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Saturday Stories: Canada's Genocide, The Immortal Susan Potter, And The Women's March
Rhoda E. Howard-Hassmann, in The Conversation, on Canada's Genocide and the case of the Ahiarmiut.

Cathy Newman, in National Geographic, on how Susan Potter will live forever.

Leah McSweeney and Jacob Siegel, in Tablet, on the vicious antisemitism of the Women's March leadership that among other disgraces has led to even its founder to call for their resignation.

Photo by Mobilus In Mobili - Women's March on Washington, CC BY-SA 2.0, Link
The False Dichotomy Between Food Calories and Food Quality
As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2015.
I come across it all the time. Angry folks who claim that when it comes to weight and/or health, calories don't matter at all and that what really matters is the quality or types of foods, or the folks who claim that the quality or types of foods don't matter at all, it just comes down to calories.

It's both of course.

The currency of weight is certainly calories, and while we all have our own unique internal fuel efficiencies when it comes to using or extracting energy from food or from our fat stores, we still need a surplus of calories to gain and a deficit to lose.

But foods matter too. Choice of food matters in terms of health, but also in terms of how many calories our body expends in digesting, and more importantly, upon satiety, which in turn has a marked impact upon how many calories, and which foods, we choose to eat.

So if you do come across a zealot from either camp that claims one or the other doesn't matter, feel free to ignore them.
10 Easy Ways to Save Your Money and Improve Your Health in 2019
As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2015.
Who wouldn't want to both save money and improve their health? If you're looking for some ways to do so, here are some quick thoughts:
  1. Unless you have a medically proven reason or need, stop buying vitamins and supplements that at best provide only the most marginal of benefits to your health (estimated savings $100-$1,000/yr).
  2. Reduce your dinners out (including sit down, fast food, take-out, and supermarket take-out) by 50% across the board (estimated savings $1,000-$5,000/yr depending on family size and meal out frequency).
  3. Never eat lunch out unless someone else is buying or unless you have a business obligation to do so (estimated savings $500-$3,000/yr).
  4. Cancel cable or satellite TV, buy an HDTV antenna (so you can still watch your local sports, news and some TV), and use Netflix, Hulu Plus, Amazon Prime or some other comparable service (estimated savings even after expenditures $250-$1,000/yr).
  5. Buy a thermos or a travel mug and a great coffee maker and kick your fancy coffee habit (estimated savings even post purchases $100-$500/yr)
Now of course there will be readers who spend more and less on various aspects of those points, but if there are readers where all 5 apply, making these changes might save them between $1,950 and $10,500 dollars.

As far as what to do with that windfall?
  1. Join a CSA farm share to increase your consumption of fresh fruits and vegetables (estimated average annual cost $400-$1,000 depending on size of share)
  2. Join a great local community centre or gym (estimated annual cost of $200-$600)
  3. Buy some used recreational fitness equipment (bikes, skis, snowshoes, etc.) from your local buy and sell (estimated one time cost of $200-$400)
  4. Take a cooking class at your local Community College (estimated cost of $100-$300)
  5. Save it all and use it for a stress relieving active vacation, or stress relieving debt relief.
(And sure, some of your own personal numbers and mileages will vary.)
Saturday Stories: Personalized Medicine's Pitfalls, Tribes Over Truths, And Lakewood's Trouble
Stephen Senn, in Nature, on the statistical pitfalls of personalized medicine

Dan M. Kahan, in Scientific American, on why smart people are vulnerable to putting tribe before truth.

Joan Didion, in The New Yorker (back in 1993), with the trouble in Lakewood
Why I Resigned My Membership In The Obesity Society
As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2015.
For those of you who don't know, The Obesity Society (TOS) is, according to them,
"North America's premier scientific organization devoted to understanding obesity"
And I wholeheartedly agree, they really are, which is why I'm anything but happy to be resigning my membership.

I've been a member for the past decade, and I do my utmost to attend their annual meeting (now known as Obesity Week).

Paying to be a member of a professional organization, to me at least, means that you believe the organization's mission and methods to be congruent with your own, and sadly, that's no longer the case with me and TOS.

My concerns began in early 2013. That was when TOS published their, "Guidelines for Accepting Funds from External Sources" position paper (the document is long longer available on TOS' page but was published by Longwoods back when). In it TOS,
"expressly eliminates all forms of evaluation or judgment of the funding source"
and instead,
"TOS chooses to focus its ethical mission on transparency in disclosing the sources of funding, clear stipulations outlining our commitment to the ethical use of funds, and a commitment to non-influence of the funding sources over the scientific aspects of funded projects and TOS as a whole."
Lastly they stipulated,
"TOS should seek funding from as wide a variety of donors as possible."
Many, myself included, felt that without explicitly saying so, these guidelines were designed as a means to open the door for TOS to seek and take money from the food industry.

Shortly thereafter TOS struck their, "Food Industry Outreach Task Force", which seems to have morphed into their "Food Industry Engagement Council", the most recent meeting of which included representatives from Kellogg's, PepsiCo, Nestlé, Dr. Pepper and Ocean Spray. There appears to be no doubt that TOS meant what they said back in early 2013.

To be clear, I'm all for dialogue, debate, and discussion with the food industry, but I just can't support taking their money, formally working with them on joint projects, or giving them votes at tables. To be sure, in these difficult fiscal times, for public health organizations, the benefit of food industry partnerships is funding. But partnerships of course need to benefit both parties, and for the food industry, partnering with health organizations has much to offer. Public health partnerships provide the food industry with high gloss brand polish, they may lead to direct or indirect co-branded sales, they may confer undeserved positive emotional brand associations, they may silence or soften industry or product criticism, they may provide industry with ammunition to fight industry unfriendly legislative efforts, and they necessitate that the partnered public health group water down public health messaging that may conflict with their partnered private industries' bottom lines.

Put plainly, a public company cannot invest in a group, program, or intervention that in turn would ultimately serve to decrease sales more than not being involved in that same group, program, or intervention. Doing so would not only be an affront to their shareholders, it'd be grounds for their lawsuits.

Let’s hope I’m wrong in thinking history won’t look kindly on these partnerships, that public-health efforts won't be hindered by them, and that instead I’ll look back one day and think I made much ado about nothing, but until then, while I'll still likely see you at Obesity Week, this is why I'll no longer be sporting a "TOS Member" ribbon on my badge.
What I Learned When I Actually Read That Prominent School Chocolate Milk Study
As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2015.
I was amazed by the uproar the publication of a Dairy Farmers of Canada funded chocolate milk study inspired last week. The study, "Impact of the removal of chocolate milk from school milk programs for children in Saskatoon, Canada", at least according to the breathless press release and the resulting press coverage apparently concluded, "it's chocolate milk, or no milk at all for many children", and while it's no surprise given the funding that the spin was chocolate milk positive (including the study's mind-numbing use of the word, "enhanced" to describe sugar-sweetened milk), after reading the actual study, I'm beyond gobsmacked.

The study methodology was pretty straight forward. For 4 weeks they offered elementary school children both chocolate milk and white milk and measured how much of each they drank and how much went to waste. Next, they stopped providing the chocolate milk for 4 more weeks and kept measuring. Lastly, they brought back the chocolate milk option for a final 4 weeks of measurements.

Now hold onto your hats. As readers of the press are likely to already know the study found,
"the children waste more milk when it’s plain."
How much more waste you ask? Just 4/5ths of a tablespoon more a day. Yup, if you actually read the study you find out that when chocolate milk disappeared the kids drank a scant 12mL less per day than they did when chocolate milk was available. If these numbers continued, kids who drank milk would drink about a cup less milk a month for a grand total of just 9.6 fewer cups over the course of their entire chocolate milk free 200 day school year.

Or would they? What about the kids who stopped drinking milk altogether because they could no longer get chocolate? Well when the researchers tried to quantify total daily consumption of milk for all students they found,
"that students’ total milk intake at home, or milk consumption at school, did not change across the study phases."
The researchers also found,
"that on average students were meeting the 3–4 servings per day recommended by Canada’s Food Guide for 9- to 13-year-olds"
and that school milk only accounted for 13%–15% of total dairy consumed.

What else did the researchers find? Well if you want a non-Dairy Farmers of Canada "enhanced" spin on things, the researchers also found that in just the first month following the removal of school chocolate milk the number of students drinking white milk increased by 466%! A number which might well have increased further over time as palates and norms in the schools changed. And what happens to former chocolate milk drinkers when they swap Beatrice 1% chocolate milk for Beatrice 2% white? Well over the course of each week they'll drink 22 fewer teaspoons of added sugar and over the course of a 200 day school year, 14,000 fewer calories and 19 fewer cups of added sugar.

So to sum up. The study found that taking chocolate milk out of schools did not affect the students' total daily milk or dairy consumption, that on average all students were meeting their daily recommended amounts of dairy (recommendations which by the way are almost certainly higher than the evidence would suggest they need be), that kids who swapped from chocolate milk to white milk drank pretty much the same amount of white as they did chocolate (unless you think 4/5ths of a tablespoon of milk is a lot), and that by removing chocolate milk from the school, in the first month alone nearly half of the initial chocolate milk drinkers switched to white and in so doing, saved themselves piles of calories and the nearly 2 full cups of monthly added chocolate milk sugar.

If anything this study lends very strong support for those thinking schools shouldn't be offering sugar sweetened milk to students.

Clearly the reporters didn't bother to actually read the study. Shouldn't they have?
Saturday Stories: The Death Of Family Medicine, Brain Terrorism, Alcohol, and A Final Movember Update
Physician Frank Warsh, in his blog, writes about "the death of family medicine", and though there are definitely those who don't share his frustrations, this is a worthwhile read to understand some of the challenges facing family medicine in Canada today.

Robin Williams' widow Susan Schneider Williams, in the journal Neurology, on the terrorist (Lewy body disease) inside her late husband's brain.

Jane O'Donnell, in USA Today, on the crisis we're not talking about that's worse than opioids - alcohol.

[And finally huge thanks to those who've already donated to my Movember fundraising efforts. Thanks to your generosity, I've raised more than $6,000 for men's health! And it's not too late - if you find this blog valuable and/or if you enjoy these weekend shares, a tax-deductible donation would be very welcome, all you need to do is click here]

Call For Help Part 2: Are You Currently On A Diet? Can You Take 2 Minutes To Complete A VERY Short Survey About It?

Today's survey is a followup to the one we sent out a few months ago. Since then we tweaked it on the advice of both those of you who responded, and some expert input. Even if you filled this out last time, we'd love for you to do so again as we're trying to iron out the kinks and I think (hope) we're pretty much there.
Back in 2012 I first posted my wish for there to be a questionnaire that would serve to help individuals and researchers determine how easy or difficult a particular diet would be to follow.

I called it the Diet Index Enjoyability Total or DIET score, and my hope was that by using a series of simple Likert scales (descriptive scales from 1-10), researchers could set out to evaluate a particular weight loss approach's DIET score where high scores would identify diets that could actually be enjoyed, and where low scores would identify under-eating, highly restrictive, quality of life degrading, dieting misery. This would be useful both to individuals who could use the DIET score to evaluate whatever approach they were considering, but might also serve as a surrogate for shorter term diet studies to give a sense as to whether or not there's a low or high likelihood of long term adherence to a particular study's strategy.

I'm happy to report that the first work on using the DIET score has been conducted by Michelle Jospe at the University of Otago in New Zealand as part of the SWIFT trial, and her and Jill Haszard's early look at the data is promising.

Part of the process required to validate a questionnaire involves a qualitative review to see whether or not it's easy to use, comprehensive, and unbiased, and this here is our second kick at that can.