Dispelling nutrition myths, ranting, and occasionally, raving


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A bit about that working mums make kids fat study

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This article: The Impact of Maternal Employment on Children’s Weight: Evidence from the UK came out a couple of weeks ago and I was appalled. Essentially, the article is blaming working mothers for making their children fat. As if working mums don’t have enough guilt dished out to them already. As if there’s a simple causal relationship between obesity and maternal employment. And as if there isn’t already enough unhelpful fat-shaming going on in our society. I was going to blog about it but a number of other people already have so why reinvent the wheel. Instead, check-out these pieces:

Working Mothers Don’t Make Children Obese by Gid M-K; Health Nerd on Medium explains why the reporting on this study was all wrong.

Aiming the Obesity Blame Game at Working Moms by Ted Kyle on ConscienHealth reminds us that correlation is not causation.

A TL;DR thread from Sean Harrison breaking down the many limitations of the study.

If you’ve come across any other great criticisms of the research (and media surrounding it) please share in the comments. I would especially love to see some from a weight-neutral perspective as the majority of the criticism has been around the study methods and sexism but I think that sizeism is a major problem with the research as well.

 

 


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Is it #NutritionMonth2019 or #DairyFarmersofCanadaMonth and #AvocadosofMexicoMonth?

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We need to talk about Nutrition Month. More specifically, we need to talk about Dietitians of Canada’s Nutrition Month recipes. It’s been a long time (back in 2012 to be specific) since I wrote about the issue of sponsorship in regard to DC’s Nutrition Month materials. To be honest, I feel like a bit of a traitor doing it (DC does many great things to advocate for dietitians), but I think that it’s a real issue. Accepting sponsorship for Nutrition Month is undermining DC’s (and by association all Canadian dietitian’s) credibility.

When DC first released their Nutrition Month recipes I was disappointed, but not surprised, to see that they were sponsored by Dairy Farmers of Canada and Avocados from Mexico. Don’t get me wrong, I consume both dairy and avocados. This is not to cast aspersions on either of those foods. However, I think that a dietetic organization accepting sponsorship from the food industry (no matter what the foods are) creates a conflict of interest. I also think that there are additional reasons why featuring these particular foods in DC resources is problematic. I’ll get into that a little later. So, as I said, I wasn’t surprised. This is nothing new for DC. I had a little rant with my RD colleagues (one of whom also happened to point out that the content of the handouts, aside from the recipes was simply duplicated from last year, sigh) and then let it go.

My frustration was reignited last week when fellow RD, Pamela Fergusson voiced her concern about the industry sponsorship of Nutrition Month on Instagram last week. She’s also written an excellent blog post about this issue that you should read.

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That got me curious so I went on the Nutrition Month website and counted how many times dairy and avocados appear in their featured recipes. Out of ten recipes, eight include dairy and four include avocados. There are 12 additional recipes on their handouts, eleven of these include dairy and six include avocados. That’s a lot of dairy and avocados!

While I love avocados, they are freaking expensive. They’re usually about $2 a piece at the grocery store here. Given that food insecurity is an issue across Canada, DC even has position papers on both individual and household and community food insecurity, it struck me as a little inappropriate for them to so prominently feature a food that’s not within the budget for many Canadians. Even for those who don’t struggle with food insecurity, avocados are often more of a luxury item than a staple food. The same goes for many dairy products, particularly cheese, which is featured in many of the DC Nutrition Month recipes. Realistically, who’s making a “crab and remoulade sandwich” for lunch??

In addition to the issue of cost, there’s the lack of alignment with the new Food Guide. Despite what many people would have you believe, milk (and dairy products) have not been removed from the new Food Guide. They’ve simply been incorporated into the new “protein foods” grouping. However, there is a strong emphasis on choosing plant-based sources of protein more often. I realize that DC would have already developed their resources before the new Food Guide came out. Even so, the old Food Guide only recommended two servings of milk (and alternatives) daily for adults. No matter which Food Guide you look at, it doesn’t make sense that DC would feature dairy in the majority of their Nutrition Month recipes.

This takes me to one last issue that I stumbled upon while tallying up the recipes featuring dairy and/or avocados. That issue is the nutrition information for the Turmeric Basil Roasted Turkey Burger. This burger contains 936 calories, 48 grams of fat (9.1 g of which are saturated), and 773 mg of sodium. To put that in perspective, that’s 416 more calories and 20 grams more fat than are in a big mac (177 mg less sodium though). It’s about 3/4 of a day’s recommended maximum intake of fat and over 1/3 of the maximum recommended intake for sodium. That’s just in one burger! I thought for sure this had to be a mistake so I tweeted at DC to ask them about it. This is the reply I received:

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A “hearty” burger indeed! As much as I believe that all foods fit and that having treats is part of a healthy diet, I really don’t think that a recipe like this is appropriate for a dietetic organization to be promoting. When people are looking for recipes from Dietitians of Canada they’re looking for recipes that meet certain nutrition criteria. They’re looking for recipes that are going to provide them with a reasonable number of calories, not too much fat or salt or sugar and plenty of vitamins and minerals. I think it undermines their credibility as an organization when they allow sponsors (such as Avocados of Mexico who developed this recipe) to be put ahead of the public who rely on dietitians for unbiased nutrition information.


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Game Fuel won’t help you up your game

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Okay, I’m a little bit behind the times I guess because I only just found out about this “Game Fuel” drink from Mountain Dew (shout-out to my friend Zach for alerting me to this product) last week even though it’s been on the market since December. I suppose I’m not exactly part of their target market though as someone who doesn’t play video games or consume energy drinks. In case you, like me, hadn’t heard of this beverage before, I’m here to give you the low-down.

Lest you were thinking that “Game Fuel” was intended for those playing physical sports games, you would be (understandably) mistaken. This “fuel” was designed specifically for video gamers.

One can of Game Fuel supposedly contains two servings, but let’s be honest, who drinks only half a can of something? That one can contains 90 calories which all come from the 23 grams of sugar. That’s just shy of 6 teaspoons of sugar for those of you who don’t feel like doing the math. It would take the average gamer over an hour of playing to use up the equivalent calories to those in a can of Game Fuel. This is also the total recommended maximum daily consumption of added sugar for women and 3 teaspoons less than the max for men. I am not mentioning children and youth here because it is unsafe for them to be consuming energy drinks. Not the healthiest of beverages but what about the alleged science behind the ingredients such as caffeine, theanine, and vitamins A and B that PepsiCo claims will increase alertness and accuracy?

There is 90 mg of caffeine in a can of Game Fuel. This is on par with an average cup of coffee. Caffeine is likely the most studied ingredient in Game Fuel and there is evidence to back-up their claim that it can increase alertness. However, it is quite easy to achieve a tolerance to caffeine and once you do, it doesn’t matter how much more you consume, you will no longer reap the original benefits. Also, it’s important to note that as with most things, more is not better. Caffeine consumption greater than 400 mg/d can lead to unwanted side effects such as a fast heartbeat, insomnia, and irritability.

L-theanine is an amino acid that is found in green tea. It has been found to act synergistically with caffeine by increasing relaxation and attention without promoting drowsiness.

Vitamin A is a fat-soluble vitamin which means that it is possible to attain Vitamin A toxicity. Generally, Canadians consume adequate quantities of Vitamin A through diet alone (it’s found in a variety of plant and animal foods) and supplementation is not recommended due to the risk of toxicity. Although the amount of Vitamin A in Game Fuel is quite low (180 mcg) it is still an unwarranted ingredient. Vitamin A, in adequate amounts (700-900 mcg/d), is important in maintaining a healthy immune system, skin, eyes.

Niacin is a B Vitamin that is important in helping your body to use fat, protein, and carbohydrates as energy. One can of Game Fuel contains 6.4 mg of niacin, about half the recommended daily intake. I am genuinely baffled as to why niacin is added to Game Fuel other than as a marketing tactic. Perhaps if this was a sports drink but let’s be honest, you don’t exactly need extra vitamins to meet your needs when you’re sitting around playing video games. The same goes for the added Vitamin B6 and Pantothenic Acid.

Long story short: this is an unnecessary product designed to meet a non-existent need. You don’t need fancy energy drinks to play video games. You’re better off sticking with water. If you don’t have the energy to stay awake to keep gaming a better alternative to Game Fuel is to actually get some sleep.

 


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How to end hallway medicine

End hallway medicine: ban hallways

There’s been a lot of talk about “hallway medicine” (i.e. patients receiving treatment in hospital hallways due to hospital overcrowding) in Ontario over the past couple of years. A recent report from the Premier’s Council on Improving Healthcare and Ending Hallway Medicine provided recommendations to the government on how to improve the current situation. The key findings from the report were as follows:

    1. Patients and families are having difficulty navigating the health care system and are waiting too long for care. This has a negative impact on their own health and on provider and caregiver well-being.  
    2. The system is facing capacity pressures today, and it does not have the appropriate mix of services, beds, or digital tools to be ready for the projected increase in complex care needs and capacity pressures in the short and long-term. 

Following the release of the report I saw a number of articles and heard several radio interviews, all of which featured emergency room doctors and occasionally nurses. Undoubtedly they have experience which can contribute the the discussion. However, I was frustrated by what I saw as the glaring absence of input from public health. I think that perhaps everyone thinks that the problem lies within the hospitals and therefore the solution can be found there too, even if it’s the suggestion from ER doctors that more home care supports are needed. However, while not an immediate solution to the problem, I think that we need to look further upstream for real long-term solutions. Adding more beds, increasing home care, and improving system navigation for patients are all important but they don’t address the reasons why so many people are ending up in the hospitals in the first place. If we can prevent the need for emergency care then we can reduce the number of people in need of hospital beds.

I was pleased to see that alPHa (Association of Local Public Health Agencies) submitted a response to the report to the government highlighting the important role of public health in improving healthcare and ending hallway medicine. I was also pleased to see OPHA (Ontario Public Health Association) submit a letter to the Minister of Finance advocating for health promotion and chronic disease prevention measures that would help to end hallway medicine. Has anyone seen anything about this in the news though? I haven’t heard any public health officials or representatives publicly advocating for the important role of public health in ending hallway medicine. Public health needs to do better at getting their messages to the public. If people don’t know about what public health does to prevent injuries and chronic disease, reduce infectious disease, and advocate for the social determinants of health then how can we expect them to support these initiatives or even to recognize how these things contribute to the demand for healthcare services?

In addition to the importance of public health in ending hallway medicine I’d like to see more effort to connect with those who are likely most in-the-know about patient concerns: reception staff. Yes, doctors, nurses, other allied health professionals, and patients can all contribute important insights but who speaks to everyone seeking care? Who hears the complaints and concerns that people may not feel comfortable voicing to doctors? Who is at the first point of interaction with the public? Reception staff. I’m sure that they could contribute a great deal of valuable information to the consultation on ending hallway medicine.

If the government truly wants to end hallway medicine they need to consider the reasons that people need healthcare and the impact that their cuts (and decisions) in other areas is going to have on the demand for hospital services. Hallway medicine is not happening in a vacuum. Cuts to social assistance, ending the basic income pilot, cutting support for cycling infrastructure, reducing funding to the Trillium fund, reducing oversight for meat processing facilities, cuts to mental health funding, ending minimum sick days and reducing employee protections, cancelling the planned raise for the minimum wage, increasing accessibility and affordability of alcohol, and on and on, are all going to result in an increased burden on the healthcare system and our hospital hallways are only going to become more crowded.


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The thing about Rupaul’s Drag Race and Tic Tacs

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I love Rupaul’s Drag Race. I know that I’m late to the party but I only started watching it after it was added to Netflix last year. I think it’s fantastic how diverse the contestants are. I mean, can you think of any other American reality show that consistently has contestants from a variety of ethnic backgrounds and such a range of body types? Despite this, it’s becoming increasingly disturbing to me that the show promotes eating disorders.

Even though there is always at least one larger queen on each season they are often among the first to be sent home and (at least from the seasons I’ve watched so far) a larger queen has never won. Contestants regularly make comments about each others (and their own) weight and size. There is clearly a huge amount of pressure to conform to an ideal.

The thing that highlighted the eating disorder aspect to me the most is the “lunch” with Ru that the contestants participate in toward the end of the each season. I put lunch in quotation marks because this so-called meal consists of a plate of tic tacs which contestants inevitably make jokes about being far too much food. Like, “oh, I couldn’t possibly!” Or “but I’m watching my figure! Ha ha ha.” I have never actually seen Ru, or any of the contestants, eat even a single tic tac. Generally, this is the only food featured in the show (although there was one challenge in which participants had to design their outfits based on cakes. Naturally, there was an observation made by Ru about the amount of cake gone from one of the larger queen’s cakes and an overwrought admission by a very thin queen to having eaten a slice of their cake). To me, this only serves to glorify eating disorders and disordered eating. Look at us, we’re so virtuous. We never eat. Not even a damn tic tac for lunch.

Given that a number of contestants have openly spoken about their past (and present) struggles with eating disorders on the show I find it really unsettling that disordered eating is being promoted by the show itself. I hope that future seasons, now that more contestants are openly talking about their personal struggles with eating disorders, will stop with the segments that glorify these illnesses.

We know that eating disorder rates are likely higher among LGBTQ+ populations and I can only assume that they are just as high, if not higher given the immense importance placed on appearance, in the drag community.

Given that it’s Eating Disorder Awareness Week I think it’s important to emphasize that eating disorders are not trivial. They are not something to be made light of nor are they something to aspire to. For instance, did you know that anorexia has the highest mortality rate of all psychiatric disorders? Bulimia can lead to electrolyte imbalances that can also result in death. These disorders take an immense physical and emotional toll on those experiencing them and on their loved ones. Sadly, rates of eating disorders appear to be on the rise.

If you are suffering from an eating disorder know that you are not alone. If you need someone to talk to and you live in Canada you can call the National Eating Disorder Information Centre for free at 1-866-633-4220. In the US you can contact the National Eating Disorder Association helpline (at the time that I’m writing this their phone line is down but you can chat with them online).