bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Should the food industry be allowed at the obesity debate?

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This article: Food firms could be out of the obesity debate baffled me. The by-line reads: “Food and drink manufacturers must emphasize the role of exercise in reducing obesity or risk being sidelined in the debate and hit with stricter regulation, according to new research.” What? Isn’t that exactly what many food and beverage companies are doing? I seem to remember Coke, for example, having an ad campaign based around how many calories it takes to burn off a coke. Isn’t this one of the biggest problems with the current debate? That you can out-run your fork? That food manufacturers want us to believe that we’re fat because we don’t move enough, not because we’re not eating properly? Sorry, hate to break it to ya, but the most important factor in losing, and maintaining weight loss, is diet. And the best way to attain a healthy diet is to prepare it ourselves rather than relying on packaged, processed, manufactured foods.

Of course, the by-line obscures one of the major recommendations of the research. That recommendation is that the role of public health in education and health programming should be emphasized. Sadly, they do state that food manufacturers should be making greater efforts to reformulate their products to meet the weight management needs of the consumers. Honestly, I think this is a fool’s errand. It’s been done before; and look where all those low-fat and fat-free products got us? Here. Greater import needs to be placed on cooking and the food system needs to be restructured so that “junk” foods are no longer subsidized, while fruits and vegetables are.

I for one, don’t see it as any great tragedy if the food industry was to be sidelined in the obesity debate. Frankly, their inclusion only serves their interests and keeps the mistaken belief that individual responsibility is the key to conquering obesity alive.


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Are mushrooms the new meat?

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How could I resist the headline: 7 simple weight-loss foods? Of course, we all know that there are no magical weight loss foods. Weight loss and management is all about the overall pattern of eating. Eating half a grapefruit before every meal, eating eggs, or blueberries is not necessarily going to mean that you’ll lose weight.

The suggestion that bothered me the most was to swap out meat for mushrooms. I’ve got nothing against mushrooms (cooked, obviously). Nothing against meat either. Certainly, if you’re a frequent meat eater and you start replacing meat with mushrooms, you’re probably going to lose weight. However, mushrooms, despite their meaty texture are not nutritionally comparable to meat and the suggestion that they’re interchangeable concerns me. Go ahead and have a portabello burger or a mushroom lasagne, but bear in mind that those mushrooms aren’t providing you with the protein, iron, vitamin B12, etc that meat does. Ensure that you include other sources of these nutrients in your diet as well as the mushrooms.


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Book Review: The Diet Fix

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I should start with a disclosure: I briefly worked with the author, Dr Yoni Freehoff at his weight management clinic in Ottawa, and I consider him a friend. That being said, I no longer work with him, he didn’t ask me to read or review his book, I didn’t even get a free copy! Okay, well, I kind of did, I borrowed one from the library. The book in question is The Diet Fix

Having worked with Yoni, and being a dietitian, there wasn’t anything in the book that was new or surprising to me. Basically, it was a refresher of everything we would cover with clients, minus specific nutrition information and individual concerns. In addition, I’m not someone who struggles with weight so it wasn’t of personal benefit to read the book. It’s hard to set aside my personal lens when writing about the book. However, as I was reading, I could think of several people I know who would likely benefit from reading The Diet Fix.

Yoni provides a great overview of the information that’s imparted at his clinic in the book. For anyone who doesn’t have access to services provided by a place like the Bariatric Medical InstituteThe Diet Fix is a decent stand-in. There’s a valuable emphasis on living the best life that you can and de-emphasis on the numbers on the scale. Many of us have developed unhealthy relationships with food and this book does its best to help the reader (re)gain a healthy relationship with food.

While there is a section about “resetting” various diets, the book is not a diet book. It’s a lifestyle guide book. The problem with diets is that they always have an end date, and then what? Yoni doesn’t harsh on Paleo (even though it’s so easy and tempting) or Clean Eating or any other money-making diet out there. As long as you’re able to happily and healthily live the rest of your life adhering to whatever style of eating you’ve chosen that’s okay. There are tips for how to make the most of any diet style.

Honestly, the only thing in the book that really bothered me was how often he says “folks”. And that’s probably just because I know someone else (who I can’t stand) who calls people “folks” all the time and it’s become like nails on the chalkboard to me. But I digress… The only statement in the book that I took any exception to was this:

Fruits and vegetables also fall into the carbohydrate catchall. For the most part, they’re all wonderful. The only possible exception is the potato. Dr. Walter Willett, Harvard’s chair in nutrition  since 1991 and the world’s second-most-cited scientist in history, once suggested that consuming one was akin to spooning pure white table sugar into your mouth.

Who am I to question the wisdom of Willett? I will anyway though. Sure, many people consume potatoes far too frequently and in less than nutritionally optimal forms (i.e. chips and fries), however, it’s my belief that the potato is an under-rated vegetable.

Minor quibbles aside, I enjoyed the last sections of the book the best. They addressed a number of issues, such as medications and raising healthy eaters, that most “diet” books would never touch. This makes it a great resource for anyone who wants to take charge of their health, impart healthy habits on their children, or who works with people who do. If you want to lose weight and don’t know where to start, if you’re a doctor or a dietitian, I definitely recommend giving this book a read.


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Are apples the key to curing obesity?

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A few weeks ago the media was reporting that apples may provide the cure for obesity. I was a little more sceptical. I mean, how many overweight and obese people do you know who eat apples? Probably lots. If apples were capable of curing obesity everyone would be thin.

My first concern was that this research was conducted on mice. That means that it may (likely) is not translatable to humans. A couple of things to consider: these mice were fattened up by being fed a very specific high-fat diet. Obesity is a complex condition with myriad factors. Unless the reason for people being overweight is due to consuming a similar diet to these lab mice, it’s quite likely that they will not respond to this weight loss treatment in the same manner as the mice. I also wondered how much apple the mice were fed. How much apple would humans need to consume to see similar results? Here’s where it gets crazy: the mice did not eat the apples. Yep, that’s right. We have no idea how much apple would be beneficial to humans as we don’t know how much would be beneficial to mice. Rather than feeding the apples to the mice, the researchers made a slurry of apple compounds and mouse faeces. They found increased levels of certain bacteria that are commonly found in the faeces of slim mice in the cultured faeces of obese mice. Their results were not statistically significant. They showed a trend toward increased levels of some bacteria and butyric acid, and decreased levels of other bacteria in the faeces-apple slurries of obese mice but none of the changes (save the decreased bacteria) were large enough to be statistically significant.

It’s impossible to say whether or not eating apples (how many, how frequently) would have similar effects on the fecal microbiomes of mice or humans. We also don’t know if these microbial changes do occur if they would result in weight loss. Without knowing this, it’s a ridiculously huge leap to suggest that consuming apples could be a treatment for obesity. This didn’t stop the authors from concluding that:

These results suggest that dietary fibre and phenolic compounds remaining in apples after IVD might help to prevent metabolic disorders driven by an altered microbiota in obesity, and potentially protect from an obesity-disturbed balance of microbiota.

It also didn’t stop the media from publishing articles with headlines like: “An apple a day could keep obesity away: Granny Smiths promote friendly bacteria helping us feel fuller for longer” and “Granny Smith apples can help prevent the damage of obesity“.

I do think that research into our microbiomes is going to provide insight into many illnesses and conditions. However, our individuals microbiomes are extremely variable. Suggesting that this research using mice will translate to obesity treatments for humans. It’s also extremely unlikely that consuming one healthy food will negate the effects of an overall unhealthy diet. That being said, apples are nutritious and it’s certainly not going to hurt you to have an apple a day.


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The cure for diabetes

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I was recently informed that there is a cure for type 2 diabetes. Apparently researchers in Newcastle have found a way to reverse type 2 diabetes. According to their website:

Our work has shown that type 2 diabetes is not inevitably progressive and life-long. We have demonstrated that in people who have had type 2 diabetes for 4 years or less, major weight loss returns insulin secretion to normal.

Obviously, we dietitians have been recommending weight loss, diet, and lifestyle changes for many years. However, these changes rarely result in a complete reversal of the condition. The best case scenario is usually that the patient is able to manage their diabetes without the need for medications. More often though, it means that the progress of type 2 diabetes is slowed and less medication is needed to keep blood sugars reasonably stable. Despite this research having been conducted back in 2008 this was the first that I had heard of it.

For those interested, the complete study Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol is available here. To summarize, they looked at eleven people whom had been diagnosed with type 2 diabetes within the previous four years. Yes, that’s correct, eleven people. That’s a pretty small sample size. That means that no matter how astounding the results, it’s impossible to say if they will be applicable to the majority of people with type 2 diabetes.

The results of the study were quite good. All of the participants saw dramatic improvements in both fasting blood sugar and plasma insulin levels after only one week. In fact, after only one week of the eight week program, these levels were indistinguishable from a non-diabetic control group. Because normalization of beta cell function and insulin levels were seen in the participants, they were deemed “cured” of type 2 diabetes upon completion of the study.

What exactly did the researchers do to “cure” these people? They placed them on strict 600 kcal a day diets. Now, I don’t know about you, but that number shocked me. 600 kcal a day is extremely low. Most medically supervised low-calorie liquid diets for obese patients still have them consuming 800 kcal a day. Most weight management programs recommend patients consume at least 1, 200 kcal a day. For most people, 600 kcal is one meal (for many people, it’s less than one meal). In this study, participants consumed 510 kcal worth of Optifast shakes per day and were encouraged to supplement with non-starchy vegetables and drink at least two litres of water (and other calorie-free beverages) each day.

Because there was no follow-up with participants upon completion of the eight week study, there is no way to know for certain if they were actually cured of their diabetes or if it returned after they completed the program. Even supposing the diet is a cure for type 2 diabetes I can’t help but wonder how many people would be able to adhere to 600 kcal a day for eight weeks. As with any medicine, it doesn’t do any good if patients won’t take it. I suspect that the majority of people would forego the cure of such a strict diet.

All issues with this being touted as a “cure” for type 2 diabetes aside, I would like to see further research in this area. Larger, longer studies would be interesting. I’d also like to see a variety of levels of caloric restriction used as well as different sources of nutrition (not just shakes).