of food, particularly “sometimes” foods that should not be consumed on a daily basis, is actually costing us more as a society in healthcare significant change in obesity rates and lifestyle related diseases is unlikely. We need to change our environment and shift our priorities. The presence or absence of a sugar tax is not the answer and arguing about it is taking us farther away from the real problems at hand.


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Is sugar making you go bald?

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My google alerts, alerted me to this clip from The Doctors that says sugar is the surprising food behind your hair loss. While absolutely being sensationalist I do have to give them a little credit for not going full Dr Oz. They made sure to state that sugar, in and of itself, is not inherently evil and that it’s fine to consume it in small quantities. According to them, sugar is leading to expanding waistlines and thinning hairlines. Sweet.

It’s a very short clip, and naturally, there aren’t any references. As far as I can tell, there hasn’t been any new research in this area. I found a few studies from about a decade ago looking at the connection between an alleged male form of PCOS (polycystic ovary syndrome) and premature balding and insulin resistance (1, 2). These studies did not explicitly examine a link between sugar consumption and hair loss.

Insulin resistance is an impaired ability of the body to properly use insulin. The causes of insulin resistance are not yet fully known; however, major contributing factors include diet and lifestyle. High levels of fat around the waist and a sedentary lifestyle may both contribute to insulin resistance. Excessive consumption of sugar and refined carbohydrates may contribute to those high levels of abdominal adiposity. However, excessive consumption of calories in general, regardless of source, may cause accumulation of excessive abdominal fat.

There are many causes of hair loss, including hormonal disruptions. These may go hand-in-hand with insulin resistance and conditions such as PCOS and type 2 diabetes.

To summarize: The Doctors have taken the leap from excessive sugar consumption to hair loss. There are many other factors at play and sugar itself would not be the direct cause of hair loss, even if it is a contributing factor in the development of hormonal disruptions. Because there are many other causes of hair loss, before you go sugar-free, you should book an appointment with your primary health care provider to obtain an accurate diagnosis. That being said, if you watched that video and thought “I’m eating too much sugar” there’s absolutely no harm in cutting back. Too much of anything is bad for you.


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If children were plants

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I cannot believe the absurdity of things like this. While the message is good, don’t give your children sugary drinks, the approach is ridiculous. Are they sincerely suggesting that human children are comparable to plants? If I still had photoshop I would change it to show the plant being offered fertilizer (or sunshine) and the child being offered salad. Or replace the plant with a pet cat or dog being offered pet food. I can’t imagine any parent (except possibly if the guy who made soylent has kids) thinking that it’s a good idea to give their children exactly the same food at every meal.

Let’s stop making silly comparisons that undermine messages. Children are not plants.