Dispelling nutrition myths, ranting, and occasionally, raving


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Which fitness tracker gives you the best calories burned for your workout? An experiment

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Remember my rant a little while ago about how you shouldn’t think of exercise and food as an equation to balance? Or my post about not using the exercise component of calorie counting apps? Well, I just wanted to add a little more to that conversation today.

I use a Garmin watch to track my runs and occasionally I’ll look at the “calories burned” out of curiosity. After a pretty fast longish interval run I noticed that the calories burned seemed rather low so I started scrolling back through and was puzzled to find a shorter easier run that supposedly resulted in a very similar caloric expenditure. That left me wondering how Garmin determined the calories burned during a run. I looked it up and it turns out that it’s related to heart rate. Sometime the heart rate monitor is wonky and (especially when it’s really cold out) will register a heart rate that would be more likely seen when I’m sitting on my butt than when I’m out booking it through speed work. That means that my Garmin (erroneously) registers minimal exertion and thinks that I’m not burning very many calories.

Today I decided to do a little experiment. I wore my Garmin, as per usual, which is synched to my Strava account. I also fired up the Nike+ Run Club app for the first time in ages and I set out on an easy(ish) 10k run. After the run, I also entered the time spent running at the closest average pace into myfitnesspal. All of these apps have my height and weight. Any guesses what the results looked like?

Garmin: 463 calories

myfitnesspal: 517 calories

Nike: 526 calories

Strava: 1371 calories!!!!

Now, I have no idea how many calories I actually used during this run, I’d wager Garmin was probably closest to the mark considering that the heart rate monitor seemed to be working properly. But Strava, what the actual hell?? Considering that Strava gets all of it’s data from my run directly from Garmin I find it amazing that it estimated I burned nearly three times as many calories as Garmin thought I did. I’m sure that if I had other apps and trackers I would have gotten slightly different results from all of them.

All this to say, if you’re exercising and tracking calories burned, you probably shouldn’t give that number too much weight. Try to think of exercise as giving you health and fitness rather than taking away calories and weight.

 

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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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Low-carb kids?!

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I came across this article recently detailing how to raise kids on low-carb diets and I honestly can’t even. It’s one thing for adults to choose to follow low-carb diets. It’s a whole other kettle of fish to inflict them on children.

The post is written by a pharmacist. I’m sorry, when did pharmacists become keepers of nutritional expertise? Has this woman never heard of scope of practice? You don’t see me running around telling people to start popping pills for various ailments. This is because I’m a dietitian, I know about food and nutrition. Medications I leave to doctors, NPs, and pharmacists.

Okay, so why is this pharmacist advocating for a low-carb diet for kiddos? The opening statement reads: “Childhood obesity is a huge problem today. Lots of parents are wondering – how do you raise kids without feeding them excessive carbs?” 

Are they? Parents, can you confirm this? It frightens me to think that this may be true.

The article makes a disingenuous comparison between two packed lunches and essentially equates low-carb to “junk food” free and, as far as I can tell, low/no grain. Trotting out that erronous message that modern wheat is different from ancient wheat and therefore the food of the devil.

Does the author bother to mention that grains contain nutrients that are important for growth and development in children? Nope. No mention of ensuring that alternative sources of B vitamins, fibre, vitamin E, certain proteins, and so on must be found for children to be healthy on such a diet. Certainly no mention that this type of diet may be setting up children for a lifetime of disordered eating.

There are other ways to prevent childhood obesity and to promote healthy eating habits in children. Forced orthorexia and elimination of food groups is not one of them. Instead, focus on providing your children with nutritious options. Involve them in food prep. Allow them to have occasional treats. Model healthy eating habits and a positive relationship with food. Eat together as a family as often as possible. Carbs are not the enemy.


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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.