Tuesday, August 21, 2012

Guiding Stars: Useful Nutritional Tool?

After a short test run last year at a few stores in Toronto, Loblaws, (Canada's largest grocery chain) has rolled out the "Guiding Stars" nutritional rating system at it's Ontario branches.

Guiding Stars is a program that scores food based on it's nutrient content using a scientific algorithm (here) that grades food on a credit/debit system.  Food score more stars for containing vitamins, minerals, fibre, whole grains and omega-3 fats. They lose stars for containing saturated fat, trans fat, added sodium, or added sugars.

A given food can obtain a maximum of 3 stars (best). The worst score is zero stars.

Guiding Stars has been present in the U.S. since 2006, but only recently began in Canada last year. For Canadians, the guidelines differ slightly than Americans, as the algorithm must align with Health Canada and the Canadian Food Inspection Agency.  For the most part, foods are very similarly rated, with one interesting exception. Canada has decided NOT to use cholesterol as a nutrient to avoid in its rating system, whereas the U.S. has. This was based on a Canadian paper published in 1990, where a scientific committee did NOT set an upper limit for cholesterol, and has not updated things since! (This needs to get updated NOW!)

The Essentials
Foods are broken into 4 categories.

  1. General Foods and Beverages
  2. Meats/Poultry/Nuts/Dairy/Seafood
  3. Fats/Oils
  4. Infants/Toddler Foods
Foods are then broken down into standardized 100kcal portions so that they can be equally compared side by side. Percent Daily Value is then calculated based on a 2000 kcal diet.

A score is then assigned by giving credits for nutrients to encourage and subtracting points for having nutrients to avoid present. The number of stars is then displayed for easy consideration.

The program is not intended to tell you what to purchase, but rather "guide" you to more nutritious choices.

Loblaws has taken this campaign one step further by offering dieticians in several locations to review the system and help consumers with their choices.

Is It A Good System?
Overall, I think the Guiding Stars algorithm is sound. A bit simplistic, but certainly something to point people in the right direction. More importantly, as an independent agent, I give them more credit than other systems like Health Check, where criteria are not nearly as stringent, and much more biased. and can be bought.

What do you think?
Do you use this, or other rating systems at the grocery store to influence your buying?

Sunday, August 19, 2012

Did I Rupture My Achilles Tendon?

I had an interesting case hobble into the clinic yesterday. An 87 year old man tells me he awoke one morning with some pain in his left foot. He swears up and down that he didn't injure it in any way, but he now can't walk on it normally. Sure enough, as I watch him come down the hall, he's moving, but only with the assistance of heavily leaning on his cane. I know this guy and he usually can move better than this.

After some gentle examination, his left calf is certainly a bit swollen, and there appears to be a gap in his Achilles tendon. I ask him to get up onto his tiptoes, and he has no strength to do so. A few other physical tests confirm my thoughts, and a diagnostic ultrasound confirms a complete rupture of the tendon!

How Does The Achilles Tendon Get Torn?
This example is certainly the exception to the rule.  The Achilles tendon is the connection between the calf muscles (gastrocnemius and soleus), and the heel bone (calcaneus). It helps the foot push off the ground when running or jumping. When it is torn, therefore, people can't get up on their tip-toes with any strength.

The classic history is a middle aged person playing a sport where quick movements or explosive jumping is involved like sprinting, basketball, tennis or squash. The person will often feel like they've been hit or shot in the back of the leg, and often either blame their playing partner for hitting them or look for the object that "hit" them. The event is usually sudden and therefore very memorable. The examination is also usually fairly straightforward with an obvious gap in the tendon, and no passive motion of the foot when testing the calf. The diagnosis is usually then confirmed by diagnostic ultrasound.

One other uncommon, but not unheard of cause is from taking quinolone antibiotics, of which Cipro is best known.

How Do You Fix It?
Generally speaking, there are TWO options - surgical or non-surgical.

Surgical management essentially sews back the two ends repairing the connection. The risks include bleeding, infection and a small risk of re-rupture in the range of 4-5%.

Non-surgical management involves wearing a boot cast with the foot slightly plantarflexed (toes pointing down) for 6-8 weeks. This allows the torn ends to come into contact with each other and heal while immobilized. Benefits are that one avoids surgery, but the risk of re-rupturing the tendon is significantly higher, in the range of 10-15%.

One should never generalize, but "generally speaking", I recommend surgery for younger athletes, and those who are going to go back to explosive type sports. For older athletes (ie over 40), I try to guide them towards non-surgical management, as the outcome is still quite good (ie 85-90%), and only go to surgery if this route fails.

Have you every torn your Achilles?
How was it managed?
Let me know!

Tuesday, August 14, 2012

Does Bribing Your Kids Help Get Better Grades?

One of my favourite "pop" economists is Steven Levitt. He is a professor of economics at the University of Chicago Booth School of Business, but is probably better known for his book, Freakonomics.

Recently, he posted a blog and podcast discussing his field research into bribing kids to try harder on tests at school. Financial incentives are nothing new, but a working paper he published in September, 2011, revealed some interesting results.

The Summary.
A total of 6,500 students in the Chicago area were involved. The students, prior to a standardized low stake test, were offered a reward (either financial, or non-financial, like a trophy or toy), just prior to taking the test. The reward would be given out immediately following the test, if improvement was shown from previous baseline testing. The control group was told nothing. In an added twist, a "loss condition" group was actually handed the reward (ie. cash or trophy)  before writing the test and had it sit on their desk while they wrote. It was taken away from them if they did not improve their mark, versus the reward group receiving their reward upon completion and improvement.

The experiment also was conducted with a delay arm, giving the reward out 1 month after testing versus no  reward. Finally, the results were analysed based on age of student, arbitrarily divided into younger children (grades 2-4) and older kids (grade 5-8).

Results were interesting. For younger children, non-financial rewards were just as effective as cash. However, in the older group, cash was king, with no benefit seen for trinkets and trophies, or even lower dollar amounts ($10 vs $20).

Most interesting though, was the "loss" group had the most significant impact. Students who were given cash prior to testing with the potential to having it taken away saw the biggest improvement.

Conclusions for Real Life.
This is pretty intriguing. Levitt's study seems to show that getting the most bang for your buck is to actually give your child a reward for doing their best on a test (ie. getting an "A" or whatever goal you designate), but adding the caveat that if they don't achieve it, the reward gets taken away.

I don't think I could be that cold-hearted, but it makes me rethink offering a little something for working a little harder.

Well, this should open up a can of worms.
What do you think?
Do you offer any rewards for tests at school? How about sport?
Does this research make you want to change your tactics?
Let me know!

Sunday, August 12, 2012

Do Nike Volts Make You Faster?

Pop Quiz Time. Who was the official shoe sponsor for the London 2012 Olympics?
Answer: Adidas. You'd be forgiven, given the exposure on the track if you'd guessed Nike.

Despite Nike not putting up the sponsorship dollars to become an "Official" Partner of the Olympics, the company has again managed to be the most prominent company of the Games. In almost every race on the track, at almost every medal ceremony, and every jump on the field,  neon yellow feet could be seen.

In a brilliant marketing move, every Nike athlete was kitted out in the same coloured shoe. Whether they were wearing the Flyknit, the Zoom, the Superfly, or any other Nike shoe, the colour was an eye-catching "Volt" - a fusion of neon yellow and lime green which jumped in contrast against the reddish-brown track.

Adidas paid 80 million pounds ($125 million CDN dollars) for the honour of being the official athletic sponsor, and the marketing department must be kicking themselves. Nike spent zero dollars, other than coming up with a simple, but brilliant idea of unifying their look for the Games.

So, does the Volt make you faster?

As in previous posts (Shoe Advice), it's more about the right shoe for your foot type. If the colour makes you feel faster, maybe. Otherwise, get what feels best for you, and don't worry about the flash.

Let's see what happens in Rio 2016, when the shoe is on the other foot and Nike becomes the official sponsor and Adidas is sitting on the sidelines. Let the marketing games begin!

What do you think?
How much does marketing hype influence you in athletic purchases?
Let me know.

Sunday, August 5, 2012

We Should ALL Have Bicycle Helmet Laws.

Following a wonderful Olympic Cycling Gold Medal in the Time Trial, Brad Wiggins called for Britain to make wearing bike helmets the law. This was in response to a cycling death at the Olympic Village, where a cyclist was killed by an Olympic Bus.

In Ontario, where I live, we have had a helmet law since 1995. However, in a classic waffling move by the government of the day, it only applies to people under the age of 18. England, currently does NOT have any laws requiring helmets, but does "encourage" their use.

Cyclehelmets.org, a great site covering worldwide use of bike helmets and their benefits can be clicked through to see what various countries around the world are currently doing.

There really is not much doubt to the benefit of wearing a helmet in the event of a crash, either falling onto the road or colliding with a vehicle. Using Ontario as an example, the percentage of head injuries in child cyclists fell from 40.6% the year prior to the law, to just 21.2% five years after its enactment. Why it doesn't apply to all ages is somewhat beyond me. An effort to enact this for everyone in Ontario failed in 2005.

Arguments that requiring adults to wear helmets when cycling would decrease the number of cyclists, that they are too hot, or cumbersome are not justifiable. Using data "showing" fatalities are not reduced when wearing helmets is absurd.

Hopefully, Wiggins, as the Olympic and Tour de France champion, will help bring this issue to the forefront.

So, do you wear a helmet when you cycle?
Would making it law stop you from cycling?
Let me know what you think!

Saturday, August 4, 2012

Customize Your Granola Bar!

My kids are really good eaters. Honestly. They just don't always like the same things. My daughter, for example, loves tomatoes. She'll eat strawberries by the pint, and devours cucumbers. My son, on the other hand, tends not to like any of these things. He does, however, like apples, carrots and is a voracious meat eater. Doesn't matter what. Just meat.

The same situation often comes to snacks. Both kids like granola bars, just not always the same flavour. We'll sometimes buy them as a treat, but I've come to realize that letting them create and customize their own is cheaper, healthier, and a lot more fun.

I've created a little template below, that allows you to mix and match, making your bars as healthy, exotic, or   bad for you as you like! Enjoy.

Recipe: Customized Granola Bars
Prep Time: 10 minutes
Cooking Time: 25 minutes.

1. Base Ingredient: 2 1/2 Cups, Total, of any of the following:
     Rolled oats, Puffed wheat, Rye Flakes, Barley, Red River cereal, or other combination.

2. Something Sweet: 3/4 Cups of any combination of the following:
     Honey, Grade B Maple Syrup (I like our local McLachlan Family Maple Syrup Farm), Molasses, Agave or other trendy sweetener.

3. Something Chewy: 1 Cup of any or all of the below:
     Dried Cranberries, Raisins, Apricots, Dates, Pineapple, Figs, Cherries, Blueberries etc. (Just keep the size of the fruit relatively small (ie, diced if larger, like dates).

4. Something Crunchy: 1Cup of any. (exclude peanuts if sending to school)
     Sunflower Seeds, Pepitas, Almonds, Walnuts, Peanuts. (chop larger nuts)
     Could also sub in Chocolate Chips, Reese's Pieces, etc.

5. Something to Hold it All Together: 1 Cup
      Try using Applesauce, Peanut Butter, Almond Butter, Pureed Dates, Nutella, Biscoff Spread, etc. (again, avoid peanut butter if sending these to school).

1.  Heat Oven to 325 F.
2.  Line an 8x8 Baking pan with parchment paper in cross-wise fashion with lots of extra overhanging.
3.  Mix dry ingredients together in a large bowl. (ie. base, chewy, crunchy). Add spice to taste. (ex cinnamon, clove, nutmeg, 1 tsp salt).
4. Mix wet ingredients together. ( ie. sweet, and something to hold it all together).
5. Combine wet into dry, and mix well.
6. Pour mixture into baking pan, and with the extra parchment paper overhanging, press mixture firmly and evenly in pan. When you think you've pressed it firmly enough, do it again and press a little more.

7. Bake for 25 minutes. Remove from oven, and let cool for 2 hours. Remove from pan and cut into desired size (squares or bars).

You can store these in an airtight container for 5-6 days. (if they last that long!)