Resolving our obesity epidemic

Last month, France initiated legislation to impose a “fat tax” on regular soft drinks and other sugary beverages. The surcharge is intended to help fight the country’s escalating obesity epidemic. 

Contrary to what Mireille Guiliano--author of French Women Don’t Get Fat--would like us to believe, France's National Institute for Health and Medical Research reports that more than 20 million French people are now overweight; seven million of those individuals are considered obese. 

France’s taxation policy follows on the heels of Denmark’s introduction of a levy on saturated fat-containing goods such as dairy products and butter. Sweden, Norway and Hungary are considering a similar tariff.

Closer to home, the Canadian Medical Association has recommended higher taxes on junk food while the B.C. Medical Association is encouraging the taxation of sugar-sweetened beverages. Because of its elusive definition, applying a tariff to junk food, per se, will require a great deal of debate. Taxing sugary drinks appears more straightforward.  

Regular soda pop, fruit-flavoured beverages and sports drinks are North American’s greatest source of added sugar. To boot, sugary beverages tend to interfere with our ability to feel full; the human body doesn’t recognize the calories from these nutrient-deficient liquids as well as those from solid food. 

Evidence linking the consumption of empty-calorie beverages with elevated risks of gaining weight and developing diabetes has prompted groups such as the Heart and Stroke Foundation of Canada, the Centers for Disease Control and Prevention, and the World Health Organization to advocate moderation.

But will increasing the price of these drinks lead to wallet-induced willpower that significantly halts the expansion of our waistlines? 

Although there’s little research supporting the effectiveness of such a measure, fat tax proponents cite alcohol and tobacco as positive examples. International studies show that public education on drinking and smoking can only do so much; increasing taxes on booze and smokes is the most cost-effective way to reduce their consumption. 

According to the Society for Research on Nicotine and Tobacco, a 10 per cent increase in the price of cigarettes results in an overall three to five per cent reduction in cigarette use. The tobacco industry’s prime targets, youth, minorities and low-income smokers, are most affected by taxation.

Fat tax supporters hope to see the generated revenue directed towards funding healthy eating and physical activity initiatives, as well as financing subsidies for nutrient-dense foods, thus making them more affordable to Canadians of all socio-economic groups.

Opponents, on the other hand, tend to view fat tax as nothing more than another government cash cow. And who can blame them for being cynical about the actual allocation of this cash? 

Adversaries generally believe the tariff is too simplistic an approach to dealing with the obesity epidemic and some go so far as question why everyone, no matter what their size, has to pay. To them a better solution involves people-of-girth taking more responsibility for their impact on health care costs by paying higher Medicare premiums.

One of the repercussions of living in our weight-biased society is such intolerance and ignorance. How quickly we forget that the number on the scales is only one of several indicators of our physical well-being; a low or “normal” weight doesn’t guarantee good health and a low reliance on our health care system. Think of chain smokers and alcoholics, who are typically under-weight. Like excessive smoking and drinking, many factors come into play to cause obesity; it isn’t simply the result of an individual’s behaviour. If it was, we wouldn’t have a epidemic on our hands in the first place.

The naysayers, however, are right about one thing: a fat tax won’t do it alone. Resolving the obesity crisis will take years of simultaneously applying complementary strategies. Along with public health education efforts and evidence-based medical treatment practices have to be regulatory and economic policies that fight powerful industry lobbyists; limit television and internet advertisements of nutrient-inferior food and beverages (particularly those aimed at children and teens); and comprehensively tax such fare. 

A good start is a one-cent-per-ounce excise tax on not only regular soft drinks but all sugar-laden beverages, on the market today, that have little to no nutritional value. And while we’re at it, let’s shift from using the shaming term, “fat tax”--another product of our weight-obsessed culture--and use a more accurate descriptor: Preventative Health Initiative (PHI) tax, anyone?

published in the Vancouver Courier , November 25, 2011

A stinky cold and flu remedy?

We’re well into flu season and by now many of us have thought about what we can do to prevent, or at least minimize the symptoms of, getting sick. To improve our immunity we may consider getting more sleep and exercise, washing our hands more often and eating foods rich in vitamin C and zinc.

But a sure-fire remedy for preventing or curing the common cold and flu continues to evade modern medicine. Here we are in the 21^st century and scientists and physicians still have no definite answers.

Enter Gene Stone, a man who obviously got tired of battling regular bouts with the flu and went out to find his own answers. Stone, an investigative health journalist and New York Times best-selling author, interviewed dozens of unusually healthy people world-wide and then selected 25 individuals who, he believed, each possessed a different secret of excellent health - a secret that made sense and was supported by research.

Stone, who experiments with almost every treatment he’s ever written about, shares his fascinating discoveries in his book, The Secrets of People Who Never Get Sick (Workman Publishing, 2010). And in an interview with Macleans' magazine, the November 29, 2010 issue, Stone reveals that if he had to chose just one tip that’s stopped him from getting sick it would have to be eating a raw garlic clove everyday. 

The medicinal effects of the stinking rose date back to 3000 B.C. where it was used to treat fever and inflammation. In the Middle Ages people believed it would protect against the plague while soldiers in both World Wars ingested garlic to prevent gangrene. 

Today most of the focus is on garlic’s cardiovascular and cancer-fighting benefits, not to mention its antiviral, antifungal and antibacterial properties. Interestingly, in 1858, French biologist, Louis Pasteur, discovered that garlic kills bacteria: one milliliter of raw garlic juice was as effective as 60 milliliters of penicillin.

  

Researchers purport that it’s the antibacterial activity of garlic juice that’s responsible for attacking bugs such as staphylococci , the bad-boy bacteria behind staph infections. 

Believing garlic’s medical value is related to its pungent taste and smell, many scientists in the field discourage taking garlic in the form of an odourless supplement. When garlic’s active ingredient, allinin, is converted to allicin from chopping, crushing or chewing a clove, hydrogen sulfide is given off and that’s sacrificed when producing garlic in a pill form. 

Garlic supplement brands are often marketed based on the amount of allicin they supposedly release after ingestion, but routine analyses of these products frequently reveal they vary considerably in their chemical composition. It doesn’t matter whether the pill contains garlic that’s been dried, powdered, or turned into a fermented extract or oily extract.

To boot, supplements may increase the risk of bleeding if taken with blood-thinning medications such as aspirin, warfarin (Coumadin), fish oil pills, or other anticoagulant drugs. They may also interact with some medications used to treat diabetes, HIV, hypertension, cancer and high cholesterol levels. 

Some people may have allergies to garlic and other foods in the genus Allium plant family such as leeks, shallots, onions and chives. Always check with your doctor before starting to take garlic supplements or large amounts of garlic in its nature state, meaning more than five cloves daily.

It appears that the best way to have fresh garlic is either raw or cooked. Current research can’t recommend an ideal dosage or the healthiest way of eating it. But whatever you do, never consume garlic that’s been stored in oil at room temperature. This is a breeding ground for the bacteria that causes the foodborne illness, botulism.

However, go ahead and add more garlic to soups, sauces, condiments and marinades keeping in mind that high cooking temperatures most likely destroy its active components.

And if you’re worried that your breath and body odour will stop traffic, keep the mouthwash handy and bathe regularly. If these tricks don’t obliterate your ode de garlic, the good news is that you’re sure to get a seat on the bus.

published in the Vancouver Courier, December 3, 2010

Warm Brussels Sprout Kale Salad

Of fall’s vegetable fare, Brussels sprouts win the fewest popularity contests. After all, how many of us have childhood memories of eating greenish-grey, foul-smelling sprouts that had been boiled to death?

But there’s a reason our mothers pushed Brussels sprouts upon us: they happen to be one of nature’s top super-foods. Not only are they packed with fibre, beta-carotene, vitamin C and phytochemicals that may protect us against cancer, they’re also a good source of vitamin K, potassium and folic acid. 

Roasting, microwaving or sauteing sprouts, until just tender, make these veggies more appealing; these cooking methods keep their pungent sulfuring-containing compound, glucosinolate sinigrin, at bay. 

Nothing makes Brussels sprouts more enticing than a toss of toasted nuts, a sprinkle of grated cheese or a bit of crispy bacon. I’m not a big fan of bacon for breakfast, but I occasionally add small amounts to soups, stews and salads. 

For easy use, section a newly-purchased package of bacon by stacking two to three slices on top of each other, rolling them tightly and then covering well with plastic wrap. Place in a durable ziplock bag and freeze for as long as 4 months. Defrost in the microwave when needed.

On a cool fall evening, make warm Brussels sprout kale salad the center of your meal. The kale bolsters the nutritional content of this dish even more by providing vitamin C, beta-carotene, calcium and potassium. Just add a high-fibre grain, a glass of red wine and fruit for dessert, and you have an ridiculously healthy meal in front of you. 

Warm Brussels Sprout Kale Salad*

serves 4

What You Need:

2 tablespoons (30 ml) fresh lemon juice (1large lemon)

2 tablespoon (30 ml olive oil ), divided in half

1 teaspoon (5 ml) Dijon mustard

1 small garlic clove, finely minced

1/8  teaspoon (0.5 ml) salt

1/8 teaspoon (0.5 ml) freshly ground black pepper

3 tablespoons (45 ml) slivered almonds

2 strips bacon

3/4 pound(375 g)Brussels sprouts, stem bud and outer leaves trimmed then thinly sliced

1/2 pound (250 g) green curly kale, leaves removed from stems and thinly sliced

2 tablespoons (30 ml) water

salt and pepper to taste

1/4 cup (60 ml) grated Pecorino or Parmigiano Reggiano (optional)

What to Do:

Combine the first six ingredients to create a lemon vinaigrette and set aside. This step can be done ahead of time to allow the flavours to intensify. 

In a large non-stick skillet, toast almonds over low-medium heat until they begin to turn golden brown. Remove from pan and set aside. 

Using the same skillet, fry bacon until crispy over medium heat. Transfer bacon pieces to a dish lined with paper towel to drain excess fat. When cooled, crumble into small pieces. 

Add one tablespoon of olive oil to remaining bacon fat in skillet and saute Brussels sprouts for about a minute. Don’t adjust heat unless sprouts are beginning to burn. 

Add kale leaves and water. Continue to saute for another minute. Brussels sprouts and kale should be a vibrant green colour. 

Remove from heat and add lemon vinaigrette, toasted almonds and bacon. Adjust seasoning if necessary and, if using, sprinkle with cheese before serving.

*adapted from this recipe by Susan Spungen for the November 2011 edition of Bon Appetit magazine.

published in the Vancouver Courier November 11, 2011.

Coming clean about detox diets

In a world where environmental pollutants and food additives are an everyday threat to our health, the idea of body detoxification seems extremely enticing. Like scouring the nooks and crannies in our homes, wouldn’t flushing out harmful substances from our bodies restore some sense of internal order? 


Proponents of detox diets and cleanses think so. For centuries, they’ve practiced the art of detoxification in an attempt to achieve optimal health. Expelling “poisons” from the body can cure maladies ranging from chronic fatigue to cancer.


The process of de-poisoning ourselves is neither pretty nor fun. Serious toxin removal usually involves fasting or at least following a strict diet void of items like sugar, processed foods, caffeine and alcohol. 


To clean out our dirty digestive tracts detoxers may also be asked to use herbal laxatives or colonic cleanses - a procedure that involves a long rubber tube, a lot of warm water and someone’s rectum. Think: high-powered douche for the bum.  


But no matter what a regime advocates, the  premise of all detox diets and cleanses is deeply flawed; it flies in the face of what we know about human biochemistry and physiology. Extensive study of both fields has taught us that we’re well equipped with a sophisticated and versatile detoxification system. Our liver and kidneys do just fine removing most ingested toxins. We don’t need to mess with nature.


Internal cleansing is not only physiologically unwarranted, it’s scientifically unfounded. No research data support the claim that detoxification successfully expels toxins and that includes more harmful chemicals like heavy metals and pesticide residues.


For most detox and cleanse marketers, this isn’t damning news. It’s not research that sells their wares, positive personal testimonies and anecdotal evidence do the trick.  


Many of us report feeling invigorated after following a regime. We’re more alert and less grumpy. I won’t argue about how a cleanse makes us feel but my hunch is it’s not the regime, per se, that creates these health effects. 


I’d bet money we feel better because we expect to; we believe we’re doing something good for our bodies - a phenomenon known as the placebo effect. 
It’s also possible that a regime triggers a healthy shakeup in our lifestyle. If we eat more vegetables, drink less alcohol or smoke fewer cigarettes we’re bound to feel a heightened sense of well-being. 


Some regimes can be a springboard for healthier eating behaviors but others can yield disastrous consequences. Detoxes or cleanses that advocate fasting make us vulnerable to developing nutrient deficiencies, dehydration and electrolyte imbalances.


Fasting or strict dieting also  means our daily caloric needs go unmet and when that happens our bodies break down muscle tissue along with other vital proteins to give us energy. The process creates two toxic byproducts: ammonia and urea. Ironically, under-eating may cause an accumulation, not an exodus, of harmful substances.

However, the biggest drawback to these regimes is that we often perceive them as a form of dietary redemption; we can eat and drink our way into oblivion as long as we occasionally purify our bodies.


This attitude gets us into trouble because instead of practicing healthy eating on a daily basis, we believe we have a quick-fix remedy for almost any health problem that comes along.

Candy is dandy, however...

photo by Claire Hugron

I may be a nutritionist but there’s no way I’m going to be a killjoy when it comes to Halloween. In my books, this fright-night celebration is about letting our kids be kids. And that means giving them the okay to indulge in sweets, if they so desire. 

Instead of outlawing Halloween treats, we need to help kids learn to manage them. According to Ellyn Satter, a Madison, Wisconsin registered dietitian and psychotherapist, Halloween can be a valuable experience for children because it teaches them how to regulate their candy intake and, potentially, improve their overall relationship with food.

Satter, who has authored four best-selling books, including Your Child's Weight: Helping Without Harming, advocates letting your child relish their Halloween haul: have them spread the candy out on the kitchen table, sort it and eat as much of it as they want. Then let them do the same the following day.

On the third day, have your youngster put their sack of goodies away and provide them with a couple of pieces at meals, for dessert, and as much as they wish at snack time. 

If your child can follow this rule, they get to keep control of their loot. If they can’t, you take the reins with the message that as soon as they can manage it, they get to keep it.

Satter’s approach isn’t easy for parents because it requires a neutral stance on sugar-laden foods and minimal interference. But it emphatically recommends that treats be relegated to structured times: meals and snacks. Accompanying candy with nutritious foods allows kids to satisfy their nutrient needs and hunger, reducing the likelihood that they’ll fill up on sweets.

photo by Claire Hugron

Having a nourishing meal before your child heads out trick-or-treating is particularly important and pumpkin black bean soup fills the bill.The black beans, which are pureed and hardly recognizable, make it a hearty dish. Prepare the soup ahead of time and serve with cut-up veggies and a whole wheat baguette.

The amount of seasoning in this soup may be overwhelming for small children’s sensitive taste buds. If that’s the case, use half the amount of pumpkin pie spice mix while sauteing the onions and garlic. You can always add more, if it needs more zip, as the soup is simmering. Pumpkin pie spice mix can be store-bought or homemade. If you don’t have it on hand, here’s a recipe.

Pumpkin Pie Spice Mix

makes 2 1/4 tablespoons

1  tablespoon (15 ml) ground cinnamon

1 1/2 teaspoon (7 ml) ground ginger

3/4 teaspoon (3 ml) ground allspice

3/4 teaspoon (3 ml) ground nutmeg

1/2 teaspoon (2 ml) ground cloves

Pumpkin Black Bean Soup

serves 6

What you need:

3  tablespoons (75 ml) olive oil

1 small red onion, diced

2 garlic cloves, minced

2  tablespoons (30 ml) pumpkin pie spice mix

1/2  teaspoon (2 ml) red pepper flakes

1/2 teaspoon (2 ml) ground black pepper

4 cups (1 litre) vegetable stock

1 - 14 ounce (398 ml) can diced tomatoes

1 - 28 ounce (796 ml) can pumpkin puree (not pumpkin pie filling)

1 - 19 ounce (540 ml) can black beans, rinsed well and drained

balsamic vinegar (optional)

sour cream or creme fraiche (optional)

What to do:

In large saucepan, heat olive oil on medium-low. Add onions and saute for about two minutes. Add garlic, pumpkin pie spice, red pepper flakes and black pepper. Stir well to combine all ingredients and continue to saute for another two minutes. 

Add vegetable stock, diced tomatoes, pumpkin puree and black beans. Stir to combine ingredients then raise heat to medium-high, cover and bring to the boil. Once at the boil, reduce heat to low and simmer for 20 minutes, stirring occasionally. Taste and adjust seasoning accordingly; salt may be needed if low-sodium veggie stock is used.

Uncover and carefully puree soup with a hand-held blender or regular blender. If using the latter, puree soup in three-cup batches, covering blender lid with a dish cloth to prevent hot liquid splashes.

If the consistency of the soup is too thick for your taste, add water to thin it out. Before serving, add a few drops of balsamic vinegar and top with sour cream or creme fraiche, if using. 

For more information about Ellyn Satter’s philosophy on feeding children, visit right here.

published in the Vancouver Courier, October 28, 2011

Learning to slow down

Recently I had dinner with my 22 month-old godson, Callum. Leftover spaghetti was on the menu and as he ate I couldn’t help but notice how much he savoured every fist-full of pasta. While there was spaghetti everywhere, there wasn’t a trace of guilt or shame to be found. And once Callum had enough, he pushed the bowl away and smacked his lips – he was done. For him, the party was over.

Watching Callum reminded me that all of us are born with that same innate wisdom about food and our bodies. As we grow older, though, some of us retain it more than others. Living in a health-conscious and appearance-obsessed society takes its toll: we can lose touch with our joie de vivre and our body’s internal cues. 

Dr. Brian Wansink, a food psychologist at Cornell University , would agree. Wansink , who is also the author of Mindless Eating: Why We Eat More Than We Think, believes we’re particularly lousy at listening to our fullness cues. Many of us don’t stop eating unless we’re physically uncomfortable.

Wansink proposes that our fullness cues are influenced by how much we chew, taste, shallow, think about food, and how long we spend eating. 

We are a nation of fast eaters. One study described by Wansink revealed that if we’re eating lunch alone, we spend only 11 minutes eating in a fast food outlet, 13 minutes in a workplace cafeteria, and 28 minutes in a moderately priced restaurant. This is bad news considering it takes 20 minutes for our stomachs and brains to realize we’ve had enough.

According to Wansink, most of us decide how much we’re going to eat before we even begin. We eyeball how much food we think we want, dish it out, and then eat until our plate is empty. Instead of relying on our body signals, the empty plate becomes our cue to stop.

After conducting countless studies, Wansink strongly believes our bodies have only three main internal cue settings: “I’m Starving”; “I’m Full but I Can Eat More”; and “I’m Stuffed”. 

Within the “I’m Starving” mode, there is a bottom level to our internal cues where, past a certain number of hours, we don’t experience hunger pains any differently. Whether we haven’t eaten for 8 hours or for 18 hours, we feel equally hungry. (Although I believe we would most likely experience other physical symptoms such as low energy and poor concentration as time went on without food). The “I’m Stuffed” setting contains our internal cue ceiling, beyond which we can’t continue to eat without experiencing physical pain. 

Between these two extremes lies the grey zone, the “ I’m Full but I Can Eat More” category, which Wansink feels requires most of our attention. This is where we can always find room for more food even though we’re close to our fullness ceiling. How many times have we found space for dessert after a filling main course?  

One of the most practical ways we can respond to Wansink’s findings is simply slowing down. The truth is the faster we eat, the more we eat. We need to give our bodies a chance to acknowledge its satiety. As much as possible we should set aside at least 20 minutes to eat a meal and 10 minutes for a snack. And just like Callum, we should try to savour every fist-full of food.

Coconut oil requires caution

Last week I was enjoying lunch with friends when the topic of conversation turned to coconut oil. One of my diet-conscious mates was describing a dish she recently prepared using the tropical fat. Everyone at the table was terribly impressed; what a healthy alternative to canola oil or olive oil. To say that I didn’t share my friends’ enthusiasm is putting it mildly.

For some time now, the subject of coconut oil has been setting off my crap detector: an intuitive device that’s been honed from years of observing the worthy-of-consideration to downright ludicrous trends in food and nutrition. 

When I began my undergraduate nutrition degree in the early 1980s, coconut oil and the other tropical fat, palm oil, were well established as the beloved fats of food manufacturers. Their creamy texture, long self-life and low cost made them ideal for producing highly-processed foods.

But by the end of that decade, about the time I started practicing as a dietitian, tropical oils experienced a major fall from grace. Nutrition research revealed that these fats were linked to elevated blood cholesterol levels and, as a consequence, could increase our risk of developing heart disease. 

Now, more than 20 years later, coconut oil can be found in many natural and health food stores where shop owners ask a pretty penny for products that claim to cure a plethora of health ailments.

Most of the positive health effects associated with coconut oil are based on anecdotal evidence; there isn’t a lot of published research. But we do know that the once-held belief that saturated fat--whether from animals or tropical oils--raised blood cholesterol levels and increased our risk of heart disease, isn’t entirely true.

Today it’s clear that the effects of saturated fat on blood cholesterol levels varies from person to person. Genetics, body weight, gender and lifestyle (such as diet, exercise, alcohol consumption and tobacco use) need to be taken into consideration.

photo by Valentyn Volkov via istockphotos.com

According to Dietitians of Canada, there is some scientific evidence that consuming coconut oil doesn’t raise our total and low density lipoprotein (LDL) cholesterol levels to the same extent as butter. However, coconut oil may increase our blood cholesterol levels to a greater extent than vegetable oils. 

All fats and oils, whether we’re talking about olive oil, butter, walnut oil or coconut oil, are comprised of a mixture of saturated and unsaturated fatty acids. While coconut oil is a highly saturated fat, it doesn’t appear to worsen or improve cholesterol levels in most people. 

This finding is supported by epidemiological studies that show people who consume high coconut fat diets--such as Polynesians--tend to have low cholesterol levels.

Although adding moderate amounts of coconut oil in the context of a healthy diet is unlikely to significantly affect our heart health, we still need to practice caution; this fat’s effects on cholesterol aren’t fully understood.

So far there’s absolutely no scientific proof that coconut oil strengthens our immunity, improves digestion, gets rid of acne, or prevents heart disease, arthritis, and other chronic diseases. 

Compared to other fats, the body uses a few more calories to process the tropical oil because of its chemical structure. But any calorie-burning effect is minimal at best; coconut oil is by no means a weight-loss aid.

published in the Vancouver Courier, October 21, 2011