Dispelling nutrition myths, ranting, and occasionally, raving


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What came first: the fried chicken or the heart disease?

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Last month a study was published about fried food consumption and the risk of coronary artery disease. The study was conducted with US military veterans and concluded that: “In a large national cohort of U.S. Veterans, fried food consumption has a positive, dose-dependent association with CAD.” Meaning that the more fried food a veteran consumed, the more likely they were to have heart disease. But what does this mean for the average person?

It’s important to note that the vast majority of study participants were men (90%) and the average age was 64. It’s well known that heart disease in women is poorly researched and important to acknowledge that the results of this study don’t necessarily apply to women. There are also many factors that contribute to the risk of developing heart disease and the researchers took the following into account: race (insofar as to categorize participants as black, white, or other), BMI, alcohol use, education status, exercise, smoking status, pre-existing type 2 diabetes, consumption of fish, fruit, and vegetables. After controlling for these factors, the researchers still found a relationship between fried food consumption and CAD.

However, the authors neglected to control for one important factor: poverty. Poverty is a significant risk factor for many so-called “lifestyle-related diseases”, including CAD. Other lifestyle factors are often also enmeshed with poverty making it nearly impossible to determine true contributing factors. People who live in poverty often have poorer diet quality than those with higher incomes and may rely on fast food, including fried foods. If poverty is indeed a greater risk factor than fried food consumption, or if fried food consumption is a result of poverty, this means that simply telling people to consume less fried food may not be the most helpful advice. It takes a certain level of privilege to be able to “choose” to consume the recommended diet. It means having the financial means, time, access, and facilities necessary to prepare nutritious meals.

While the findings of this study support the common belief that fried food is not a healthy choice they also serve to entrench the belief that diet is all about choice when for many people it is not. We need to look further than fried food to determine the root causes of illnesses such as coronary artery disease if we truly want to work to reduce incidence of these diseases.


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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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A bit about that working mums make kids fat study

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This article: The Impact of Maternal Employment on Children’s Weight: Evidence from the UK came out a couple of weeks ago and I was appalled. Essentially, the article is blaming working mothers for making their children fat. As if working mums don’t have enough guilt dished out to them already. As if there’s a simple causal relationship between obesity and maternal employment. And as if there isn’t already enough unhelpful fat-shaming going on in our society. I was going to blog about it but a number of other people already have so why reinvent the wheel. Instead, check-out these pieces:

Working Mothers Don’t Make Children Obese by Gid M-K; Health Nerd on Medium explains why the reporting on this study was all wrong.

Aiming the Obesity Blame Game at Working Moms by Ted Kyle on ConscienHealth reminds us that correlation is not causation.

A TL;DR thread from Sean Harrison breaking down the many limitations of the study.

If you’ve come across any other great criticisms of the research (and media surrounding it) please share in the comments. I would especially love to see some from a weight-neutral perspective as the majority of the criticism has been around the study methods and sexism but I think that sizeism is a major problem with the research as well.

 

 


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How much would you be willing to pay for a burger?

http://www.livingwagecanada.ca/

Last week as I was reading twitter over breakfast I had the misfortune of coming across a conversation about living wage. An elected official (who shall remain nameless to protect the ignorant) had the audacity to suggest that people clamouring for a living wage for all would no longer be doing so if they had to pay more for their burgers. I’m sorry, what?! To which I subtweeted that all members of government should have to have mandatory training on the social determinants of health and poverty. But I have more to say about the subject than 140 characters permits.

First, I would just like to state that we should pay more for fast food burgers (and probably for a lot of other food as well if we want our farmers to be able to earn a respectable living feeding all of us).Yes, the cost of some goods and services would most likely increase if all employers were forced to pay their employees enough money to live above the poverty line. Cue the cry that this is unfair to small business owners and that all “shop local” campaigns in the world won’t be able to prevent many of them from going under if they had to pay their employees enough to survive comfortably on. There are a number of reasons that this would most likely not be the case. And a number of ways to prevent it from occurring.

If everyone was making a respectable amount of money then more money would be available to go back into the economy. More people would be able to spend their hard-earned dollars at local businesses or on more expensive big macs. The additional expense to adequately compensate employees wouldn’t have to be shouldered by the (small) businesses themselves. The government could subsidize these wages, provide grant money, and/or tax breaks to businesses, or even create a guaranteed minimum income program. While I can understand the fear of business owners it also draws my ire that some people would immediately react negatively at the suggestion that they pay their employees a reasonable wage.

We know that income is one of the top social determinants of health (1). We also know that food insecurity (which is the result of poverty and inadequate income) results in astronomically higher costs to the medical system than are seen for those who are food secure (2). Frankly, I find it appalling that any elected government official in this day and age would manage to be so woefully unaware of these facts, and so unwilling to engage in meaningful conversation with those trying to bring this information to his/her attention.

I also find it amazing that so many business owners and managers fail to see the connection between employee satisfaction, morale, and the success of their business. I’ve had a number of jobs over the years and I’ve seen employers who clearly value their employees and treat them with respect. Unfortunately, I’ve seen far more who see their staff as expendable and rather than taking the time and resources to make their employees happy they’d rather see them quit as soon as a better opportunity presents itself and just hire someone new. Happy healthy engaged knowledgeable appropriately compensated employees are truly the most valuable asset any employer could have.

So, yes, if paying more for a burger is all I have to do to help provide people with a living wage and save them from precarious employment then I think that’s a pretty small price to pay.