Weighty Matters Essay About Myself

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Food Industry Furious With Health Canada's Front-of-Package Plans

If Health Canada takes Chile's lead, we too might see Frosted Flakes boxes change from looking like those on the left to looking like those on the right.
When industry is furious with a government proposal it's a safe bet that proposal is likely to affect their sales, and so when I learned that the food industry was incensed by Health Canada's front-of-package plan proposals (Aric Sudicky, a final year medical resident who was rotating through our office at the time, watched the recent roundtable style consultation hosted to discuss the implementation of what will be a Canada wide front-of-package program, via teleconference and reported to me that industry was none too pleased), I wanted to learn more.

Now this post isn't going to delve into whether or not those are the best 3 targets for front-of-package symbols, instead I want to focus on the lobbying and machinations of industry.

First though, a tiny bit of background.

In creating a new front-of-package symbol for Canadian consumers, what Health Canada doesn't want is a program that emphasizes so-called positive nutrients as 50 percent of Canadian package fronts already have those (put there by the food industry directly to help sell food), or one that requires a second step of thinking to interpret (eg studying the nutrition facts table) as that has been shown to lead to misunderstanding, or a hodgepodge of programs (as more than 150 front-of-package labeling programs have already been documented in Canada) .

What Health Canada does want is a single, standardized system, that involves a prominent symbol, that's consistently located, that doesn't require nutritional knowledge to understand, to help consumers identify products with high levels of nutrients that Health Canada deems are concerning to public health, that by itself provides the required interpretation for its meaning. Such a system would be consistent with the core recommendations made by the U.S. Institute of Medicine.

Breaking it down further, what Health Canada wants is a system that conveys simple to understand information, rather than one that presents data requiring interpretation.

Further still?

Health Canada wants warnings.

In their recent meeting, Health Canada presented their wants to food industry stakeholders, as well as the evidence they feel supports them, and invited them to submit their thoughts and suggestions for a symbol to fit Health Canada's 4 design principles:
  1. Follow the "high-in" approach
  2. Focus only on the 3 nutrients of public health concern (sugar, sodium, and saturated fat)
  3. Be 1 colour (red) or black and white; and
  4. Provide Health Canada attribution
As to what this might look like, here are some mockups put together jointly by the Canadian Cancer Society, Canadian Medical Association, Canadian Public Health Association, Diabetes Canada, Dietitians of Canada, and the Heart and Stroke Foundation.

Given that warning symbols aren't likely to be good for business, I was curious as to industry's response to the ask.

Suffice to say, industry is indeed unhappy.

The Retail Council of Canada wants Health Canada to implement instead an instruction for consumers to turn products around and study their nutrition facts tables, and they don't want Health Canada's name mentioned on the symbol. They are apparently worried that including Health Canada's name on the symbol might be misinterpreted as a government endorsement which in turn would lead consumers to eat more of the products with the warning labels. They're also apparently simultaneously worried that if the symbol utilized is already recognized to be a danger symbol, it could lead consumers to believe there is a food safety risk, and that if used, children, accustomed to seeing these symbols on foods, might lead them to think that cleaning supplies with danger symbols are safe to consume.

The Food Processors of Canada used bold to point out that, "the meeting didn't agree to anything", and that, "Health Canada has lost its way on the obesity issue". They think that what's needed is more public education, not a front-of-package warning program.

The Canadian Beverage Association expressed their, "deep concerns", and that though they were happy to have been included in the meeting, their definition of "deep and meaningful dialogue" with industry should include a process whereby industry participants would all discuss and agree upon what the program would entail.

Food and Consumer Products of Canada also wanted to express their disappointment that they weren't provided the opportunity to be more directly involved in crafting the proposal's criteria and their concerns about "the integrity and transparency of the consultation process". They sent a second note expressing their hope that the criteria still have room to evolve and that their preference is for traffic lights as they believe, "information – good and bad – builds on consumer literacy".

Dairy Farmers of Canada expressed their concern that the proposed warning system lacks the nuance required "to distinguish between nutrient-dense and nutrient poor foods" (sweetened milk will likely be slapped with a high in sugar warning), and that they'd be happy to support, especially, "if coupled with exemptions for nutritious dairy products", those programs that would provide data for consumers to study and interpret (like for instance the Facts Up Front program illustrated below).

There was however, one response from industry that was heartening. It was from Nestlé, whose representative reported being, "a little embarrassed" by how industry presented their views during the roundtable, and, "that Nestlé is not fully aligned to some of the comments that were made by some of our trade associations, and a few of us are feeling very frustrated."

Whatever comes of all of this, one thing's for sure. The food industry's near uniform opposition to Health Canada's proposed front-of-package warning label criteria is strong indirect evidence in support of their utility, as for the food industry, salt, sugar, and fat are the drivers of profitability and palatability, and they'll oppose anything they worry might limit their use.

So kudos to Health Canada for sticking to their guns, and also for honouring their pledge to make this process transparent by sharing with me industry's responses.

(and if you clicked on any of the industry letters to read, this is the post roundtable letter from Health Canada to which they're all referring).

Hey American Youth Soccer Organization, Kids Don't Need Sugar To Play

It's difficult to overstate just how aggressively the American Youth Soccer Organization (AYSO) allows Nesquik to push chocolate milk on their young players.

The reason why is simple. In 2014, AYSO partnered with Nesquik and named it, "the official “Chocolate Milk” of AYSO."

Nesquik's AYSO enabled health washing centres around the supposedly "ideal ratio" in chocolate milk of carbohydrates to protein that "can help refuel and restore exhausted muscles".

"Exhausted muscles"?

I did a straw poll on Twitter of parents whose kids play soccer.

94% of the 269 respondents reports their kids as actually moving for less than 60 minutes per soccer outing, with vast majority of respondents reporting less then 30 minutes of movement.
Those poll results correspond nicely with those found by objective measures and published in Pediatric Exercise Science whereby accelerometers revealed that kids only spend 17 minutes of a 50 minute soccer match engaging in moderate-to-vigorous activity.

Now putting aside the discussion of ratios and whether chocolate milk has a special role in "refueling", it's difficult for me to imagine that anyone would suggest that kids moving for less than 30 minutes at a stretch (or even an hour), have "exhausted muscles" that need any special attention.

But I'd be wrong, because Registered Dietitian Tara Collingwood is out there for Nesquik to tell parents that chocolate milk is a healthy, perhaps even necessary, choice.

I know this because a close friend of mine and father of recently AYSO soccer enrolled twin 8 year olds and a 5 year old, has been sending me the signed by Collingwood promotional materials that arrive courtesy of AYSO in his inbox.

Here are Collingwood's "Hydration Guidelines" that recommend not only post game chocolate milk, but also suggest kids quaff 4-8oz of a sports drink for every 15 minutes played.

Here's Collingwood's post game snacks handout which of course includes chocolate milk.

Here's Collingwood's grocery list that includes chocolate milk (with its nearly double the per drop calories of Coca-Cola along with 2.5 teaspoons of added sugar per cup) in her list of "best foods"

Here's Collingwood's game day recommendations, which if my calculations are remotely accurate, would provide my friend's barely moving 5 and 8 year olds with somewhere between 400-600 game based calories, and more than a day's worth of added sugar (especially if drinking sport drinks ever 15 minutes as she recommends) apiece.

And here's Collingwood touting chocolate milk as one of 5 "must-have" foods alongside spinach, salmon, bananas, and whole wheat wraps.

And please don't think that AYSO cares enough about your kids to not allow Nesquik to target them directly with marketing either.

Nesquik has also paid Latina Mommy Bloggers to spread the word about the miraculous marriage of soccer and sugar-sweetened milk.

Here's another

And another

And another

In fact there are many, many, more.

AYSO, if you honestly cared about kids' health and sports nutrition, you'd put an end to this partnership, as Collingwood's love of chocolate syrup notwithstanding, it's nutritionally indefensible.

Good Lord! British NHS Just Banned Surgeries For Patients With Obesity (And Smokers)

In what is perhaps the world's most biased and blame based health policy, A British NHS just banned patients with obesity or who smoke from receiving elective surgeries in a bid presumably to inspireencouragehelp whip and prod people into losing weight (or quitting smoking - but I'm not going to touch on smoking in this piece, not because I agree with the policy, but rather because it's not my area of expertise).

The policy's two primary presumptions are ignorant and misguided.

The first has to do with the value of BMI as a clinical tool. While it's true that the risks of medical complications and morbidities rise with weight, BMI is a measure of bigness, not health. Half of the NFL have been reported to have BMIs greater than 30, as did my friend and colleague Dr. Spencer Nadolsky pictured below in his wrestling days when he sported a BMI of 32.

The second presumption is that obesity is a disease of personal responsibility and choice. While no doubt weight can be dumbed down to eat less, move more, I still find it shocking that public health professionals and policy makers exist who believe that somehow people with obesity simply haven't absorbed enough societal guilt, shame, and discrimination to finally lose weight.

Of course, even if you do want to embrace personal responsibility as the sole cause of obesity, medicine isn't about blame. We patch up drunk drivers and folks who don't wear seat belts. We treat people with asthma who don't bother keeping up with their puffers, pneumonias exacerbated by the early discontinuation of antibiotics, and the psychotic breaks of folks who stop their antipsychotics.

Oh, you want surgical examples?

How about liver transplants in patients who once suffered with alcoholism; or how about one that doesn't involve a so-called vice at all - heart bypasses on folks who simply didn't bother to take their blood pressure, cholesterol or diabetes medications?

We operate on them all in a timely manner, and so we should, but yet here the NHS feels comfortable discriminating against people with obesity, because they apparently still feel justified discussing obesity on the basis of blame based causation.

But putting those two erroneous presumptions aside, the notion that blame based medicine is something that the UK wants to adopt is plainly repugnant. Medicine's not about blaming and shaming. Life is complicated. And even if a person has the time and personal health to allow a run at intentional behavior change, how high on the list of priorities do you think healthy living lies for someone whose children struggle with substance abuse, or whose debts are staggering, or whose spouse is hobbled with post-traumatic stress disorder? Or someone with any of those same issues who is also unemployed?

Clinically useless truisms aside, obesity is complicated, and moreover we have yet to discover a non-surgical, reproducible, and uniformly effective plan for the management of obesity. And while there's no argument about the fact that in a ideal world everyone would take it upon themselves to live the healthiest lives possible, there's two problems with that argument. Firstly, not everyone is interested in changing their lifestyle, and secondly, statistically speaking, the majority of even those who are interested and successful with lifestyle change will ultimately regress. Meanwhile the burden of suffering that the elective surgery those with obesity are being denied may add to absenteeism, presenteeism, pain, depression, and more.

If someone from the NHS' clinical commissioning groups (CCGs) in Hertfordshire (who thought up this loathsome, biased, and backwards policy) is reading this, I want to remind you of the NHS Constitution's first guiding principle:

"The NHS provides a comprehensive service, available to all

It is available to all irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status."
Either you're going to have to reverse this idiotic policy, or amend that statement above to explicitly exclude those with obesity.

For shame.

(In rushing this post through, I utilized paragraphs from a number of previous stories I've written about obesity, blame, and bias)

PepsiCo Confirms They Care About Profit, Not Health

This post is not an indictment of PepsiCo.

In fact I've picked on PepsiCo far less than I have on Coca-Cola over the years because for the most part, PepsiCo hasn't cynically pretended that health mattered to them as vocally as has Coca-Cola.

For PepsiCo, health was always about sales. They simply wanted to make money selling less awful junk food.

Well, that hasn't worked out so well, and so PepsiCo, in a 3rd quarter investors meeting a few weeks ago, did as companies do when faced with disappointing sales figures - they pledged to increase their marketing of their flagship sugary beverages (Pepsi and Mountain Dew).

This shouldn't surprise anyone.

PepsiCo's job is to maximize their profits, and while there may be times when profits and public health collide, if they don't, PepsiCo will protect their interests, not yours and mine.

And this post comes with a serving of especially delicious irony in that just one day after PepsiCo's announcement that they were going to pump their sugary fare, PepsiCo's VP of marketing Gary So published this piece on Medium about how great PepsiCo's commitment is to reducing the consumption of calories and sugar from beverages.

As I've said before, the food industry is neither friend, nor foe, nor partner.

[Thanks to Consumerist Community Editor Laura Northrup for pointing me to the AP piece]

My Kids Go Trick or Treating. Yours Probably Should Too.

(A variation of this post was first published October 24th, 2013)

It's coming.

And I'm not really all that worried. At least not about Halloween night.

The fact is food's not simply fuel, and like it or not, Halloween and candy are part of the very fabric of North American culture, and so to suggest that kids shouldn't enjoy candy on Halloween isn't an approach I would support.

That said, Halloween sure isn't pretty. On average every Halloween sized candy contains in the order of 2 teaspoons of sugar and the calories of 2 Oreo cookies and I'd bet most Halloween eves there are more kids consuming 10 or more Halloween treats than less - 20 teaspoons of sugar and the calories of more than half an entire package of Oreos (there are 36 cookies in a package of Oreos).

So what's a health conscious parent to do?

Use Halloween as a teachable moment. After all, it's not Halloween day that's the real problem, the real problem are the other 364 days of Halloween where we as a society have very unwisely decided to reward, pacify and entertain kids with junk food or candy (see my piece on the 365 days of Halloween here). So what can be taught on Halloween?

Well firstly I think you can chat some about added sugar (and/or calories), and those rule of thumb figures up above provide easily visualized metrics for kids and parents alike.

Secondly it allows for a discussion around "thoughtful reduction". Ask them how many candies they think they'll need to enjoy Halloween? Remember, the goal is the healthiest life that can be enjoyed, and that goes for kids too, and consequently the smallest amount of candy that a kid is going to need to enjoy Halloween is likely a larger amount than a plain old boring Thursday. In my house our kids have determined 3 candies are required (and I'm guessing likely a few more on the road) - so our kids come home, they dump their sacks, and rather than just eat randomly from a massive pile they hunt out the 3 treats they think would be the most awesome and then silently learn a bit about mindful eating by taking their time to truly enjoy them.

The rest?

Well it goes into the cupboard and gets metered out at a rate of around a candy a day....but strangely....and I'm not entirely sure how this happens, maybe it's cupboard goblins, but after the kids go to sleep the piles seem to shrink more quickly than math would predict (though last year my oldest told me she believed it was her parents eating them and that she was going to count her candies each night). I've also heard of some families who grab glue guns and make a Halloween candy collage, and dentist offices who do Halloween candy buy-backs.

Lastly, a few years ago we discovered that the Switch Witch' territory had expanded to include Ottawa. Like her sister the Tooth Fairy, the Switch Witch, on Halloween, flies around looking for piles of candy to "switch" for toys in an attempt to keep kids' teeth free from cavities for her sister. The joy and excitement on my kids' faces when they came downstairs on November 1st that first Switch Witch year was something to behold, and is already a discussion between them this year.

And if you do happen upon our home, we haven't given out candy since 2006 and we haven't been egged either. You can buy Halloween coloured play-doh packs at Costco, Halloween glow sticks, stickers or temporary tattoos at the dollar store (glow sticks seem to be the biggest hit in our neighbourhood), or if your community is enlightened, you might even be able to pick up free swim or skate passes for your local arena (they run about 50 cents to a dollar per so if you're in a very busy neighbourhood this can get pricey).

[Here's me chatting about the subject with CBC Toronto's Matt Galloway]

Small Study Suggests Body Contouring Surgery Augments Bariatric Surgery

One of the nearly inevitable adverse effects of bariatric surgery is loose, excess, skin, and generally speaking, the only recourse for dealing with it is more surgery.

Here in Canada, whereas bariatric surgery is covered by our healthcare system, with the exception of medically necessary panniculectomies, post bariatric surgery body contouring surgery is not.

Putting aside both quality of life and aesthetics as rationale for skin removal surgery (and there are very reasonable arguments supporting both), here's a new one (at least for me). If the outcomes of this small study hold true, body contouring surgery may dramatically enhance long term weight loss outcomes.

The study was retrospective and it sought simply to compare the long term weights of those who had both body contouring surgery and bariatric surgery with those who only had bariatric surgery.

Interestingly, the study found that while weight loss was comparable between subjects 2 years post bariatric surgery at 35.6% in the bypass/contouring group and 30.0% in just bypass group (with the 5% additional difference perhaps explicable simply on the basis of the weight of removed skin), with time, the just bypass group regained significantly more weight. By 5 years (the duration of the study), the bypass/contouring group were maintaining a 30.8% loss, while the just bypass group had regained such that they were only maintaining a 22.7% loss.

Now this was a small study, and retrospective rather than randomized - in turn this might mean that the association is related to other factors (for instance socio-economics as body contouring is expensive and clearly those that can afford it, may well have other privileges and circumstances that might be beneficial to post-surgical weight management). Also worth noting that the 5 year losses of the just bypass group aren't as high as seen in other bariatric surgery studies.

Am looking forward to more research on this (ideally randomized), as for many post bariatric surgery patients, excess skin has a dramatically negative effect on their quality of life, and perhaps, if it was shown that body contouring surgery helped patients maintain their losses, insurers and governments might cover the procedure.

Should We Be Treating Type 2 Diabetes With Bariatric Surgery?

I'm resurrecting and tweaking this piece, for the third time now, consequent to the publication in the New England Journal of Medicine of the 12 year data that continues to strongly support the use of bariatric surgery to treat type 2 diabetes.
In case you missed the news, a recent study published in the New England Journal of Medicine demonstrated dramatic benefits of bariatric surgery in the treatment of type 2 diabetes.

Now I'm not going to get into the study here in great detail, but it followed 1,156 patients from for 12 years and divided them into 3 groups. Those who sought and chose not to have bariatric surgery. Those who sought and had bariatric surgery. And those who did not seek nor have bariatric surgery. Researchers examined all of them at baseline, 2 years, 6 years, and 12 years in terms of whether they had type 2 diabetes, hypertension, or hyperlipidemia.

The results were striking.

With a follow up rate of 90% at 10 years researchers demonstrated that not only were patients 12 years post bariatric surgery maintaining an average loss of 77lbs/26.9% (the non-surgical groups at 12 years lost an average of nothing), but that amoung those patients who had diabetes pre-surgically, 12 years later, 51% were in remission. And for those who are curious about such things as odds ratios, the odds ratio for the incidence of type 2 diabetes at 12 years was 0.08 (95% CI, 0.03 to 0.24) for the surgery group versus the non-surgery group.

(and though they weren't quite as striking, the surgery group at 12 years also had markedly higher remission rates and lower incidences of both hypertension and hyperlpidemia)

So basically here we have a surgical intervention that is dramatically better medical management for type 2 diabetes - a condition that causes cumulative damage and can wreak havoc on a person's quality and quantity of life.

Yet many MDs, allied health professionals and health reporters, including some who I know, respect, and admire, regularly discuss how we shouldn't be looking to surgical solutions for diabetes because patients could instead use their forks and feet. While there's no argument about the fact that in a ideal world everyone would take it upon themselves to live the healthiest lives possible, there's two problems with that argument. Firstly, not everyone is interested in changing their lifestyle, and secondly, statistically speaking, the majority of even those who are interested and successful with lifestyle change will ultimately regress - the simple fact remains that we don't yet have a proven, reproducible and sustainable approach to lifestyle change of any sort.

And what of those folks not wanting to change? I say, "so what?". Since when did MDs, allied health professionals or health columnists earn the right to judge others on their abilities or desires to change? Our job is to provide patients with information - all information - including information on lifestyle change, medical management and surgery. We can even provide patients with our opinions as to which road we think may be best for them, and why, but honestly, given the results from these studies, I'm not sure how anyone could make an evidence based case that surgery isn't a very real and powerful option that ought to be discussed with all of their patients with type 2 diabetes and obesity.

Unless of course that someone has some form of weight (or simply anti-surgery) bias.

Let me give you another example. Let's say there was a surgical procedure that women with breast cancer could undergo that would reduce their risk of breast cancer recurrence by roughly 30%. Do you think anyone would question a woman's desire to have it? I can't imagine. And yet lifestyle - weight loss and exercise has indeed been shown to reduce risk of breast cancer recurrence by 30%. Think people would dare suggest the women choosing surgery were, "taking the easy way out", that they should just use their forks and feet?

We've got to get over ourselves.

Until we have a proven, remotely comparable, reproducible, sustainable, non-surgical option, if you bash the surgical option on its surface for being "easy", or "wrong", you might want to do a bit of soul searching as to whether or not you're practicing good medical caution, or if instead you're practicing plain, old, irrational bias.

[and for new readers to ensure there's no confusion - I'm not a surgeon]

Saturday Stories: Hazing, Intellectual Freedom, and "Madness"

Kindergartners Don't Need "Fun Snack" Days

Received this from a long time reader.

It was the note sent home with her first Kindergartner from his school. Apparently mini-donuts are this month's "Fun Snack".

Next month's Fun Snacks, my reader was told, will be from A&W.

The question that leaps to my mind is, "Why?"

Why do 5 year olds need "Fun Snack" days at school?

I mean if schools wanted to provide 5 year olds with a special snack day, why not something like, "Funky Snacks", where once a month kids try foods and flavours specific to different ethnic backgrounds (ideally foods reflecting their class' different cultural backgrounds)? Given it doesn't take much to get a 5 year old excited, this might be a great way to expand their horizons and taste buds.

But why a food based day at all?

Why not a monthly "Fun Reading Day", "Fun Dress Up Day", or "Fun Singing Day"? Or how about "Fun Extra Recess Day", or "Fun Fitness Day"?

Why don't more people question the wisdom of teaching 5 year olds that fun is found in a mini-donut, or A&W fries?

Why are so many schools and teachers seemingly incapable of (or unwilling to) finding creative ways to entertain and reward their students?

The answer?

No one's paying attention.

Fun Snack Days for Kindergartners are our new normal.

We're all frogs in a steaming pot of junk food that has taken roughly the past 60 years to reach a rolling boil.

Maybe Physicians Should Stop Wondering Why Patients Visit Quacks

Last week I received an email from a long time reader who recounted her experiences seeking help following her heart attack (at age 43!). I want to share her story as it speaks to just how poor a job our medical education system is doing in providing physicians with training in lifestyle modification (including diet, fitness, sleep, stress, etc.). The tl;dr version is that despite her incredible willingness and interest in affecting change, none of the physicians she saw were able to provide her with any specific and actionable advice. Clearly if this is the norm, we need not wonder why our patients are turning to quacks for help at times. For my take on the physician's role in lifestyle, here's a brief op-ed I wrote for the CMAJ, and as far as this reader goes, I steered her to these 8 big ticket items as her first line priorities. While she wanted to remain anonymous, she did agree to allow me to share her letter
On March 12, 2015, I had a heart attack. I had a heart attack. I had a heart attack. Sometimes I feel like I have to say it again and again because it doesn’t seem real to me. I was 43 years old and what I thought was relatively healthy.

The events of how my day started were mundane. I woke, made coffee, had a shower, poured coffee and sat on my bed to drink my coffee and decide what to wear that day. What began as an uncomfortable feeling in my chest, that I thought would pass, increased in discomfort to a point where I began to feel like I was suffocating. My mind was racing, I wondered if I had any aspirin, I wondered if I should go to the hospital, I wondered if I should call the ambulance. I decided to wake my son and have him drive me to the hospital.

When I arrived at the hospital, my son dropped me off. He had to go home to drive my other kids to school. I walked into the hospital. I believe that arriving at the hospital myself and walking in myself led the people working in triage to believe that whatever was going on with me was not serious. She asked me to have a seat, she asked me to move to a different seat, she called other people in ahead of me. I waited about 20 minutes before being called in to see a doctor. I get it, I probably didn’t fit the ‘profile’.

When I was finally hooked up with an EKG, I believe that they could see the irregularities in my heart rhythm, I was offered two aspirin to chew and they took blood. The blood work confirmed that I was having a heart attack and I was given the antithrombotic injection. By 11:00 I was heading to St. John, NB to have a dye test.

In St. John, I saw plenty of doctors. They set me up with a cardiac catheter that day. During the procedure, the doctor stopped and asked if I was experiencing any stress in my life, that there were no blockages and he didn’t have to complete the procedure because he could see there were no blockages. He asked about stress, because usually there is residue after a blockage is broken down by the antithrombotic and I had no residue.

I left St. John the next day. As I was leaving, I asked if there was anything I needed to know. I was on a battery of medication, but no one talked to me about lifestyle. Whether I should take it easy, whether I should avoid activities, how I should get back into my daily life. I asked and I was told to just do what I could.

I went home without seeing a dietitian. No one spoke to me at all about nutrition, activity, or managing stress. I do have family history, and it seemed that that family history completely defined my experience. No one was curious about why I had a heart attack, because I have family history. Family history was as deep as they looked.

That was 2.5 years ago

I continue to ask….and no one refers me to anyone who can help me with my diet, managing stress, or incorporating activity into my life. I search out this information myself. Always looking for what I should be doing. I see a nutritionist weekly, one that I sought out and pay for out of pocket. I see a trainer at the gym. I google search reputable sites on lowering LDL and improving heart health.

Most recently, I saw my heart doctor. My LDL was higher than it should be. I am not taking medication. I asked if there’s anything he can tell me about my diet or activity…anything at all. I practically begged for a referral, an insight, an idea…..what I got were to handouts. One distributed by Becel and one from the egg Farmers of Canada. I left mad and frustrated.

The next day my family doctor’s nurse called to see if my heart doctor had gone over the results of my blood work. I said that I had seen him and that he “sort of” went over the blood work. I was leaving an opening for her to suggest an appointment to go over my blood work. Her reply was “OK, I was just wondering if you knew”.

The health system has continually left me feeling unimportant and let down through this experience. I am so willing to make the changes I need to but there is no one in the health care system making suggestions.

So I am writing to you, partly to assuage my frustration in being offered healthy diet handouts from Becel and egg farmers by my heart doctor, partly to feel some support, and partly for advise or information or insights.

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Saturday Stories: The UN, The Skid Row Fixer, And Polar Bear Propaganda

How Your New Year's Resolution To Up Your Exercise Might Lead You To Up Your Weight

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014 and given it's New Year Resolution time, figured this might be worth revisiting.
File this study under reality.

Researchers were curious whether or not labelling exercise "fat-burning" (as many exercise machines do) would have an impact on how much food a person ate post exercising.

The protocol was simple. Subjects were brought individually to a lab and were told they were there to evaluate newly developed training software for bike ergometers. They were then equipped with a heart rate monitor and completed a 20 minute low-moderate intensity cycle. Participants were randomly assigned to have one of two posters tacked to the wall in front of them while they rode. The first had a poster stating, "Fat-burning exercise – developing training software for exercise in the fat-burning zone.", and the second, "Endurance exercise – developing training software for exercise in the endurance zone." Following their rides subjects were told they could help themselves to snacks while completing a survey and were offered water and pretzels. Pretzels consumed were measured by means of a scale before and after each participant.

The results?

"Fat-burning" labels did have some impact, but I'm not going to dwell on it. Instead I want to point out that across both treatments participants burned on average 96 calories during their rides and they then proceeded to eat 135 calories (41% more calories than they burned) of post-exercise pretzels.

Combine these results with those from a study published a few weeks ago that people who went for a walk and told they were "exercising" consumed 41% more calories from indulgent desserts and drinks following a post-walk lunch than those who were told they were walking for "fun".

We do eat because we exercise and I think in large part it's because we've been taught that we're supposed to - both by the food industry (see up above) and sadly too, by public health departments (see down below with the "Less Sit, More Whip" City of Ottawa bus poster) and health professionals who have markedly overplayed exercise's role in weight management.

If you are interested in weight loss, make sure that regardless of how much you're exercising, you're paying attention to to food as well.

Lose weight in the kitchen, gain health in the gym.

Docs! Please Stop Telling Patients How Many Pounds They Need to Lose!

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.
I don't think a week goes by without a patient in my office recounting how at their last physical their doctor told them how many pounds they ought to try to lose. Sometimes those MDs will be going by BMI tables and aiming patients at a BMI less than 27. Othertimes those MDs will be pulling those numbers right out of their proverbial butts with random guesses of how much would be "good" or "healthy".

No doubt too, in the majority of cases, the recommendation to lose a particular amount of weight didn't come with any useful advice on how exactly those pounds were supposed to get lost.

So fellow MDs, if you're reading this, if you think weight is having a negative impact on one of your patient's health or quality of life I do think a respectful discussion of the issue is warranted. But before you go down that road you need to know a few things.

Firstly you need to know that despite what society teaches, we don't have direct control over our weights. Sure, indirectly behavioural choices can influence weight, and yes, we can likely suffer ourselves down to whatever weight we choose, but suffering doesn't last, and consequently the direct control of losing "x" pounds - that's nonsense - if desire, guilt or shame were sufficient to lead to specific amounts of loss the world would be quite slim.

Secondly you need to understand that if you have no useful weight management advice to offer beyond the less than useful, "try to eat less and move more", all you're really doing is undermining your doctor-patient relationship as the likelihood of your patients not wanting to lose if their weights are truly affecting their health or quality of life, is likely close to zero, and yet here you are, their doctor, telling them something they already know, inferring quite clearly that you think that if they just put their minds to it they could make it happen, while simultaneously offering them no actionable help or support whatsoever.

Docs, if you're concerned about one of your patients' weights, make sure you have a realistically actionable plan to help them with. If you yourselves are providing lifestyle advice, please consider personally living by that advice for at least a month or two to ensure it's remotely realistic and to help you to understand what your patients might face as challenges with it. If you don't plan on providing any advice yourself, please explore your community's options and find an organization or an individual that you personally research in regard to their program's safety, efficacy and ethics. And lastly, don't ever target numbers on scales as there's simply no way to ensure your patients will get there, nor is there necessarily any need that they do given that markedly subtotal losses, when combined with lifestyle changes (or even lifestyle changes alone without weight loss), are likely more powerful medically than any drug you have ever prescribed.

Putting this another way, as my friend Dr. Jamie Beckerman is liable to say, the goal is the road, not the destination.

Saturday Stories: Racial Disparity, Swedish Anti-Semitism, Teen Bariatric Surgery, And Aymen Derbali

Nina Martin and Renee Montagne on black women, racial disparity, and dying in pregnancy and childbirth

Paulina Neuding, in the New York Times, with the uncomfortable truth about Swedish anti-Semitism.

Julia Belluz, in Vox, with a rich and thoughtful piece on the story of Jewel, a teen who recently underwent bariatric surgery.

Andrew Potter, in The Globe and Mail, with the story of Quebec mosque shooting hero Aymen Derbali (and if so inclined, here is a link to a current fundraising campaign for him)

Does Your Doctor Know How To Weigh Your Child? I'm Betting Many Don't.

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.
On the surface it doesn't sound all that difficult.

Ask child to stand on scale. Weigh. Record weight. Done.

Working with parents of children with obesity, it seems many doctors nowadays feel it's important to add in some judgement or scary statistics such that after 'weigh' and before 'done' comes a speech on the dangers of weight along with the implicit or explicit suggestion that the child is responsible - either for gaining the weight or for not losing it.

I don't think that's fair. Moreover, I don't think it's helpful and I think it may well do harm.

It's not fair, especially with younger children, given that they're not in charge. They don't do the grocery shopping. They don't cook the meals. They don't set the example. They live the lives their parents teach them to live. They're life's passengers, not the drivers.

It's not helpful because speeches or stats without action plans by definition aren't helpful.

It's potentially harmful because the negative emotions bound to be generated by this sort of an interaction may well erode a child's self-esteem, body image, and their relationship with food. It may also lead that child's parents to adopt a knee-jerk pattern of restriction, guilt and shame that is far more likely to make matters worse than better.

The safest way for a physician to weigh a child is to tell the truth as to why weights are important. The truth is that children need to be weighed because medication is dosed dependent on a child's weight and therefore physicians need to have fairly current weights on their growing patients in case they fall ill and require a prescription. And should a physician have a concern about a child's weight I'd encourage them to have a discussion with that child's parents with the child absent and clearly, there's not much point even having the discussion unless that physician has suggestions or resources beyond the tritely useless truism of "eat less, move more".

Nothing Good Can Ever Come From Weighing Your Child

Today's post was first published on US News and World report back in 2013
I'm not suggesting your child should never get weighed – certainly I'd encourage annual weigh-ins with your child's pediatrician or family doctor to track your child's growth curves – I just don't want you weighing your child.

There are three main reasons for a parent to want to weigh his or her child. The first would be a worry about a child not growing sufficiently – and herein I'd encourage you to defer to your child's doctor to determine whether or not worry is warranted.

But the second and third reasons are the ones that concern me. The second reason is a parent's belief that his or her child's weight is too high. The third reason is the second reason's corollary, where a parent might be weighing a child to see if the child has lost weight or to keep track of the rate of gain.

The thing is, scales don't measure anything other than weight. They don't measure the presence or absence of health; they don't measure whether a child is being fed a nutritious diet; they don't measure whether a child is regularly active; and they don't measure self-esteem. But they sure can take away self-esteem, can't they?

And while I haven't seen a study that proves it to be true, I'd be willing to wager that scale use in children has played a formative role in the development of many mood disturbances and eating disorders over the years. I worry greatly about the impact of weighing children on their self-esteem, body image and relationships with food.

Yes, childhood obesity is worrisome. And yes, if you're worried about your child's weight – especially if it's having a negative impact upon his or her health or quality of life – you might want to try to help. But weighing your child doesn't actually do anything. All weighing your child does is teach him or her that scales measure success, self-worth and parental and personal pride – and that weight is all that matters.

You might think that tracking your child's weight loss on a scale may be motivating, but celebrating a loss on a scale is no less risky than shaming a gain; they're flip sides of the same coin – the coin that says scales measure success. And what happens if that child who is losing one day gains?

A child's actual weight doesn't really matter, at least not in any constructive, formative way. Ultimately, a child's weight is not something that is directly controllable. Weight's primary levers – eating behaviors and activity levels – have dozens, if not hundreds, of drivers and co-drivers, and many of them won't in fact be modifiable.

Genetics, peer groups, socio-economic status, coexisting medical conditions (both mental and physical and for both child and parent), food available at school and after-school activities and many more factors all have a very real impact on weight, while none are particularly changeable. Moreover, weight management is a struggle for highly motivated, fully mature adults with various weight-related medical conditions. Should we really be expecting children to accomplish a task that eludes most grown-ups?

If you're worried about your child's weight, look to those weight-relatable behaviors that you might actually help to change instead of weighing your child. For example, consider the source, quality and quantity of their calories and of the meals you're providing them. Perhaps pick up a set of smaller plates, bowls and cups (for the whole family, not just the child) as a study that came out just last week found kids ate 52 percent more cereal when eating from a large bowl instead of a small one.

Look to your own examples for fitness, and cultivate active family outings. Review your home's screen-time rules, and certainly rid all bedrooms (again, including your own) of televisions (which has been shown to dramatically increase risk of obesity in children. Cut your cable (and hence, eliminate the constant food advertisements your children are exposed to), and ensure that your child's bedroom and habits are conducive to adequate sleep (as short sleep duration is also strongly associated with increased weight).

While it's true that there are things affecting your child's weight that you won't be able to change, it's also true that there are many things affecting their weight that fall within your parental discretion to change – and it's there where you should expend your energies. Importantly, do so without explicitly putting a focus on weight as the cause of your home's changes or the child as their sole target; instead, put the focus on improving the health of your family as a whole, with your changes affecting every member of the home, as the cultivation of healthy living behaviors provides benefits to everyone at every weight.

Bottom line: If you're concerned about your child's weight, don't rely on a number to tell you or your child how he or she is doing. Simply measuring weight does nothing to help you understand how it got there, nor will it do anything to help it go away, but doing so may make your children hate themselves just a little bit more each time you put them on that scale.

High School Phys-Ed Horror Story Highlights Risk of Tying Exercise To Weight Loss

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014.
Thanks to Jonathan Clow for sharing this story with me.

So last year a PE teacher at Huron Park Secondary School in Woodstock, Ontario had their Grade 10 co-ed class use scales and measuring tapes in front of one another to calculate their body mass indices. Why? Because his gym class for the semester was to include once weekly circuit training that consisted of ten 90 second stations of burpees, weighted squats and other squat variations, mountain climbers, with no breaks, then a water break then 2 more circuits at 60 seconds and 30 seconds each without a break in between. At the end of the semester the kids were to once again publicly re-weigh and measure themselves in order to see how much weight their once weekly circuit training helped them to lose.

Oh, and he also allegedly informed the kids whose BMIs were elevated to begin with that they would likely develop diabetes.

No doubt the PE teacher was well-intentioned and felt that both public shame and just a bit of moving around would help his students because as far as he was concerned weight is an "energy balance" issue between in and out and that if he just had the kids up their "out", the problem would be solved. I've no doubt too, that his sentiments represent the societal norm rather than an exception.

I'm told the kids mounted a boycott and letter writing campaign to the school but am unsure on how it all shook out. Fingers crossed for the kids.

I'd imagine there are many more such PE based horror stories out there, and if the teacher or school is reading this, perhaps he might have a peek at this meta-analysis of school PE programs which demonstrated yet again (and yes I know I'm a broken record), that weight wise, kids aren't going to outrun their forks, or this study that suggests negative experiences in high school PE may well discourage the adoption of a commitment to lifelong exercise.

Bottom line for all of us - exercise should be cultivated and promoted on the basis of health and fun, and fat shaming has no place (or utility) in society let alone in a high school's curriculum.

Saturday Stories: Chess Robots, Man Flu, and The Best Restaurant in London

Juice is NOT a F@*#ing Fruit Part II

As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2014 and this piece on juice.
Juice is an incredibly frustrating beverage. Despite packing the same caloric and sugary punch of Coca-Cola, unlike sugared soda, juice's undeserved health halo regularly leads to its provision, consumption (and often over consumption) in the name of nutrition - especially to and by our children.

And kids really shouldn't be drinking the stuff, or at the very least, not in the name of health.

The Canadian Pediatric Society and the American Academy of Pediatrics both recommend that juice be capped for kids at half a cup daily. And make no mistake, the capping isn't because juice is so damn good for the kids that we don't want them to drink too much of it, but rather because every glass contains 5 teaspoons of sugar (or more) and calories which won't be compensated for with decreased portions at their next meals.

The World Health Organization also considers juice to be nothing more than a sugar delivery vehicle and in their recent draft guidelines on sugar consumption specifically call out juice as a source of undesirable free sugars.

Yet there's this piece that came across my Newswire just last week. It was a press release put out by Coca-Cola (makers of Minute Maid) and Breakfast Club of Canada and it featured Teresa Piruzza, MPP for Windsor West and Minister of Children and Youth Services launching the newest Ontario Breakfast Club, which judging from the press photo up above involves the indoctrination of children into believing that fruit juice is a healthy part of their breakfast and the provision of juice boxes (containing more juice than our experts' daily recommended maximum), festooned with cartoon characters that in turn might further increase a child's consumption and desire for same.

Can you imagine a similar scene with the Minister of Children and Youth Services grinning and handing out Vitamin C fortified soda, in cartoon covered cans, to children in the name of breakfast?

According to the press release,
"Breakfast Club of Canada supports healthy breakfast programs at 1,266 schools, supporting nearly 130,000 children and serves close to 21 million breakfasts every year and that Minute Maid® has partnered with Breakfast Club of Canada since 2003, donating Minute Maid® juices to support programs across Canada."
Breakfast I'm all for, but marketing sugar water to children and washing it in BS "corporate social responsibility", food insecurity, and health, is incredibly misguided, and incredibly sad.

(And if you're looking for Juice is NOT a F@*#ing Fruit Part I click here)

Teaching Your Kids To Cook Is More Important Than Teaching Them To Play Soccer Or Hockey

Source: USAG-Humphreys' Flickr
So this post, originally published at US News and World Report a few years ago, will be the last of this recent sled of in defence and support of home cooking.
Once upon a time, not so long ago, people ate out for a reason. Maybe it was in celebration of an anniversary, a birthday or a promotion. Maybe it was out of necessity to seal the deal with an important prospective client. Or maybe it was the understandable consequence of travel. But one thing's for sure — we didn't used to eat out simply because we could. Eating out was special.

Growing up in the 1970s, meals out were exceedingly rare for my family. Aside from our every-other-year family vacations, I'd bet we only ate out once every few months or so — and almost always to mark an occasion. I don't think we were atypical in how we spent money on food back then; as a society, the 1970s saw roughly 30 percent of our food dollars spent on food prepared outside of the home. Today North American society is over 50 percent.

Working in my office, I'd venture my average patient is eating out three to four times a week. And yet, it's not laziness that drives their frequent meals out. Regular meals out are simply North America's new normal. And it's a new normal that I think is a huge player in our collectively poor health.

While there is no one singular cause for our societal struggle with diet and weight-related conditions, one of the primary drivers is our unbelievably frequent use of restaurants, cafeterias and take-out food. Sometimes we justify these choices because there's a "low-fat", or "low-carb", option or something that sounds safe and healthful, and sometimes we convince ourselves it's due to a lack of time — that we honestly don't have the five or so minutes it would take each morning to brown-bag a lunch.

But I'd bet that most of the time we don't even think about whether we should or shouldn't be eating out. And we don't think about it, because the regular use of restaurants, or of supermarket take-out, or of nuking a box or assembling a jar of this with a box of that and calling it cooking, is just what we all do. And generally people don't question conventions that simply reflect regular behaviour.

I'd go further and say that families are often looked at with scorn when the vast majority of their meals are transformed from minimally processed and fresh whole ingredients. The "normal" of convenience has people seeing the cooking family as having an "obsession" with health or nutrition beyond what "normal" people consider to be healthy.

At the end of each day, we're all consumers of the exact same amount of time. While no doubt, there are those who have far tougher lives than others, and some work far longer hours, there was a time when each and every last family out there, regardless of how rough their circumstances, was obligated to find the time to prioritize cooking as part of day-to-day requirements, because there simply was no alternative. And while there are definitely people whose life circumstances truly make regular cooking an impossible and unreasonable goal, there are definitely others who have been convinced, or have convinced themselves, that it's not doable.

Now I'm not trying to romanticize the foods we all once cooked. I'm certain many a meal from those days would have turned many a dietitian white with horror. But I'd argue that the simple act of cooking — a health-preserving life skill — is a skill that risks extinction. In some families, regular home cooking is a phenomenon not seen for three generations.

My guess is that even the worst home-cooked-from-fresh-whole-ingredients meals from back then were likely to be lower in calories, sodium, and sugar than many healthy-sounding restaurant choices today. More importantly, those meals were far more likely to involve shared meal preparation and cleanup along with their consumption as a family ritual, around a table free from today's drone of kitchen-based TV sets and the pings and beeps of emails, tweets and Facebook updates from our electronic leashes.

So what have we prioritized in cooking's place? Kids' organized sports? Longer work hours? Our favourite TV shows? Text messaging? Social media?

Boiling it down to its essence, ultimately what we've prioritized as more important than cooking is convenience. Moreover, we go out of our way to convince ourselves (as does the food industry) that convenience can still confer health, that those boxes that claim they contain healthy nutrients and those menu items that include vegetables are in fact good for us. But looking around us — and given the urgency of the problem and the never-ending call to arms to fix it — it sure doesn't seem as though convenience is doing a very good job.

The inconvenient truth of health is that healthy living does require effort. There are no shortcuts.

And if you're looking for the one thing you can do that would most dramatically improve your or your family's health, my money would be on you prioritizing the regular, uninterrupted use of your kitchen. Prioritize it at the expense of your electronic tethers and, yes, even at the expense of your children's after-school sports, as teaching your children the life skill of cooking trumps their need to learn how to play soccer - and if you have time in your life for that, you definitely have time in your life for this.

And please don't misread this as if I'm suggesting that change need be absolute or all at once. Maybe commit to cooking one additional meal a week, and it certainly need not be complex. The goal is to cultivate love affairs with our kitchens, but that doesn't mean you'll be madly in love from day one, and while I don't think we should stop taking advantage of the miraculous times that we live in and should still enjoy and savour some wonderful meals out, we should be aiming at making eating out special again — a rare and exciting treat. In other words, aim to eat out for occasions, and not just because it's Tuesday.

Introducing #15by15, My Wife's Life Skill Challenge For Our (And Your) Family

Our family's current week's meal plan as laid out by our 10 year old on Sunday (it's a magnetic whiteboard that lives on our fridge)
Today's guest post comes from my wonderful wife Stacey who has recently implemented a new challenge for us - she calls it #15by15 - where 15 is the minimum number of meals we want each of our kids to know how to make, entirely by themselves, by the age of 15.
Fifteen by fifteen”. That’s what I told my kids when they recently helped to make our menu plan for the week, and this time were instructed to add in one meal each that they would cook from scratch, with or without my help.

I’m not going to lie, there was some whining. My three kids, now aged eight, ten and thirteen, have been helping to create menu plans that include breakfast, snacks, lunch, dinner and even treats for several years now (ht stands for "Halloween Treat" - they generally last them an entire year), as well as cooking with me and/or my husband. The kids take turns doing this from week to week because they recognize that we all have different favourites, and they want to make sure that theirs are included.

Our kids also recognize that for a household to run well, and for their mom to yell less (because, well, life is stressful enough without having to worry about each meal and snack that comes next), we all need to pitch in and help. This includes other household chores, like doing the laundry, loading and unloading the dishwasher, setting and clearing the table, taking care of the cat's food and litter, and taking out the trash, among others. My kids know that while these are not particularly fun activities, they are life skills, and that they aren’t likely to be taught how to do them anywhere but home.

In my mind, perhaps the most important of all of these life skills, is the skill of cooking.

From the time my kids were old enough to provide constructive criticism of mine or my husband’s cooking escapades, they have also been asking that we teach them how to make particular favourites before they move out. And so, with that, came our promise to them,
"When you leave home, you will leave with a cookbook of family favourite recipes, an Instapot (because they’re awesome), and a minimum of fifteen meals that you can make completely on your own from scratch."
And while there may have been whining when first announced (and perhaps even a bit of trepidation from me as I thought about the mess that would be my kitchen on at least a tri-weekly basis (I'm not including the nights my husband cooks, god-bless his mess)), my kids have fully embraced this new goal, reminding us that it is their turn to cook, with my older two kicking us out of the kitchen when they're up – which is beyond awesome, because they know that I have difficulty stepping back and allowing them to do their thing, and clearly they are more than capable.

While I can’t say that there hasn’t been an impact on the cleanliness of my kitchen, I can say that the mess has been worth making in reaching the goal of my kids becoming self-sufficient and capable of cooking with fresh, whole ingredients. They are well on their way to being able to cook fifteen meals by the time that they are fifteen years old, and, at least to date, they continue to be excited in finding and cooking new recipes, and full of pride as our family consumes them.

If you have a young family, perhaps you can consider taking on the #15by15 challenge too.

You'll Gladly Die for Your Children; Why Won't You Cook for Them?

Today the Heart and Stroke Foundation published a report by Dr. Jean-Claude Moubarac that found Canada's biggest consumers of ultra-processed food are our children. Canadian kids between the ages of 2-18 are consuming over half of their calories from ultra-processed foods, and kids aged 9-13, are closing in on 60%. When I read the report, one which clearly suggests that cooking is a lost art, it reminded me of this article which I first published in USNews and World Report in 2013 (and I'll have more on this subject from my wife on Thursday)..
I'm a parent of three. I hold no illusions that I'm a uniquely dedicated parent or that my love for my kids is greater than anyone else's. And like all parents, should the opportunity arise, I'd gladly, immediately and unquestioningly give my life for their's. And it's my firm belief in the incredible and powerful love of parents for their children that regularly leads me to scratch my head and wonder: Why it is that while most every parent would happily die for their children, it's an increasingly rare parent who will cook for them?

I've heard all of the explanations—time, cost, after-school activities, lack of cooking skills, picky eaters, etc. But ultimately, I think the real reason parents who would die for their children are comfortable feeding them from boxes and drive-thrus isn't due to a lack of love or concern. It's because society has been so firmly and conclusively duped into believing that doing so is both safe and healthful that it has become our new normal.

Remember that the foods we feed our children are, quite literally, their building blocks. Consequently, we are building a nation of children constructed from the food industry's deceptively and, at times, deceitfully marketed salt, sugar and fat offerings of convenience.

But more than that, the manner in which we feed our children is the model from which they're likely to draw upon to feed their futures. If fast and processed food assembly make up the bulk of their childhood "cooking" experiences, where actual cooking is a grumbling rarity relegated to holiday dinners, do you think your children are likely to take the time to cook and look after their nutrition as young adults or as parents themselves?

The statistics are ugly. Nearly half of our food dollars are being spent on restaurant and out-of-the-home convenience foods. In our homes, the percentage of food dollars being spent on processed foods has doubled since just the early 1980s. But again, we're not eating this way because we don't value health or love our children. We're eating this way because the food industry has festooned boxes of salt, sugar, fat and pulverized white flour with claims of added "nutrients" and health benefits; they've also convinced us that mixing, pouring, stirring and adding is "cooking."

The fact the food industry has succeeded in doing this in part may have to do with our species-wide desire for convenience, because, at the end of the day, it's simply not about time. Recent reports put the average American in front of a television for 34 hours a week and on the Internet for another eight–sure sounds like time's something of which we actually have plenty.

Fixing this problem will require more than just trying to make parents feel guilty. At this point, many parents have been led by lax front-of-package labeling and advertising laws to faithfully believe that the boxes they're feeding their children do in fact conveniently and healthfully replace fresh, whole-ingredient cooking. Plus, they themselves may have grown up in homes where actual home cooking was anything but the norm and may not know how to cook.

So what should we do? Here's a start:

• We need to take away the food industry's upper hand in the supermarkets. We need to change labeling laws and hamstring the ability of the food industry to hoodwink harried parents into believing that a sometimes-comfort food like mac and cheese can ever be a smart choice. Why should the onus be on the consumer to turn boxes over to study the nutrition facts panel to ensure that the claims on the front of the package are supported by its actual contents? Moreover, are consumers actually equipped to do this from a nutrition-education perspective?

• We need to bring back home economics. Sadly, there are many families in which regular home cooking was last seen three generations ago. I think children shouldn't be allowed to graduate high school without knowing how to cook 10 simple, healthful, fresh, whole-ingredient meals on their own. As well, we should consider using our schools' abandoned kitchens after hours to help teach basic cooking skills to families as a whole.

• We need to denormalize the reliance on convenience when it comes to feeding our children. As a society, we need to prioritize our kitchens as the healthiest and most important rooms of our homes. And we'll likely need hard-hitting public health campaigns that criticize the food and restaurant industry as well as nutrition education in schools.

The shift from regular home cooking to the mess we're in now didn't happen overnight, and it's going to take time to reverse. We need to rise up and reclaim our kitchens and shift the balance of power from the food industry to loving moms and dads who no doubt would die for their children and, if empowered to do so, I've no doubt would cook for them, too.

We need to champion produce and not products, and we needed to have started yesterday.

Saturday Stories: Professor Piffle, Opioids, and Weight Lifting

By U.S. Navy photo by Mass Communication Specialist 1st Class Brock A. Taylor [Public domain], via Wikimedia Commons
Ira Wells, in The Walrus, with a story more for we Canadians on Jordan Peterson, the Professor of Piffle.

Admiral James Winnefeld, in The Atlantic, on how no family is safe from the opioid epidemic.

Alex Hutchinson, with his new gig in Outside, on how if you want to delay death, you should probably be lifting weights.

[And thanks to the great generosity of friends, family, and readers, this year's Movember fundraising amounted to $4,553. If you'd like to watch my kids shave off my moustache, here's that video]

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