Dispelling nutrition myths, ranting, and occasionally, raving


2 Comments

Book review: Hunger by @rgay

IMG_20170624_111551.jpg

I don’t really feel like a review of a person’s memoir is appropriate. Who am I to be critical of anyone’s experience or how they choose to write about it? So this is not really a review, but more of a recommendation.

I’ve had this book on my reading list for about a year now. Ever since I heard about it on This American Life, I believe. Yet somehow I missed its release. Not by much, I don’t think. As soon as I saw that it was out I hustled over to the local bookstore to pick up a copy.

Hunger is Roxane Gay’s memoir about growing up, suffering trauma, and the huge role that food has played in her life subsequent to that experience. Hunger is more than a memoir though. It’s an eye opening entry into someone else’s world. A world that most people like to pretend doesn’t exist. The world of someone who is “morbidly obese”. For people of all sizes, this book provides important insight into the world and how we could all make it a little bit better for everyone living in it.

As I read, I marked the pages of passages that I wanted to refer to in this post so let’s take a little look at some of the parts that stood out the most for me.

On page 6, Gay writes about the arbitrary cut-off point for obesity and how the term “morbidly obese” essentially frames fat people as “the walking dead”. This goes to show the deep level of stigma around fat in our society and how that attitude is ingrained in medical professionals.

On page 66, Gay writes about losing weight and how as she became thinner she became more visible to those around her. It’s ironic that the larger our bodies are, the less visible we become to other people as fellow humans. Less worthy of attention, respect, and love. It’s sad that this is the way we have chosen to treat each other and I think that we should all take a hard look at our own biases and try harder to treat everyone equally, regardless of size. Pages 120-121 offer some insight into how “well meaning” friends, family members, and even strangers, provide “advice” in completely unhelpful ways.

On page 139, Gay talks about Oprah’s struggles with her weight and I love this passage so much:

In yet another commercial, Oprah somberly says, “Inside every overweight woman is a woman she knows she can be.” This is a popular notion, the idea that the fat among us are carrying a thin woman inside. Each time I see this particular commercial, I think, I ate that thin woman and she was delicious but unsatisfying. And then I think about how fucked up it is to promote this idea that our truest selves are thin women hiding in our fat bodies like imposters, usurpers, illegitimates. 

Then, there are other parts that were eye-opening to me. On page 157 Gay writes about strangers taking food out of her grocery cart and offering her unsolicited nutrition advice. I cannot even imagine how it would feel to have someone pass judgement on me and remove items from my shopping cart. It blew my mind that people do this.

I also never thought about the lack of clothing options for people who are overweight and how fraught shopping can be as Gay shares on page 180. Or the pain that many chairs can cause (p. 202). Or the difficulty that flying can pose (p. 209).

There were many more passages that I marked because I thought she put so many things so well but rather than retype her book here, you should probably go buy it yourself and mark all of your own favourite passages.

Hunger should be required reading for all dietitians, medical professionals, humans.

Advertisements


1 Comment

Book Review: The Diet Fix

imgres

I should start with a disclosure: I briefly worked with the author, Dr Yoni Freehoff at his weight management clinic in Ottawa, and I consider him a friend. That being said, I no longer work with him, he didn’t ask me to read or review his book, I didn’t even get a free copy! Okay, well, I kind of did, I borrowed one from the library. The book in question is The Diet Fix

Having worked with Yoni, and being a dietitian, there wasn’t anything in the book that was new or surprising to me. Basically, it was a refresher of everything we would cover with clients, minus specific nutrition information and individual concerns. In addition, I’m not someone who struggles with weight so it wasn’t of personal benefit to read the book. It’s hard to set aside my personal lens when writing about the book. However, as I was reading, I could think of several people I know who would likely benefit from reading The Diet Fix.

Yoni provides a great overview of the information that’s imparted at his clinic in the book. For anyone who doesn’t have access to services provided by a place like the Bariatric Medical InstituteThe Diet Fix is a decent stand-in. There’s a valuable emphasis on living the best life that you can and de-emphasis on the numbers on the scale. Many of us have developed unhealthy relationships with food and this book does its best to help the reader (re)gain a healthy relationship with food.

While there is a section about “resetting” various diets, the book is not a diet book. It’s a lifestyle guide book. The problem with diets is that they always have an end date, and then what? Yoni doesn’t harsh on Paleo (even though it’s so easy and tempting) or Clean Eating or any other money-making diet out there. As long as you’re able to happily and healthily live the rest of your life adhering to whatever style of eating you’ve chosen that’s okay. There are tips for how to make the most of any diet style.

Honestly, the only thing in the book that really bothered me was how often he says “folks”. And that’s probably just because I know someone else (who I can’t stand) who calls people “folks” all the time and it’s become like nails on the chalkboard to me. But I digress… The only statement in the book that I took any exception to was this:

Fruits and vegetables also fall into the carbohydrate catchall. For the most part, they’re all wonderful. The only possible exception is the potato. Dr. Walter Willett, Harvard’s chair in nutrition  since 1991 and the world’s second-most-cited scientist in history, once suggested that consuming one was akin to spooning pure white table sugar into your mouth.

Who am I to question the wisdom of Willett? I will anyway though. Sure, many people consume potatoes far too frequently and in less than nutritionally optimal forms (i.e. chips and fries), however, it’s my belief that the potato is an under-rated vegetable.

Minor quibbles aside, I enjoyed the last sections of the book the best. They addressed a number of issues, such as medications and raising healthy eaters, that most “diet” books would never touch. This makes it a great resource for anyone who wants to take charge of their health, impart healthy habits on their children, or who works with people who do. If you want to lose weight and don’t know where to start, if you’re a doctor or a dietitian, I definitely recommend giving this book a read.


17 Comments

Dissecting the Wheat Belly

url-2

I wasn’t planning on blogging about Wheat Belly. I just thought that I should actually read it so that I could discuss it knowledgeably. However, I made the mistake of starting to read it right before bed and was seething with frustration by the end of the introduction! I’ve decided to record my thoughts in response to particular statements in the book as a cathartic exercise.

I am going to argue that the problem with the diet and health of most Americans is not fat, not sugar, not the rise of the Internet and the demise of agrarian lifestyle. It’s wheat – or what we are being sold that is called wheat.

The advice we’ve been given to eat more “healthy whole grains” has deprived us of control over appetites and impulses…

Hold up! So, is wheat the problem? Or are grains in general the problem? After all, there are many other grains besides wheat. I sure hope that Davis can make up his mind before the end of the book.

Davis provides a couple of examples of people benefiting from eliminating wheat from their diets. Are these your average overweight Americans? Nope. A woman with ulcerative colitis and a man with joint pain. It’s entirely possible that these two people were suffering from some form of wheat allergy. Two people with specific health conditions are not enough to prove that wheat is what’s making everyone fat.

Just looking at the cover… Those bagels look delicious. I never eat bagels. What voodoo is this book?

Chapter One: Davis keeps mentioning weight gain being concurrent with the increased consumption of “healthy whole grains”. Then he uses whole wheat bread as the example because it has a high glycemic index (putting aside the fact that this would likely be mitigated by consuming bread with other foods). To me, this is not a healthy whole grain. How about wheat berries? One quarter of a cup of which contains only 170 calories, 6 grams of fibre, and 7 grams of protein. The problem here is not the grain, it’s the processing. Oh, and let’s not forget the consumption of excess calories!

Chapter 2: All this talk about the message from health organizations being to “eat more healthy whole grains”. Funny, I always thought the message was to make more of your grain servings whole grain. Not simply to eat more whole grains overall.

This chapter focuses on the vast genetic difference between modern wheat and its ancestors. Haven’t we hugely altered the genetic profile of all of our crops though? None of them would be the same as those consumed by previous generations. This loss of diversity is certainly unfortunate from an environmental as well as a culinary standpoint. However, I’m not sure why wheat has been singled out here. Why not corn, or milk, or honeycrisp apples? Etc.

I also love Davis’s little “experiment” on himself (wherein he feels fab after eating a three egg cheese omelette for breakfast but foggy after toast). Of course there could be no bias or psychological factors involved when he has a vested interest in the results showing that modern wheat is toxic. (Please read the previous sentence in sarcasm font).

Chapter 3: Where we learn that wheat is dangerous for numerous reasons. One reason: it’s abundant in carbohydrate which gives it a high glycemic index. I’ve blogged before about the foolishness of claiming a snickers bar is healthier than whole wheat bread simply because it has a lower GI. In addition to the carbohydrate, wheat is uniquely dangerous because it contains gluten which causes illness in those with celiac disease and wheat allergy. Funny that this should also make wheat perilous for those of us without those conditions to consume. People can be allergic to any food. Just because some people react badly to a food doesn’t mean that no one should consume it. If that were the case we would all be extremely malnourished.

Chapter 4: Some mention of interesting sounding research involving gluten and the brain. As my first degree was in psychology I love research that marries nutrition and psych. Must check-out the original articles to see if it was good research.

Can’t help but wonder why it’s necessarily a bad thing that wheat is allegedly a mood enhancer. Perhaps there may be psychological benefits to wheat consumption.

Chapter 5: Am starting to get very annoyed with Davis’s persistent claim that the health care industry pushes “more healthy whole grains”. 1. We do not. We push more vegetables and to choose whole grains instead of white flours. 2. There are many grains other than wheat. We encourage variety

I am also getting frustrated with the yammering on about the high GI (glycemic index) of whole wheat bread. GI isn’t very meaningful. GL (glycemic load – how much an actual serving of a food increases blood sugar) is more helpful. Still not the be all and end all in diet but better than GI. The GL for whole wheat bread is only 9. That’s a low glycemic load food.

Now he’s using celiac disease as an example. Yes, of course people lose weight if they give up gluten (which is in more grains than just wheat; negating the blame wheat for everything theory) and don’t replace it with calorie dense gluten-free alternatives. This is because they are consuming fewer calories! I will give Davis credit for advising people not to replace glutenous foods with highly processed gluten-free alternatives.

Chapter 6: I’m mostly fine with the information about celiac disease although there is some manipulation of stats to make it appear as if gluten is also the cause of other ailments such as diabetes, cancer, gastric reflux, and IBS. I’m finding myself wondering if every little ailment I have might be cured by the elimination of wheat.

Chapter 7: I agree that carbohydrate reduction may be beneficial to glucose control for those with diabetes. However, I disagree with Davis laying the blame on wheat. There are many sources of carbohydrate and blood glucose control would likely be seen by limiting all sources, not just wheat.

Chapter 8: Davis writes about the association between celiac disease and osteoporosis. The problem with association is that it doesn’t equate to causation. Isn’t it likely that the cause of osteoporosis in celiac sufferers is due to chronic nutrient malabsorption? Therefore, extrapolating that wheat causes osteoporosis to non-celiac sufferers is quite a stretch.

Chapter 9: I find it interesting that Davis states that eliminating wheat will reduce blood acidity. Unless you have a medical condition, our bodies are excellent at regulating blood pH balance. In addition, the ketosis that Davis encouraged with his low-carb diet can, if extreme enough, actually increase the acidity of blood: keto acidosis.

Chapter 10: This chapter is all about how wheat causes heart disease through increased small particle LDL and triglycerides. While it’s true that wheat products may contribute to these undesirable particles in the blood it’s important to note that wheat is not the only culprit. Any simple carb can contribute to elevations in these particles. As can a lack of exercise/sedentary lifestyle, excessive alcohol consumption, and genetics. Wheat is the easy target because it’s dominant in our North American diet. This doesn’t mean that it’s to blame for heart disease.

Chapter 11: Absolutely terrifying to think that suddenly we could start suffering from cerebral ataxia. Davis sure is doing a good job of scaring the wheat out of us. It’s true that gluten may play a role in some cases of cerebral ataxia. However, how common is cerebral ataxia? According to the National Ataxia Foundation, an estimated 150, 000 Americans have hereditary or spontaneous ataxia. That’s about 0.04% of the population. If we look only at the prevalence of sporadiac ataxia, we’re looking at about 0.0084% of the population. Considering that some of these cases may be related to gluten, we’re looking at a really small percentage of the population. We already have so much to worry about. This is fear mongering.

Chapter 12:

Wheat is really the worst in carbohydrates. But other carbohydrates can be problem sources as well, though on a lesser scale compared to wheat.

Davis then goes on to list foods that should be reduced or eliminated: cornstarch and cornmeal, snack foods (e.g. Chips, pretzels, and crackers), desserts, rice, potatoes, legumes, gluten-free foods, fruit juices, soft drinks, dried fruit, other grains,

Are you thinking what I’m thinking? This sounds very much like many other low-carb fad diets with a touch of paleo thrown in for good measure.

Note that once wheat is eliminated and an otherwise thoughtful approach to diet is followed – I.e., eating a selection of foods not dominated by the processed food industry but rich in real food – there is no need to count calories or adhere to formulas that dictate optimal percentages of calories from fat or proteins. These issues, very simply, take care of themselves…

This is quite simply untrue. Calories do matter. If you consume more calories than you burn you will gain weight. If you consume fewer calories than you burn you will lose weight. Of course it’s not a simple mathematic equation but to suggest that the mere elimination of wheat will lead to weight loss is incredibly misleading.

As I was reading I made note of all the conditions which Davis stated that wheat elimination could alleviate or cure:

Obesity (especially visceral fat), schizophrenia, depression, breast cancer, various digestive problems, eating disorders, diabetes, IBS, GERD, cancer, hair loss, arthritis, LDL, heart disease, encephalopathy, peripheral neuropathy, cerebellar ataxia, seizures, and myriad skin conditions.

I’m sure that I missed a few in there. I don’t know about you, but when I hear about a cure-all like that I think “snake oil!”. There are too many promises here. Too good to be true? I’m afraid so.

While most of us could benefit from consuming more varied sources of grain and fewer processed foods, eliminating wheat is not a magical cure. It’s just another fad diet.


Leave a comment

Book review: The Cure for Everything by @CaulfieldTim

I finally finished reading The Cure for Everything by Timothy Caulfield recently. I loved that it was an approachable read. Timothy’s writing style and self-revelations made it accessible to lay readers (even those without the slightest scientific inclination), entertaining for science geeks, and informative for all.

I was surprised to learn the importance of lifting heavy weights to fitness. I am also still reluctant to accept that stretching is unnecessary. I agree that stretching doesn’t prevent injuries and I don’t generally stretch pre-workout. However, I think that there are benefits to stretching after exercise or as exercise (e.g. yoga). When I first starting seriously exercising over 12  years ago I had major cramps in my calves due to lactic acid build-up from failing to stretch. Once I started adding a few stretches into my routine the pain went away. Plus, if you want to be remotely flexible, I’m not sure how you’re going to achieve that without stretching. Anyway… this was really my only issue with the book.

It was refreshing to read a chapter on nutrition in which I couldn’t find anything to majorly disagree with. Personally, I don’t go in for calorie counting as I think more focus needs to be placed on developing a healthy relationship with food and finding pleasure in healthy choices. However, I can’t say that no one should calorie count and for some people it is a useful technique in weight management.

While reading the book I was feeling so smug that I believe in science. Then I got to the final chapters… I know that there can be major ethical conflicts with published research but somehow I had managed to push out of my mind how pervasive it can be. My smugness quickly vanished. I consoled myself with the knowledge that good science is still good but homeopathy is pretty much always a sham.

I recommend that everyone read this book. Health care professionals should read it as both a reminder and a source of information on other areas of the industry. Everyone else should read it to help them extract the truth from the many conflicting and misleading messages about health that are constantly inundating us through the media and friends.