Dispelling nutrition myths, ranting, and occasionally, raving

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Canada’s Healthy Eating Campaign: Too little too late?

On Monday our esteemed Minister of Health, Leona Aglukkaq announced funding for a national healthy eating initiative at the Summit on Healthy Weights. It seems that finally, after years of talking about what we should do to address the obesity epidemic in Canada the government is ready to take action. Unfortunately, that action is destined to be woefully inadequate. What action are they taking you ask? Well, they started off with the Nutrition Facts Campaign in the fall of 2010. This campaign introduced the notion of “A little or a lot” and focussed on teaching consumers how to use the Nutrition Facts table and the Percent Daily Value to help them make healthy food choices. Anybody feel like they’re making better food choices since that campaign launched nearly a year and a half ago? How many people (outside of those in health care and government) are even aware of that campaign? As a dietitian, I don’t even use the Percent Daily Value when making food choices (yes, I do use the remainder of the Nutrition Facts panel) so I wonder how many consumers actually use it. I don’t think the Percent Daily Value is a great tool because it’s based on an “average” person and most of us have varying caloric and nutrient needs, most of us are not actually average. The Nutrition Facts panel is not great, why are we basing an education campaign around an inferior tool? Wouldn’t it be better to be creating better labelling that’s easier for consumers to use? And how about encouraging consumer to eat foods that don’t have nutrition labels, i.e. vegetables and fruit, arguably the foods that most of us do not consume enough of? Okay, so the next phase of campaign will be doing that along with encouraging consumers to reduce their intake of food and drinks high in calories, fat, sugar, and sodium. How will the government do this? It will be “promoted creatively through various outreach partnerships, social media engagement and web tools.” They’re also going  to provide advice on “how to follow Canada’s Food Guide by choosing the right amount and types of food at home, at the grocery store and when eating out.” I’m all for education and increased awareness but I don’t think that knowledge alone is enough to change behaviour. Take us dietitians again, it’s been shown that we fall prey to the same portion distortion tricks and underestimation of calories when eating out, as other consumers and we have at least four years of nutrition education. How can we possibly think that one little public awareness campaign is going to help consumers avoid these pitfalls. We have engineered an obesogenic environment and now we expect individuals to save themselves from it by telling them to eat less junk and eat more vegetables? I’m pretty sure people already are aware that these are things that they should be doing. Unfortunately, our society is set-up to make these changes incredibly difficult. Yes, we need to increase awareness but that should only be the smallest part of our efforts. As hard as it’s going to be we need to redesign the environments in which we live, work, and play to make healthy eating the easiest and most desirable choice.

I just happened across this “Continuum of Education, Marketing, and Law” in an article about active living. It states that educational approaches to manage behaviour should be used when: 1. Target market is prone to behave as desired, 2. Self-interest and benefits of the behaviour are easily conveyed to target market, 3. There is no or weak competition. Social marketing approaches to manage behaviour should be used when: 1. Target market is neither prone nor resistant to the behaviour being promoted, 2. Self-interest and benefits can be conveyed to target market by enhancing and managing the offer, 3. The competition is active. Law-based approaches to manage behaviour should be used when: 1. Target market is resistant to behave as desired, 2. Self-interest and benefits cannot be conveyed to target market, 3. The competition is unmanageable. I would argue that all three approaches are needed, particularly the third one, as we are not liable to change our eating behaviours through healthy messaging alone.


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Allergy testing

It puzzles me why allergists don’t advocate for themselves more. Maybe they have more business than they can handle? Us dietitians are always wrestling with the confusion between us and nutritionists. Yet, I hear about people getting “allergy” testing done by naturopaths all the time and I never hear allergists raising concerns about this.
According to the American Academy of Allergy Asthma & Immunology, “an allergist is a pediatrician or internist with at least two additional years of specialized training and is the best physician to diagnose and treat allergies and asthma”. These are highly trained doctors who only use legitimate testing methods. If you think that you may have a food allergy you should be asking your primary health care provider for a referral to see an allergist. Legitimate forms of allergy testing include: skin prick, food challenge, and in some cases blood tests.
The AAAAI also tells you what tests to avoid, as they are not believed to be useful or effective. These tests include: massive allergy screening tests done in supermarkets or drug stores, applied kinesiology (allergy testing through muscle relaxation), cytotoxicity testing, skin titration (Rinkel method), provocative and neutralization (subcutaneous) testing or sublingual provocation.
Childhood allergies can often be out-grown. According to the Food Allergy Guidelines most children will out-grow milk, egg, soy, and wheat allergies. Peanut and tree nut allergies are least likely to be out-grown. The optimal way to determine if an allergy has been out-grown is through a challenge test which should be done under medical supervision in case a reaction does occur.

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Prescription for a healthy diet

Have you all heard about the doctors in Alberta prescribing exercise to their patients? If not, and you want to read more there was an article in the Edmonton Journal. Basically, patients are given prescriptions for duration and intensity of exercise and receive a free pass to the local recreation centre for a month. I think this is a pretty neat initiative and I don’t understand why it’s not being done for diet as well. As pretty much any medical professional who knows anything about obesity will tell you, diet is a far larger part of the weight loss equation than exercise is. Diet is also a factor in numerous chronic and acute diseases which may or may not be linked to obesity. I think that doctors should be collaborating with dietitians to provide prescriptions for a healthy diet. This prescription should also include one or two sessions with a dietitian.

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The Phenomenal Pistachio

Happy Pistachio Day! Pistachios are one of my favourite nuts. They’re delicious and highly nutritious. Pistachios are a good source of fibre (3 grams per 30 gram serving). They’re also packed with vitamins and minerals and are relatively low in fat and calories in comparison to other nuts. They’re great as a snack straight from the shell, or you can try adding them to salads or granola.

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The great garbanzo

As much as I love hummus, after having it as my workday snack (with carrot and celery sticks) for the past week I decided that I wanted to try chickpeas in another state next week. I bought a can (if you’re feeling more ambitious, feel free to start with dried chickpeas). Preheat the oven to 350F. Drain and rinse. Place a tea towel or paper towel on a baking sheet. Dump the chickpeas on top then gently press another towel on top to dry. Remove the towels and toss with a teaspoon of olive oil. Place in the oven and roast until crispy (not smooshy!) and deep golden brown, about 40 minutes, stirring or shaking the pan occasionally. Remove from oven, place in a container with an airtight lid and sprinkle with your seasoning of choice (I went with chipotle seasoning), cover and shake, remove cover to cool. Once cooled these will keep for up to a week in an airtight container.

Chickpeas, also known as garbanzo beans are a great inexpensive vegan-friendly source of protein. They’re also a good source of potassium, magnesium, iron, and calcium. They’re great in salads and stir-fries.