Dispelling nutrition myths, ranting, and occasionally, raving


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The real cause of Type 2 Diabetes

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The other day someone I follow on Twitter shared a tweet from an MD/PhD student that said that, “excess calories causes diabetes” and that this results from ready availability of palatable food, sedentary lifestyles, and genetics. Apparently anyone who disagrees with this assertion is either trying to sell you something or wants you to think they’re smart. I scrolled back and forth a few times before deciding I really didn’t want to get into a “thing” on twitter but it really got under my skin and I just can’t let it go. I decided that blogging about it would be more productive than arguing with someone who’s already made up their mind about the motives for my disagreement without hearing why I take issue with his sweeping statement. Just to be clear: I have nothing to sell you and I’m not trying to make you think that I’m smart. I just don’t like this simplification of a complicated disease.

To begin, I am assuming that the tweeter was referring to Type 2 Diabetes, not Type 1. A little bit of a pet peeve of mine when people don’t distinguish between the two because despite leading to similar consequences they really are separate diseases with different causes and treatments.

Okay, so my problem with this doctor’s statement is really the implications that it has for people with T2D and the lack of acknowledgement of health inequities that contribute to the development of T2D. Yes, he mentions that it’s the food environment and the inactive lifestyle that is common in our society that’s the problem. This, I will admit, is a step above simply blaming people for eating too much and not exercising enough. However, the implied solution is the same for both messages: don’t eat too many calories and get off your lazy butts and you won’t get T2D. Unfortunately, it’s not that simple. For many, poverty and health inequities are at the root of many chronic diseases, including T2D.

Recent research has highlighted the relationship between the social determinants of health and chronic diseases, such as T2D. This research has shown that, “social determinants (such as income, education, housing, and access to nutritious food) are central to the development and progression of Type 2 diabetes” and, “individuals with lower income and less education are 2 to 4 times more likely to develop diabetes than more advantaged individuals”. That’s right, privilege provides greater protection against developing Type 2 Diabetes than does lifestyle “choices” while poverty greatly increases risk. Not to mention that certain racialized and ethnic groups are often touted as having greater risk for T2D even though much (if not all) of this increased risk can be attributed to inequities and racism experienced by these groups.

We need to stop thinking about T2D as the result of lifestyle choices and start thinking about it as the result of societal structures. If you have the level of privilege where you can choose to eat healthfully and be physically active that’s great and you should absolutely do so. But we need to stop pretending that it’s lifestyle “choices” that are causing this disease when many people do not have that choice.


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The dark and dirty side of cooking shows

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Oh hi. Sorry for the hiatus. I went on vacation and then I didn’t really feel like blogging. I’m still not sure that I do, to be honest. It kind of feels like an obligation. I’m much more fired-up about the Ontario budget that was released last week and the sense of impending doom accompanying the fall federal election than I am about anything nutrition. However, I have been thinking about a topic for a little while, and that’s food safety.

I was watching the Big Family Cooking Showdown on Netflix – which I highly recommend by the way, especially season two – and was disturbed by some of the lack of hygiene that I saw. There were people with long hair that wasn’t tied back, people fixing their hair and not washing their hands after, people crying and wiping their eyes and noses with their hands and then continuing to cook. Not to mention the few times when foods, including meat, were served not fully cooked. Now, these aren’t professional chefs, they’re just home cooks, but I still feel like the producers should have ensured that safe food handling practices were followed.

On a similar note, a recent study found that there is inadequate food safety information provided in many Canadian cookbooks. Considering that most cookbook authors are not food safety experts this really doesn’t come as a huge surprise. I think that either they themselves lack the food safety knowledge required to impart that information on the readers or they simply assume that these things are common knowledge. Unfortunately, given the lack of food literacy in the general population (consider the recent hullabaloo about people eating undercooked chicken fingers) I don’t think it’s safe to assume that safe food handling practices are common knowledge. To be fair, where do we think people are learning this information? Not in schools where mandatory home economics were cancelled in Ontario (and most other provinces) in the 1990s. Not at home where the majority of parents are no longer cooking meals for the family most nights of the week.

So, what’s the big deal? Why was I grossed out by the behaviours of some of the contestants on the cooking show? Why am I possibly never attending another potluck in my life? It’s because these unsafe food handling practices can make you sick. Health Canada estimates that between 11 and 13 million Canadians suffer from foodborne illness each year. The majority of these cases are linked to foods prepared at home, not from restaurants.

While I am not a food safety expert, I have completed food handler training and I regularly teach the basics at cooking classes. Here are a few of the most common unsafe food practices I see:

  • Food is left unrefrigerated for too long. This may be someone grocery shopping and leaving perishables in their car while they run other errands or people leaving leftovers out overnight. Foods that need to be refrigerated (such as meat, fish, poultry, tofu, dairy products, and prepared mixed dishes) should be refrigerated within two hours. Left out in the “danger zone” (i.e. room temperature) for longer than that can allow any bacteria present to multiply to levels that may make you sick.
  • Cross contamination. People use the same cutting board and knife for raw meat and then veggies, meat is stored on the top shelf in the fridge, hands are not washed thoroughly after handling raw meat. Use separate cutting boards for raw meat and veg or ensure that you prepare ready-to-eat foods first and cut-up your meat last. As for hand washing…
  • People don’t wash their hands often enough or thoroughly enough. I think everyone knows that they should wash their hands after they use the bathroom and before they begin preparing food. However, I see people touching their cellphones, hair, faces, pets, etc. and then continuing to cook without washing their hands. All of these things (yes, even your face and hair) are covered in bacteria that have the potential to make you sick. Always wash your hands after touching anything other than the food and cooking tools, or after handling raw meat, fish, or poultry. Proper hand washing means wetting your hands first, then lathering for about 20 seconds (make sure you get your thumbs, between your fingers, and around your nails!), rinsing, and drying your hands, and not turning off the tap with your now clean hands (use paper towel or a hand towel for this).
  • Meat is not fully cooked. Did you know that you can’t tell if meat is properly cooked just by looking? Get yourself a probe thermometer and take the temperature to ensure that it’s hot enough all the way through to have killed the bacteria. Some meat is okay to serve a pink inside (like a steak) other meat is not (like chicken or hamburger – don’t @ me).
  • Tasting the food using the stirring spoon and then continuing to use that spoon to cook. Nobody wants your slobber in their food! If you want to taste while you’re cooking (which is definitely a good idea to ensure you’re getting the seasonings right) take a clean spoon, use it to scoop up a taste, then wash that spoon.
  • Not washing raw vegetables and fruit. You don’t know where they’ve been before they made it to your kitchen. There may have been bugs and manure on them at the farm, all of the hands that have handled them from the farm to the distribution centre to the store. Think of how many people you see fondling tomatoes and putting them back, or dropping one on the grocery store floor. Do you think they all washed their hands thoroughly after using the bathroom? You don’t need those fruit and vegetable washes. Just running water and friction; rub them with your hands under the running water. Even if you’re peeling them, if you’re cutting through the peel, you should wash them first. Otherwise, anything that was on the outside will be dragged down through the inside by the knife.

It’s one thing if you want to take the risk of eating unsafe food yourself. Perhaps you won’t follow all of these rules yourself (although you really should). It’s a whole different matter when you’re making food for other people. Please heed safe food handling practices! For more on food safety checkout Fight Bac!


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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.