Dispelling nutrition myths, ranting, and occasionally, raving


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If men got pregnant…

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Today I just want to rant a little bit about the patriarchy and research, particularly in relation to mothers and pregnant women. You’ve likely all heard about the difference between men and women when it comes to heart attacks, leading to missed diagnoses in many women, and how most drug trials are done using men so that we have very little evidence regarding the efficacy and side effects of many medications on women across their lifespan.

Then you see results of studies like this one which, despite the cognitive effects of alcohol consumed during breastfeeding no longer being evident when children are 10 years of age, provides the message that breastfeeding women should not consume alcohol. This despite the fact that alcohol is removed from breastmilk at the same rate as it is from the bloodstream. This means that while pumping and dumping is an ineffective measure to prevent infants from consuming alcohol via breastmilk that mothers can still safely consume alcohol and breastfeed provided they allow for adequate time for alcohol to clear from the milk. If you’re a breastfeeding mum, you can use this table to determine how long you’ll need to wait after drinking before you can breastfeed your baby (unfortunately, it might be longer than you would think).

Women who are of childbearing age are often told not to consume alcohol at all. Just on the off chance that they might get knocked up and damage the fetus before they realize that they’re pregnant. Women who are pregnant should definitely never consume any alcohol at all because their baby might end up suffering the effects of Fetal Alcohol Spectrum Disorder (FASD). And yet, many perfectly healthy babies are born to women who consume alcohol during pregnancy, indicating that there is likely a window (or windows) during which a certain amount of alcohol may be consumed without affecting the development of the fetus.

Pregnant women are shamed for drinking coffee, and some have even been refused coffee by baristas (and they say dietitians are the food police!). This despite the fact that pregnant women can safely consume up to 300 mg of caffeine a day (about the amount you’d get from a grande coffee). And the fact that the research on caffeine consumption during pregnancy is mixed.

Pregnant women are not allowed to eat: soft cheese, deli meat, sushi (unless it’s veggie), raw eggs, tuna (and other large fish), organ meat, raw sprouts, paté, unpasteurized juice or cider, store-made salads, and packaged salads, many herbal teas.

Naturally we want to exhibit an abundance of caution when the health of the woman and the fetus/infant are potentially at risk. However, I bet that if men were the ones giving birth that we would know exactly how much of all these things could be safely consumed during pregnancy and breastfeeding and the precise windows during which they needed to be avoided. But because (cis) men don’t give birth or breastfeed but they generally conduct most of the scientific research we are told to err on the side of caution. I mean what do they care if we can’t have a beer for 30 or so years because we might get pregnant at some point during that time, or enjoy some lovely brie because there is a teensy risk that we might get listeriosis and miscarry. As long as we are protecting their offspring that’s all that matters. And if a woman dares to defy all of the dietary restrictions placed on her during pregnancy societal shaming will cause her to toe the line. After all, questioning these restrictions shows that you are an unfit mother and selfishly putting your enjoyment of bruschetta ahead of your own child for whom you should be enthusiastically giving up everything for while your husband is out drinking with his buddies.

Please note: I am not suggesting that women who are pregnant reject all of this dietary advice. There are very real risks to consuming these foods and beverages during pregnancy. I am however suggesting that we reject the unquestioning acceptance of these restrictions because you know that if men were the ones getting pregnant there would already be a body of research into precisely what could be consumed when.


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In the chocolate milk war which side will you take?

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A school in Ottawa decided to no-longer offer chocolate milk to students as part of their milk program. This, I should add, was based on a vote taken at a parent council meeting. Predictably, a bunch of parents, students, and assorted individuals from all over the province are outraged at this infringement on their freedom. This despite the fact that chocolate milk has not been banned from the school, the school is simply no-longer selling it to the kids.

I’m listening to the radio call-in program about this outrage and quite frankly I feel like throwing up my hands, saying eat and drink what ever you damn want, and going off to farm alpacas or something similar that will simultaneously allow me to forsake my current profession and keep contact with human beings at a bare minimum. I mean honestly, what is wrong with people. It is that vital that your child have chocolate milk at school once a week that you’re launching a protest over the removal of chocolate milk from the school milk program but you can’t be assed to pick up a carton of chocolate milk at the store to send to school in your child’s lunch? Do you not normally buy groceries? How do you feed your child outside of school if it’s too much of an ordeal to dump a cup of chocolate milk in a container and pop it in your kid’s lunch box? Lest you think I’m exaggerating, just listen to the first guest on the show. This is literally her argument. If you want your child to have chocolate milk so badly, give it to them yourself. You can let your kid guzzle chocolate milk at home until the cows come home.

Then, there are people arguing that kids should get chocolate milk as part of the school milk program because this may be the only little bit of nutrition they get. That may well be true (and this is incredibly sad) but may I be so bold as to point out that white milk is still available through the program? As my friend Yoni has often argued, suggesting that children be given chocolate milk for the nutrition in milk is like arguing that they be given apple pie for the nutrition in fruit.

I think that many of the people arguing for keeping chocolate milk on-offer in schools have fallen for the marketing hype and genuinely think that chocolate milk is a “health” food. There was one dad who called in and said that his kids drink chocolate milk every day and nothing else sweet, except juice. But he was all for pop being banned in schools because kids get too much sugar. Well, one cup of orange juice has 22 grams of sugar, the same amount of pop has 26 grams, and chocolate milk has 24 grams. That’s not a huge difference. If sugar is your concern, then chocolate milk and pop are on par with each other.

Removing chocolate milk from a school milk program is not denying parents the right to give their children chocolate milk. It’s removing one source in a landscape that is saturated in chocolate milk, pop, juice, sports drinks, and energy drinks. Should any and all foods be available for purchase in schools? Schools do not have an obligation to act as grocery stores. They do not have to sell any and all products that a child might desire. Making white milk the only option (for sale) in schools helps to make the healthy choice the default for students.

There is no good reason for schools to be offering children chocolate milk as part of their milk programs. I applaud this school for taking the initiative to remove the option of chocolate milk from their program. Schools should be places where children learn and that includes learning healthy behaviours, including making healthy food choices. Schools should not be profiting from selling children foods that should not be a regular part of their diets. It’s disgraceful that some parents think that daily delivery of chocolate milk is a greater priority than the actual health and well-being of their children. So much so that they are willing to publicly fight against a decision that was made with the children’s best interest at heart. If they have this much time and passion about school nutrition maybe they can take some of that energy and put it into fighting for a national school lunch program. You know, something that would actually benefit children. Sorry if I sound a little harsh but it frustrates me to no-end that people are so self-centred that they are unwilling to put the well-being of children, both their own, and others ahead of their own uninformed opinions. Cry me a freaking river (of chocolate milk).


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Whole Life Challenge review

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You know what I’m sick of? Engineers and people with zero nutrition education making claims that you can “biohack” your life, undermining dietitians, and giving one-size-fits all nutrition advice. This rant seems appropriate coming on the heels of my post about the carnivore diet.

Earlier this summer my brother asked for my thoughts about this “Whole Life Challenge” that a bunch of people in his office were doing. He was a little sceptical about the nutrition advice they were providing and wanted to know my thoughts as a registered dietitian.

My first question was, “who is behind this challenge?” Well, we’ve got the founders: Andy who has a background in sales and engineering (quelle surprise) who then opened a crossfit gym and Michael who was a coach and manager at a crossfit gym, and has a degree in philosophy and culinary arts. Well, at least he’s got a little knowledge of food in there but as most know, culinary arts and dietetics are woefully disconnected professions with chefs learning little to nothing about nutrition. The remainder of the team is comprised of the CEO, social media, web development, content manager, corporate relations, a couple of customer service reps, chief technology officer, and public relations. There is absolutely no one working for this enterprise that has any background in nutrition or health. Sigh. 

At a glance, the “challenge” doesn’t look so bad. The idea is to work on seven daily habits over the course of six weeks. You get points for completing each of the daily habits and you’re supposed to play with a team (the more people playing the more money they make this will help “foster success”). The habits are as follows: nutrition, exercise, mobilize, sleep, hydrate, well-being, and reflect. Many of these are areas that most of us could stand to improve on. Of course, I’d like to reiterate that the people who created this challenge have zero education pertaining to any of these topics. Cost is $39 US per player.

Unfortunately, you have to pay to play so I can’t access all of the materials available to players, including the nutrition plans. Fortunately, I have the inside scoop ;) and was able to view the nutrition material. They’ve created three levels with the highest being the “performance level”. This level is for those who, “already have good eating habits that you just want to fine tune, have athletic or performance-related goals, or have a pressing health or inflammation condition that you’d like to address”. The level below that is the “lifestyle level” which is, “A good choice if you are looking for a long-term lifestyle nutrition program. This is a great start to a sustainable practice of living a healthy lifestyle”. The easiest level is “kick start” which is supposedly, “a great place to start if you’re new to the health and fitness game and need to make the most important tweaks to get yourself started in the right direction”.

At each level of the plan you’re given a list of foods that are “compliant” and “non-compliant”. The higher the level, the fewer the foods that are compliant. How did they determine which foods are “compliant” and which are “non-compliant”? Excellent question. I have no idea other than the statement they make at the top of the charts: “When you see (*) next to a food, it indicates the food is compliant but should be eaten in moderation, as there are potentially negative effects from overconsumption”. I assume that this means that they believe there are negative effects from consumption of “non-compliant” foods. What these negative effects are is anyone’s guess. Maybe weight gain? Inflammation? Enjoyment of life? The non-compliant foods for the “performance level” are: deli or processed meats, soy, corn, white potatoes, soybeans, taro, yucca, beans and other legumes, dried fruit with added sugar, peanuts, peanut butter, hydrogenated oil, industrial vegetable and seed oils, every grain and grain product, alcohol, soda (diet or regular), juice, all dairy (except butter), the only snack foods allowed are baked sweet potato fries or chips and baked vegetable chips. Yum yum. To be fair, they do say that this diet would be difficult to maintain long-term and “maybe not even necessary”. Yeah, no shit.

Just for fun, and your reading pleasure, my brother endeavoured to follow this diet for a few days. My brother is a prolific runner, he’s in his third year of a running streak and he’s fast. He eats a balanced and varied diet and enjoys the occasional beer; a candidate for the “performance level” if there ever was one. Unfortunately, he came down with a cold at the same time so his report was: “my lack of energy could have been the diet or being sick”. N of 1, inconclusive.

That being said, while this diet might work for some, it’s probably not the best diet for most endurance athletes. It can be very difficult to obtain sufficient nutrients and calories and attain peak performance on such a limited diet. Also, beans and legumes and whole grains are full of good nutrients as well as being affordable. Any non-medical diet that tells you to eliminate all of these foods is unlikely to be sustainable or healthy in the long-run, particularly for those who engage in long runs (sorry, not sorry).

Six weeks isn’t all that long and when people are working in a group challenge there’s more incentive to stick to a plan than there would be on their own. There’s also minimal risk of nutrient deficiencies being a serious concern over such a short time frame. However, because this challenge is framed as a short-term undertaking and the diet plans aren’t easily sustained, I worry that this will encourage weight cycling in participants (which may actually be more harmful than maintaining a higher weight long-term) and discourage long-term adoption of healthy behaviours. If you’re only adopting these “habits” for six weeks to win a challenge and it’s a major change from your usual lifestyle I can imagine that at the completion most people celebrate finishing by ditching all the “habits”. It would be interesting to see research on participants of a challenge like this.

This plan is also very prescriptive. Apparently I should be drinking 37 ounces of water a day. There is no mention of drinking to thirst here or adjusting intake based on physical activity, temperature, or other fluid intake. You are not learning to listen to your body on a plan like this. There is no allowance for individual differences or personal preferences. Compliant foods equate to “good” and non-compliant equate to “bad”. This reinforces the false moralistic attitude that many people have about food. It also fails to consider that we eat for many different reasons and that taking pleasure in food and enjoying food socially are important aspects of eating. Framing healthy eating as being complicated and unpleasant only serves to make people adopt an all-or-nothing mindset toward a (perceived) healthy diet. Winning at this challenge may only set you up for failure when it’s over.


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Why science is failing

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After my fellow dietitian Abby Langer wrote this article for Self, which I personally felt was quite considered and rather generous to the carnivore movement, I noticed a commonality among many of the people spewing abuse and vitriol (does an all-meat diet make you exceptionally angry?) toward her, and RDs in general. Any guesses? It was that many of them were engineers. I’m not sure what’s up with that. However, I can tell you that they are far more confident in their belief in the magic of the carnivore diet than I am in probably anything.

Then I was listening to StartUp podcast and something clicked. This season they’re following what’s called a “church plant” which is people trying to start new churches. On the last episode they were talking to a researcher who said that membership in all Christian churches in North America is declining, except for at evangelical churches. The reason for that? The certainty the evangelical church provides. Unlike other churches where there may be grey areas, things left up to interpretation, the evangelical church has definitive answers. And people like certainty. In religion and in nutrition.

You’ve probably heard the comparison of certain dietary beliefs to religious beliefs before. It’s nothing new. People attach their sense of self to a religious or dietary belief. They’re vegan, paleo, vegetarian, carnivore, catholic, or muslim. In the realm of diets, dietitians are agnostic. In the realm of medicine, Western doctors are agnostic. A great deal of the time, science is agnostic. We constantly question our beliefs and change them as new evidence comes to light. When someone asks is corn good for me we inwardly cringe because there are so many ways to answer that question and they all start with “it depends”. The carnivores are the evangelicals of the dietary world. They have all the answers with the utmost certainty. And how can someone who’s desperate to find a diet that will cure what ails them not be enticed by that confidence when faced with dietitians and doctors who are saying “let’s try this first and if that doesn’t work then we’ll try this” and on and on. We don’t offer a one-size-fits-all approach. We offer tailoring to help individuals find the way of eating that fits them best.

If you want certainty without evidence then you can find all the advice you want, and then some, from carnivorous engineers on twitter. If you’d rather have uncertainty and a little variety in your diet then find yourself a dietitian.


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So you don’t want the government in your kitchen

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According to Wikipedia, “A government is the system or group of people governing an organized community, often a state.[1] A government is like a clan with the purpose to govern the whole family or whole nation with powers of financial, military and civil laws. The main purpose of government is to seek the welfare of the civilians and to fulfill their need for the betterment of the nation.”

Canadians have a poor understanding of government. This comes as no surprise to me as I frequently see people complaining that the government should merely educate people about making healthy choices rather than introducing legislation that would make it easier for us to make healthy choices and/or harder to make unhealthy choices.  People want the government to stay out of their kitchens, shopping carts, restaurants, etc. This attitude shows a great deal of privilege, and ignorance.

To be able to afford to choose what we want to eat when we want to eat it is a measure of privilege. There are many people in Canada (and other countries) who don’t have that luxury. People who have no choice in what they eat, who can only afford or access limited options, people who go hungry.

Policies, subsidies, taxes (and tax breaks), legislation, and tariffs are all factors influenced by government that impact how much we pay for various products. Unlike something like a sugar-sweetened beverage tax, the consumer doesn’t directly see the effect of these factors on the price they pay at the cash register so they often don’t even realise just how much the government is influencing the cost of food. Also, there is a certain judgement value that comes with a tax like a SSB tax; taxes such as this are often referred to as “sin taxes”.

Yes, elected officials serve us and we essentially hire them to represent us in government. However, it’s also their job to “seek the welfare of the civilians”. So, what should the government do when our desires “I want to eat chips and drink pop for breakfast, lunch, and supper” are diametrically opposed to our welfare? It’s a tricky question. I certainly don’t want the government telling me what I can and can’t eat; and I’m a dietitian! I also know that education is not the (sole) answer.

Most people have a decent understanding of which foods they should be eating more of, and which they should be eating less of. Simply telling people to eat more vegetables and drink less pop is unlikely to result in any change in eating habits. I do think the government has a role to play in helping us to adopt healthier eating behaviours.

In terms of education, rather than simply promoting messages and plastering billboards telling us what foods to eat (or to limit) or putting calories on menus (ahem), the government should be making food literacy a mandatory component of the curriculum in schools. Children should be learning where food comes from, how to prepare it, how to read nutrition facts panels and ingredient lists, and how to find credible nutrition information in a sea of goop.

Beyond education, the government should be looking at the factors that influence our food choices. The most commonly cited of these factors are: access, affordability, time, and personal preference. A little brainstorming about these:

  • Access: there could be legislation about where fast food outlets can be located and ensuring there are grocery stores, markets, or convenience stores stocking nutritious foods to serve all communities. Many grocery stores are now offering delivery options; perhaps the government could support these initiatives.
  • Affordability: while it’s a bit of a myth that healthy eating has to be expensive, there can be more of an up-front cost to purchasing food for a healthy meal than there is to buy a burger and fries. In addition to creating policies and subsidies that would make healthier foods such as fresh produce more affordable, the government could also look to the creation of affordable housing, better transit systems, and basic income guarantees (BIG) so that people have more money in their pockets for nutritious food.
  • Time: part of the food literacy education in schools would serve to show people that it is possible to make a quick, healthy, and tasty meal. In addition to this, the government could pass legislation around work hours so that more people could have flexibility in their days and more time to prepare food. BIG would also support this as it would provide value for labour in the home. If our society put more value on food preparation and family meal times then as individuals we would be more likely to put in the time to cook and eat together.
  • Personal preference: this is a little trickier for the government to address. However, given the other measures, I think that an increase in appreciation for nutritious food would follow. If parents have more time and money and access to nutritious food, then they’d be more likely to choose these foods. Particularly if they’ve had exposure to these foods from a younger age through things such as food literacy education in schools.

The government is already in your kitchen, in your shopping cart, in restaurants, on the farm, in the grocery store. No one is saying that the government should ban the consumption of pop, or any other food. Rather than removing personal choice, legislation can serve to give more choice to those who are currently limited by their circumstances, and make it easier for all of us to make healthier choices.