Dispelling nutrition myths, ranting, and occasionally, raving


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Canada’s not-so-innovative strategy to achieve healthy weights

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A few weeks ago, to little fanfare, the government of Canada announced an “Innovation Strategy” to achieve healthy weights in Canada. My coworker alerted me to it and got me going out on a rant on a Friday afternoon. Don’t get me wrong, there’s some good stuff in here: promoting active neighbourhoods to increase access to green spaces and encourage active transportation, promoting traditional foods, and early childhood interventions for priority populations. However, for the most part I was hugely underwhelmed by the strategy.

Most of the initiatives involved some form or other of food charity, such as expanding the community food centre model. While I appreciate the CFCs efforts to improve on the traditional food bank through the addition of cooking programs, gardens, and social inclusion, when it comes down to it, they’re still a charitable organization doing the work that our government should be doing. These programs also still put the onus on the individual to seek out and access the available services, rather than implementing programs that would be universally available. Also, I understand the desire to target people living on low incomes and experiencing food insecurity but I don’t believe that obesity and unhealthy lifestyles are something that only affect that population.

I know that it would be more complicated than throwing some money at some existing programs but I think that there are many things that the government could have chosen to do that would have a much greater impact on the health of Canadians. How about a national school lunch program? This would reach every child in school without stigma and would ensure that children had the nutrition needed to learn and grow. How about bringing back mandatory home economics or teaching food literacy in schools and supporting school gardens? Yes, I realize that the curriculum is under provincial jurisdiction but there must be some way to get this back in schools. That would ensure that all children learned food skills rather than just those attending limited classes. As we know, food skills are lacking across all income levels in Canada and are not just an issue for those living in poverty. How about subsidizing fresh vegetables and fruit making it easier for Canadians to afford these nutritious foods? I know that this one is working its way through government right now, but how about putting a ban on marketing to children? And not just “junk” food but all food as we know that children (and even teens, and let’s face it, adults) are ill-equipped to contend with the marketing abilities of the food industry (possibly more on this next week). How about increasing access to registered dietitians so that people who want to speak with a RD can do so? How about collaborating with doctors, farmers markets, and grocery stores to enable all physicians to “prescribe” vegetables and fruit? These initiatives would have far greater reach and impact than the ones selected by the government. It really makes me wonder who’s informing these decisions there and it enrages me that our governments continue to throw our money at piecemeal initiatives that are unlikely to make any significant long-term change in our health.

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The Food Guide needs to rise above dietary dogma

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A while ago I remember reading an article by some doctors about how the updated Canada’s Food Guide should be promoting a low-carb, high-fat (LCHF) diet. Then last week there was another article about a “prominent Ontario doctor” who asserts that the new Food Guide is being based on “very bad science”. And I’m just so frustrated that doctors, who we all know receive minimal nutrition education, are getting so much press for their self-serving misinformed opinions.

First of all, these doctors all serve to benefit if their particular dietary dogma is promoted. The doctors pushing the LCHF agenda make a living by putting people on this diet. The doctor who said the new Food Guide is based on “very bad science” and should instead contain specific diet recommendations (e.g. low-fat, DASH, LCHF) has received money from the Dairy Farmers of Canada in the past (and as we know, they are highly opposed to the potential shift from the current Food Guide food groupings).

Secondly, they seem to have a poor grasp of population health and the purpose of a national food guide. When we’re talking about population health we’re talking about improving the health of the entire population. We are not trying to address specific medical concerns of illnesses. We’re also not trying to put the entire country on a weight loss diet, which seems to be the perspective that these physicians are taking. Similar to the daily recommended intakes for vitamins and minerals, which are based on the average amount that a healthy person requires each day, the food guide is intended to promote a healthy dietary pattern for most healthy Canadians. Obviously we are all different and our needs and optimal diets will vary, hence the fact that this is called a guide. It’s not a prescriptive diet, it’s one size fits most with some personal tweaking, not one size fits all straight off the rack. It’s not meant to address every, or actually any, disease states. That’s why we have dietitians and doctors and primary healthcare to help individuals with specific health concerns. It’s meant to promote a healthy pattern of eating among as much of the population as possible. It’s not at all, “picking a specific dietary plan for all Canadians is the wrong approach and that, like all clinical processes, treatment should be considered based on individual patient needs” as the doctor in the second article said. It’s providing general guidance on healthy food choices for those who aren’t in need of clinical treatment.

The narrow focus on clinical care and treatment in the realm of healthcare does a disservice to us all. As does the medicalization of eating. In order to promote health and wellness in our communities and country we need to move back upstream and start preventing the need for many doctor visits, hospital stays, and medications. That sort of thing is achieved through population-based measures that address the social determinants of health and general guidelines such as Canada’s Food Guide.


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Why we need to stop with the meat and alternatives

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Ever since the new Food Guide consultations began the dairy and beef industries have been pushing back hard. They’re afraid that if the traditional food groups are dismantled, and if the food guide encourages people to consume more plant-based sources of protein, as has been put forward in the consultation, that there will be decreased consumption of dairy and beef. It’s understandable that they would want to protect their interests. After all, going from being featured prominently in the current (and previous versions) of the Food Guide with food groups named: Milk and alternatives and Meat and alternatives, to receiving little-to-no mention is a bitter pill to swallow. On the other hand, it’s a hugely positive step for the health and wellness of Canadians.

You see, words matter. “Alternative” is generally different than the norm. According to the dictionary, the definition of alternative is, “one of two or more available possibilities.” By naming food groups “Meat and Alternatives” and “Milk and Alternatives” we’ve positioned animal products as the norm and plant-based sources of similar nutrients as differing from the norm or abnormal. This positioning makes it sound like meat and milk are the front-runners and the “alternatives” runners up. This does a disservice to the health and budgets of many Canadians, particularly those living on low incomes, as meat is positioned as something to aspire to and the “alternatives” (which are often more affordable options such as beans, lentils, and tofu) as inferior.

I think that the standard Canadian home-cooked meal is often some variation on meat and potatoes. Having taught cooking classes for people living on low incomes for the past few years I have found that even if participants are open to trying new foods and recipes they are often unable to sell their family members on beans and lentils and other more affordable sources of protein. One of the few negative pieces of feedback we receive is that participants would like more meat in the meals we prepare. For many reasons we emphasize vegetables and “alternative” sources of protein in our classes. Among those reasons are: nutrition, food safety, variety, and affordability. Meat is generally one of the more expensive foods at the grocery store. By creating the impression that meals centred around meat are something to aspire to we’ve really done a disservice to Canadians. The majority of us don’t consume even the minimum recommended servings of vegetables and fruit each day and don’t consume enough fibre.

Milk is widely encouraged as a beverage with meals, on cereal, with snacks, and for sports recovery. It’s been positioned as the beverage for growing children and for seniors for bone health. While not quite as costly as meat, serving for serving, it’s still a pricey beverage in comparison to water and many other drinks. Setting aside vitamin D, which milk is fortified with, there are many other sources of the nutrients we commonly consume milk to obtain. Calcium is found in many leafy green vegetables, tofu, beans, nuts, and seeds. Protein is found in beans, lentils, eggs, nuts, seeds, and tofu.

All this to say, that despite the push-back, I think that (if Canadians pay attention to the new Food Guide when it’s released) ditching the current configuration of food groups, or even just the current naming of food groups, will be beneficial to the health and pocketbooks of most of us. If we stop seeing plant-based sources of protein as “alternative” and start recognizing them for their delicious value then maybe we can get out of that meat and potatoes mentality and start enjoying a wider variety of nutritious meals.


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Kid-friendly foods aren’t doing kids any favours

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Not being a parent I hadn’t realized the excess of unhealthy recipes on the Internet promoted as “kid-friendly”. That is, until last week when I was searching for recipes to update the selection we offer at our children’s cooking classes at work.

I was searching for “kid-friendly recipes” and “kids cooking” and similar terms thinking that the results would quickly yield some new promising recipes to try. Boy was I wrong. Nearly every recipe was either unhealthy or a bizarre offering for a child. For example, a slide show of recipes would go from donut hole kebabs and “spider burgers” (umm… ew) to “semolina and sun-dried tomato waffle pizzas” or banana split bites and any number of variations of chicken fingers to “pappardelle with leeks and corn”.

Most of the recipes were intended to appeal to children, not so much to involve them in the kitchen, unfortunately. Even more unfortunate was the fact that most of the recipes were high in sugar, salt, or fat (or some combination thereof). Pappardelle and sun-dried tomato pizza notwithstanding, I don’t think we often give kids enough credit as adults. Just as I’ve discussed before, when it comes to kids menus and family cookbooks, the assumption seems to be that children innately dislike anything nutritious (or they need to follow our personal dietary beliefs despite the potential inadequacy of nutrition and promotion of future disordered eating, but I digress). For the most part, kid friendly recipes seem to comprise one of two categories: completely lacking (or minimally containing) vegetables or fruit or vegetables or fruit made to look like adorable animals or something else. Fruit animals are fine and all, although I would hate to be the parent who had to spend ages styling my child’s food every day to get them to eat something green. The real issue here is that most of the offerings were not nutritious balanced meals. Most of them consisted of only two food groups: meat (no alternatives) and grains. Oh, and fries which I refuse to count as a vegetable, sorry. I think that most people agree that nutrition is important for children’s growth, development, and health. And yet, there seems to be some cognitive dissonance because even as people are saying this, they’re sitting their children down to a meal of chicken fingers and fries.

We adults need to stop assuming that children won’t like foods that are nutritious and assuming that there are “kid foods” and “adult foods”. Presenting these unhealthy options as “kid-friendly” and not exposing children to a variety of foods simply results in a self-fulfilling prophecy. If children are never given the chance to try new foods, they will never learn to like them. Give kids a chance.


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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,