Dispelling nutrition myths, ranting, and occasionally, raving


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Is a spoonful of sugar the way to get the vegetables to go down?

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When I saw this article: “Sugar, salt or sweeteners may be key to getting children to eat greens” last week in the Nutrition Resource Centre “News in Brief” email I knew that I had to read more. I mean, were the authors really suggesting that we should add sugar to veggies to get infants and toddlers to eat them? Or was this just a case of a misleading or misinterpreted press release? I found a copy of the full article: Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables and set about reading.

One thing that struck me right away was that this study was done with adults, no infants or toddlers, or children of any age were involved in the research. Adult participants were provided with puréed vegetables (broccoli, kale, and spinach) with varying concentrations of added sugar. They were asked to rate them on various attributes, and most importantly, they were asked to indicate whether or not they liked or disliked each sample. I was surprised that the conclusion would be drawn that adding sugar to green vegetables is a reasonable means to encourage infants to eat them (I’m saying infants because these were puréed veggies and as such are really only suitable for babies just starting to eat solid foods) based on ratings by adults. After all, adults have very different palates than infants and have very different relationships with food that have been shaped over decades. To me it seems inappropriate to conclude that because adults preferred sugar sweetened veggies that infants will as well. The authors themselves also state that, “It should be noted that infants and toddlers are also not merely small adults”. However, they also use the analogy of adults beginning coffee consumption with added sugar and gradually weaning off the sugar as justification for proposing adding sugar to vegetables when the World Health Organization, among many other bodies, is currently encouraging reduced consumption of added sugars.

The second thing I wondered about was precisely how much sugar was added to each serving of vegetables. The news article, and much of the journal article, references 1% and 2% concentrations but what did that translate to in teaspoons or grams? It sounds pretty innocuous, right? 1% or 2% is hardly anything. Well, in actuality the 1% was equivalent to the addition of 1/2 teaspoon per serving and the 2% was equivalent to 1 teaspoon per serving. Not an insignificant amount when you’re talking about toddlers who are generally only consuming a tablespoon or two of a food in a serving. Interestingly, the researchers asked parents how comfortable they would be offering their babies vegetables with added sugar in amounts of 8 calories, 16 calories, 1/2 teaspoon, or 1 teaspoon. The 8 calories = 1/2 teaspoon = 1% concentration. The 16 calories = 1 teaspoon = 2% concentration. Essentially asking: how can we frame this added sugar to make it more palatable to parents who are trying to feed their children healthy diets?

Despite the general conclusion that adding sugar to vegetables may encourage young children to eat them, even the ratings by adults were not overwhelmingly improved by the added sugar. For broccoli and kale purées both 1% and 2% sugar increased overall liking. For spinach the 2% sugar (but not the 1%) increased overall liking. For broccoli and spinach the sugar increased the ratings of liking from disliked to liked. However, for kale, even at the highest sugar level ratings never rose above the midpoint (i.e. neither like nor dislike). So, these adults did not like any of the green vegetables to begin with (at least not in puréed form) but after adding higher quantities of sugar they liked the spinach, and even with the smaller quantity of added sugar they liked the broccoli. But neither amount of sugar was enough to get them to like the kale. Would babies have different initial reactions to these vegetables? Would the addition of sugar cause them to change these reactions? I don’t know and I don’t think anyone can say based on the results of this study alone.

Just for fun, I took a look at the funding sources for the study after I finished reading it. Can you guess what one of the funding organizations was? If you guess the Sugar Association you’d be correct. I think this explains a lot because honestly I was a bit baffled as to why anyone would be looking into adding sugar to get babies to eat vegetables and why such tenuous conclusions would be drawn and publicized based on the actual findings. But who other than the Sugar Association would think that we need to encourage babies to eat more sugar?

I think a better analogy than the sugar sweetened coffee for this research would be the argument that chocolate milk is a good way to get kids to drink milk or that baking apples into a pie is a good way to encourage fruit consumption. In some ways it’s even worse because infants are at the mercy of their caregivers when it comes to what foods are offered to them and encouraging a preference for only sweet foods at such a young impressionable age could have long lasting implications for their food choices and health throughout their lives.

 

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Who would you rather have as your nanny: Ronald McDonald or Justin Trudeau?

I just read an article about the proposed revisions to Canada’s Food Guide and an article about the predatory tactics of the food industry in Brazil back-to-back and was duly infuriated by both.

I was annoyed by the Food Guide article’s pitting of vegans against dairy farmers and the creation of drama where none is needed. The new Guide is going to be based on science, not industry, not special diet groups. There is nothing to indicate that dairy will be removed from the guide. Just relax. And so what if it takes the environment into account? The original food guide was intended to help prevent nutrient deficiencies during wartime rationing. Why not try to protect our planet while trying to promote healthy eating habits? After all, if we destroy the earth, nutrition won’t really be all that much of a concern. But I digress…

I read the comments on the divisive Food Guide article. I know, I know I should never read the comments. As a dietitian though, I like to know what I’m up against and what the public response is to a tool that I will likely have to promote and use in a professional capacity. Here are a few of them:

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There were people refuting this nonsense but the fact that so many people think that the government should play no role in promoting a healthy diet is baffling to me. Most people agree that diet-related chronic diseases are a significant concern in Canada but think that the government should do nothing to help people prevent them.

Then we have Nestle and other major food companies promoting unhealthy choices everywhere we go. The story of Brazil is particularly egregious but if you think that these companies care any more about residents of Canada, the US, or any other country, you’re sorely mistaken. Junk food marketing is ubiquitous, and it’s everywhere. From use of fast food as fundraisers for health charities to cartoon mascots on food products, to product placement in movies and tv shows, to sponsorship by food companies of athletic teams and events, to paid product placements in stores, and so on.

People complain bitterly about not wanting the government in their grocery carts or kitchens yet they gladly throw open their doors for the food industry. So many would rather have a company that only cares about profits telling them what to eat than a government that cares about improving the health of its citizens. The government isn’t forcing people to eat certain foods and never eat others. Even if milk was removed from the food guide entirely, it’s not like you’d have to start buying black market milk on the dark web. It’s just trying to provide guidance to people to help them make healthy choices.

You’re opposed to the nanny state are you? Well, we already have a nanny state and the food industry is running the show. It’s time for the government to take back some control and put industry in time-out.


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Why industry shouldn’t have special input into the food guide

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With the recent public consultation on the new Canadian “food guide” just coming to an end I’ve been noticing a lot of push-back from industry. There was a letter from a MP voicing concern about the new food guide as the new guiding principles seem to be steering people away from animal-based sources of protein and encouraging the consumption of more plant-based proteins. “I am concerned that the guiding principles released by Health Canada for Canada’s new food guide may have significant negative impacts on Canada’s meat and dairy sectors, and also the health of Canadians,” said Miller.

There was also a news clip featuring a spokesman from the Canadian Cattlemen’s Association voicing “concern” that Canadians will be nutrient deficient if they replace meat with chickpeas.

There’s been an entire website set-up by Canadian Dairy Farmers entitled “Keep Canadians Healthy” with the message being that people need to drink more (cow’s) milk and that the new food guide is going to “discourage Canadians from consuming dairy and meat products”. They go on to say that, “Left unchecked, Health Canada’s recommendations will not only cripple an important Canadian industry, but have long-term health consequences for all Canadians.” 

These examples are exactly why so many of us dietitians, doctors, and others have been complaining about the direct involvement of industry in developing previous iterations of the food guide. I can understand why those whose livelihood depends on the sale of dairy and beef would be concerned that the new food guide will (likely) not continue to serve as free advertising of their products. Although nobody really pays the food guide much heed anyway when they’re deciding what to put in their mouths.

The purpose of the food guide is to help Canadians to eat healthy. The food guide should be based on the best possible evidence. If you think that the dairy and beef (or any other food industry for that matter) has your health at heart you are sorely mistaken. Their goal is to make more money by selling more product.

As a dietitian, it’s my professional goal to help people to eat better. I don’t have any products to sell. I consume dairy products and meat (although I don’t consume much meat). I’m not trying to destroy the beef or dairy industries. I can honestly tell you that most Canadians would benefit from consuming less meat and that it’s not necessary to drink milk to meet specific nutrient needs. Most of us could stand to consume more plants and more plant sources of protein. It’s highly unlikely that anyone in Canada is going to suffer from nutrient deficiencies because Health Canada finally grew a backbone and stopped allowing industries to shape the food guide. Also, the food guide is not going to be telling people to become vegan or vegetarian, it’s hopefully (and rightfully) going to encourage people to consume less meat and more plants.

No food guide is ever going to be perfect. It’s never going to satisfy everyone and I’m sure that I’ll find something wrong with it when it’s released. However, as I’ve said before, it’s a guide, not a bible. It’s a tool to help people to make healthier choices. By using current evidence to inform the content, we’re already a step closer to a better tool.


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Should the government allow industry to market to kids in schools?

 

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Last week I found out about a new food literacy initiative. According to the introduction to their online survey (which unfortunately only wants input from teachers, principals, and board of education consultants) this initiative will involve visits to schools to provide hands-on healthy eating education opportunities. This initiative is an undertaking of the Dairy Farmers of Canada.

I am all for getting food literacy education back into schools. I think that by educating children from a young age about growing, harvesting, preparing, and enjoying food we could prevent a lot of the unhealthy eating habits and chronic diseases that are so prevalent in our society. However, I don’t think that this should be done by any means necessary, and I see the provision of food literacy education by industry as highly problematic.

This is nothing against milk, or the Dairy Farmers of Canada. Milk is a nutritious food and can (although it doesn’t have to) be part of a healthy diet. I love lots of dairy products. I still don’t think that it’s appropriate for Dairy Farmers of Canada to be providing nutrition education in public schools.

From the Dairy Farmers of Canada website:

Run for farmers by farmers, Dairy Farmers of Canada is the voice of Canadian dairy farmers.

Dairy Farmers of Canada (DFC) is the national policy, lobbying and promotional organization representing Canada’s farmers living on approximately 12,000 dairy farms. DFC strives to create stable conditions for the Canadian dairy industry, today and in the future. It works to maintain policies that foster the viability of Canadian dairy farmers and promote dairy products and their health benefits.

Dairy farmers fund its operations, including promotional activities.

I think that makes it pretty clear what their mandate is. It’s not to provide unbiased nutrition education to children. It’s to promote their products to consumers. Make no mistake about it, that’s what they would be doing by providing food literacy education to children in schools. They would be marketing to the next generation of consumers.

Would it be appropriate for Coca Cola, McDonald’s, or Frito-Lay to provide food literacy education to a captive group of school children? Just imagine if KFC announced that it would be providing food literacy education to children in schools. Parents and the public would be freaking out. It’s no more acceptable for the dairy industry to be given access to children in schools just because some dairy products are nutritious. It’s highly inappropriate, not to mention ironic, for any food industry lobby group to be marketing to children in schools whether it be under the guise of food literacy education or not.

 


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Hey food industry, get out of RD conferences! #FNCE

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I had a blog post all written for you lovelies, cued-up, ready to go. Then I started seeing the tweets coming out of FNCE (Food and Nutrition Conference and Expo) and I got all annoyed and tweeted what you see above because apparently I’m a masochist. That unleashed a fun afternoon of back-and-forth with fellow RDs on twitter who either don’t see conflict of interest as an issue in our profession or don’t really care.

I keep being about to say “I’m sorry but…” but I’m NOT SORRY DAMMITYou are not immune to marketing. No one is immune. Not me, not you, not anyone and if you think you are then you are the extremely rare exception or you are sorely mistaken. Many dietitians (myself included) regularly bemoan that we can’t get any respect as a profession. Do you really think that showing your influence can be bought with a free sample is helping us to become respected on the same level as other healthcare professionals?

Let me tell you a little tale. Once upon a time I worked in a grocery store (yes, I was an RD at this time). In my position I was responsible for a department, helping customers, teaching classes, providing demos, etc. Myself, and others in the same role at other stores regularly received training, lunch and learns, and samples from vendors. Product knowledge is important if you are talking to customers about food and supplements. The thing is, we didn’t receive training on or samples of all brands. So which products were we more likely to recommend? The ones we’d gotten to try, the ones we felt more connected to. Sure, I never recommended a product that I was morally against (I told people not to buy raspberry ketones if they asked for my opinion)or didn’t genuinely like, but I’m sure that there were equally good alternatives to many products that I didn’t steer people toward because I had no experience with them.

So, when dietitians argue that industry at conferences is fine, I disagree. Sure, walnuts and almonds are great but if they’re the only nuts there what are the chances that dietitians are going to be subconsciously influenced to promote those to their clients over nuts that don’t have representation at the expo? Yoghurt’s great and there are myriad options at grocery stores. If Siggi’s and Chobani are the only yoghurt brands represented at FNCE, which brands do you think that RDs are going to be more likely to choose and recommend?

Some argued that the FNCE is, in part, an expo. True enough, but as a conference organized by the national dietetic organization in the US it’s expected that most attendees will be dietitians. The focus should be on providing them with current evidence-based nutrition information.Having a captive RD audience for marketing at a conference organized by a body that’s meant to represent RDs is reprehensible. It’s time for the FNCE to drop the E.

Lest you still believe that RDs are a higher breed of human and somehow immune to conflicts of interest and marketing tactics, check out the selection of tweets below. Names and handles have been removed because this is not about singling out dietitians, it’s about drawing attention to the larger issue. Kudos to the companies present at FNCE for generating all of these free advertisements. Shame on the Academy of Nutrition and Dietetics for allowing this to occur.

 

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