Weighty Matters

Why This Pear Makes Me Wary of Food Frequency Questionnaires

yonifreedhoff@gmail.com (Yoni Freedhoff) — Wed, 22 May 2013 09:30:00 +0000

I'm skeptical of food frequency questionnaires.

For those of you who don't know what they are, an FFQ serves in many research studies as the underpinnings of diet history whereby research subjects recall what they've eaten which serves as the basis for the diet aspect of the study at hand.

That pear up above?

It wasn't an exotic variety - it was a Bartlett. It weighed 0.9lbs (60% more than a "large" pear is supposed to) and contained more calories than a Mars bar.

I've also had oranges larger than grapefruits, plums larger than apples, and grapes the size of golf balls.

Coupling the facts that we often forget what we've consumed, that our eyes are terrible scales, and that food has grown dramatically over the years (even foods like fruits), I can't help but question the veracity of FFQs.

Has made me wonder whether or not a photo diary to go along with an FFQ would reduce error.

Might make for a good study.

The American Board of Obesity Medicine Must Choose: Quackery or Quality?

yonifreedhoff@gmail.com (Yoni Freedhoff) — Tue, 21 May 2013 09:30:00 +0000

Since 2005 I have been a certified Diplomate of the American Board of Obesity Medicine (ABOM) - now a joint venture between the American Society of Bariatric Physicians and the Obesity Society - and in a few more years I'll be faced with the choice of re-certifying, or letting my credentials lapse.

Part of my decision no doubt will be whether or not I feel the ABOM and I are on the same page in regard to science, medicine, ethics, and values when it comes to obesity medicine and I'm not convinced right now that we are.

You see a few months ago the ABOM put out a press release (that's a screenshot up above) highlighting the upcoming appearance of one of their board members on the Dr. Oz show. Her name is Dr. Denise Bruner and she was on Dr. Oz to promote the use of 5-HTP as an appetite suppressant. The ABOM also showcased her upcoming appearance of their Facebook page:

Both the press release and the Facebook update were quickly removed after I pointed out that given the ABOM's ultimate aim to be accepted as a credible medical organization it might be best to not promote 5-HTP supplementation for obesity given that the evidence base on its utility is anything but robust (here's a pubmed search that includes the 25 total citations that mention 5-hydroxytryptophan and obesity whereby the most generous take on the research would be that in the late 1980s and early 1990s two small studies suggested the possibility that 5-HTP supplementation might help ever so slightly with weight management).

But that's not the end of the story. While I was heartened that the ABOM saw fit to rapidly remove their endorsement of a nationally televised promotion of a non-evidence based supplement, I still struggle with Dr. Bruner's ongoing inclusion on the ABOM's board.

I struggle not simply consequent to Dr. Bruner's at best highly preliminary promotion of 5-HTP to literally millions of members of a very trusting public, I struggle because Dr. Bruner is currently a provider of the, "HCG Diet Protocol". Below is a screenshot from her office's website, and because I found it so incredulous that a board member of the ABOM was an HCG diet provider just to be sure I called her office yesterday and confirmed that if I paid Dr. Bruner $200 for an initial consultation, and then an additional $800, that she would inject me with HCG daily for a month.

The evidence base to date on the hCG Diet is clear. It's quackery.

The Obesity Society put out a position piece on the hCG diet last year. In it they state,

"We conclude that the scientific evidence does not support the use of HCG for the treatment of obesity. This position is in agreement with the U.S. FDA. The Obesity Society is committed to advocating the use of therapies for the treatment of obesity that are evidence-based and rejects those that have been shown to be ineffective."

The American Society of Bariatric Physicians also has a position piece affirming their non support of the HCG diet and in a 2011 press release supportive of the FDA's removal of "homeopathic hCG" from the market noted succinctly,

"Obesity is a chronic disease which is best treated by a physician who specializes in weight loss and practices medicine based on sound scientific principles. Unfortunately, hCG does not live up to those standards."

Dr. Bruner's practices, both in what I see as a markedly overhyped promotion of 5-HTP on national television and her use of hCG on her patients, run contrary to my take on what represents evidence-based obesity medicine, and the fact that she sits on the ABOM's board gives me great pause as to the value of that certification. So too does the title of one of the ASBP's upcoming webinars, "Controversies Concerning HCG for Weight Loss". Malpractice isn't controversial, it's malpractice.

Perhaps with this post the ABOM will see fit to consider whether or not Dr. Bruner represents their organization's aims, and moreover, whether or not there should be some mechanism to de-certify physicians whose practices belie the ABOM's standards of practice.

At the end of the day if the ABOM is hoping to be deemed credible it's going to have to choose to stand strongly against quackery and it's going to have to do so without external blowhards like me needing to point that out.

Saturday Stories: Self-Obituary, Running and GMOs

yonifreedhoff@gmail.com (Yoni Freedhoff) — Sat, 18 May 2013 09:30:00 +0000

Canadian journalist/publisher icon Peter Worthington's self-penned obituary. Quite the life lived.

The story of Bret - he's a runner.

Nature covers genetically modified crops along with some scary truths and some myths.

Is This the Future of "Child Size" Drinks at McDonald's?

yonifreedhoff@gmail.com (Yoni Freedhoff) — Fri, 17 May 2013 09:30:00 +0000

I do loves me Parks and Recreation.

I had tried to put this clip up before but it was an unofficial version and NBC yanked it down....but now they've put it up themselves. So sit back and enjoy the future of child-sized in today's Funny Friday feature.

Have a great weekend!

(Email subscribers, head to the blog to watch)

Coca-Cola Never Ever Markets to Kids and Is Part of Obesity Solution iPhone Edition

yonifreedhoff@gmail.com (Yoni Freedhoff) — Thu, 16 May 2013 09:30:00 +0000

So yesterday I downloaded Santa's Helper - an iPhone game produced by Coca-Cola.

Apple's app folks determined it was for users aged 4+ (see that little symbol I circled in the top right corner)

And you should know too that Apple also has a 12+ designation which according to their guidance system means,

"Applications in this category may also contain infrequent mild language, frequent or intense cartoon, fantasy or realistic violence, and mild or infrequent mature or suggestive themes, and simulated gambling which may not be suitable for children under the age of 12."

And while I realize there's no violence in the game, the age of 12 is where Coca-Cola claims to draw the line at advertising,

"We have historically not placed – and continue the practice today of not placing – advertising for any of our beverages on any media that is primarily directed to, and has an audience of 50% or more, children under the age of 12."

So who is this game for, this game where the goal is to help a Coca-Cola drinking Santa drop presents down chimneys while little Coca-Cola trucks pass by on the streetscape below?

Aside from Apple's suggestion it's for children above the age of 4, it doesn't explicitly say, but after spending a few minutes with it I can tell you this - the gameplay's dead simple.

So simple in fact that even a young child could play it.

So simple in fact that only a young child would want to.

But don't you fret. Coca-Cola's part of the solution, not part of the problem.

State of Ohio Partners up with McDonald's and Coca-Cola to Promote Tourism.

yonifreedhoff@gmail.com (Yoni Freedhoff) — Wed, 15 May 2013 09:30:00 +0000

Thanks to fellow physician Dr. Tony Almazan from Dayton, Ohio for letting me know about how Tourism Ohio has partnered up with McDonald's and Coca-Cola to help promote visiting one of America's heaviest States.

And what a partnership it is! Not only does the partnership steer people to visit McDonald's, but it also steers them explicitly to a large beverage from Coca-Cola whereby consumers who buy a large Coke (not small or medium Cokes) at McDonald's can trade the cup it came in for discounts at various Ohio tourist destinations.

Brilliant!

And clearly a salient example of just how important obesity is to the Coca-Cola corporation who now promote themselves as being partners in trying to create a healthier America. Maybe they'll also give them all soccer balls?

[For those who like numbers, a large Coca-Cola from McDonalds? At 30oz it's just 1/4 of a cup shy of a litre and it packs 280 calories coming from its 19 teaspoons (76g) of sugar.]

Coca-Cola's Newest Anti-Obesity Contributions Include Soccer Balls and Permission Marketing

yonifreedhoff@gmail.com (Yoni Freedhoff) — Tue, 14 May 2013 09:30:00 +0000

The inspired altruistic work of the Coca-Cola company continues! In case you're wondering what I'm talking about, I'm talking about a beverage company that is pretending to care about fitness to be part of the "solution" to obesity and they've just announced their latest round of "help".

What sort of help?

Distributing thousands of "Coca-Cola soccer balls" at major sporting events.
Encouraging people to sign up for myCokeRewards to get a chance at winning a pedometer....and enjoy an immersive Coca-Cola centric marketing experience on their website and give Coca-Cola permission to market to them directly.
A new campaign calling on Americans to vote for their favourite parks so Coca-Cola can give them a grant to build something.
Coca-Cola "Happiness" trucks to roll through more neighbourhoods and towns to inspire people to "move to the beat"....and drink a Coca-Cola bottled beverage.

Hurrah?

Sigh.

Just a few quick quotes to keep in mind as to what's in it for Coca-Cola when considering these interventions. Here's Coca-Cola's marketing chief Joe Tripodi chatting about the value of getting people voting and involved with "charitable" programs like myCokeRewards from last year's Wall Street Journal

"If we can get 40 million-plus fans, or even some subset of them talking positively about the things we’re doing, ultimately that’s a good thing for us”

And by "good thing" Mr. Tripodi means sales,

"I think it’s probably a leading indicator of potential sales."

And what kind of sales does Mr. Tripodi hope for? He told CNBC in 2011,

"We want to double our business in basically a decade."

Somehow I don't think a doubling of Coca-Cola's business is going to help obesity much, do you?

Probably not soccer balls or permission marketing either.

Guest Post: 9 Year Old Boycotts Coca-Cola Sponsored School Dance

yonifreedhoff@gmail.com (Yoni Freedhoff) — Mon, 13 May 2013 09:30:00 +0000

A little while back I received an email from a blog reading grandparent. He wanted to let me know about his 9 year old granddaughter's response to learning that her school dance was to be funded by Coca-Cola,

"Dear Dr Freedhoff,

Thought you would like to know that my granddaughter Frances (9) has refused to participate in a Cola-Cola dance which her school has arranged as part of some sports sponsorship thing, this without any prompting from me. She must have been reading your blog. She wants to wear a t shirt with "water " written on it."

I reached out to him and asked if his granddaughter might want to write a short comment regarding her decision as well as send along a photo of her protest shirt.

She obliged!

"I did not want to be in the coca cola dance, because little children shouldn't be dancing in the favor of a soda company. Also my sports teacher shouldn't be encouraging small children to drink it. You need to stick to healthy foods like fruit,vegetables,meat,and occasionally oils and sweets.

-Frances-"

And for those public health folks who think partnerships of their organizations with the food industry are a-ok now you know that even some 9 year old kids perceive them as problematic conflicts on interest.

Granddad - I imagine you're darn proud of your granddaughter. Good on her!

Saturday Stories: Parental "No" Insufficiency, School Lunches, and Depression

yonifreedhoff@gmail.com (Yoni Freedhoff) — Sat, 11 May 2013 09:30:00 +0000

Fantastic piece from Anna Lappe in Civil Eats on why the argument that parents can simply educate and say "no" to combat predatory food industry kid targeted marketing is nonsense.

Why the New York Times dubbed Grade 4 student the Michael Moore of the Grade School Lunchroom.

Hyperbole and a Half's Allie with an incredibly personal, insightful, artistic, and cuss word filled look at the current state of her depression.

[And if you don't follow me on Twitter or Facebook, this week's US News and World Report piece is on how desk jobs probably aren't responsible for societal weight gain, and here's an interview I did with Global when I was in Halifax on the issue of parental "No"s and healthful eating.]

The Best Kiss Cam Video Ever?

yonifreedhoff@gmail.com (Yoni Freedhoff) — Fri, 10 May 2013 09:30:00 +0000

Today's Funny Friday video's lesson is simple - don't ignore a kiss-cam.

Have a great weekend!

(email subscribers head to the blog to watch)

Parental "No" Files: Why Does My Kid Recognize McDonald's If They've Never Been There?

yonifreedhoff@gmail.com (Yoni Freedhoff) — Thu, 09 May 2013 09:26:00 +0000

Sent to me by blog reader Tara Newman following its display in her child's preschool.

McDonald's fry containers to help teach reading.

And people wonder why their child who has "never been to McDonald's" recognizes those iconic arches by name.

It's not just the food industry who markets junk food, the food industry has many willing marketers including folks whose jobs it is to nurture our children.

And no doubt the teacher who put the display together wasn't going out of his or her way to market McDonald's, they likely didn't give it a second thought, instead they played upon the normalized ubiquity and allure of junk food to try to engage young minds and in so doing, further normalize it into everyday life.

It's not McDonald's that's the problem, it's its normalization.

[Tara also mentioned that her daughter's preschool teacher is buying her daughter's class a McDonald's lunch as an end of year celebration. Sure Tara could say "No", but is it really that easy?]

Not That I've Ever Shopped At Abercrombie & Fitch Before But Certainly Never Will Now

yonifreedhoff@gmail.com (Yoni Freedhoff) — Wed, 08 May 2013 09:30:00 +0000

Because I won't support weight bias.

Thanks to Eating Rules' Andrew Wilder for forwarding this my way but it would seem that Abercrombie & Fitch CEO Mike Jeffries doesn't want women with overweight or obesity to even shop in his store (the largest pant size Abercrombie & Fitch make for women is size 10).

And you know what, my 3 girls, I'm pretty sure they'll be just fine with our family's boycott of Abercrombie & Fitch as perhaps unlike Mr. Jeffries, who in the past has been quoted as being very supportive of his store's exclusionary practices, my girls are decent human beings.

(though I suppose I probably already ought to have had Abercrombie & Fitch on my boycott list for making thongs for little girls)

Ontario Police Reward Children for Good Deeds with 710ml "Froster" Containing Half a Cup of Sugar!

yonifreedhoff@gmail.com (Yoni Freedhoff) — Tue, 07 May 2013 09:30:00 +0000

It's called "Operation Freeze" and it involves Peel Regional Police "ticketing" children seen doing a good deed and encouraging them to perceive doing the right thing as "cool" by means of providing them with a citation that includes a coupon for a 710ml convenience store "Froster".

That 710ml Froster?

444 calories and 103.2gr of sugar (26 teaspoons - half a teaspoon more than half a cup!)

And of course it also comes with the message that good deeds deserve sugar sweetened treats and that said treats are rewards for a job well done.

Would free passes to city run sporting facilities have been too difficult to obtain for the city run police department to give out in sugar's stead?

Sigh.

Announcing My Office's New Childhood Obesity Treatment Program with Two Huge Twists

yonifreedhoff@gmail.com (Yoni Freedhoff) — Mon, 06 May 2013 09:30:00 +0000

I'm absolutely thrilled to announce that starting early this summer my office will be launching its own treatment program for children with obesity that we're calling Family Reset - and there are two huge twists.

The first - we won't be treating children. At least not directly.

I've always worried about the risks for children involved in weight management programs. I've worried about risks to their self esteem, body image and relationship with food and I've worried that they would feel, unfairly, as if their weight were their own faults. Consequently, Family Reset, an interdisciplinary year long program involving 6 months of unlimited access to registered dietitians, social workers, personal trainers and physicians, followed by 6 more months of careful follow-up with the same team, will be delivered exclusively to parents of children aged 13 and younger whose weights put them in the 85th percentile or higher. In so doing we'll be working hard to ensure that parents don't in fact download guilt or blame onto their children, but rather work with us to improve their entire family's healthy home environments hopefully without the child ever being aware of the intervention. And while children themselves won't be "treated" for their weight, they will however receive some group classes with a social worker with a special interest in children where the classes will focus on mental and social health and well being.

The highlights of our Family Reset program include the following:

All parents are followed by a physician.
All parents receive 6 months of unlimited one-on-one counselling from a registered dietitian, behaviourist and exercise specialist who will work on family health, parenting, nutrition, healthy active living and the cultivation of healthy attitudes surrounding weight and body image. Parents will continue to meet with all team members following those 6 months at prescribed intervals, but if the need arises, emergently as well.
All parents who themselves have overweight or obesity will be provided with BMI’s existing 6 month behavioural weight management program which also includes unlimited access to all team members, as well as on-site group fitness classes three times weekly for 6 months.
Five group classes for children, led by a specialized social worker/behaviourist with sessions focusing on self-esteem, anti-bullying, body image and stereotypes, depression, anxiety, and anger management. There will be no emphasis or discussion on weight at these meetings aside from how weight might play into the emotions and issues being discussed.
One group class for parents led by clinical psychologist on mental health issues and their impact on self-efficacy, stress management, self-esteem, relationships and their interplay with weight management.
One group class for overweight and obese adults led by a clinical psychologist on common psychological roadblocks to self-efficacy.
Ten hours of one-on-one therapy with a clinical psychologist for parents struggling with mental health issues such as depression and anxiety as improving the treatment of mood disturbances will likely improve those parents' interactions with their children
Monthly group fitness outings designed for families led by exercise specialists to introduce families to different active living options.
Two group cooking classes for all parents at a rented outside facility designed to teach basic cooking and meal preparation skills. Thanks too to the generosity of best selling cookbook authors Greta and Janet Podleski, each family will receive a free copy of their latest compilation The Looneyspoons Collection which was Canada's best-selling cookbook of 2012.

The second huge twist?

Our Family Reset program has been funded by Ontario's Ministry of Health, and consequently, despite the tremendous amount of resources being offered, won't be a financial burden. Our office is extremely humbled and honoured to be involved with this project and we would like to extend special thanks to Health Minister Deb Matthews for her consideration and for rapidly responding to Ontario's recent Healthy Kids Panel Report which called for further investment into treatment programs for children with obesity.

This pilot program will run for the next 3 years, support 375 families, and for Ottawa, will help to alleviate the current burden on CHEO's REAL program for children with obesity which in turn has a year long wait list, and stricter enrolment criteria.

If you have a child 13 and under whose weight places them in the 85th percentile (for an article on how to calculate this click here) or higher and would like to be considered for our Family Reset program please give our office a call at 613-730-0264, or send Caroline an email and we will add you to our list of interested parents and contact you sometime in the next 4-6 weeks to discuss next steps.

[Ottawan bloggers, facebookers and tweeters - would greatly appreciate it if you could share this post and spread the word.]

Saturday Stories: Vegans, Pirates and Musicians

yonifreedhoff@gmail.com (Yoni Freedhoff) — Sat, 04 May 2013 09:30:00 +0000

Buzzfeed and their 19 most annoying things about being a vegan (kicked my way by one of my good friends who's a vegan)

Sweet brilliant revenge on gaming pirates.

And lastly some crazy riders from musicians on Vice.

[And if you don't follow me on Facebook or Twitter, here's this week's US News and World Report piece on how scales don't measure how you're doing.]

It's Always Great to Have an Uber-Cute Workout Buddy

yonifreedhoff@gmail.com (Yoni Freedhoff) — Fri, 03 May 2013 09:30:00 +0000

Today's Funny Friday video involves squats.

And a cute workout partner.

Have a great weekend!

(Email subscribers head to the blog to watch)

Badvertising: Tropicana Trop50 Watered Down Stevia'd Orange Beverage

yonifreedhoff@gmail.com (Yoni Freedhoff) — Thu, 02 May 2013 09:30:00 +0000

Short and sweet.

Wanna know what has 100% less sugar and calories than the leading Trop50?

Water.

Sugar water with vitamins, even watered down sugar water with vitamins, is still sugar water with vitamins (and is most assuredly not a fruit).

Drink your water.

Eat your fruit.

Guest Post: Innovative Study Gets Doctors and Patients with Obesity Talking

yonifreedhoff@gmail.com (Yoni Freedhoff) — Wed, 01 May 2013 09:30:00 +0000

Today's guest post is I believe the third for Dr. Sara Kirk. Dr. Kirk holds a Canada Research Chair in Health Services Research within the School of Health and Human Performance at Dalhousie University and a cross-appointment with the IWK Health Centre.

Sara’s research group, Applied Research Collaborations for Health (ARCH), uses a social-ecological approach to understand lifestyle factors influencing health status and health services utilization, particularly in relation to excessive weight gain. In particular, ARCH is looking at how obesity is managed within the health setting, as well as in understanding the contribution of the "obesogenic" environment to population weight status.

Today Dr. Kirk shares with us an innovate project out of her ARCH group that looks at the dialogue between a person with obesity and their physicians.

The recent guest post “Do Medical Schools Teach Future Doctors About Weight Management?” by medical student, Jill Trinacty, highlights a number of shortcomings with the current model of medical education when it comes to doctors counselling obese and overweight patients. The frustration Jill feels is indicative of the health care system as a whole: as we grapple with rising rates of obesity and an overburdened health system, there is a lack of clarity around who the key players in managing obesity are, particularly in the primary care setting, and how they view this problem. Many health care professionals feel ill-equipped to identify and deal with issues around weight management and are unsure of their roles and responsibilities.

These deficiencies deserve attention within the Canadian health system, and indeed elsewhere, and innovative research in Nova Scotia is tackling them head-on. Through a series of in-depth interviews, we have examined the experiences of individuals living with obesity, the perceptions of health care providers and the role of social, institutional and political structures in the management of obesity. This study is the first, to our knowledge, to look at the challenges of managing obesity from these multiple perspectives.

In over 40 interviews, we observed how the management of obesity within the health care system is rife with weight bias, stigma and blame. Individuals living with obesity felt that they did not receive the support they needed from their health care providers, while health professionals did not know how best to raise the issue in a respectful way. Furthermore, many participants shared that the relationship between the individual and the health professional was critical for successful weight management. Individuals living with obesity reported feeling that, due to the sensitive nature of the topic of weight, the existence of a trusting, mutually respectful relationship with their health care provider was essential. Unfortunately, this was not their experience in practice. On the other side of the therapeutic relationship, health professionals shared their views related to their own professional frustrations regarding the challenges involved in managing obesity within a system that is not structured to support chronic health conditions and a health issue for which they receive inadequate training. Many health professionals wanted to be able to offer more support, but simply did not know how to within the constraints they faced. Our findings highlight the need for better education for health professionals as Jill identified in her post.

The rich narratives we obtained from our participants have subsequently been developed into a dramatic presentation, depicting the relationship between a health professional (family doctor) and an individual living with obesity (patient). In this dramatic presentation, both internal and external dialogue highlights the spoken and unspoken tensions that were identified by our participants. Early data from pilot work suggests that the presentation offers a powerful medium to raise awareness of these tensions and to provoke a constructive dialogue to address them. We have shared two videos (also embedded down below), one discussing the study findings and a shorter recording of the dramatic presentation. These are available for educational use. This dramatic presentation is ideal for use as an educational tool for health professionals to address the tensions identified through this study. We will also be showing the live drama at interprofessional education events across Atlantic Canada. If you are interested in having the dramatic presentation performed live at an event, please email for details.

Our findings add to a growing body of literature that challenges a number of widely held assumptions about obesity within a heath care system that currently is not designed to provide the support that individuals living with obesity need. It is our goal that the study data inform obesity policy management practices for the future. We think helping health professionals see what is going on behind the scenes is a step in the right direction and we look forward to hearing the views of your readers on our approach.

All or Nothing Thinking Will Always (Eventually) Get you Nothing

yonifreedhoff@gmail.com (Yoni Freedhoff) — Tue, 30 Apr 2013 09:30:00 +0000

Is there an area of life that is more all or nothing than dieting and weight management?

Truly everything else in our lives we'll happily accept our personal bests as great, and more importantly, we're realistic about them. We appreciate that while we can no doubt always do better or try harder that there are fair limits to how hard we can try.

I remember trying to get into medical school. Boy I spent a lot of time in the library and when I didn't get in to medical school on my first try, following my rejection I didn't wish I'd truly eliminated every last ounce of my social life to study - I was disappointed, but I was sure that I had done my best knowing full well that at the expense of real life no doubt I could have done more.

Bests aren't perfection. Bests are affected by real life. Bests need flexibility. And bests change depending on circumstances.

Those folks who head into weight management thinking their bests need to be perfect, that they need to always be on? No doubt in my mind for the vast majority it's just a matter of time before they've frustrated and disappointed themselves often or badly enough that they'll quit trying altogether.

All or nothing almost always gets you nothing.

Badvertising: Does Kellogg's Lead the World in Nutritional Bafflegab?

yonifreedhoff@gmail.com (Yoni Freedhoff) — Mon, 29 Apr 2013 09:30:00 +0000

"Nourish your radiance"

"specially designed with essential nutrients"

"manage your shape"

"nourishment is a beautiful thing"

Really? Nourish your radiance? And you're supposed to nourish it with Special K?

You know what I think's a beautiful thing?

Advertisements that don't rely on made up nonsense to try to sell food.

That ad up above?

It ain't beautiful.

Saturday Stories: Terrorism vs. Guns, Sedentary Living, Real Food and Supplements

yonifreedhoff@gmail.com (Yoni Freedhoff) — Sat, 27 Apr 2013 09:30:00 +0000

A great piece from Michael Cohen in The Guardian discussing the differing American responses to terrorism and guns.

A very easy to follow infographic from Exuberant Animal on the vicious cycle of sedentary living.

Summer Tomato and Foodist author Darya Pino updates her essential, "How to Find Real Food at the Supermarket" flowchart.

As an added bonus - if you've got a question about a supplement - any supplement - check out the work done over at Examine.com.

[And if you don't follow me on Twitter or Facebook here's this week's US News and World Report column on the 7 steps you need to take for successful family meals.]

True Facts About the Sea Pig

yonifreedhoff@gmail.com (Yoni Freedhoff) — Fri, 26 Apr 2013 09:30:00 +0000

Today's Funny Friday video had me scratching my head as I'm certain I've met many people who I presumed breathed through their anuses, and yet they weren't sea pigs.

Have a great weekend!

(email subscribers you need to head to the blog to watch)

Why I Oppose McDonald's and Coca-Cola's Sponsorship of the Canadian Obesity Network Summit

yonifreedhoff@gmail.com (Yoni Freedhoff) — Thu, 25 Apr 2013 09:30:00 +0000

Among this year's sponsors of the Canadian Obesity Network's Scientific Summit are Dairy Farmer's of Canada ($30,000), McDonald's ($10,000), Coca-Cola ($10,000), food industry front group Food and Consumer Products of Canada ($10,000), and the Canadian Beverage Association ($5,000). I'm sure it won't come as a surprise to any reader here that I think these partnerships are ill advised.

But first a bit in CON's defense. To be fair and clear, the Canadian Obesity Network was born out of industry and for industry, where CON's actual stated mission is,

"to act as a catalyst for addressing obesity in Canada and to foster knowledge translation, capacity building, and partnerships among stakeholders so that researchers, health professionals, policy makers, industry and other stakeholders may develop effective solutions to prevent and treat obesity."

Where I struggle today is that CON is no longer simply a networking tool. Due to the tireless hard work of its team and members, over time, CON has become so much more than a network. Today CON serves the public, the media, and policy makers as Canada's go-to organization for opinions, ideas and support on matters pertaining to obesity's treatment, prevention and policy interventions. CON has very much become the public face of obesity in Canada, and events like the Summit and the many practical workshops CON puts on throughout the year are not simply geared for networking, but rather for education, and do undoubtedly help to steer this country's course in dealing with this issue. As a further testament to just how important CON has become to obesity policy in Canada and just how far it has grown from a simple network, if there were a federal or provincial program focused directly or indirectly on obesity that CON was not somehow involved in as an adviser or participant, I'd honestly be shocked. It's these hard earned roles outside of networking that give me pause with CON's food industry partnerships,.

While there's a great chance that most CON members would never think that they themselves might be influenced by taking money from industry or by attending food industry sponsored events, research on both food and drug industry involvement and sponsorship suggests the contrary to be true. Remember too that conflicts of interest are defined simply by the potential or the perception of a conflict. Among the many potential risks of the food industry sponsoring CON's Scientific Summit, consider whether or not reliance or acceptance of food industry dollars might impact upon CON or CON's members abilities to speak forcefully and critically on issues such as mandatory menu board calories, soda taxes, advertising bans, or cup size bans, or whether consciously or unconsciously food industry partnership and reliance will water down, limit or influence opinions therein? Unfortunately, there's no doubt these conflicts of interest sully CON and its members' reputations and scientific authority - a fact made clear to me by the many emails of concern and disdain that I've received from both individuals and organizations who independently discovered the Summit's sponsorship page and Coca-Cola and McDonald's involvement.

As for what this will buy industry - well it will literally buy them entry into the, "we're not part of the problem, we're part of the solution" club, and in turn their partnership and support of CON will be wielded to help deflect scrutiny and industry unfriendly legislation, as well as provide them with access to CON's hard earned emotional, scientific and ethical capital with which to associate their brands. In Coca-Cola's case an additional $16,000-$24,000 (numbers dependent on how many seats they're renting) their sponsorship dollars are buying them them a 90 minute infomercial to be delivered to the country's leading obesity related policy makers, researchers and clinicians by Coca-Cola vice president and chief scientific and regulatory officer Dr. Rhona Applebaum. Her talk is entitled,

"Can a Beverage Company Make a Positive Difference in the Fight Against Obesity?".

As to what Dr. Applebaum's going to say, I'm confident it'll include the position she regularly champions, that singling out sugar sweetened beverages - the largest sole source provider of calories in North America - is misguided in the fight against obesity as she states so clearly here,

"If we are really honest with ourselves, we know that no one group or sector can solve this problem alone and searching for a silver bullet that miraculously stops obesity is just not realistic. Targeting scapegoats or pointing fingers is simply a waste of energy."

Though it would seem that so long as the finger pointing isn't directed at sugar sweetened beverages and that instead it's pointed at some drop in energy expenditure, that pointing is just fine by her,

Dr. Applebaum's talk will also undoubtedly include Coca-Cola's overarching message - that the answer lies in "balancing" energy-in vs. energy-out (and likely too the purchase of artificially sweetened beverages) - that consuming their sugar laden products is dandy so long as a person exercises, and that "all calories count", meaning an oversized can of nutritionally bereft, sugar-spiked, Coca-Cola's is no better or worse for health or weight than anything else. And how Coca-Cola is spinning that message publicly is noteworthy too. Check out this recently released advertisement that details how drinking a can of Coca-Cola buys you 140 "Happy Calories" and then shows you all the fun things you'll be able to do consequent to drinking them,

Or this recent piece where they launched an assault on chairs (yes, chairs),

And here's betting Dr. Applebaum doesn't bring up the multi-year advertising campaign specifically targeting children that Coca-Cola announced yesterday which will include co-branding with their 16oz and 20oz bottles.

Were CON simply a networking organization, while I still would be unhappy with food industry sponsorship, I likely wouldn't have felt compelled to pen this post. But given the important and substantial role CON has so rightly earned for itself as a leader in Canadian research, policy, education and discourse on obesity, I think these sponsorships sell short CON, its membership and the public.

[When writing this post I emailed CON's scientific director and hopefully still my friend Arya Sharma and invited him to write a post on why he supports food industry sponsorship. I'd encourage you to read his posting too so you can hear the other side to this argument. Click here to read Arya's thoughtful post.]

Children's Hospitals Selling Out for Peanuts in Misguided Slices For Smiles Eat Pizza Campaign

yonifreedhoff@gmail.com (Yoni Freedhoff) — Wed, 24 Apr 2013 09:30:00 +0000

Have you heard of Slices for Smiles?

It's the Pizza Pizza partnership with children's hospitals and their Foundations that literally raises money by means of selling pepperoni pizzas. The flyer posted up above (which arrived in my mailbox a few days ago) reports the partnership includes the Children's Miracle Network, SickKids Foundation, Raising Hope Children's Health Foundation, the CHEO Foundation and the McMaster Children's Hospital.

As I've blogged about before, associating Pizza Pizza with fundraising helps to elevate Pizza Pizza's brand a number of ways: The insanely low prices for pizza coupled with children and charity drive customer loyalty and increase frequency of fast food consumption, while the explicit provision of support for fast food's purchase by children's hospitals furthers the normalization its consumption which in turn help to drive the ever increasing pace of diet and weight related diseases in kids. Moreover the tie in with such an incredibly heart felt charity generates an emotional feeling that gets bound to Pizza Pizza's brand.

So do the hospitals at least make a killing by selling the seeds of illness?

Doesn't look that way.

According to Pizza Pizza's Slices for Smiles Foundation homepage since 2007 the campaign has raised $1,000,000.

That's $1,000,000 over 6 years split up at least 5 ways.

That's $33,333 a year each.

An unbelievable bargain for Pizza Pizza (remember too, they're donating "a portion of proceeds" from their sales - this isn't straight philanthropy).

An incredible sell out of the kids these hospitals and Foundations are supposed to protect and champion.

Parental "No" Files: Canadian Hockey Continues to Sell Access To Your Children

yonifreedhoff@gmail.com (Yoni Freedhoff) — Tue, 23 Apr 2013 09:30:00 +0000

Today's Parental "No" comes from mom and blog reader Shari Kneen whose 9 year old son received the coupon for Pizza Pizza fries from his coach for playing a game of "penalty free" hockey. Is there anything a child does in an organized manner these days that isn't rewarded with junk food or candy? Wouldn't simple praise from coaches and parents suffice for "penalty free" hockey played by a group of 9 year olds?

What's in it for Pizza Pizza of course is a whole fresh crop of young customers who will hopefully associate Pizza Pizza with fun, sport, a job well done and reward - messaging they'll potentially carry with them for life and potentially pass on to their own kids.

What's in it for the Ontario Minor Hockey Association and the Greater Toronto Hockey League is undoubtedly money.

Good business for Pizza Pizza, but a real shame both the OMHA and the GTHL seem to value money more than kids' health when one might argue that healthy kids are their primary businesses.

Here are Shari's thoughts,

"Just when I thought I hadn't seen food rewards lately on my kids sports teams - here we go again! I hate the message we are sending to our kids. Companies shouldn't be allowed to do this. I blame OMHA for even accepting this sponsor!"

Me too Sheri, though to be fair, the OMHA and GTHL probably didn't give a second though to the promotion - society has so normalized this sort of practice that no one even thinks to question it.

And therein lies the problem.

[Update: Thanks to @teacherace for pointing out that in order to get the free fries you need to purchase a slice of pizza and a can of soda]

[For past Parental "No"s and Canadian Hockey click here, here, here, and here.]