Dispelling nutrition myths, ranting, and occasionally, raving


4 Comments

The real cause of Type 2 Diabetes

8g0as

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.


6 Comments

Are calories an enemy?

Screen Shot 2018-11-17 at 3.55.30 PM.png

I would like to propose that we stop demonizing calories. All too often I see products promoted as “low-calorie” or “calorie-free”. I hear jokes about things like it’s okay to eat a broken cookie because the calories all leak out. Consuming as few calories as possible is considered virtuous. This despite the fact that we need calories to live.

Just in case you need a quick refresher on calories, despite what many people will have you believe, a calorie is a calorie. The definition of a calorie is, “the heat energy required to raise the temperature of one kilogram (rather than a gram) of water by one degree Celsius”. Calories provide us with energy. Energy to get through each day but also energy for your body’s systems and cells to function. Without a source of calories you will die.

So, why do we think that calories are bad and something to avoid? Because we’ve learned that excess calories, those we don’t use up, are often stored by our bodies for later use in the form of fat. And fat is bad because our society has rather arbitrarily decided that being thin is more attractive. Regardless of your body shape or size though your body still needs calories to function.

Wouldn’t it be wonderful if we lived in a world and mental space where instead of choosing 100 calorie snacks or avoiding foods because they contain “too many calories” we could look at food as a pleasurable way to nourish our bodies? Not just to think of food as fuel but as an essential component of self-care. Calories are not the enemy, they are vital to life.


3 Comments

Healthspan app review

20180311_102631

I read this article about a “new app that identifies your nutrition gap” a little while ago. According to the article, the app (Healthspan) will make individualized supplement recommendations that you can order in-app based on your diet. Naturally, I was concerned. Ideally, we should be aiming to obtain the majority of our nutrients from food. I envisioned an app designed to push supplement sales and was concerned about the safety and accuracy of recommendations made through an app. I figured I shouldn’t knock it until I tried it though so I downloaded the free app and tried it out for a week.

Healthspan is very similar to other food and activity tracking apps in that you enter your daily food consumption and your physical activity. I’ve written about some of the pitfalls of these apps before, in particular their accuracy when it comes to calories burned and the notion of “earning” more food with exercise.

When you first download Healthspan you enter your weight, height, age, etc and it gives you your daily caloric intake to attain your goal. According to the app, for me to maintain my current weight I should consume 1143 calories a day. This is quite low and certainly lower than the number of calories I actually consume every day. Of course, I “earn” more calories through my regular exercise. Just for fun I changed my goal to see what my daily caloric allotment would be if I wanted to lose two kilos. I now have a measly 914 calories per day to work with. To put that in perspective that’s roughly the calories in a Big Mac and medium fries. A 900 calorie per day diet is generally considered to be a very low calorie diet and not recommended to be undertaken without medical supervision. The app however, provided me with no warning. It just readily lowered my daily calorie goal. Interestingly, when I further decreased my goal weight to 44 kg (which would render me significantly underweight for my height) my calorie goal remained at 914/day.

Healthspan does offer you the opportunity to obtain free supplement samples when you register. Unfortunately, they’re only available to those in the UK so I was unable to determine what the samples were. Following that, you can order supplements through the app but the description of this process given in the original article is a little off-base. The app doesn’t make recommendations based on your recorded dietary intake. Rather, you complete a questionnaire and based on your responses it recommends a multivitamin supplement. The recommendation seemed pretty generic for any woman of my age (see below). Despite this, it still concerns me that supplements are available through the app given the questionable quality and safety of many supplements available on the market.

Screenshot_20180201-214121

Aside from this, another rather significant issue I had with the app was logging my food intake. While it was quite user-friendly to enter foods and beverages I’d consumed, the selection was extremely limited and there was no way to determine ingredients in mixed dishes, nor to enter your own recipes or nutrition information. For example, I made a vegetable curry for supper one evening. There was a vegetable curry option I could add but there was no way of knowing if the ingredients were similar to the curry I ate and for anyone who’s ever had curry, you know that the recipes can vary considerably. The same held for other dishes such as smoothies, lasagna, granola, stir-fry, and so on. There was also a number of foods that I couldn’t find at all in the database and had to make my best guess at what would be most similar. Based on this, I question the ability of the app to record calorie and nutrient intake even remotely accurately.

Each day, the app gives you a score out of 100 that appears to be based on your physical activity and calorie consumption. However, participation in challenges also counts toward this score. Without participating in these optional challenges, I was never able to achieve better than a 60 on any one day. On most days, I was even lower than this. Personally, even though I wasn’t using the app to genuinely achieve any goal, I found this really discouraging. If I was actually trying to reach personal nutrition and physical activity goals I can imagine this score would be off-putting.

I know that people really like apps to track things like food and exercise but I’d give Healthspan a pass if you’re looking for an app for these things.

 

 

 


5 Comments

Which fitness tracker gives you the best calories burned for your workout? An experiment

20170507_195119

Remember my rant a little while ago about how you shouldn’t think of exercise and food as an equation to balance? Or my post about not using the exercise component of calorie counting apps? Well, I just wanted to add a little more to that conversation today.

I use a Garmin watch to track my runs and occasionally I’ll look at the “calories burned” out of curiosity. After a pretty fast longish interval run I noticed that the calories burned seemed rather low so I started scrolling back through and was puzzled to find a shorter easier run that supposedly resulted in a very similar caloric expenditure. That left me wondering how Garmin determined the calories burned during a run. I looked it up and it turns out that it’s related to heart rate. Sometime the heart rate monitor is wonky and (especially when it’s really cold out) will register a heart rate that would be more likely seen when I’m sitting on my butt than when I’m out booking it through speed work. That means that my Garmin (erroneously) registers minimal exertion and thinks that I’m not burning very many calories.

Today I decided to do a little experiment. I wore my Garmin, as per usual, which is synched to my Strava account. I also fired up the Nike+ Run Club app for the first time in ages and I set out on an easy(ish) 10k run. After the run, I also entered the time spent running at the closest average pace into myfitnesspal. All of these apps have my height and weight. Any guesses what the results looked like?

Garmin: 463 calories

myfitnesspal: 517 calories

Nike: 526 calories

Strava: 1371 calories!!!!

Now, I have no idea how many calories I actually used during this run, I’d wager Garmin was probably closest to the mark considering that the heart rate monitor seemed to be working properly. But Strava, what the actual hell?? Considering that Strava gets all of it’s data from my run directly from Garmin I find it amazing that it estimated I burned nearly three times as many calories as Garmin thought I did. I’m sure that if I had other apps and trackers I would have gotten slightly different results from all of them.

All this to say, if you’re exercising and tracking calories burned, you probably shouldn’t give that number too much weight. Try to think of exercise as giving you health and fitness rather than taking away calories and weight.

 


3 Comments

Is healthy food cheaper? Is that even the question?

 

VS (1).jpg

Continuing on with my ranting discussion about food security, I can’t help but comment on a study out of England that was getting huge media attention over the past couple of weeks. The study showed that “pound for pound” it was less expensive to eat healthy foods than to eat ultra-processed foods. The majority of the news stories concluded that poor people could be eating healthfully they just prefer to pay more for “taste and convenience”, according to one of the study’s authors. To which I say, check your privilege.

As I’ve said before, food insecurity is not a matter of simple math. While there are certainly myriad factors that contribute to our decisions about what to eat, lack of income is the root cause of food insecurity. Dismissing money as a concern on the basis of this study is wishful thinking more than anything. It’s also an insult to people who are struggling to make ends meet and feed themselves and their families.

Because some researchers went to the store and found that a pound of carrots is cheaper than a pound of french fries, the logical conclusion is that everyone should be able to afford to eat nutritious meals prepared from minimally processed ingredients? That seems like quite the leap to me. There’s no accounting for calories or ease of preparation in this comparison. Sure, a pound of vegetables may be less expensive than a pound of frozen ready-meals but I think that most people would agree that carrots do not make a balanced¬†meal on their own. To make a nutritionally balanced meal, you’d need to round those carrots out with some dark green leafy veg, some protein like meat, fish, beans, or tofu (the authors acknowledge that meat and fish are the exception to their affordability rule), and a grain such as rice, quinoa, or whole grain bread. As most of these items need to be purchased in quantities greater than those needed for a single meal, it can quickly become more expensive to buy ingredients for a home cooked meal than it is to buy something already, or nearly, prepared. Yes, pound for pound, a bag of rice will be less expensive than frozen dinners but a bag of rice doesn’t make for much of a meal.

Stop trying to use your research to “prove” that poor people are choosing to feed their children junk. Take a good hard look at your own privilege and ask yourself how you can make this a more equitable society in which we try to help those who are struggling rather than shaming and blaming them.