Dispelling nutrition myths, ranting, and occasionally, raving


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Are pharmacists the new dietitians?

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The other day I was in a grocery store when a recording came over the PA system encouraging customers to speak to the in-store pharmacist about making healthy food choices. Naturally, I was like “what the fuck??”. People wonder why dietitians are so defensive of our profession. This. This sort of thing is exactly why. Because everyone seems to think that they’re qualified to dole out nutrition advice despite the fact that dietitians are the only professionals who spend over four years studying nutrition in university and must indefinitely continue our education to maintain our licensure.

It’s not cool of the chain to be asking pharmacists to provide dietary counselling. If you want to offer that service, hire yourselves some damn dietitians. It’s also not cool of the pharmacists to accept that added responsibility.

Yes, pharmacists are a wealth of knowledge when it comes to medications and they can be hugely helpful in advising customers about potential drug-nutrient interactions regarding medications that customers are taking. They more often than not, likely have a greater knowledge about nutrients in food than your average person. However, none of this equips them with the expertise to provide nutrition counselling.

The scope of practice for pharmacists in Canada contains no mention of nutrition or dietary counselling. Store owners may not know that this service is outside the scope of practice for pharmacists. Therefore, I believe that the responsibility lies with the pharmacists on-staff to let the company know that they are should not be providing this service to their customers. As allied health professionals they should recognize the limitations of their own scope of practice and defer to RDs in matters of nutrition counselling.

When I worked in a grocery store we had an in-store dietitian as well as pharmacists on-staff and everyone worked together to provide customers with the best service possible. Pharmacists have enough to do without having to get into nutrition counselling with customers, which, when done appropriately, can be quite time-consuming. Do you really want to wait longer to pick up your prescription? Setting aside the issue of expertise, do pharmacists really have the time to devote to counselling customers on nutrition? Let dietitians, who are actually trained to provide individualized dietary advice, provide this service so that pharmacists can focus on their own area of expertise.


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Just because it’s “always delicious” doesn’t mean it’s not a diet book

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Last week I attended the Ambition Nutrition Symposium in Toronto, to which I was fortunate enough to win free tickets. The theme of the conference was “bringing it home” and was intended to help translate nutrition theory into the kitchen and onto client’s plates. While I’m not sure the day really succeeded in that regard, I still found it to be an interesting conference with a variety of speakers and delicious food (thank you George Brown culinary students!). That being said, from my perspective, there was an elephant in the room. That elephant was the tension between professions and dietary dogma.

We started the day with a great presentation by Dr. Kelly Brownell, director of the World Food Policy Centre, among numerous other titles. He spoke about the difficulty we often face when addressing food-related issues through policy as something that benefits one area (e.g. nutrition) may cause unintended harm in another (e.g. agriculture). The goal of his new centre is to bring stakeholders from all the areas together to try to develop policies that will benefit all areas. As an aside, one thing I noticed about the list of stakeholders he shared was the lack of the public. As “end users” I think that it’s essential that the public (or specific groups from the public such as those experiencing food insecurity) are involved in these discussions.

Later in the morning we had an excellent presentation by Nishta Saxena, a dietitian. Maybe I’m a little bit biased as an RD but I felt that she did a fantastic job of presenting the struggles we face in addressing healthy eating with clients when they are constantly bombarded by misinformation in social media. How do we combat “sexy” social media influencers as professionals who must provide evidence-based factual information and are less inclined to posed half naked with overflowing mason jars of green smoothies? Several years later and dietitians still aren’t sexy ;)

We also had Saxena and chef Christine Cushing call out juicing and juice diets (while a new cold pressed juice company presented at one of the breakout sessions and provided samples during food breaks). Cushing mocked the caveman diet and then we had a snack break with “paleo” brownies. Saxena belittled meal kits and our swag bags contained a coupon for Hello Fresh. Hello elephant.

Follow-up Saxena’s fantastic presentation with a discussion with Dr. David Ludwig and his wife chef Dawn Ludwig to promote their new book “Always Delicious” which we all got a copy of in our swag bags. Full disclosure, I have been critical of Ludwig in the past. I tried to come into it with an open mind though, I really did but the elephant would not settle down. Despite their protestations that it was not a diet book, if it talks about weight loss, fat adaptation, is filled with testimonials (from readers who have lost weight), and has a prescriptive DIET with three phases, it’s a goddamn diet book. I’m not going to get into the science of his insulin hypothesis here because my point is not to critique his beliefs but if you want to read more about it I recommend this short article by Stephan Guyenet. I’m also not here to question the “success” people have had on Ludwig’s diet. If people are happier and healthier following this plan, I think that’s great. My issue is with the framing of this diet as the best way to eat for everyone and that the best way of eating is one that promotes weight loss. They talked about “NSVs” (non-scale victories) but the only examples I saw in the book and heard during the talk were a reduction in blood pressure and going down a pant size (which while technically not a weight loss “victory” is still a “victory” over an “unruly” body).

For a day that was meant to promote health through food there was a whole lot of talk about The Obesity Problem which is really not the direction that we want to take if we want to encourage people to have healthy relationships with food and their kitchens. I encourage everyone to read this piece about one woman’s “life as a public health crisis”.  If obesity is a “problem” then food is the enemy. That mindset does not lead to healthy attitudes and behaviours. You don’t need to “retrain” your fat cells, they are not disobedient puppies. Rather, we as a society need to retrain our attitudes toward our bodies and our food so that we can once again be friends with both.


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Are Clif Bars a healthy snack?

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I wanted to write a little about Clif Bars because I think there’s a lot of confusion about them. Before I start though, I should get this out of the way, this is not a sponsored post. I have no affiliation with Clif Bar whatsoever. Okay, now that that’s out of the way, let’s get to it.

For those who don’t know what Clif Bars are, I’ve linked to their website above. Basically, they are energy dense snack bars designed to fuel athletes before, and depending on the activity and the athlete, during exercise. If you go to their website the first thing you see are a collection of images of people engaged in physical activity from climbing to cycling. Much of their energy density comes from sugar. One bar contains 20+ grams of sugar (that’s about 5 teaspoons) and about 250 calories. This nutritional composition is often a good thing for athletes who are looking for easy to digest snacks that will quickly provide them with fuel. However, for non-athletes, or people who are not looking for a calorically-dense snack, possibly not the best choice.

The reason why I wanted to write about this today is because I think most people who are consuming Clif Bars as a snack are not aware that they’re intended for active people and are operation under the false impression that they’re a “health food”. Anybody else watch the new version of Queer Eye? It was great and I totally want to be the first woman on the show (hook me up!) but I digress. There was an episode in which the man they were making over was talking about how he tries to eat healthy, and then listed off fruit and Clif Bars, as examples of the healthy foods he consumes regularly. And I thought to myself how misguided this belief is that Clif Bars are a “healthy” snack for the average Joe who has a relatively sedentary job. He’s just getting a whole lot of sugar with a few vitamins and minerals thrown in. For comparison’s sake, a Mars bar contains 260 calories and 30 grams of sugar, a Snickers bar has 250 calories and 27 grams of sugar, an Oh Henry! bar has 260 calories and 26 grams of sugar. All quite similar to a Clif bar.

Despite the fact that Clif Bars are clearly intended for athletes and active individuals, I doubt that many people purchasing them are visiting their website and are likely unaware of this intended consumer. They’re sold in grocery stores with all the other snack bars, sometimes at the cash, and sometimes in free-standing displays. Aside from the picture of the man climbing the mountain on the front, there is little reason to believe that they’re not intended for the average individual.

Just for fun, I did a twitter poll to see what people thought (pictured above). Of course, my tweeps are an above average bunch and the results likely reflect that. I got a few comments from people that “it depends”, “with a caveat”, and that the question was a false dichotomy.

Now that I’ve totally ruined Clif Bars for you, I will mention that they have newer products that are actually pretty decent snacks. I always have a stash of snacks in my desk at work and one of my favourites to have on-hand is the nut butter-filled energy bar which has considerably less sugar than the original energy bar, (although the same number of calories – I should add that while I do have a predominantly sedentary job, I also run every day and regularly engage in other physical activity) only about two teaspoons. My favourite is the peanut butter flavour (yum!). Even newer on the market is the whey protein bar which has only about one teaspoon of sugar, 14 grams of protein, and 260 calories (these are good when I have a long day and a long run, otherwise they’re a little higher in calories than I’d normally want in a snack).

I should also mention that ideally a healthy snack contains two food groups, preferably with one of those being vegetables and fruit. Some examples: an apple and a handful of nuts, hummus and veggie sticks, a banana and peanut butter, bell pepper and cheese.

Long story short, are Clif Bars a “healthy” snack? Probably not for the average person but… if you’re an athlete or have a very active job and aren’t consuming many other sources of added sugar then maybe.


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Should we allow advertisers to have unlimited access to children?

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As in many countries, including Canada, there is currently a push in the UK for a ban on “junk food” advertising to children. Naturally, there’s push-back but surprisingly not (just) from the food industry but from registered dietitians. I have to admit, I was pretty taken aback when I saw a number of Bristish dietitians arguing against this proposed ban on twitter last week. I know that we don’t always agree, but I thought that this would be one measure that all dietitians would support.

The arguments I saw against the ban were as follows:

  1. This won’t make much of a difference
  2. The term “junk food” is unscientific
  3. Only people who work in advertising should be allowed to have an opinion on advertising
  4. Parents should just “say no” to their children when they beg for products they’ve seen advertised
  5. Parents should do a better job parenting and control the tv their children are watching
  6. There are bigger issues than this so why are we wasting our time on support for an advertising ban
  7. This campaign is just about making Jamie Oliver look good

Let’s address these shall we?

  1. There is no one measure we can implement that will make a substantial change in childhood obesity and healthy eating. However, a ban such as this is just one of many measures that, together, will improve the eating habits of children. See last week’s post for a few other ideas. There is evidence to support restricting marketing of food (and other products) to children. If marketing to children wasn’t effective companies wouldn’t continue to do it.
  2. I agree that marketing to children should not apply to “junk food”. I think that a complete ban on advertising food should be implemented. This would avoid the whole distraction and difficulty of defining “healthy” and “unhealthy” foods and protect children from the promotion of food which encourages overeating and the development of unhealthy relationships with food.
  3. Do I even need to comment on this one? Does anyone outside of industry truly believe that industry self-regulation is a good idea? Yes, let’s put the fox in charge of the hen house. What could possibly go wrong?

4. Most parents I know would be much happier not to have to constantly have to say no to their children. Banning marketing of food to children would help parents to do their job. It would make it just that little bit easier.

5. Excuse me, your privilege is showing. Must be nice to be a parent who has complete control over every bit of advertising your child is exposed to and who prefers to “just say no” to your child when they’re pitching a fit in the grocery store.

6. Sure, there are lots of serious issues facing society and children today. That doesn’t mean that we can only address food insecurity at the expense of all other issues. Similar to number 1, we can address many issues simultaneously, and banning advertising to children really doesn’t have any downside (unless you’re feeling sorry for cereal and pop manufacturers).

7. Y’all know JO drives me as batty as the next person but I’m not inclined to cut off my nose to spite my face. I’m happy to put aside my disdain for Jamie in support of ending marketing to children.

For more information on Marketing to Kids, and to support Bill S-228 in Canada, check out Stop Marketing to Kids.


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Canada’s not-so-innovative strategy to achieve healthy weights

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A few weeks ago, to little fanfare, the government of Canada announced an “Innovation Strategy” to achieve healthy weights in Canada. My coworker alerted me to it and got me going out on a rant on a Friday afternoon. Don’t get me wrong, there’s some good stuff in here: promoting active neighbourhoods to increase access to green spaces and encourage active transportation, promoting traditional foods, and early childhood interventions for priority populations. However, for the most part I was hugely underwhelmed by the strategy.

Most of the initiatives involved some form or other of food charity, such as expanding the community food centre model. While I appreciate the CFCs efforts to improve on the traditional food bank through the addition of cooking programs, gardens, and social inclusion, when it comes down to it, they’re still a charitable organization doing the work that our government should be doing. These programs also still put the onus on the individual to seek out and access the available services, rather than implementing programs that would be universally available. Also, I understand the desire to target people living on low incomes and experiencing food insecurity but I don’t believe that obesity and unhealthy lifestyles are something that only affect that population.

I know that it would be more complicated than throwing some money at some existing programs but I think that there are many things that the government could have chosen to do that would have a much greater impact on the health of Canadians. How about a national school lunch program? This would reach every child in school without stigma and would ensure that children had the nutrition needed to learn and grow. How about bringing back mandatory home economics or teaching food literacy in schools and supporting school gardens? Yes, I realize that the curriculum is under provincial jurisdiction but there must be some way to get this back in schools. That would ensure that all children learned food skills rather than just those attending limited classes. As we know, food skills are lacking across all income levels in Canada and are not just an issue for those living in poverty. How about subsidizing fresh vegetables and fruit making it easier for Canadians to afford these nutritious foods? I know that this one is working its way through government right now, but how about putting a ban on marketing to children? And not just “junk” food but all food as we know that children (and even teens, and let’s face it, adults) are ill-equipped to contend with the marketing abilities of the food industry (possibly more on this next week). How about increasing access to registered dietitians so that people who want to speak with a RD can do so? How about collaborating with doctors, farmers markets, and grocery stores to enable all physicians to “prescribe” vegetables and fruit? These initiatives would have far greater reach and impact than the ones selected by the government. It really makes me wonder who’s informing these decisions there and it enrages me that our governments continue to throw our money at piecemeal initiatives that are unlikely to make any significant long-term change in our health.