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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Help me tell the government that we need @EatRightOntario

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Last week I received some upsetting news: EatRight Ontario is shutting down at the end of March due to a loss of government funding. This is sad news for the dietitians who currently work there who will be losing their jobs, for dietitians across the country who use their resources, and not least of all, for Ontarians who will lose free remote access to the services of Registered Dietitians.

I was still mulling over how to approach this on the blog when I attended a webinar today. It was hosted by Food Secure Canada and was about effective lobbying for food system transformation. As the Members of Parliament were talking about how important it is to copy your local representatives on letters to Minsters I realized that this was just what I needed to do about ERO. I didn’t want to have a big pointless bitchfest on here. I wanted to do something with the potential to make a real difference. My solution: I decided to write a letter to Eric Hoskins, the Minister of Health and Long-Term Care (the department responsible for the now withdrawn funding for ERO) and to cc my local MPP so they’re aware of the huge loss that the termination of this service is going to have on Ontarians and Canadians. I thought that I would share my letter with you so that you can copy and paste it, make it your own if you want, and send it to your MPP and Dr Hoskins. After all, if we don’t let our representatives know what our concerns are, how can be expect them to effectively represent us?

Dear Dr. Hoskins,

It has recently come to my attention that the Ministry of Health and Long-Term Care will no longer be providing funding for EatRight Ontario. As you are aware, ERO is a provider of evidence-based nutrition resources and tools which are used across the country, and beyond. ERO also enables Ontarians who might not otherwise have access to a Registered Dietitian to call or email a RD for free. The loss of these services as of the end of March is going to be a huge blow to these individuals as well as to healthcare professionals, particularly Registered Dietitians, who use these resources and who refer people to their services.

ERO had 22,198 contacts between January 2017 and December 2017. These consisted of 11,562 telephone calls and 10,636 emails. This does not include the millions of visits to the website every year. ERO was also the recent recipient of an internationally recognized eHealthcare Leadership gold medal for Best Overall Internet Site. At a time when other provinces, such as Newfoundland and Saskatchewan are just starting telehealth dietetic services it is a step backward for Ontario to be terminating an established service.

Chronic diseases are the leading causes of preventable death and disability in Canada. Poor diet is a major contributor to risk of chronic disease and is a modifiable risk factor. RDs are the only regulated source of credible nutrition information in Canada. Unfortunately, many Canadians who would benefit from nutrition counselling do not have access to a RD as a result of limited services available in their area and/or a lack of coverage for RD services. A telehealth service such as ERO enables Ontarians, regardless of location or financial means, to access the services of a RD, thus promoting health equity across Ontario. Teledietetics is proven to provide positive outcomes in a number of areas. Such a service saves healthcare dollars by relieving some of the burden on emergency and local healthcare providers by reducing the need for these services. It also allows RDs, particularly those in public health, to focus their efforts on population health interventions as they can direct the public to a central credible source of nutrition information rather than spending time duplicating efforts by all creating similar factsheets and resources.

The loss of ERO will mean a loss of access to credible nutrition information for Ontarians, and Canadians, at a time when it is vital to combat the misinformation widely available on the Internet and peddled by self-styled nutrition “experts”. I urge you to reconsider the decision to terminate the funding for EatRight Ontario. If this is not an option, I ask that you continue to keep the ERO website live until an alternative site can be arranged to house and maintain the resources. I also ask that you include access to Registered Dietitians as part of your consolidated telehealth services.

Respectfully,