Dispelling nutrition myths, ranting, and occasionally, raving


What is “real” food?

I was about to do some dreaded yoga the other day and YouTube always makes you sit through an ad before you get your video. This time the ad caught my attention.

A bunch of cute kids identifying foods. Intended to elicit our horror at the inability of children to recognize peppers while quickly naming chicken nuggets. Sure, it’s sad that many kids don’t recognize vegetables. What got me though was the fact that this was an ad for Kashi!

Kashi, a brand that sells highly processed cereals and granola bars, chock-full of ingredients that are likely unrecognizable as “real” food by the majority of the population, not just cute children.

For example, here’s the ingredient list for their classic Go Lean cereal:

Puffed seven whole grains and sesame cereal (hard red wheat, brown rice, honey, cane syrup, barley, triticale, oats, rye, buckwheat, sesame seeds), corn flour, expeller pressed soy grits, corn meal, cane syrup, expeller pressed soy protein, oat hull fibre, wheat bran, soy flour, corn bran, seven whole grains & sesame flour (whole: oats, hard red wheat, rye, brown rice, triticale, barley, buckwheat, sesame seed), salt, natural flavour, annatto colour.

Lots of grains, sure. There’s also sugar in there three times. And how about expeller pressed soy protein as a recognizable “real” food. Or “annatto colour”? Yep, whole grains, and a whole bunch of irony in Kashi products.


The “real food” fallacy


All of a sudden, it seems that Zoe Harcombe is everywhere. She was providing ludicrous nutrition advice for sufferers of yeast infections (thanks @RD_Catherine for the link). Sorry y’all yoghurt won’t cure yeast infections. Yes, choosing a yoghurt with probiotics is great for overall health but it’s more because of the by-products produced by the bacteria (e.g. B vitamins) than because of the bacteria themselves. Unfortunately, most of the bacteria in yoghurt will not survive your stomach acid.

What I really want to address though, is her popular article in the Daily Mail (thanks to @ERHWG for sharing the article and her rage): Diets Make Us Fat. The Solution is Simple. The basic premise is that we need to eat “real food” as opposed to fake  “manufactured food”. Calories don’t matter, and we shouldn’t be counting them. All that matters is eating “real food”.

But what is “real food”? I don’t think you’ll find many dietitians who disagree with the importance of cooking and eating more vegetables, fruits, and minimally processed foods for overall health and weight loss. However, I don’t think the division between “real” and “fake” food is particularly useful. Nor is the vilification of whole grains. Grocery shopping is complicated enough and people are hard-pressed for time. Making them feel guilty for buying anything in a package is not going to help them to adopt healthier habits.

It’s also possible to be over weight when consuming a “real food” diet. You know why? Because calories do matter. I’ve met plenty of people who are over weight who eat very healthy diets. Simply telling people that if they eat “real food” is not going to solve the obesity crisis. If I was over weight and someone gave me this advice I would be insulted. Not everyone who is over weight or obese is subsisting on a diet of big macs and kit kat bars. Consuming more calories than we need, regardless of the source, will result in weight gain.

Finally, the reason that diets don’t work is because they’re short-term fixes. Not because people are necessarily consuming the wrong types of foods or because they’re counting calories. The problem with diets is that they have an end date. They are not sustainable lifestyle changes. The other reason that they don’t work is because our food system is broken. Our environment is structured such that the unhealthy choice is the easiest choice and it’s a lot of work not to be over weight. Placing the onus on the individual and suggesting that if they only stopped counting calories and ate “real food” doesn’t even come close to addressing the true societal roots of the obesity epidemic.


Second guessing the second guessing the dietitian post


I’ve been noticing a disturbing trend among dietitians lately. It involves a certain division of RDs into two groups: “real” food RDs and all of the other RDs. Honestly, I’m not sure what the non-real food RDs are eating and advising others to eat. So far as I can tell, “real” food is the paleo diet and if you’re not paleo you’re not a “real” food RD. The implication being that dietitians advising you to consume anything other than paleo are inferior. I wrote a bit about this nutritional elitism last week. It offends me that, despite being an avid cook, some dietitians would suggest that I don’t eat “real” food because I don’t buy-in to a particular diet. I can assure you, I am not a machine (despite what some on fito have suggested), I do not run on diesel, electricity, nor hot air, I consume a variety of foods for fuel.

This “real” food RD group lead me to this post: Why you should second guess the dietitian. Now, I know that things are different in the US than they are in Canada so I’m trying not to take this too personally. However, it’s extremely frustrating to devote years of my life to a profession that I’m passionate about and to see others (including those within the profession) bashing it. It’s understandable that the author would have a hate-on for dietitians. She’s a holistic nutritionist, and as such, would be subject to much disdain on the part of dietitians due to the lack of evidence-based practice and of professional accountability in her chosen career. I don’t want to turn this into an “us versus them” diatribe though. I have no desire to get into a mud-slinging match. I know some reasonable and intelligent holistic nutritionists. No, my issue is the undermining of dietitians based on a couple of negative personal experiences the author had and based on the actions of the American governing organization (Academy of Nutrition and Dietetics – AND).

The gist of the article is that dietitians lack credibility because their governing organization is in cahoots with the food industry. There is no doubt about it; that’s a huge conflict of interest. It’s ludicrous that the food industry would be providing funding and education for dietitians via their professional organization. However, this does not mean that you can’t trust dietitians. It’s also important to note that there are a number of dietitians rallying against the relationship between the AND and the food industry, both through the group Dietitians for Professional Integrity, and through personal decisions. Despite what the author would have you believe, we dietitians are not all attending conferences and lapping up nutrition “education” provided by Hershey and Coke.

Sure, there are going to be some (as in any profession) who are going to unquestioningly accept any nutrition information provided to them in a conference or a webinar. However, from my experience, the vast majority of RDs are intelligent enough to question information presented to them (regardless of the source) and to filter out the wheat from the chaff.

Yes, as the author says, any reputable dietitian will also suggest that you should question any health information given to you. Doctors, dietitians, holistic nutritionists, none of us are infallible and the field of nutrition is constantly evolving. Dietitians are committed to life-long learning and to providing evidence-based advice. We are not droids for the food industry.

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Keeping the math in diabetes


I was innocently reading twitter last night when I saw the following tweet from a Holistic Nutritionist: 

Are you Diabetic? Get away from the numbers! No carb counting, no constant testing, just REAL FOOD! That’s the answer.

I completely understand what she was getting at. I speak with many newly diagnosed diabetics who are overwhelmed and have no idea what they can eat. I also get a lot of them looking for “diabetic” cookies, granola bars, and sweets. This is during their first grocery shop after diagnosis. I loathe the vast majority of sweets marketed to people with diabetes. Most of them would not fall under the heading of “real food”. They’re full of sugar alcohols and highly processed ingredients. And despite that, they still often have a considerable amount of sugar. What so many people don’t understand is that people with diabetes can eat “real food”. They don’t need to have specially formulated bars and snacks. In fact, the diet that’s recommended for people with diabetes is the diet we should all be following: lots of vegetables along with protein, healthy starches, and dairy (or alternative) products. So, yes, “real food” is the recommended diet for all.

This is where I get ranty… This advice is dangerous. If I was newly diagnosed as diabetic I would not find this helpful. Yes, constant testing of blood sugar is no longer recommended. That doesn’t mean that people with diabetes shouldn’t check their blood sugar at all. It can be very helpful for people with diabetes (especially those who have just been diagnosed) to figure out what foods and activities may trigger highs and lows. It can also help people to become attuned to what high and low blood sugar feels like. Carb counting is also a useful tool for those with diabetes. Consistent quantities of carbohydrates are needed to ensure that appropriate doses of medicine are prescribed. Carb counting helps to make sure that appropriate serving sizes of carbohydrate are being consumed and can help reduce the need for medications. For those with insulin pumps, carb counting is necessary to determine how much insulin should be administered at meal times.

Yes, “real food” is important but taken alone it’s a simplistic solution. The numbers are useful tools to help people figure out when, what, and how much of “real foods” to consume.