Canadians Who Care About Science Might Not Want To Vote NDP

I have to admit, I found this story jaw dropping.

The federal NDP health critic, Don Davies, is opposed to plans geared to rein in the wild, wild, west of natural health products and supplements that prey on desperate Canadians.

The proposed regulations are meant to require, gasp, that natural health products have evidence to prove they’re both safe and effective before they’re allowed to be sold.

In the CBC story, Davies even parroted the common line that it’s too expensive for supplement makers to conduct studies to prove their products work. That statement contrasts poorly with the other one he gave in the same article where he reports the natural health industry enjoys $12 billion in Canadian revenue and $2 billion in exports.

But even were it true, that there’s a presumably want-to-be federal Health Minister arguing we shouldn’t require proof of safety and efficacy for products being sold to Canadians in the name of treating their medical conditions, for anyone who cares even an iota about science, should be a non-starter.

And it gets worse.

Davies, in trying to push his post-science world view, was encouraging people to sign a petition developed by the Health Action Network Society (HANS), a Vancouver charity with a history of spreading anti-vaccination claims, but they themselves noted that they were not working with him directly.

Shame, shame, shame, indeed.

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Let’s Stop Using The Terms “Healthy Weight” And “Normal Weight”

Words matter, and your weight cannot determine whether you’re “healthy“, or “normal“.


Firstly, scales don’t measure the presence or absence of health, and so the term “healthy weight“, means literally nothing.

Secondly, the CDC defines a “normal weight” as one giving a person a BMI between 18.5 and 24.9 yet if we were using the word normal correctly, it would differ by country and would reflect its population’s mean BMI. So in Nauru for instance normal weight would be a person whose BMI was 32.5, whereas in Eritrea it would be someone whose BMI was 20.5. Given mean BMIs in the US and Canada are 28.8 and 27.2 respectively, in North America, it should be considered abnormal to have a BMI between 18.5 and 24.9.

So what could we use instead?

Risk based terms.

Weight, though not a guarantee for any medical problem, does increase the risk of many, and so I’m proposing that rather than terms which confer judgment, we categorize weight as low-risk, medium-risk, and high-risk, and by doing so we’ll stop the erroneous use of healthy and normal terminology that constantly and insidiously promotes weight bias, shame, and stereotype.

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Saturday Stories: Crane Wife, Domestically Violent Cops, and Brain Boosting

CJ Hauser, in The Paris Review, with the crane wife.

Kyle Hopkins, in Propublica, on the village where every cop has been convicted of domestic violence.

Kaitlyn Tiffany, in Vox, on brain boosting.

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If There Were Quick, Easy, Flying Leaps That Lasted, You’d Have Already Taken Them

The saying is that long journeys begin with first steps, not flying leaps, and if there were flying leaps that routinely led to lasting change, you’d have already taken them.

It’s a straightforward message, but when applied to weight management, diet culture regularly asks us to ignore it.

The inconvenient truth of healthy living is that it will certainly require effort.

Yes, there are likely those who will succeed by changing everything all at once, but for most, slowly building and layering change, and respecting the fact that their roads will absolutely also see their share of disappointments and setbacks, is the way to finally get somewhere.

Your first step might be as small as losing one restaurant meal a week in place of cooking, or trying to reduce your sugar sweetened beverages by 50%, or actually scheduling a day to buy, or a service to deliver, weekly groceries, but if you choose steps you can actually accomplish without suffering, you’re more likely not to fall, which in turn, will help keep you moving forward.

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The Clinical Importance Of The Limbic Dump

This week I am speaking at the LATAM Obesity Summit in Santaigo, Chile, where I again had occasion to hearing my Canadian colleague Michael Vallis (Halifax), speak about behavioural change. In his talk, he discussed an important strategy in counselling patients, whch he referred to as the “limbic dump”. As readers will know, the limbic system is responsible for holding our emotions – anxiety, fear, apprehension, disappointment, frustration, but also, joy, optimism, anticipation, motivation. In a classical doctor-patient encounter, the doctor generally focusses on analysing the problem (making the diagnosis) and giving advice (providing treatment) – both are functions that largely rely on the cognitive or “logical” part of our brains. The general idea is that, the doctor will provide rational information and advice to the patient, and the rational part of the patient’s brain will take in this advice and “follow instructions”. Unfortunately, in most situations, this “rational” approach is overriden by the limbic or “emotional” part of the patient’s brain, which is far too busy dealing with feelings (shame, fear, anxiety, disappointment, frustration, etc.) to take in the “rational” information that is being provided. This is where the “limbic dump” comes in. As Vallis points out, before getting into the “rational” part of any encounter, it is far more useful to begin by allowing the patient to first “dump” their concerns (or successes) on the table. Once these are out in the open, have been duly acknowledged, and discussed, the conversation can move on to the more “logical” transactional part of the encounter. Now, after the “limbic dump” you actually have a patient who is able to listen to what you have to say. Of course, all experienced clinicians probably already know this. I, for one, generally start any patient encounter with an open ended question as to how the patient is feeling about how things are going. This gives them the opportunity to “dump” their feelings on the table – positive or negative. Only after acknowledging these (sometimes prompting them for details), do we move on to the more objective part of the encounter (I’m a big believer in motivational interviewing, so generally, I let my patients do most of the talking). Now, thanks to Vallis, I have an explanation and term for what I have been doing all along – long-live the “limbic dump”. @DrSharmaSantiago, Chile

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Saturday Stories: Running While Fat, Running While Female, And Frustrating, Confusing, Israel

Kate Brown, in Runners World, on running while fat.

Cara Harbstreet, in Human Parts, on running while female.

David Horowitz, in The Times of Israel, with an incredibly insightful interview with Matti Friedman with some background on how and why for many, Israel may baffle or infuriate.

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Why You Should Turn Off Your TV And Holster Your Devices Before You Eat

Ok, it’s a short study and it relied on dietary recall, but if taken at face value, the results certainly suggest you should be turning off your devices and eating away from the TV.

The study involved the 3 day recall of both diet and media use among 473 individuals.

Plainly, researchers found that meals that were consumed along with some form of media distraction contained 149 more calories. They also found that people consuming those extra calories at a media meal did not compensate by eating less at their next meal.

Given how easy it is to do this, and how by doing so you might even strengthen some interpersonal relationships by eating with friends or family around a table, you really have almost nothing to lose by trying, except perhaps a few calories.

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2nd International Symposium on Obesity Mechanisms, Leipzig 2019

For the past 10 years, I have had the rather exclusive privilege of being on the External Advisory Board (which I have chaired for the past five years) of the Integrated Research and Treatment Center (IFB) AdiposityDiseases, a multi-million Euro a joint research and clinical center of the University and the University Hospital Leipzig – sponsored by the German Federal Ministry of Education and Research. This funding period has now come to term (although obesity research will remain alive and kicking in Leipzig) and the 2nd International Symposium on Obesity Mechanisms, marks an important celebration of this milestone. The three-day symposium, at which I will be presenting the Key Note Lecture, is held in collaboration with the DFG-funded SFB1052 and focuses on central obesity mechanisms, brain periphery crosstalk, adipose tissue heterogeneity, adipokines, and the clinical consequences of obesity.  The findings and publications emanating from this research consortium over the past decade are far too numerous to mention in this post (publications appeared in the New England Journal of Medicine, The Lancet, Cell, Nature, Nature Medicine, and other top international journals). As Matthias Blüher remarked in his opening address, many of these findings are now finding their way into translational research, including the testing of novel anti-obesity compounds and behavioural interventions based on findings from neuroimaging studies. I, for one, have very much enjoyed being associated with these important efforts here in Leipzig and look forward to continuing involvement in the exciting work that continues to advance our understanding of this complex chronic disease. @DrSharmaLeipzig, Germany

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Saturday Stories: Suicide, Goop, Vaccines, And Kurbo

Connie Schultz, in Creators, on what to say (and not say) to someone whose loved one has died by suicide.

Amanda Mull, in The Atlantic, on what Goop really sells.

Richard Conniff, in National Geographic, on the world before vaccines.

[And if you don’t follow me on Twitter or Facebook, here’s my take on Weight Watcher’s new kids Kurbo app and how while Weight Watchers might know kids aren’t likely to lose much weight, do the kids?]

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The Rewards Project – A Registered UK Charity Geared At Putting An End To Sugary School Rewards

So it’s back to school time, and zero doubt, many of your kids are going to have teachers and schools who will use candy and junk food as a reward.

It’s a shame too, not just because they’ll be providing your kids with junk, but also because they’ll be teaching them, over and over and over, that junk is a reward for anything and everything.

I’ve written before about easy non-junk food rewards for teachers, I’ve also written about how you might want to approach things with your kids’ sugar pushers, and I even kept track one year of just how much junk other people were offering my kids. What was clear from the response to all of these pieces was just how prevalent this problem was, and just how frustrated parents are.

Well as a sign of those times, in the UK, a new charity has popped up called The Rewards Project and its mission is trying to change this common practice. Click through and you’ll find some sample letters to send to your child’s school (though I think they’d be much better were they to offer some alternatives and suggestions in them and as I wrote about and linked above, lead with praise for the school and its teachers).

All this to say, if there are charities popping up geared at tackling this issue, clearly there’s a real appetite out there for change. In turn this suggests – and my experiences with my kids’ schools and more would definitely support this notion – that your kids’ schools and teachers might be more open to changing things than you might think.

You’ll never know unless you try.

(Thanks to Dr. Miriam Berchuk for sending this my way)

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