Friday, December 30, 2011

Stephen Colbert Night in Canada!

I definitely have a man crush on Stephen Colbert.

There, I said it.

God love him, he's today's 2008 recycled Funny Friday.

Have a great weekend!

(email subscribers, head to the blog, this one's definitely worth it)

[Originally posted in May 2008]

Thursday, December 29, 2011

My Loot Bag Manifesto



She's 4.



Thankfully, my loot bag manifesto is a short one:
I hereby proclaim that an enlightened loot bag contains no candy!
Pass it on!

[Originally published October 23rd, 2008]

Wednesday, December 28, 2011

Coca Cola Lies to Doctors?


Sure looks that way to me.

The ad pictured above appeared on page 1632 of the June 17th edition of the Canadian Medical Association Journal.

The ad leads,
"Can't remember the last Coca-Cola ad targeted at children? There's a reason"
Reading the paragraph below,
Then they go on to brag about their voluntary efforts,
"And as a founding member of Canadian Children's Food and Beverage Advertising Initiative, we'vre recetnly extended this policy to include all forms of media, including broadcast, print, the web and beyond."
So what's my issue?

Well I can remember boatloads of Coca-Cola advertisements targeting children. From the famous Mean Joe Green football jersey commercial, to Santa Claus, little stuffed vending machine animals, animated polar bears, video games and recording and sports idols.

Thankfully, youtube remembers them as well and a smattering of them are posted down below (email subscribers, you'll have to actually visit the blog by clicking here as embedded videos don't make it into the email).

Visiting the Coca-Cola company's website you'll find that there's a lot of small print attached to their pledge but basically it comes down to this - it only applies to programming that is specifically geared towards children under the age of 12. I suppose that means targeting children during any family friendly shows (American/Canadian Idol, sports, some prime time stuff) is fair game and I suppose it also means Coca-Cola thinks your 12 year old is an adult.

What a beautiful example of how Big Food sponsored voluntary "regulation" through grandiose sounding endeavours such as the "Canadian Children's Food and Beverage Advertising Initiative" aren't worth the paper they're written on.

[Originally posted July 23rd, 2008]



CHRISTMAS (Entire commercial with 12 year olds)








Tuesday, December 27, 2011

Dr. Sharma and I Have Single Bypasses!


What you see above is a picture of me and my friend and colleague Dr. Arya Sharma (The guy on the left. The guy with the stethoscope? That’s the Grill’s owner “Dr.” Jon) at the Heart Attack Grill (blogged about previously here), but really what you're seeing is a picture of Arya and me practicing what we preach.

You might think that my statement above doesn't make sense, after all, the Canadian Medical Association Journal labeled me a "nutritional watchdog" and I run a behavioural weight management program and Arya, well Arya's the head of Capital Health's Weight Wise - the country's largest tertiary care bariatric centre and the scientific director of the Canadian Obesity Network, how could us eating - "flatliner" fries and "single bypass" burgers reflect our practices?

Simple - we preach that food and calories, while worth monitoring for nutrition and weight, are also used in life for comfort and celebration, and if you can't use food for comfort and celebration from time to time, you're probably on a diet and long-term, it's probably going to fail.

In terms of my lifestyle, excluding vacations and conferences I probably eat out a maximum of twice a month and just like most folks, I enjoy the taste of some foods that are let's say less than optimally nutritious, and sometimes I'll indulge. However what I don't do is give myself a carte blanche during those meals out - instead I choose the healthiest option that I think I'll enjoy so for instance at the Heart Attack Grill I had the single bypass (rather than the double, triple or quadruple), shared a fries with Arya and had water to drink.

As I regularly say weight management and healthy eating - they're about living the healthiest lives you can enjoy, not the healthiest lives you can tolerate. The former's a liveable lifestyle, the latter's just another short-term diet.

So if you're in Phoenix and you're so inclined, the Heart Attack Grill might well be worth a visit, but as the posting on their door states in big, bold, red writing,
"Caution! This Establishment is BAD for your Health!"

[Originally posted October 9th, 2008]

Monday, December 26, 2011

The Canadian Government Thinks Dietitians are Useless!


Or so it might seem.


That sure seems a bit incongruent doesn't it?



and that,
Tony Clement, our former Minister of Health has stated,

If you'd like to complain to our current Minister of Health Leona Aglukkaq feel free to click on her name to send her office an email.



Anyone out there up for a petition?

UPDATE: A kind reader has informed me that really the person in charge of these type of decisions is Mr. Vic Toews from the Treasury Board. If you'd like to email Vic Toews simply click his name.

[Originally posted January 9th, 2008]

Friday, December 23, 2011

2011 Bye Bye! (and good riddance?)

Certainly not the most auspicious year in history as evidenced by this week's Funny Friday Jib Jab retrospective video.

Here's rooting for 2012!

Will be off next week but will have some of my favourite posts from way back in 2008.

Have a great week, and thanks for reading!

Thursday, December 22, 2011

Resolution Series Day 12: YOU!

Day 12: YOU!






Make this the first of many years of you.

Wednesday, December 21, 2011

Resolution Series Day 11: Small Steps!

Day 11: Small Steps!

It goes somewhat hand in hand with striving not to be perfect, but the fact remains, people often take flying leaps at their New Year's Resolutions.

The thing about flying leaps? You tend to land on your face.

Small steps?

You might actually get somewhere.

Unfortunately the road to New Year's Resolutions for many has been paved by reality television, and real reality sure ain't the same thing.

Reality television teaches you to try to lose huge amounts of weight each and every week, to restrict, deny, and avoid dietary indulgences, that exercise in order to be useful needs to be performed in massive amounts (often the point of throwing up) and be painful.

And while those strategies may well work for contestants on a reality television show, they sure aren't going to work well for a working mom of 3 kids in hockey, or in my case, a working dad of 3 kids with a blog.

Remember, it's the healthiest life you can enjoy, not the healthiest life you can tolerate. Any more and you can probably kiss your resolution goodbye.

This year? Resolve to take small steps and leave the flying leaps to idiotic television shows.

Tuesday, December 20, 2011

Resolution Series Day 10: Look at Pricetags!

Day 10: Look at Pricetags!

So let's say you wanted to buy a new outfit and that you decided to shop on Beverly Hills' Rodeo Drive. If you didn't look at price tags before you bought your clothes, do you think you'd be pleasantly surprised when you got that month's Visa bill?

I'm guessing not.

Weight wise, the currency of weight is calories, and unfortunately the world out there? It's the Rodeo Drive of calories, where foods that don't look like much, or foods that are "healthy", may still have stupidly high, non-intuitive caloric prices.

I'm not saying calories are the be all and end all of nutrition, but they're certainly a nutritional determinant of health. Research regularly and conclusively points at calorie reduction as life extending, and therefore even if weight's not your concern, a reduction in your total calorie consumption may be beneficial.

Thankfully nowadays calories are easy to identify. Whether by means of nutrition facts panels, online resources, or in some States, even posted on menu boards.

So this year, resolve to look at price tags, with the question to be asking yourself, "Is it worth the calories", and where sometimes, even if they're exceedingly high, the answer's going to be "YES!".

Calories are but one branch of your decision making tree, where other branches might include your stress level, religious holidays, how long it's been since you've indulged in it, how good or bad your day might have been, what your calories have looked like lately, etc.

But they do make a difference.  For instance, I've never met a muffin worth its calories, and once you start looking at price tags, you might feel the same.

Monday, December 19, 2011

Resolution Series Day 9: Burn your Pigeonholes!

Day 9:  Burn your Pigeonholes!

People sometimes lock themselves down.


This year resolve to do neither.






Saturday, December 17, 2011

Friday, December 16, 2011

The Innocent Joy of Being Evil

I know Santa pays attention to naughty and nice.


Have a great weekend!

(email subscribers, hit the blog to watch)

Thursday, December 15, 2011

Resolution Series Day 8: Beeps and Boops!

Day 8: Beeps and Boops!

Thankfully these days, if we want to remind ourselves of something, we don't need to tie a string onto our finger, instead, we can use the magical world around us.

Everything these days beeps or boops.

Cellphone and smartphone calendars and alarms, reminder apps, Outlook, text messaging, emails. There's no shortage of means to get in touch with oneself.

The thing about resolutions, by their very definition they're things you're not accustomed to doing in your normal, default, daily routine.

So how do you turn a resolution into a habit?

You consciously remind yourself over, and over, and over again, of those very things you're resolving to change.

This year resolve to remember, and resolve to do so without using one extra ounce of brain power or resilience, resolve to do so with beeps or boops.

Set your cell or smart phone calendar to remind you to snack, to shop for fresh produce, to exercise. Schedule your resolutions into your outlook reminders. Use text messaging services like  OhDon' or send emails out into the future.

Why would you naturally remember to do things you aren't accustomed to doing?

Beeps and boops? They're your secret resolution weapons. Wield them well.

Wednesday, December 14, 2011

Resolution Series Day 7: Construct, don't Destruct!

Day 7: Construct, don't Destruct!

I've blogged about this resolution before.

This year resolve to ask yourself constructive questions, rather than destructive ones.

People generally interpret their lives through a series of reflective questions, and when things are going well, we tend to fall into questions like,
"What's my problem"

"What's wrong with me?"

"Why can't I just do this?"
And brains? Well, they're very accommodating. If you ask your brain to point out, "what's wrong" with you, it will readily and happily do so.

Self-destructing by piling guilt, anger and derision on yourself is no way to build a lifelong change.

If you want to change for good, I'd recommend you build on constructive, positive questions, because remember, your brain is accommodating.

So instead of the destructive questions like those above, when things aren't going well, when you're unhappy with your performance or the situation, resolve to ask these constructive questions instead,
"What can I do right now that'll help?"

"What can I do tomorrow to improve things?"

"What can I do today that I can be proud of?"
And suddenly, instead of beating yourself up, your helping yourself out.

Tuesday, December 13, 2011

Resolution Series Day 6: Meet Your New Best Friend!

Day 6: Meet Your New Best Friend!

Who is it?


What do I mean?

We don't treat ourselves very nicely.

Whether it's struggling with healthy living behaviours, parenting, or doing our jobs, we're usually our own worst critic and most of us regularly heap piles of self scorn on our already weary shoulders.

There's an easy-ish way out of the circle of shame - treat yourself like you would your best friend.

Whatever's going on or going wrong in your life, ask yourself what you'd tell your best friend if they were recounting the exact same scenario.

My guess?

It'll be both kinder and more constructive than the guilt and self-loathing you're likely to be loading on yourself.

Shouldn't we all resolve to be our own best friends?

Monday, December 12, 2011

Resolution Series Day 5: A New After-school Activity!

Day 5: A New After-school Activity!

There's no debate, exercise is the single most important modifiable determinant of health.  The even better news is that there's really no need for skill - plain old walking works great.  Of course that doesn't stop any of us parents from schlepping our kids here there and everywhere for exercise "lessons" - soccer, hockey, skating, dance, the list, and the time involved, can sometimes seem and feel endless.

But with all of those after-school sports, is something else suffering?

I'd say so.  In fact I'd say that perhaps all of those after school skill building activities are actually decreasing the likelihood of parents teaching their children the single most health conferring skill imaginable - the skill involved in transforming raw ingredients into food. The skill of cooking.

Cooking is quickly becoming a lost art.

With the incredibly fast pace of our lives and world these days, it's no wonder cooking's falling by the wayside. Between chauffeuring kids to their various after school activities, to the electronic tethers we all now wear, time has become more pressured than ever. And of course restaurants of all sorts are everywhere to fill the void.

Resistance isn't futile.

Resolve this year to ensure you teach your children how to cook (and if you yourself don't know how, this is your opportunity to ask them to help you to learn).

Find a simple and easy to follow cookbook (like for instance any of the Looney Spoons' books) and book off one night a week as a family cooking night.

Each week a different family member gets to take a turn picking, prepping and cooking a recipe. Of course parents can and should help, this isn't about division of labour, this is about sharing and learning the love and joy of cooking.

Pick the recipe out on a pre-specified night each week at the dinner table. Ensure you schedule a time to shop for the recipe's ingredients before the day of, and perhaps even prep the ingredients together the night before cooking so that putting things together the next day is a quick snap.

Your kid missing one extra after school activity isn't likely to have any negative long term impact on their health. Their leaving your home not knowing how to cook will, as not only will it lead them into the processed food world's nutritionally bereft embrace, it might lead them to lead their future families into it as well.

In a sense, your family cooking nights?  They're for your unborn grandchildren.

(P.S. - Not my wife and kid up above)

Saturday, December 10, 2011

Saturday Stories - Dying, Personal Responsibility and 23.5 hours

Dr. Ken Murray tells us how doctors die.

Wonderful piece on how personal responsibility is a horrible way to consider disease prevention or treatment (when you read this think about things like weight bias and the parental no defense to the food industry).

Toronto's Mike Evans wonders if you can survive on 23 1/2 hours a day (fabulous video) - link here for email subscribers and embedded below for visitors:

Friday, December 09, 2011

Do Your Kids Smile for their School Portraits?

Mine sometimes do...but certainly not always.

Today's Funny Friday?

Behind the scenes of school portraiture.

(Email subscribers, head to the blog to watch)

Have a great weekend!

School Portrait (2011) from Michael Berliner on Vimeo.

Thursday, December 08, 2011

Resolution Series Day 4: Reclaim Your Table!

Day 4: Reclaim Your Table

I know you have one. You might even have two. A dining room version and a kitchen version.

But do you use them?

Most of us (sadly me included many nights), pile up our plates and head to the living room. It's a practice we all ought to stop, and assuming my wife's in agreement, this one's a resolution for us as well. We're going to rediscover our table, maybe not every night, but certainly some and maybe many.

If you live alone, eating at the table will allow you to pay attention to your food and actually enjoy your bites rather than just mindless chewing (and if the bites aren't as enjoyable as you'd like, that might be a cue for you to try some new dishes). Turn on some of your favourite music, reflect on your day, and savour your meal. If you're trying to lose or maintain your weight, eating mindfully might allow you to get away with smaller portions than those you'd have plated for your televised meal.

If you live with adult loved ones or roommates, eating at the table will allow you to share your days, and spend a few moments of quality time in a world that has too few.

If you live with children, eating at the table will first and foremost teach them that families eat at tables, but has also been shown to be correlated with a healthier diet for the children, lesser body weights, and decreased adolescent acting out type behaviours.

Don't let your kitchen table just be a place to pile stuff up.

This year resolve to reclaim your table and stake your dietary flag in as often as you possibly can.

(P.S. - That's not my table)

- Resolution series to continue on Monday!

Wednesday, December 07, 2011

What I Now Have in Common with Dr. Oz

Simon and Schuster's Free Press!






Resolution Series Day 3: Lose a Box!

Day 3: Lose a Box!

When my wife and I first met, her freezer was full of boxes. There were chicken fingers, burritos, pierogies, and fish sticks.

Now I can't brag too much. While I wasn't a box sort of bachelor, my staples were home made burgers, steaks, pizzas and chicken wings.

Over time our dietary worlds have changed - in part because of the career path I found myself upon, in part because of simply getting older/wiser, and in part because we had children.

Nowadays there are no boxes in our freezer.  In fact it's an extremely rare meal that's not home made, from scratch.

Of course we didn't get to where we are now overnight. Instead we slowly lost boxes.

I think the pierogies might have been the first to go, followed by the fish sticks. A few years later the chicken fingers were gone and finally the burritos.

You don't need to get where you're going overnight. In fact that's a great way to not get there.  Flying leaps land you on your face.

Instead start with a small and very doable step.  Why not take a boxed food inventory of your freezer and resolve to permanently lose the most nutritionally offensive box?

In it's place?

Learn a new home made, from scratch, produce rich meal.

Once one box is successfully done and gone, consider when you might want to tackle the next.

In terms of what's replaced our boxes, here's one we love. It's stupidly healthy, ridiculously inexpensive, strangely coloured, but wonderfully delicious and extremely hearty:
Lose a Box, Stupid Easy, Beet Curry (Serves 4)

1 large beet
1 can coconut milk
1 can chickpeas (rinsed)
1 onion
4 cloves garlic
1/4 to 1/2 vegetable bouillon cube (depending how salt sensitive you are)
2 tablespoons tomato paste
2 tablespoons curry powder
3 tablespoons chopped fresh coriander
1/8 teaspoon salt
1 teaspoon sesame oil
1 cup Brown rice or quinoa

1. Cook chickpeas until tender
2. Cook brown rice or quinoa on side to serve over
3. Peel and dice beet root and cook in simmering water until tender
4. Chop up beet leaves
5. Saute garlic and onion with some sesame oil for extra flavour
6. Add coconut milk, diced beet root, chickpeas, tomato paste, tiny bit of stock cube and curry powder and bring to boil and when boiling add in chopped beet leaves (or cooking greens). Boil for 5 more minutes
7. Sprinkle with fresh coriander and serve over brown rice or quinoa

Per serving 410 calories, 12g protein, 9g fibre, 427mg sodium

Tuesday, December 06, 2011

Resolution Series Day 2: Pre-Eat

Day 2: Pre-Eat

Another incredibly easy one.

You're going to have lots of celebratory meals this month. Office get togethers, family dinners, vacationing, etc. Most folks think that their best plan is to ensure they skimp on their calories all day long so that when their celebratory meal time comes around, they've got more caloric room for indulgences.

That's a terrible plan.


Because you'll end up combining frank hunger with a terrifically human reason to eat (celebration), along with markedly more indulgent food, social pressures, and probably alcohol.

And hunger wins of course. Go to the supermarket hungry and you'll know what I mean, you shop differently when you're hungry.

Sitting down to eat hungry is exactly the same, just on a smaller scale. Simply put, you'll be shopping from your plate.

But what happens when you go to the supermarket not hungry? Well you buy what you need and aren't tempted to buy much else.

Show up to your festive meal not hungry and you'll eat what you need - including a more indulgent menu given the circumstances, but by not being hungry, and by being in control, you'll have a far easier time navigating your choices and your portions.

My recommendation? Resolve to "pre-eat" all of this year's celebrations. Not only have all of your day's meals and snacks, but ensure you have an extra 200-300 calorie, protein inclusive snack half an hour before you head out to your dinner. The calories you'll spend "pre-eating" will be dramatically outweighed by the calories you don't consume from the seconds you leave on the table, the more thoughtful navigation of choices and a more controlled consumption of dessert.

You don't crave green leafy salads when you're hungry. The flip side of that? You don't crave much at all when you're full. So this year, pre-eat, avoid hunger, and thoughtfully indulge because it's a celebration and not uncontrollably indulge because you're hungry.

Monday, December 05, 2011

Resolution Series Day 1: Like Em!


My 12 Days?


Which brings me to my first recommended resolution:

Day1: Like Em!


What do I mean?





Saturday, December 03, 2011

Friday, December 02, 2011

The Beauty of a Single Second

Life's fleeting.

Today's Funny Friday video isn't so much funny as it is astounding in its ability to demonstrate how much beauty can exist in even a single second.

Thanks to my wonderful wife and my delicious children, I'm blessed with many such seconds.

Have a great weekend!


Thursday, December 01, 2011

American Dietetic Association Under Fire from RDs for Corporate Ties

Over the years much has been said about the close relationship between the American Dietetic Association and the food industry, but not too much has been done about it.

Perhaps that's changing.

Thanks to Canadian RD Cara Rosenbloom for pointing me to a grass roots initiative that took the ADA's "" website and created their own version, "".

Now the site itself is alarmist, woo-y, kinda anti-science, and a bit over the top, but their campaign to have the ADA sever their ties with food industry funding is one I fully support.

And why wouldn't they do so?

What a tremendous public relations ride they could take on such a move, and it'd be a move that at least superficially, sounds like an easy thing to do as Colby Vorland once calculated, if the ADA wanted to raise as much money annually from their members as they currently do from the food industry they'd only need to charge each member $41 more per year.

I doubt they'd lose members if that $41/year was rolled out with a clear explanation of what it was for. In fact I bet they could roll out a $50/year increase and help fund a new initiative that combats food industry spin. I'd bet further that many RDs who may have left the ADA in disgust, would in fact rejoin, increasing their coffers further.

Heck, if they did that, and if they let me, I'd join.

Wednesday, November 30, 2011

Has Your Doctor Ever Taken a Lifestyle History?

Whether you're worried about your weight or not, how you live your life - how you eat and how you play - will markedly impact on your health and well being. In fact it'll impact on your health far more than any drug your physician could ever prescribe.

So why is it that most people have never had their physicians discuss healthy living with them?

Sure, a doc may ask you whether or not you exercise, and might even inquire into your sleep, but do they delve further?

My belief, though unproven, isn't that doctors aren't interested, and it's not that they're unaware of the benefits of healthy living, but rather that they're simply not taught to consider lifestyle in their clinical history taking, nor how to champion healthy living effectively.

So what are the top 10 things I would want physicians to explore with you at a bare minimum?

In no particular order:
  1. How many meals do you eat out (including cafeterias), order in or take out (including prepared supermarket counter foods) per week?
  2. Do you feel comfortable cooking?
  3. How many meals a week do you cook yourself by means of the actual transformation of raw ingredients?
  4. How many glasses of milk, juice, sugared soda and/or alcohol do you drink a day?
  5. What do you put in your coffee or tea, and how many do you drink a day?
  6. What's your typical pattern of daily eating (ie do you miss meals or snacks and what do you typically have for breakfast/snacks/etc.?)?
  7. (If married and/or with children) How many meals a week do you eat together as a family?
  8. What was your favourite sport or activity as a kid and why aren't you doing it today?
  9. How many minutes of simple walking might you be able to add to your day without it being a hardship, and when would it be (ensuring goal here is Specific, Measurable, Attainable, Realistic and Timely)?
  10. (If a parent of still at home children) Are you living the life, food, fitness and health wise, that you want your child to be living, and if not, what do you think you might improve?
While I realize this list is by no means exhaustive (for instance it doesn't touch on other hugely important issues like relationships, friendships, sleep, job satisfaction, parental struggles, sandwich generation issues, socio-economic stressors, etc.) and may only scratch the surface of healthy living, it would certainly help a physician to get a sense of how their patients are managing their two most important determinants of health, and provide a myriad of opportunities to try to help collaboratively trouble shoot common barriers to healthy lifestyles.

Unfortunately, while we physicians are all taught to examine the micro level minutia of each and every physical system in our annual review of systems, I strongly and firmly believe that as far as health benefits go, it'd be far more valuable to our patients to review the macro level of how they're are actually living their lives.

Of course asking those questions up above will also necessitate having answers...and sadly, therein lies the problem.

Medical schools and residency programs may do wonderful jobs at preparing us on how to treat illness with pharmacotherapy, but sadly the vast majority do a respectively terrible job at preparing us how to help patients manage, as Yale's David Katz puts it, "medical destiny's master levers" - forks and feet.

Here's hoping that one day, the day will come where forks and feet get the medical respect they so clearly and desperately deserve.

Tuesday, November 29, 2011

You can stack your deck, but you can't get a new one!

Long time readers will know, I'm a slow runner.






And enlightening.





Monday, November 28, 2011

Are you Feeding your Children Properly?



Here are the top 10 take home messages:
And number 10?

  • Don't reward them with food.
  • Disband the clean your plate club.
  • Sit at the table and eat with your kids.
  • Don't skip meals.
  • Dramatically minimize meals out and takeout.
  • Involve your kids in cooking.
Or put even more simply?

Live the lives you want your children to live.

Saturday, November 26, 2011

Saturday Stories - WWII, Astrophysics and Smoking Marathoners




Friday, November 25, 2011

Grossest. Card Trick. Ever.


The world is a strange place.


Think David Blaine mixed in with 8 year old boy humour.

Don't say I didn't warn you.

Have a great weekend!


Wednesday, November 23, 2011

What is your Toothbrush Level of Exercise?

Do you enjoy brushing your teeth?


I'm guessing it's the latter.




The eight words?
Some is Good. More is Better. Everything Counts.

What's that?


5 mins? 10 mins?





Now go brush your teeth!

Tuesday, November 22, 2011

Does your Bench need a Bedside?




The results?


So is this helpful clinically?






(And BTW, my bedside's always open)

Monday, November 21, 2011

Life's not a straight line (and some runs stink).


Life's not a straight line.







Do your best, and love it!

Saturday, November 19, 2011

Saturday Stories - Crowns, milk and vegetables?

Do growing kids really need buckets of milk?

Mark Bittman and the New York Times cover Burger Kings new predatory children's marketing campaign.

Marion Nestles collects the coverage on pizza's new appointment as a vegetable.

Friday, November 18, 2011

Who Knew Liam Neeson was so Damn Funny?

Looking for a straight man to be in your funny movie?

Today's Funny Friday proves ever so conclusively that you should look no further than Liam Neeson.

Have a great weekend!

Thursday, November 17, 2011

You Can Always Do Your Best!

Ever have a write-off day?


There's no need for that if your best is your goal.

What do I mean?






Perfection's an awful goal.

Do your best.

Wednesday, November 16, 2011

Enjoy every sandwich!

Do yourself a favour. Watch this video, and when it's available, consider buying the book.

[Hat tip to my inspirational friend and colleage Dr. Derek Puddester]

Tuesday, November 15, 2011

Why Cholesterol Screening for Kids is the Wrong Idea

If your ears are tuned to the health-o-sphere, I'm guessing you've heard that America's National Institute of Health's NHLBI has recommended screening children starting at age 9 for hyperlipidemia, and doing so by means of a blood test.

While I won't debate the gravity of the rising tide of childhood hyperlipidemia, diabetes, obesity, hypertension, etc., I really do scratch my head about their recommendations.

Firstly I don't believe in ordering blood tests where there's a low likelihood of clinically relevant consequent intervention. What I mean is, doctors shouldn't order tests unless the results have a clear cut, reproducible and clinically effective response.  So what type of response will there be?  Obviously it won't be the kids intervening themselves as it doesn't matter what you tell a 9 year old about their cholesterol, they're 9 years old! Does anyone really think a 9 year old has the necessary insight to react rationally to an elevated serum cholesterol? The problem is, neither do adults. In fact we as a profession seem to be almost wholly incapable of inspiring lifelong change even in supposedly insightful adults with elevated cholesterol.  I wonder therefore why we think we're so good at it so as to ask a child to endure a screening blood test at age 9.

Secondly, even if we could affect lasting change, are the recommendations provided proven to be a clinically reproducible, useful and efficacious dietary pattern?

Well, from what I can gather, fancy expert panel or not, they seem to have simply regurgitated the same low-fat message that recent years have pretty much proven to be non-helpful in preventing cardiovascular problems in adults. And despite regurgitating old, proven to be ineffective with adults advice, what's perhaps more shocking is what they didn't recommend. From what I read there's not one word about whole-food cooking, and not one word about the processed food environment in which these kids are drowning.

I find that absolutely astonishing. Much ado was made about how we have to work with best available evidence in terms of testing 9 year olds rather than wait for the clinical trials. How about the best available evidence that from a dietary perspective society's nutritional fracture is the loss of the ability, desire, time, and/or motivation to regularly transform raw ingredients into meals? Where's the advice to actually cook from scratch? To minimize all meals out and not just "fast" food? To stay away from boxes? Instead all I see is the DASH diet, a call to avoid eggs (good grief), and a call to avoid full fat milk.

Lastly, do we really need 9 year olds to endure a blood test to know that they're on an unhealthy path, and moreover and more importantly, are high cholesterol, sugar or blood pressure really the barometers of dangerous dietary or lifestyle dysfunctions?  Does that mean that kids who eat atrocious diets and live unhealthy lifestyles but don't have signs of traditionally adult diseases are safe?

Whether they've got elevated cholesterol, sugar or blood pressure or not, how about we teach doctors to take detailed eating and lifestyle histories from every kid, at every annual visit?

What sort of history?

Well for starters, how about questions like:
  • How many meals out a week (including cafeterias, take out and restaurants)?
  • Who, if anyone, is cooking?
  • How much juice?
  • How many sweetened beverages?
  • What are their patterns of eating like?
  • Do they struggle with any disordered eating?
  • What does their parental healthy living role modeling look like?
  • How many hours of screen time?
  • What time do they go to sleep?
  • How is their body image?
  • How is their self-esteem?
In medical school I was taught that over 90% of diagnoses can be made on the basis of history alone. Rather than recommending a blood test, how about recommending physicians take lifestyle histories and that way, instead of just focusing on those kids who are unfortunate and predisposed enough to be developing "adult" style chronic diseases at a frighteningly young age, we can focus on all kids, including those whose youth might still be protecting them against an awful lifestyle.  Don't those kids need help too?

My view from the trenches for those folks in their ivory towers?

We don't need a blood test from a 9 year old to know if a kid needs help, and looking at the actual recommendations these experts have put forth, I think it's pretty clear they need some help too.

So my two cents addition to this expert report (and I'll keep it short and sweet)?
  1. Lifestyle history from all kids starting at birth (obviously with parental input until the kids are old enough to answer for themselves).
  2. As a family: Cook.  From scratch.  More often than not. (oh, and mixing things from packages together isn't actual cooking).
  3. Live the lives you want your children to live.

Monday, November 14, 2011

Is your spouse sabotaging your weight management efforts? Please RT!

Spousal sabotage is a common complaint.










Friday, November 11, 2011

This video almost makes me want to buy a dog.

My children, if you're reading this, please note that I said almost!

Today's Funny Friday involves a dog who really, really, wants to play with the baby.

Have a great weekend!

(Email subscribers, head to the blog to watch)

Thursday, November 10, 2011

Book Review: Hold that Hidden Salt!




Perhaps you simply want to lead a healthier lifestyle.


What’s the solution?














Wednesday, November 09, 2011

The LA and New York Times Forget Something Important

What'd they forget?

That study outcomes don't always matter.




My response?


What am I getting at?


Of course not.



Tuesday, November 08, 2011


This year I turned 40.


But here's the thing.




1. I qualify.
2. I don't.




I think you probably see where I'm going with this.





