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Honourable Leona Aglukkaq
Minister of Health
House of Commons
460 Confederation Building
Ottawa, Ontario
K1A 0A6
Dear Minister Aglukkaq,
MY NAME IS YONI FREEDHOFF and I'm a physician located in Ottawa with special interests in nutrition and in public health advocacy.
I'm writing you today with regard to trans-fat.
As I'm sure you're aware, on June 20th, 2007 your predecessor Tony Clement ignored the recommendations of the Government's own Trans-Fat Task Force that called for the immediate regulation of trans-fats and instead announced,
"Today industry is being given notice they have two years to reduce the levels of trans fats or Health Canada will regulate their use."
So how did the food industry use their two-year free pass?
Not well.
Sally Brown, Chair of Canada's Trans-Fat Taskforce reports,
"Although some companies and sectors have stepped up to the plate and done well, overall the food industry is not sufficiently reducing trans fats voluntarily."
What else has happened over the course of the past two years?
And of course it's not as if Health Canada is incapable of bans on dangerous chemicals. Here's Health Canada's rationale for the banning of bisphenol-A from baby bottles,
"We have immediately taken action on bisphenol A, because we believe it is our responsibility to ensure families, Canadians and our environment are not exposed to a potentially harmful chemical."
Yet in that same press release Health Canada stated,
"The scientists concluded in this assessment that bisphenol A exposure to newborns and infants is below levels that may pose a risk"
And just last week Health Canada announced a ban on six phthalates compounds that the most recent comprehensive review article notes,
"Analysis of all of the available data leads to the conclusion that the risks are low, even lower than originally thought, and that there is no convincing evidence of adverse effects on humans. Since the scientific evidence strongly suggests that risks to humans are low, phthalate regulations that have been enacted are unlikely to lead to any marked improvement in public health."
Contrast those actions with the inaction on trans-fat, a compound that head of the Trans-Fat task force has stated is,
"a "toxic" killer that need to be removed from the food chain as soon as possible"
where,
"the longer we wait, the more illness and in fact death will happen, so we know we have to get it out of our food supply"
and that,
"there is no safe amount of trans consumption"
Superficially it would appear to me that Health Canada only tends to leap into action on matters that are politically palatable.
If it truly is Health Canada's
"responsibility to ensure families, Canadians and our environment are not exposed to a potentially harmful chemical"
Why then is trans-fat still on Canada's store shelves?
Two years is two years too many. Minister Aglukkaq, how many more thousands of Canadians need to die before Health Canada takes real action?
Sincerely,
Dr. Yoni Freedhoff, MD
Medical Director, Bariatric Medical Institute
575 West Hunt Club, Suite 100
Ottawa ON K2G5W5
IN MORE THAN 20 YEARS OF MEDICAL PRACTICE, I have yet to meet a patient who chose to be fat. I have also yet to meet a patient who chose to have diabetes, wished for a heart attack or longed for cancer. But while we often look at diabetes, heart disease or cancer as the result of bad genes, bad luck or both, most people attribute obesity to simply making poor choices. Why can't people with excess weight just push away the food and get off their butts? Why should the community pick up the tab for obese people's health problems resulting from gluttony and sloth?
Obesity is a disease that, like diabetes, heart disease or cancer, has a complex causation (genetic, physiological, lifestyle, environmental etc.). The underlying causes and paths to obesity are manifold — no one is immune. A change in economic status or activity level (due to aging, injury or illness), an introduction of a weight-promoting drug for an illness, becoming pregnant, or moving to a less walkable community can result in obesity.
Few recognize or acknowledge the close relationship between mental health and eating behaviour — whether causal as in the form of depression or addictions or as a major barrier to treatment as in attention deficit disorder or chronic pain. For many, eating is the easiest and most affordable means of coping with stress, anxiety, boredom, loneliness, isolation, abuse, despair and frustration. Fast food is not the cause of obesity — it is merely a symptom of a society that does not take time to eat.
Whatever the cause, once established, obesity becomes a chronic condition for which we have no cure — only treatments. Whether the treatment consists of behavioural interventions such as dieting or exercise, prescription anti-obesity drugs, or even surgery, when the "treatment" stops, the weight comes back. Thus, the dieter has to keep dieting, the runner has to keep running, the bypassed stomach has to stay bypassed — for life. The folks who believe the solution to obesity is as easy as "eating less and moving more" are probably busy counting the fortune they made on the stock market by "buying low and selling high."
Thus far, no society has found a way to stop or reverse the obesity epidemic. It appears fundamentally tied to our lifestyles — high stress levels, no time for families to sit down to meals, abundant supplies of cheap, highly palatable, energy-dense foods, automation and elimination of physical activity from our homes and workplaces, dependence on powered transportation instead of our feet. Are any of these conditions likely to be reversed in the foreseeable future? Probably not.
So where do people trying to control their weight go for help? The commercial weight-loss industry, while often promising solutions that sometimes defy scientific rationale, does little to help. This is because the only weight loss that matters is the weight you keep off — too little (if any) with most products and programs. Unfortunately, too many health professionals also do not understand obesity; they offer advice that is useless, expect the impossible from their patients, fail to acknowledge root causes, or ignore the barriers to treatment.
It is becoming increasingly evident that addressing obesity requires the same resources and paradigms as treating other chronic diseases such as diabetes, asthma or heart failure. The same principles apply — education, lifestyle change, self-monitoring and, in severe cases, prescription medications or even surgery. As with all chronic conditions, treatments have to be continued for life — patients need regular checkups, encouragement and guidance to avoid recidivism or progression of the underlying condition.
All of this will require money — money that the health care system cannot afford not to spend. Not addressing obesity today means addressing the complications of obesity tomorrow. If we do not prevent, control and treat obesity today, we will never have enough diabetes centres, heart hospitals, cancer wards or orthopedic clinics to deal with the multitudes of patients disabled and defeated by obesity.
Many organizations such as the federally funded Canadian Obesity Network are working toward finding solutions to prevent obesity and improve the care of those suffering the consequences of excess weight. But solutions to obesity will require the same public support, political decisions and health-care resources as targeted at other conditions such as diabetes, cardiovascular disease or mental health.
We have a lot to lose — but, fortunately, far more to gain.
:: Arya Sharma is a professor of medicine and chair for obesity research and management at the University of Alberta.
by Peter Janiszewski, MSc, PhD Candidate Peter is a PhD candidate in the School of Kinesiology and Health Studies at Queen's University. For more health and fitness news, visit his website at obesitypanacea.com
IN PAST POSTS, I have discussed the numerous reasons why high fructose corn syrup (HFCS) is a substance worth avoiding — first and foremost, it is a key player in the obesity epidemic, contributing hundreds of calories (but no nutrients) to many of society's favourite foods (Fluff is my personal favourite). But now it turns out that the negative effects of HFCS are even more far-reaching than I had thought. I am not speaking about the recent reports that HFCS may be tainted with mercury (detailed here by Darya Pino at Thought for Food), although that is also very frightening. No, according to the interesting new book Fruitless Fall by Rowan Jacobsen, HFCS also plays an important role in the recent decline in worldwide honey bee populations, a situation which Jacobsen suggests will have a dramatic impact on our ability to produce enough fresh fruit to feed ourselves in the coming years.
Historically, honey bees collected pollen and nectar from plants, providing them with both the protein and carbohydrates that they need to live healthy, productive lives. However, in recent years beekeepers have begun feeding bees HFCS as a way to maintain their energy stores in the winter. As I mentioned earlier, HFCS is full of calories, but devoid of protein or other nutrients. Thus, bees whose diet consists mostly of HFCS are nutrient deprived, resulting in weak immune systems, hives that are riddles with viruses (Jacobsen describes it as a scenario similar to bee AIDS) and the eventual collapse of the entire hive. Although HFCS is not the only major problem afflicting modern bee populations (pesticides and less than ideal living conditions also play important roles), Jacobsen suggests that HFCS plays a key role in the recent collapse of bee populations across North America.
Why does this concern us, and how does it relate to obesity? Well, it turns out that commercially raised honey bees are responsible for pollinating a massive proportion of our food supply, including pretty much all our fruits and berries (including the fruit that we tend to think of as vegetables), and thus without bees, our food supply will shrink dramatically. Many people (myself included) are urging people to eat a more healthful diet higher in plant-based foods — that's going to be much harder, if not impossible, if fruit supplies go down the tubes. If Jacobsen is right, this is an issue which won't just affect obesity rates (although it undoubtedly will, one way or the other), but the ability of society to provide itself with nutritious food.
So let's recap. High fructose corn syrup is unequivocally bad for people — the best thing that anyone can say about it is that it is no worse than table sugar, which is hardly a ringing endorsement. It may contain mercury, which is obviously a bad thing. And it may be contributing to an epidemic among a species of animal which we are completely dependent upon for nearly all of our fresh fruit. Why is this stuff being produced at all???
Are you kidding me?! Health Canada weighs fortifying junk foods
HEALTH CANADA IS PROPOSING to let manufacturers add vitamins and minerals to a wider range of products including cookies.
Health Canada wants to allow food manufacturers to add nutrients to a wider variety of foods, including junk food — a proposal that has some health specialists worried.
Canada has mandatory fortification programs to add vitamin D to milk and folic acid to flour, but the new proposal to allow discretionary fortification has some critics concerned that companies will sell junk food such as cookies and chips with vitamins or minerals added as a healthy alternative.
"I think it's just an advertising ploy and gimmick with no health benefit whatsoever," said Dr. Tom Ransom, an endocrinologist and obesity expert with Capital Health in Halifax.
"My concerns are people might be avoiding healthy foods because they think, 'Now I don't need my apple a day, I can have a chocolate bar a day.'"
The industry group Food & Consumer Products of Canada released a report recently calling on the federal government to speed up its two-to-five-year decision-making process for food additives and health claims.
"We're not looking here at all for less regulation," said Nancy Croitoru, president and CEO of the trade association representing companies that manufacture food and consumer products.
"What we're looking for is smarter regulation so that we can really provide Canadians with the healthy products that are now available out there."
Health Canada's website said focus group participants did not suggest people would increase the amount of junk food they eat as a result of added vitamins.
The department said the change would increase nutrients in the food supply. Food companies could market enhanced products as good or excellent sources of the added nutrient, while consumers would be protected from excessive vitamins and mineral nutrients in foods.
But foods with added nutrients, mineral or bacterial cultures would not be a good source of nutrition for a society already struggling with an obesity epidemic, Ransom said. Adding vitamins does not remove fat or calories from the products.
Health Canada was expected to publish the draft regulatory changes for public comment weeks ago, but hasn't explained the delay.
Vanessa Williams, a high school student in Halifax, said she isn't sure she would eat a vitamin-enhanced version of the bag of cheese snacks she had for lunch.
"If it tasted the same, yeah, maybe," Williams said. "I guess if it is sort of better for you, you should probably go for that over Cheetos puffs."
WELL Read: Dumb Jocks No Longer Physical Activity is not only good for the body, but also for the brain
by Martin Collis
IN MANY WAYS I feel that it's frustrating that an article like this still needs to be written. Of course physical activity is good for the body and the mind. I wrote about this in the Summer 2003 edition of 'Well' where I featured the results of testing nearly a million California school children. Simply stated, in every grade tested the fittest children did best academically and the least fit children had the poorest academic scores. As I wrote 6 years ago,
“If it were something other than physical fitness that seemed to boost academic performance everyone would be clamoring for it. If it came in a package, if it was convenient, if it saved a few short-term dollars, if it was a quick fix, if it could be used as a fundraiser or perhaps if it was novel, high tech and trendy, the movers and shakers in education would be demanding its place at every grade level. But physical education is not new, the Greeks saw it as an integral part of a balanced education 2000 years ago and built gymnasia and palastrae where their boys and young men (they still had gender problems) could exercise and discover the harmony of body, mind and spirit and strive for 'arete' or excellence.” The Romans spoke of 'mens sana in corpore sano', a healthy mind in a healthy body.
Fifty years ago President John Kennedy wrote an article called “The Soft American” in Sports Illustrated, in which he said that physical activity was the “basis of dynamic and active thought” and we know he was right, but in the ensuing fifty years the average American has become softer and less active. Throughout the centuries, enlightened societies have realized that a key part of the human potential movement is movement itself.
We don't need what's new for our children, we need what's best, and in order to be at their best as fully functioning human beings, children need to be physically educated. They need a vocabulary of movement skills and they need physical fitness.
California Department of Education research on nearly one million students in grades 5, 7 and 9, correlating their fitness score, as measured by the six item Fitnessgram score, and SAT scores in mathematics and reading. (2002)
This article focuses on children, but the requirement for regular physical activity does not end with graduation, it is a life long necessity.
I was inspired to write after seeing a brief T.V. documentary about the impact of introducing a vigorous program of physical activity to the 19,000 students in the district of Naperville, Illinois. These students did not do some of the stereotypical gym activities such as dodge ball, volleyball and gymnastics, but instead worked on equipment similar to that found in a state of the art fitness club. (When I taught physical education, one of my guiding principles in creating a curriculum was to include activities which kids who didn't like phys. ed., would pay money to attend out of school. At the time this included marshal arts, jazzercise, yoga and strength training.)
In Naperville the fitness of their student body (an appropriate phrase) has been transformed by participation in daily fitness. In this program students don't compete against others, or try and reach arbitrary goals, but instead try to improve their personal activity intensity as measured by heart rate monitors.
When one group of Naperville sophomores was tested for body composition, 3% were overweight compared to the National average of 30%. Even more remarkable than their physical improvements, were the mental and academic performance which accompanied them.
READ THIS CAREFULLY
In 1999 Naperville's 8th graders were among some 230,000 students from around the world who took an international standards test called TIMSS (Trends in International Mathematics and Science Study) which evaluates knowledge in math and science. In recent years students in China, Japan and Singapore have outpaced American kids in these crucial subjects, but Naperville is the conspicuous exception: when its students took the TIMSS, they finished 6th in math and 1st in the world in science!!!
The preceding paragraph was quoted from the brilliant new book, “Spark” The Revolutionary New Science of Exercise and the Brain. “Spark” was written by John Ratey, M.D. of Harvard Medical School and shows the importance of exercise, not only as an academic stimulus, but also as a non pharmacological way of dealing with ADHD, stress, menopause, addictions, depression, anxiety and aging itself. Physical activity helps make you lean, it helps you learn and has a positive impact on the biochemistry of your body/mind.
In his book Dr. Ratey refers to physical activity as 'Miracle Gro' for the brain, which impacts not only the biochemical functioning of the brain but also its structure. The daily walk, your bike ride to work, some regular laps at the pool and work outs in the gym actually change the architecture of your brain. “The neurons in the brain connect to one another through 'leaves' on tree-like branches and exercise causes those branches to grow and bloom with new buds, thus enhancing brain structure and function at a fundamental level.” If there was any residual doubt about the relationship between cardio-vascular fitness and academic performance, it was put to rest when the results of testing 2.5 million children in Texas were released. Cardio vascular was measured by the standardized Fitnessgram test and academic performance by T.A.K.S. (Texas Assessment of Knowledge and Skills). The pattern we saw in California was repeated. Children with the highest cardio-vascular fitness, scored highest on TAKS, and as their cardio-vascular fitness declined, so did their TAKS score. These results should have been headlines throughout North American and yet among educational administrators there seems a reluctance to admit that the physical education programs they've been reducing and eliminating for the past few decades hold part of the answer to raising academic performance in schools.
Summary of Texas Youth Fitness Study Initial Results
Significant associations were consistently found between physical fitness and various indicators of academic achievement.
The results were controlled for the influence due to socio economic status, minority status and school.
The consistent relationships observed support the thesis that physical fitness is associated with academic achievement in school aged youth.
There was a strong association between measured fitness and school attendance.
Higher levels of fitness were associated with fewer negative school incidents.
What about Canada? More Smoking Guns
There has been no mass testing of students such as we've seen in California and Texas. However, there have been numerous initiatives by organizations and Provincial governments to encourage and support more active children. (Speakwell has been working with the BC government on school based pedometer programs.)
A school program in City Park Collegiate in Saskatoon created by 8th grade teacher Allison Cameron got the predictable wonderful results when she instituted daily vigorous physical activity for her students. Allison acquired treadmills, Dance Dance Revolution, elipticals and other fitness equipment. After four months there were significant fitness gains among students, a 5% decrease in BMI (reflecting fat loss) and jumps in academic performance, which would warm the heart of teacher, student, parent and administrator alike. The average measureable gain in language arts was over 30%, while math scores improved over 17%.
More information about the City Park program and results can be found at:
In summarizing thinking about exercise and the brain, it's fun to read an informal blog from the school.
How Exercise Promotes Learning
The First Way
The first big reason that exercise is very important for (students at City Park Collegiate in Saskatoon) is that it helps address the systems of the brain; the attention system, the impulse control system, the memory and learning system and the part of the brain that's involved with learning and memory, the part of the brain that's the executive functioning area of the brain, or the frontal cortex. Exercise activates this area of the brain. So what you get, are people who are sharper. They're more attentive, they're less impulsive, they're less fidgety. They can sustain their attention longer, and it promotes their ability to sort through information and take it in.
The Second Way
The second big way that exercise works on the brain is it promotes the internal environment of the brain, of our hundred billion nerve cells that are swimming around in this soup, if you will. Exercise causes a release of all kinds of good things that are known as neurotransmitters, as hormones, as growth factors that actually makes our cells more ready to do their job. And our brain cells' major job, in terms of learning and memory, is to change - adapt we call it. And that means grow. Exercise promotes the best optimal environment for us to do this, to change and grow.
The Third Way
The third way that exercise helps with learning and with brain growth, is it promotes a process which we call neurogenesis, or growing new brain cells. There's nothing that we know of, that does this better than exercise.
Conclusion
So three ways help the learner learn better. We improve the environment for the cells to grow and change and cement in the information. And we also add more brain cells specifically in the area of the brain that has to do with learning and memory, an area called the hippocampus, which we think of as Grand Central Station for memory. And this is the area that adds cells every day. When we learn, we add more cells, but when we exercise, we add many, many more cells. Exercise is the best stimulus for the brain to be ready to learn and grow. Now the biggest problem with our new world, with the cyberworld, is it allows us to sit. We are a sedentary culture. The top ten reasons why we die are contributed to greatly by our sedentary living. Also, by not moving, by sitting, our brains are not as active, and they start to erode much quicker. For instance, if middle-aged people are sedentary, and they begin to exercise three to four times a week, they can stave off cognitive decline later in their life by ten to fifteen years. Some studies suggest that if they do this, they will cut the risk of Alzheimer's disease in half, just by regular exercise. Now for our kids. It's even more important that they try to optimize their brains as much as possible, so that they can be better adjusted and ready to take on the new information that they are presented.
There is no better start to anybody's day than brisk physical activity.
'If your brain feels flabby, check out your legs.'
by Dr. Arya Sharma
by Peter Janiszewski, MSc, PhD Candidate
But foods with added nutrients, mineral or bacterial cultures would not be a good source of nutrition for a society already struggling with an obesity epidemic, Ransom said. Adding vitamins does not remove fat or calories from the products.
