Dispelling nutrition myths, ranting, and occasionally, raving


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Cruciferous crusaders or (not so) superfoods? The truth about veggies & cancer

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Did you hear the news? Last week it was announced that there’s no evidence of a link between vegetable and fruit consumption and risk of developing cancer. This proclamation was based on the results of a large-scale analysis of data from cohort studies in Japan.

Before everyone rejoices and throws the contents of their crispers in the compost, opting instead to have ice cream for supper maybe we should take a closer look at the original research.

The first caution I’d make is that this is based on a study of people in Japan. Because the average Japanese diet and lifestyle differs significantly from our North American diet and lifestyle we can’t conclude that results seen in people in Japan will apply to people in Canada or the US, or pretty much any other country.

The second caution, and this is the big one, is that the frequency of consumption of vegetables and fruit used in the study was very different from what’s recommended here. The greatest consumption of veg and fruit recorded in the study was “almost daily”. Compare that to the recommended 8-10 servings per day in Canada’s Food Guide. Stating daily consumption of veg and fruit tells us very little about the true picture of veg and fruit consumption. This categorization allows a person who eats one apple a day (and no other veg or fruit) to be viewed as the same as a person who eats veg and/or fruit at every meal and snack and consumes a wide variety of produce. The method of categorization in this study really only allows us to conclude that at minimal consumption levels, eating vegetables and fruit doesn’t appear to provide protection against cancer when compared to eating vegetables and fruit infrequently (or almost never??). The fact that almost never is even an option makes me wonder about the accuracy of self-reporting and the possibility that people in that group could be more likely to succumb to ailments such as scurvy before cancer would have a chance to get to them.

The third point to mention (although hopefully I don’t need to) is that absence of evidence is not evidence of absence. Just because this study didn’t find a relationship between the consumption of vegetables and fruit and the development (or prevention) of cancer doesn’t mean that there isn’t a connection between the two. It’s possible that using different parameters might show that a greater consumption of vegetables is linked to a decreased risk of certain types of cancer.

The final point that I think is important to make is that we don’t eat food in order to prevent cancer. Even if this study is showing us that eating vegetables and fruit doesn’t confer protection against cancer upon us (and I’m not even remotely convinced that it does) there are plenty of other good reasons to eat vegetables and fruit. Vegetables and fruit provide us with many vitamins and minerals that are vital to the function of our bodies. They provide us with fibre which is essential for gut health. They provide us with water and energy, which are both necessary for our survival. They also add flavour, colour, and variety to our diets making meals and snacks enjoyable. All this to say that while cookies are delicious they still aren’t a balanced nutritious meal. Vegetables and fruit still have important roles to play in keeping us healthy.


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Down with “cake culture”

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Shout out to the Faculty of Dental Surgery at Britain’s Royal College of Surgeons for taking one for the team. At the start of the year they released this statement encouraging workplaces to “cut cake culture”. Which prompted opinion pieces such as this one: Royal College of Surgeons’ warning on ‘cake culture’ leaves sour taste. What a nice change it is to have another profession being smeared as food police. Dietitians welcome you to the club with open arms.

In all seriousness though, as a dietitian and a human who works in an office and who eats food (and even cake), I wholeheartedly support the statement by the Faculty of Dental Surgery. Sugary treats have become the standard in our culture. Many workplaces have cakes for birthdays, retirements, wedding showers, baby showers, holidays, promotions, pretty much any occasion we can come up with. Maybe these celebratory cakes wouldn’t be such a big deal if they weren’t just one piece of a larger ultra-processed excessive food environment. Unfortunately, they are and we can’t just look at a celebratory workplace cake in isolation. We also need to consider the fact that there are other “treats” in the workplace. Food at meetings, well-meaning coworkers bringing in homemade goodies, leftovers from meetings, candy bowls, vending machines, potlucks, rewards of pizza or meals out. These are just the landmines that people must navigate while at work. Outside of work there’s fast food outlets everywhere, there’s food for sale near the checkout in nearly every store (I’m looking at you Canadian Tire, HomeSense, Staples, Bed Bath & Beyond, et al), nearly every social interaction involves food. Workplace cakes are no longer the innocent celebratory treats that they were in the past.

The opinion piece is disdainful of the stance of the Faculty of Dental Surgery on workplace cakes. The author believes that energy would be better spent focusing on workplaces conditions such as that we’re never really “off” or packing people into cubicles like “battery hens”. Also worthy causes but not exactly within the purview of dentists. There’s also the logical fallacy of framing the argument as if one can care about workplace cakes or one can care about “real” problems in workplaces. This doesn’t have to be an either-or situation. I can be concerned about my workplace food environment and other workplace conditions at the same time. The author then goes on to raise additional workplace food environment issues. Certainly proper meal breaks, access to nutritious food, and a culture that values long workdays over productivity and work-life balance are all important concerns. Again, not so much from a dental perspective. However, they along with the “cake culture”, all play a role in our ability to make healthy choices.

Questioning the need to celebrate every occasion with cake is not an attack on women, as much as the author might like us to believe. What’s worse here: offending the fictional Margaret by limiting the number of occasions at which she can bring in cake, or failing to provide a supportive food environment for all staff? Anyhow, if the right approach is taken, there should be no offence caused.

Creating a positive food environment at work can be difficult. Food and emotion and reward are so closely intertwined in our society. This doesn’t mean that it can’t be done. With time, understanding, and diplomacy it is possible to make real positive change at work. No one should be acting as the food police, and no one should be acting as a food “pusher”. We all need to be more understanding of the fact that for many people a piece of cake is not a simple pleasure.

If you’d like to create a healthy food environment at your workplace, or are just curious about the idea, I highly recommend checking out the Ontario Society of Nutrition Professional’s Toolkit: Creating a Healthy Workplace Nutrition Environment. This toolkit can help you figure out where to start with creating a healthy nutrition environment at work, how to get buy-in, and provide you with many other resources.


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A “no seconds” policy will only feed disordered eating habits

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When I saw the headline “Could enforcing a ‘no seconds’ policy at dinner time help combat childhood obesity?” I thought “I hope this isn’t as awful as I think it’s going to be”. I’m sorry to say that it was every bit as awful as it sounded, and then some.

I was horrified to read the following in the first paragraph: “doctors are warning that parents should ban their children from second helpings to protect them from becoming overweight”. It didn’t get any better. This suggestion was based on research by a behavioural obesity researcher. The crux of her argument being that children are becoming overweight and obese because their parents are allowing them to stuff their greedy little faces at mealtimes. She is quoted as saying: “all parents should be being vigilant about portion control, so a no seconds policy” so, unfortunately, it would seem that her opinions are not being misrepresented.

Apparently the reason that many children are becoming overweight and obese is because they’re eating 12 more calories at every meal than they need. I’d just like to point out that if this were in fact the case, then these children would not be getting sufficient calories for healthy growth and development if they were denied seconds as a second helping of nearly anything would likely exceed 12 calories. Twelve calories of most foods would amount to a minuscule quantity.

According to Dr Llewellyn (the researcher mentioned above), “Some children are unable to regulate what they eat for themselves and many will not turn down food, even if they are not hungry”. Indeed, there are some children with genetic disorders, such as Prader-Willi Syndrome who are constantly hungry. However, disorders such as PWS affect about 1 out of every 15, 000 children born. That’s nowhere near the third of children estimated to be overweight or obese.

I think that enforcing no seconds policies will only lead to increased rates of disordered eating. Most children are born with the innate ability to eat when they are hungry and stop eating when they are full. Most children unlearn this ability as they get older and are encouraged by parents to clean their plates, are bombarded by food advertisements, observe the eating habits of family members, are served excessively large portions at meals, are offered treats and snacks throughout the day, etc.

More important than a theoretical excess 12 calories at each meal that a child may or may not be consuming is the formation of a healthy relationship to food. Arbitrarily placing limits on servings at mealtime will only feed an unhealthy relationship with food. This sort of thing teaches children not to trust their hunger cues, having the opposite of the intended effect. It teaches children that food is emotionally wrought. Denying hungry children food teaches them that they cannot trust their appetites and may also teach them that their self worth is measured on the scale. Pretty much the definition of an unhealthy relationship with food.

Rather than making mealtimes a minefield, parents should be role modelling healthy attitudes and eating habits. They should be providing their children with nutritionally balanced meals at regular times and allowing their children to decide when they’re full. Whether that mean that they leave food on their plates or ask for more.


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Cancer diet

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Anybody else see this article about a journalist who gets cancer and starts praising nutribabble? The description really says it all: After beating cancer, Scott DeSimon rediscovered his appetite—and lost his skepticism for wellness and nutrition trends. Meet the superfoods that guided him back to health.”

The gist is that the author gets cancer, goes through conventional treatment, loses a bunch of weight, finishes the treatment and attempts to regain the weight. Eschewing what he sees as healthy eating (“I know what constitutes a healthy diet: lots of vegetables, meat mainly as a flavoring, no processed foods”) he goes for quantity over quality and calories over micronutrients in an effort to regain the weight he lost during radiation. Unsurprisingly, he makes himself sick by ingesting copious quantities of fast food and restaurant food. So, he turns to a professional. Sadly, not a dietitian nor any sort of cancer specialist. Instead, he goes to Dr Lipman who has devotees such as Gwyneth Paltrow, as if that’s a selling point. Dr Lipman is a big fan of superfoods, cleanses, supplements, and has a website with testimonials. All of which are red flags of quackery and basically amount to a red sail, or whatever you want to picture for an oversized red flag. There are testimonials from actors and fellow quacks like Mark Hyman and Christiane Northrup.

Once the author goes on the extremely restrictive diet prescribed by Lipman, he magically feels much better and he slowly starts to regain weight. While he claims to be skeptical about the regimen, it comes across as hollow to me. It’s like I rolled my eyes but threw away all of my food as started living off cashew milk and chia seeds. Of course he’s going to feel better, he’s finished radiation treatment, regained his tastebuds, and started eating again (1). I’m not saying that the diet Lipman put him on is bad, I’m just saying that there are some pretty significant confounders here and correlation does not imply causation. It’s quite likely that he would have started to feel better on a much more relaxed diet and that the strict diet is falsely being credited with his recovery.

I don’t think that anyone with cancer should feel like they have to give-up gluten or sugar or coffee. They also shouldn’t feel as if they have to subsist off expensive “superfoods” and supplements. Healthy eating, whether you have cancer or not, does not have to be a complicated or costly endeavour.

For more information on cancer nutrition visit:

Canadian Cancer Society

Cancer Dietitian

Jean Lamantia

 


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Have you ever “undone” all your hard work at the gym with a burger? This post is for you.

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Have you ever said, or thought, something along the lines of “I cancelled out my workout by eating doughnuts”? How about “I just undid all my work at the gym by having pizza for supper”? Or, “I earned this treat because I ran today”? I’m pretty sure I’ve been guilty of saying those sorts of things. Many of us probably have. For some reason I seem to have become acutely aware of it recently.

I see articles, blog posts, tweets, overheard conversations, where people make statements like those in the examples above all the time. Since it’s the New Year, I expect that a lot of people are making health and fitness related resolutions. I’ve shat all over such resolutions in the past so I won’t do that again today. Instead of resolving to lose weight, exercise more, eat healthier, undergo metamorphosis, perhaps we should consider resolving to shift our mindsets.

The thing is, you’re never cancelling out, undoing, or negating physical activity by eating too much or eating foods that aren’t super healthy. You’re also never earning them by putting in time on the dreadmill. We need to separate the two. Remember when I talked about my problem with many food tracking apps and websites? We often overestimate how many calories we’ve burned during a workout. It’s more than that though. It’s that both exercise and nutrition contribute to our health and well-being but they are both completely separate entities and we need to stop thinking of them as two sides of a scale.

Regardless of what you eat, exercise is still beneficial. Exercise can improve your sleep quality and duration, it can help reduce stress, it’s important for both physical and mental health and can reduce the risk of many diseases. Conversely, regardless of how much you move, a healthy diet is still beneficial. Good nutrition can reduce the risk of many diseases, provide you with energy, can help you recover from injury… Obviously, the two are important contributors to good health. Obviously, you’re going to reap greater benefits if you are both physically active and eat a nutritious diet. However, if you workout and eat a cheeseburger you haven’t then cancelled out your workout. You’ll still be getting some benefits from being active. You’ll still be better off than if you sat on your butt all day and then ate a cheeseburger.

So, stop being so hard on yourself. Stop thinking you’ve failed if you haven’t done an hour of spin and followed that up with a kale salad. Try to separate your thoughts about exercise and your thoughts about nutrition. Your workout happened no matter what you ate afterward. A burger and fries doesn’t erase a swim.