|Saturday Stories: Special End Of Life Edition|
letter to his metastases I published as a guest post on this blog last September) died this January, on life Newly Widowed.
Carol Cowan-Levine in The Walrus on the failure of Canada's healthcare system and the death of her daughter by suicide.
Catherine Porter in The New York Times on the living wake and medically assisted death of John Shields.
|Parents, How Many Of These Scenes Resonate For You?|
As a father of three, today's Funny Friday sure was familiar.
Have a great weekend!
|No Coke and Pepsi, Adding Fibre and Pro-Biotics Doesn't Make Liquid Candy Healthy|
First up is Coca-Cola Plus. Launched in Japan each bottle of the diet soda beverage has 5gr of added insoluble fibre. According to its official press release,
"Drinking one Coca-Cola Plus per day with food will help suppress fat absorption and help moderate the levels of triglycerides in the blood after eating"And a statement to that effect will apparently be placed directly on the front of the bottle.
"more than 1 billion active probiotics in each serving"What will they do for you?
According to PepsiCo they will,
"work to promote gut health"Desperate times call for desperate measures I suppose.
[Sorry, earlier version had Coca-Cola, not PepsiCo making Tropicana]
|An Incredibly Belated Review of James Hamblin's Terrific New(ish) Book|
Full disclosure: I received an e-copy of Hamblin's If Our Bodies Could Talk: A Guide to Operating and Maintaining a Human Body for review from James' publisher Doubleday. I should also disclose, I was likely predisposed to enjoying this book as I've long been incredibly fond of Hamblin's Twitter feed and Atlantic pieces. I'd have written this sooner, but I have this rule of not writing about things I haven't actually read myself and it took me longer than I expected - not because I didn't enjoy it, but more because I fall asleep in about two seconds flat every night. Also, if you use the Amazon links I provide, Amazon will send me a tiny commission.James Hamblin is a medical doctor. But he doesn't practice medicine in its traditional seeing his own patients sense, instead his practice involves the translation of health into words for whoever wants to read them as he decided to pursue journalism and writing rather than the much safer path of radiology. Hamblin's main platform is his work with The Atlantic where he's a senior editor, and he's also a must-follow (if you like wonderfully dry humour) on Twitter.
Hamblin's book, If Our Bodies Could Talk: A Guide to Operating and Maintaining a Human Body, was published back in December. Simply, it's a collection of questions spanning various topics about health, the human body, followed of course by Hamblin's science-informed answers. It's also a lot of fun.
From questions like,
"Why don't eyelashes keep growing"(and answers that include, "For three months, then, the hair is called a "club hair". It is, like so many people in clubs, outwardly fin-looking but actually dead at the roots"), to
"Does the G-spot exist?"(and Hamblin's admonishment, "never liken it to a bike tire"), to
"What about Smartwater?"(where Hamblin helps you to learn that "electrolyte enhanced" means "bullshit"), the book covers a lot of ground.
Because each question and answer are fairly short, the book makes for excellent bed time reading (in that sense it reminded me some of another book I loved - Bill Bryson's A Short History of Nearly Everything). And along with the humour and pith, comes a great deal that's both fascinating and informative (did you know that the hyperbole of carrot eating leading to better night vision arose in part as an attempt to conceal Britain's discovery of radar in World War II, or that Ben Carson (yes, that Ben Carson), played an important role in the treatment of an exceedingly rare and devastating brain disease?).
So why do you need this book when you can simply Google those very same questions? I think Hamblin covers this aptly by noting that
"Googling health information is roughly as reliable for finding objective answers as picking up a pamphlet on the subway floor"The book is a delight. Suitable too for those parents like me who want to teach their children, without lecturing, that critical appraisal is sadly necessary in this day and age (another recommendation here is to listen to the podcast Science Vs. with them).
If you're looking for a book that entertains while it educates and you'd like to purchase a copy for yourself, here's an Amazon link to it for my American readers. And if you're living here in Canada - this one's for you (though at least when I was typing this, it would still be cheaper to use the American link).
|Saturday Stories: Slavery, Young Physicians, and Sexism|
an article on modern day slavery that I can't imagine you haven't read, but on the off chance, find some time and do so.
Suzanne Koven in The New England Journal of Medicine with her letter to a young female physician.
Eve Forster in Vox on sexism in science and her telling social experiment.
|Schoolhouse Rock's "I'm Just a Lie" (Thanks Jimmy Kimmel)|
For those of us old enough to remember, "I'm Just a Bill", todays' Funny Friday is sure to bring a smile. A sad one though.
Have a great weekend!
|Guest Post: Public Health RD Questions Ontario's Calorie Labelling Rollout|
Last week an RD who'd prefer to remain anonymous asked me if they could share their thoughts on Ontario's new calorie labelling initiative with my readers. I readily agreed, and I agree with much of this post. I'm strongly supportive of calorie labelling, but the rollout certainly could have been more thoughtful. And while I agree with all of this RD's closing points, I don't see calorie labelling vs. other changes as being either or - I'd like to see them all.On January 1st of this year it became mandatory for restaurants with at least 20 locations in Ontario to post the calories on their menus. Many dietitians and other healthcare professionals rejoiced as this information would help people to make better, or at least more informed choices when eating out. Personally, I was a little more skeptical. From what I had seen from other places implementing similar legislation resulted in little if any change in eating habits. We are always talking about evidence-informed decision making in healthcare, yet this legislation from the Ministry of Health and Long-term Care seemed to be based more on appearances than on evidence.
There were problems from the start. Training for public health inspectors (who are responsible for enforcing the legislation) didn’t take place until just over a month before the legislation took effect. It was made very clear to the PHIs that they were to only ensure that eating establishments adhere to the legislation; i.e. that calories were posted in the appropriate places in large enough font and that the contextual statement was posted. They were not to question the calorie counts posted. Some of you might remember the time everyone got upset about Chipotles posting the calories for just the chorizo in a wrap, rather than for the entire wrap. Well, if something like this were to happen in Ontario, unless a complaint came from the public, the PHIs have no recourse. They might see calories posted that seem blatantly incorrect but they have been instructed not to question them. Restaurant owners and operators need only use means that they “reasonably believe” to determine the calorie counts. That means that calorie counts could be determined by a bomb calorimeter (accurate) or by myfitnesspal (questionable) as long as the owner believes it to be accurate. The Ministry declined to provide PHIs with any guidance as to what methods and tools would be appropriate so they are left to take restaurant owners at their word.
Framing this as an initiative to decrease childhood obesity was a huge mistake in my mind. Teaching children to calorie count is not healthy or helpful. Nor is simply providing calorie amounts to parents when caloric needs vary so much among children. Sometimes providing just a little information can be dangerous. I’m sure that the government meant well and they thought this would be a great visible way to show that they’re tackling childhood obesity while downloading the cost onto restaurant owners, win-win. However, this legislation should have been targeted toward adults only. Children should never be counting calories.
The point of this legislation is ostensibly to help the public make informed choices. To that end, you would think that there would have been a public education campaign launched well in advance of the implementation of the legislation. You would be wrong. Despite numerous requests from public health dietitians, and assurances that public education was coming, it wasn’t until over a month after the legislation came into effect that any “education” was undertaken. As a dietitian, I was expecting information on how to use the newly available calorie postings to make better choices. Boy was I wrong. Instead, the Ministry released a series of ads that read more like fast food advertisements and essentially just say “calories are now on menus”.
I see these and I think, “wow! Poutine and hash browns are so low in calories. They’re not as bad a choice as I thought.” Not at all the message that I think should be coming through this campaign. It’s embarrassing that the government used our tax dollars to pay people to come up with these terrible ads. Apparently they focus group tested them and the teens thought they were hilarious. Perhaps they can’t tell the difference between laughing with you and laughing at you? Regardless, there should have been someone working on this campaign who saw that it wasn’t sending the intended message (check out the comments). They should also realize that simply telling people that calories are posted on menus isn’t sufficient to aid them in appropriately using this information. As it stands, it only serves to help those who are already health conscious and who know roughly how many calories per day they should be consuming. They should have been giving people the information and tools to better understand and use the calorie counts.
Does putting calories on menus even work? There was a recent webinar by Health Evidence on this and they said that on average, it led to reductions of about 70 calories per day. Which sounds great except that the average caloric intake of people in the studies was about 3000 calories a day, about 1000 calories more than the recommended daily calories for an average adult. So, yes, putting calories on menus may lead some people to choose items with fewer calories but if they’re still consuming about 900 more calories than they need I’m not sure that’s anything to write home about.
Calories are only one piece of information and I worry about putting too much emphasis on it. Restaurant meals tend to be obscenely high in sodium but the calories won’t tell us anything about this. Calories also don’t tell us if a menu item is nutrient dense or nutrient void. It can make it appear that deep-fried foods are equal to salads.
Something else to consider, beyond the concerns I mentioned above about the accuracy of the methods used to determine the calorie counts, is the human factor. Even if the calories are accurately measured, that’s based on the sample as provided by the restaurant which you can bet is going to put that food in the best light possible. Do you really think that line cooks in a restaurant, or teenagers at Five Guys are concerned about portioning things so that meals contain the same number of calories as is posted on the menus? I doubt it. they’re probably using more oil on that stir-fry or scooping extra fries onto that plate. It’s pretty safe to assume that the actual number of calories in any given menu item is going to be higher than the number posted on the menu so take the number on the menu with a grain of salt.
I’m sure that there are people reading this thinking “but at least they’re doing something. What would you do?” I would bring back mandatory home ec in schools. I would help to ensure better access to and affordability of nutritious foods across the province. I would provide more support and funding for healthy eating and food literacy initiatives for all ages. Instead of accepting that people are going to eat out regularly, and assuming that providing calories on menus is going to make people healthier, we should be encouraging people to get in the kitchen.
|Guest Post: Local Teacher's Tips For Cultivating Healthy Classrooms|
Modelling Healthy Living in a Primary Classroom:
It can be a challenge to create a classroom where healthy activity levels and food choices are promoted. Here are some of the ways I try to promote healthy lifestyles in my classroom.
Modelling Health Activity Levels:
Being an active Role Model:
On May 7th (2017) the families in my class raised $500, to support my CN Cycle for CHEO (Ericsson 70 km) ride.
Physical Fitness Embedded in Daily Physical Activities (DPA), Gym and Special Event Days:
During the autumn and the spring, students do a morning run three times a week, and a group dance (Dancemania) twice a week before heading up to class. In the winter, students do body break dances on Go Noodle (https://www.gonoodle.com) or stair climbing in school for their DPA. We also have special fitness based days (e.g., a Winter Walk to School Day, a Bike Day, five days of Skating at Dulude Arena, etc.) With staff and students taking part in these activities, fitness and fun is the goal for everyone!
Modelling Healthy Eating Habits:
Setting an Example with Nutritious Lunches:
When the students see me eating a healthy lunch (e.g., a sandwich, soup, salad and/or leftovers from home), I am modelling good choices for them. When I see students enjoying a healthy food item during a Nutrition Break, I might comment on how tasty the food looks. If a child has a less healthy food item in their lunch bag, it is not up to me to critique the food choice. Food shaming is disrespectful, unhealthy and poor behaviour modelling for a teacher. Packed lunches from home reflect a family’s food culture, food prep skills and/or budget.
Food-Free Birthdays Celebrations:
Activity Based Holiday Treats:
Sugar and Salt Free Math Activities:
Instead of using food items for graphing and sorting, the students in my class use Legos, plastic counters and other reusable manipulatives. Or, they use seasonal materials found in nature (e.g., leaves, pine cones and oak keys). They still enjoy sorting and graphing, without having to eat unhealthy foods in the process.
A Focus on Intrinsic vs. Extrinsic Rewards:
One of the tenets of our Alternative school is that we do not give out rewards for good behaviour, effort or work. The goal is to have students behave well, make an effort and work hard, and then experience the intrinsic satisfaction of a job well done. That means no stickers or other extrinsic rewards…and therefore no candies or other sugary treats!
On these special days, the students in my class usually get a little gift bag from me. Instead of giving them food items, I always make them a handmade, handwritten card. Gift ideas might include themed pencils, erasers, notebooks, books and passes to skate or swim at City of Ottawa pools and arenas. The students enjoy the writing, reading and sporting activities!
Growing Up Organic:
Several other colleagues are working toward creating an on-site school garden. Growing Up Organic (a garden and farm based educational program for children) is providing startup workshops for students. The workshops include the following topics: soil exploration, seed saving, planning a garden, planting a salad garden, seed starting and transplanting. The goal is to teach students greater food literacy and food skills. Ideally, they hope to create a sustainable garden that produces produce that can be shared amongst community members, including the Parkdale Food Centre.
It takes a community to create an environment where children can learn, by example and through practice, to develop life-long fitness and nutritional habits. Together, we can make a difference!
The opinions expressed in this post are the author's own and do not necessarily reflect the ideas of the Ottawa Carleton District School Board.