Dispelling nutrition myths, ranting, and occasionally, raving


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Rocco’s dispiriting diet

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Okay, I have to go and be all unsexy again and tell you that a healthy diet doesn’t have to consist of ridiculously overpriced supplements and complicated recipes made from rare ingredients scavenged by sherpas from the top of mountains in Peru, or whatever. I know that it’s boring and basic but you can eat only easily identifiable foods, available at your local grocery store, simply prepared and be healthy.

What prompted this? Have you seen the news about celebrity chef Rocco DiSpirito’s “unbelievable amounts of food” diet? You know what it reminded me of when I was reading it? That moon juice lady’s diet.

I think it’s fantastic that Rocco is feeling healthy on his diet. That doesn’t mean that it’s for everyone. Just because he’s lost weight doesn’t mean he’s suddenly an expert on weight management or nutrition. Just like how everyone who eats seems to fancy themselves nutrition experts, it seems like everyone who’s lost weight fancies themselves to be weight loss gurus. It’s like that time my boyfriend’s knee was mysteriously swollen and I told him it was probably bursitis and he went to emerg and waited a quadrillion hours to have the doctor take a cursory glance at him and reach the same diagnosis. So, basically, I’m a doctor now and if you tell me your ailments I’ll diagnose you. Save you a bunch of time in emerg.*

Anyway… Rocco’s diet honestly doesn’t sound like all that much food to me. I do manage to put away quite a bit myself but if he’s starting his day with an almond milk protein shake (more about this later) he’s probably not starting off with many calories. His next “meal” was cantaloupe with stevia and his homegrown herb puree “sugar-free” of course which is very important when you’re pairing it with a fruit that’s calories pretty much 100% come from sugar. Next was pickled mackerel (fresh from the boat; don’t even bother if you don’t have your own personal fisherperson). Afternoon snack was: Bluefish Tacomole. ‘It’s a taco shell that we make from fiber and protein and it had guacamole and local bluefish made on our 700 degree plancha.'” Second afternoon snack was a bar and a shake (both products available for purchase on his website, more on this later as well). Supper was taste-testing some food he prepared for an event. No wonder he found himself “starving” when he got home at 3 am and promptly scarfed: “Berry Beignets, Stuffed Green Peppers with Turkey and Tomato, Chocolate Protein Bar”. Pretty much the closest thing to a proper meal he ate all day.

Because Rocco has become a weight loss expert simply by shedding 30 pounds he now sells a line of affordable outrageously overpriced nutritional supplements so that we can all benefit from this expertise he can make money. Links in the article (which leave me wondering, is this really an article or a thinly veiled advertisement?) take you to his product website. Naturally, there is no information on the size of each product, nor the nutrition information, but these are minor details when you’re buying the perfect body. Rocco’s “Just Shakes” boast home delivery (which is apparently unique when Internet shopping) and, “contain 28 grams or more protein, are dairy free, sugar free, gluten free, non-GMO, lactose & whey free, soy free and contain at least 8 grams fiber.” A steal at $299 USD ($389.67 CAD plus an arm and a leg and your first born in shipping and duties) for an unspecified quantity. His bars are: “made with only eight 100% all organic ingredients: organic puffed brown rice, cocoa powder, freeze dried strawberries, dark chocolate, pumpkin seeds, coconut nectar and stevia. No preservatives, stabilizers or additives of any kind. At only 102 calories and a gram of fat THIS BAR IS A REAL TREAT—it is Reduced calorie / Low fat / Saturated fat free / Cholesterol free / Low sodium / No added sugar.” Apparently coconut nectar doesn’t qualify as “sugar” because Rocco and his marketers are hoping we’re too stupid to realize that coconut nectar = sugar. At only $48.95 for a box of 12, $63.79 CAD, that’s $4.08 per bar ($5.32 CAD). That’s a pricey 102 calories.

I think it’s great that Rocco is so pleased with his current diet that he feels the need to share it with the world. I think it’s a shame that he’s profiting from the sale of outrageously overpriced products and that his diet is being packaged as a healthy weight loss choice for all. We’re all different, our nutritional needs, likes, and body shapes and sizes vary considerably. Just because a celebrity, chef or otherwise, has lost weight eating a certain way doesn’t mean that it’s the way we should all be eating.

*Please note, I do not in any way fancy myself to be a doctor. Do not come to me for diagnosis. Go to your family doc or emerg as the situation warrants.


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Will new nutrition labels make us all thinner?

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Not to be negative, but I saw this headline: How much will new nutrition labels help fight obesity and I immediately said “not at all” (in my head because I was at work and our office is open-concept).

I know the new (American) nutrition facts panel is supposed to help curb obesity because they’ve made the calories so damn big but personally I think it’s not going to help anyone to lose any weight. If people are counting calories and trying to lose weight making them bigger isn’t going to make weight loss any easier. If someone’s not counting calories it’s unlikely that a big bold calorie count is going to prompt them to change their minds about their purchases. I also think the emphasis on calories is not beneficial to anyone.

Yes, lots of people find calorie counting helpful when they’re trying to lose weight. I still yearn for a simpler time when we didn’t need this information. When we didn’t rely to heavily on prepackaged foods that managed to jam in so many calories and so few nutrients. Personally, I think that, for the average consumer, the ingredients label is where they should be looking more often than the nutrition facts panel. The NFP doesn’t tell you anything about what’s in the food you’re potentially putting in your mouth. It just tells you about the artful mastery of the manufacturer who wants to make sure you buy into the charade of fortified highly processed products as healthy choices.

Putting calories front and centre puts a negative lens on food. It takes away from food tasting good, being pleasurable, and providing us with energy and puts the emphasis on guilt and shame. Neither of which are things we should be associating with food.

Rather than focusing our efforts on fighting against obesity we should be fighting for health.


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Let them eat chocolate cake for breakfast!

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I saw the headline: Chocolate cake for breakfast? Research says it’s good for both your brain and your waistline and thought “this should be interesting”.

The author suggests that we should eat chocolate cake for breakfast because one study found that higher chocolate consumption was associated with improved cognitive function. While another study suggested that those who ate larger breakfasts (including a dessert) lost more weight and ate less later in the day than those who started their day with a less substantial meal. A bit of a leap, if you ask me to then conclude that we should be eating chocolate cake as part of a weight management cognitive enhancement regimen.

Looking at the study that ostensibly concluded that chocolate improved cognition, it immediately jumps out at me that the study drew from data from food frequency questionnaires. As you know, these are notoriously inaccurate. I also think that it’s important to note that the questionnaire in question didn’t differentiate between dark, milk, and white chocolate. White chocolate being up for debate as to whether or not it’s truly chocolate, and the form of the chocolate not being recorded (chocolate bar, ice cream, cake, cookie…) it would be difficult to conclude that there was any one attribute of these forms of chocolate that could improve cognition. As the authors point out, there is no way to infer a causal relationship. Just because people who ate chocolate at least once a week fared better on cognitive tests than those who ate it less than once a week doesn’t mean that there’s not some other reason that they fared better on these tests. While the results were statistically significant, I wonder how meaningful they are in actuality.

While I can attest to the benefits of “front loading” your day for many trying to lose weight or maintain weight loss, I wondered about the study the article referenced. Fortunately, someone else had already thrown shade on it (back in 2010!) so I don’t feel the need to duplicate their comments. For anyone who can’t be bothered to click the link, suffice to say the study author has come out with a diet book and the study upon which she based this plan is flawed.

Okay, what’s the takeaway? I’ve got nothing against chocolate. I’ve got nothing against chocolate cake. In fact, writing this post prompted me to fetch a slice of leftover chocolate cake to munch on while I typed. That being said, I wouldn’t include it as part of a nutritious breakfast. If you were eating chocolate cake for breakfast on the regular you’d be hard-pressed to get all of the nutrients you need without getting more calories than you need. If you want to add chocolate to your breakfast in a healthier way you could add some cocoa powder to your smoothie or some raw cacao nibs to your oatmeal. Save the cake for special occasions (and blogging).

 

 


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AspireAssist: a tool for weight loss or developing an eating disorder?

Twitter was all worked-up about a new weight loss treatment, called AspireAssist, earlier this week (thanks to @markjmcgill for telling me about it). This treatment involves the insertion of a tube into the stomach that can be opened after a meal to allow a person to discreetly ditch half the food they just consumed into the nearest toilet. I think that the gut (pun fully intended) reaction of many is “gross”. I can understand that reaction. Thinking about pouring half of the gnocchi and broccoli I just ate for supper through a tube in my stomach for about 5-10 minutes does kind of gross me out. I don’t think there’s anything wrong with reacting that way. I also find vomiting gross. Essentially this is just vomit by-passing the stomach. Gross no matter what the route.

Maybe you don’t find vomit gross though. That’s fine. To each their own. Moving on to the real issue…

How this can be marketed as a “non-surgical weight loss procedure” is a little puzzling to me. Sure, it’s not nearly as invasive (or risky from a physical standpoint) as standard bariatric surgery. It still involves putting a hole in a person’s stomach and inserting a tube with a valve. If cutting a hole in the stomach isn’t surgery, then I don’t know what is.

Suggesting that patients can be home in a couple of hours really hits home that “quick fix” mentality. It says, here’s an easy way to deal with something that you’ve been struggling with for years. I assume that anyone willing to undergo such a procedure will have been struggling to lose weight for years. I can’t imagine anyone who wasn’t desperate to lose weight being willing to go the AspireAssist route. However, I can imagine a whole lot of people who don’t need to lose weight being willing to undergo the surgery and I hope that any surgeons offering this procedure will be following very stringent criteria to ensure that it doesn’t become the “new bulimia”.

I know I wasn’t the only one who immediately thought, this is just bulimia by-passing the vomiting. It’s slightly better than binging and purging, in the sense that you won’t be destroying your esophagus or your teeth. There’s of course risk of infection, as you would see with enteral tube feeds. I could quite honestly see this becoming the “new cleanse” if we’re not very careful. I could see stars having the tube inserted to help them lose weight for movie roles or for red carpet events. I can see Gwyneth talking it up on Goop.

While the makers say that “over time, as patients learn to eat more healthfully, they can reduce the frequency of aspirations.” I worry this sort of procedure/device won’t promote better eating habits. Are being forced to chew your food thoroughly and consume plenty of water with your meal going to be good enough to help a person develop healthy eating habits. Is learning that you can dispose of 30% of the food you eat giving a positive message about food? It’s certainly not encouraging reduced food waste. Is it telling people that food can be pleasurable and nourishing?

What about the social ramifications? People who struggle with over eating and weight loss often struggle with self esteem and confidence issues. Is hiding in the bathroom for 10 minutes after every meal going to help improve a person’s sense of confidence? If I had to spend 10 minutes draining my stomach after every meal I would avoid eating with others. I wouldn’t want to eat at work. I wouldn’t want to eat at a restaurant or a friend’s house. I would only want to eat in my own home (never with guests) because I would feel so embarrassed about the time I would need to spend in the bathroom after we ate. Maybe that’s just me. But maybe not. Would that foster a positive relationship with food? I think not.

I have huge concerns about this sort of device. About the message it sends about the importance of being skinny above all else. About the potential physical and emotional consequences it might have on the users. And about the message it sends that there’s a “quick fix” for obesity. As far as I can tell, this is nothing but a medically endorsed form of bulimia.

 


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Should doctors be treating obesity?

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Image “Bigger than your head” by Mandy Jansen on Flicker. Used under a creative commons licence

I was thinking about Western medicine the other day and how all too often it seems that the approach is to treat the symptoms rather than to determine the cause and to try to remedy that. That got me to thinking about our approach to obesity and how, in a sense, having doctors (or any medical professionals) treat it means that we’re treating the symptom rather than the cause.

Yes, there are many causes of obesity. But when we boil them all down it really comes to our environment and collective lifestyle as a society. The way our lives are set-up it’s a battle to avoid becoming overweight or obese. Our jobs, our food system, our neighbourhoods, our social activities, our sleep habits, etc. are all contributing to the ever climbing obesity rates.

Sure, many medical professionals are fighting the good fight. Some are trying their best to help their patients learn to reengineer their lifestyles to lose weight. Some are pushing for changes to our built environment. But these battles are large and weren’t intended to be fought by MDs, RDs, and RNs. None of us learned how to design communities, to build grocery stores, or to structure offices while we were in school.

The real battle needs to be fought by government officials, engineers, designers, and planners. These are the people who can get to the root of the problem. Maybe as healthcare professionals we can help direct them to the sources of the issue. We can also continue our efforts to treat the symptoms as they surely deserve some tending to. However, until we can create some sort of coordinated widespread interdisciplinary approach to curbing obesity we’re just going to be continuing to give out bandaids to those in our care.