Dispelling nutrition myths, ranting, and occasionally, raving

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Have a merry Coca Cola Christmas


Today I just want to have a little rant about the obesogenic environment we live in.

The other day I had to go to Walmart for something. I know, I know. It’s a store that I normally avoid like the plague but knitting emergencies do strange things to people. Anyway… Christmas is popping up all over the place despite the fact that it’s obscenely early and one of the first things I saw upon entering Walmart was a huge bin of Coke Christmas ornaments. These weren’t just ornaments though, they were bottles of Coke shaped like Christmas balls. Beside the fact that they’re completely impractical, they’d break pretty much any branch, why on earth do we need to put pop on a Christmas tree? I truly hope that this is a sign that the mighty are falling. If Coca Cola are becoming so desperate in their marketing that they’re resorting to make ornaments filled with pop maybe they’re not doing so well. Honestly, there is more than enough celebratory eating over the holidays is it really necessary that people adorn their trees with Coke???

Later that same day I went to Starbucks for coffee with a friend. I know, more corporate shame. Would you believe that there are no other coffee shops in the city open past 6 pm? I would choose somewhere local in a heartbeat but without that option I found myself ordering one of the new chestnut praline lattes. Because it was night time and I’m an old dietitian I ordered it decaf, half sweet, with 2% milk. Silly me, because I failed to request no whipped cream or sugary sprinkles. I’ve ranted about the use of sweetened coffee as the default for their iced coffees before but really, this is just a crime against coffee. No coffee shop beverage, aside from an espresso con panna, should automatically come with whipped cream and sugary sprinkles. A latte by definition is espresso, steamed milk, and a little bit of foam. Not whipped cream. Not sprinkles. If customers want those options they should have to specially request them and pay a little extra. Why must the unhealthy option be the default? Even at half sweet it tasted very sweet. According to the Starbucks website there’s 31 grams of sugar in a tall chestnut praline latte. That means in my half sweet version (which I scooped the whipped cream and sprinkles off of) there was still nearly 4 teaspoons of sugar! If I ever get it again I’m going for 1/4 sweet, which, at 2 teaspoons of sugar is still too sweet. Screw it, I’ll just have an herbal tea.


Why fruit and veg aren’t the right prescription for health


I feel like I’m being a bit of a stick in the mud, but I’m not sure that I’m onboard with this new fruit and vegetable prescription initiative in New York. Naturally, I’m all for people consuming more fruits and vegetables. I’m just not sure that this is the way to go about getting people to eat more fruit and veg. Nor am I convinced that this is the ideal way to target people.

Doctors are giving out vouchers for fresh produce at a hospital in an area that has a high level of poverty and a low-level of fresh produce consumption (according to the article I linked to, as many as 5 out of 10 people in the area consume no fruit or vegetables in a given day!). These doctors are giving the vouchers to obese patients as they are at greater risk of developing diseases such as type 2 diabetes, cardiovascular disease, and certain cancers. The theory is that this will prevent the development of many of these diseases in these individuals. This is where I see the first problems with this strategy. In an area that is highly impoverished it seems unfair to give these vouchers solely to obese patients. Surely there is a high level of malnutrition amongst the normal, over-, and under-weight population as well considering the fact that insufficient income is the number one factor contributing to food insecurity. Wouldn’t it be better to give these vouchers out to all patients, or at least those earning less than a predetermined income level? Weight is not the best barometer of health and I’m fairly certain that people at all weights and income levels could do with eating more vegetables.

Another concern of mine is that many people won’t have the means, ability, or inclination to prepare fresh produce. Similar to the saying, you can lead a horse to water but you can’t make him drink. It’s all fine and well to tell people “go, get yourselves some fresh vegetables”. It’s another thing entirely for them to actually procure the vegetables and then prepare them in a healthy manner. Anyone who’s ever worked in a food bank can tell you that clients will often pass over fresh produce (there can be a number of reasons for this but it’s often because they’re unfamiliar with the foods and don’t know what to do with them).

My final concern is that this program is likely to have little to no effect on the “obesity epidemic”. Yes, increasing access to fresh nutritious foods is a lovely gesture but it does nothing to combat the obesogenic environment in which we live. We need to overhaul our entire food system and societal structure if we want to make any serious headway with curbing obesity.

This initiative reminds me of the one started in Edmonton by doctors who were (are?) prescribing exercise to their patients. I would still love to see an initiative that saw prescription of dietitian services to patients and not just obese patients. The dietitian could help the patients to figure out ways to improve their dietary habits that would work for them. They could also provide education on nutrition and food preparation and perhaps at this point the patients could be provided with vouchers for fruits and vegetables. It’s obviously not going to put an end to the obesity epidemic but it’s something that could be relatively easily implemented while we fight to change the current food environment.


Finally weighing in on the NYC soda ban

I’ve been finding the response to NYC’s recent ban on the sale of pop (soda to you Americans) in containers larger than 16 oz interesting, and telling. A recent poll in the States found that many citizens are opposed to government involvement in deciding what we eat. These respondents don’t want the government to restrict pop size, post calories, or limit fast food outlets. The notion that the government isn’t already deeply involved in determining our diets is a little naive. Why do you think that pop is so inexpensive anyway? Government subsidies to sugar producers, that’s why.

The main reasons people cite for not eating healthily are lack of time and affordability. Why do we lack time? Because our society has been constructed around the notion that putting in long hours at sedentary jobs is ideal. Why are healthy foods (at least perceived to be) less affordable than their unhealthy counterparts? Because ingredients that go into “junk” foods are often subsidized by the government, allowing the food industry to produce them cheaply and advertise them relentlessly.

The government decides how our cities are built, what developers are given permits to build. The government is already deeply involved in the lengthy process of determining what and when foods pass through your lips. These decisions may not be as obvious as bans on big gulp sodas, but in a way that makes them even more important because we’re not consciously aware of their impact on our lives. We live in an obesogenic environment. It’s currently far harder to be a healthy weight than is it be overweight or obese. This is not a matter of personal choice.

Banning large soda sales is a great step in the right direction. No one ever needs to have a pop as big as 16 oz, let along larger. Clearly we are unable to avoid the lure of “value” for our money. We need to government to step in and help us to help ourselves. As I said before, as long as we’re going to act like children we are in need of a so-called nanny state.

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Canada’s Healthy Eating Campaign: Too little too late?

On Monday our esteemed Minister of Health, Leona Aglukkaq announced funding for a national healthy eating initiative at the Summit on Healthy Weights. It seems that finally, after years of talking about what we should do to address the obesity epidemic in Canada the government is ready to take action. Unfortunately, that action is destined to be woefully inadequate. What action are they taking you ask? Well, they started off with the Nutrition Facts Campaign in the fall of 2010. This campaign introduced the notion of “A little or a lot” and focussed on teaching consumers how to use the Nutrition Facts table and the Percent Daily Value to help them make healthy food choices. Anybody feel like they’re making better food choices since that campaign launched nearly a year and a half ago? How many people (outside of those in health care and government) are even aware of that campaign? As a dietitian, I don’t even use the Percent Daily Value when making food choices (yes, I do use the remainder of the Nutrition Facts panel) so I wonder how many consumers actually use it. I don’t think the Percent Daily Value is a great tool because it’s based on an “average” person and most of us have varying caloric and nutrient needs, most of us are not actually average. The Nutrition Facts panel is not great, why are we basing an education campaign around an inferior tool? Wouldn’t it be better to be creating better labelling that’s easier for consumers to use? And how about encouraging consumer to eat foods that don’t have nutrition labels, i.e. vegetables and fruit, arguably the foods that most of us do not consume enough of? Okay, so the next phase of campaign will be doing that along with encouraging consumers to reduce their intake of food and drinks high in calories, fat, sugar, and sodium. How will the government do this? It will be “promoted creatively through various outreach partnerships, social media engagement and web tools.” They’re also going  to provide advice on “how to follow Canada’s Food Guide by choosing the right amount and types of food at home, at the grocery store and when eating out.” I’m all for education and increased awareness but I don’t think that knowledge alone is enough to change behaviour. Take us dietitians again, it’s been shown that we fall prey to the same portion distortion tricks and underestimation of calories when eating out, as other consumers and we have at least four years of nutrition education. How can we possibly think that one little public awareness campaign is going to help consumers avoid these pitfalls. We have engineered an obesogenic environment and now we expect individuals to save themselves from it by telling them to eat less junk and eat more vegetables? I’m pretty sure people already are aware that these are things that they should be doing. Unfortunately, our society is set-up to make these changes incredibly difficult. Yes, we need to increase awareness but that should only be the smallest part of our efforts. As hard as it’s going to be we need to redesign the environments in which we live, work, and play to make healthy eating the easiest and most desirable choice.

I just happened across this “Continuum of Education, Marketing, and Law” in an article about active living. It states that educational approaches to manage behaviour should be used when: 1. Target market is prone to behave as desired, 2. Self-interest and benefits of the behaviour are easily conveyed to target market, 3. There is no or weak competition. Social marketing approaches to manage behaviour should be used when: 1. Target market is neither prone nor resistant to the behaviour being promoted, 2. Self-interest and benefits can be conveyed to target market by enhancing and managing the offer, 3. The competition is active. Law-based approaches to manage behaviour should be used when: 1. Target market is resistant to behave as desired, 2. Self-interest and benefits cannot be conveyed to target market, 3. The competition is unmanageable. I would argue that all three approaches are needed, particularly the third one, as we are not liable to change our eating behaviours through healthy messaging alone.