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Book Review: Grain Brain – by David Perlmutter, MD


Perlmutter, a neurologist in Naples, Florida claims that inflammation is the cause of many neurogenerative diseases and disorders such as dementia, diabetes, depression, ADHD, irritable bowel, and Alzheimer’s. The solution according to Perlmutter is to eliminate gluten, follow a low-carb diet and feed your brain a diet that’s high in fat. Fat, he claims will provide the nourishment that the brain needs. The diet involves restricting carbohydrates to 30 to 40 grams a day, followed by a maintenance phase of 60 grams of carbs.

Like most dietitians, I find this advice to be unsubstantiated at this time. Much of the evidence cited in the book is anecdotal and based on testimonials as well as the author’s own experience with his patients. The overpromise of health benefits from his diet plan raises another red flag. Plus, science tells us that carbs (more specifically glucose, and not fat) are the preferred fuel for our brain.

The author’s recommendation to increase our intake of fat to 80% of our daily calories warrants discussion. It’s a far cry from Health Canada’s fat recommendations of 20-35% of our daily calories. While it’s true that we could all stand to increase our consumption of healthy monounsaturated fats and omega-3 fats from foods such as fish, avocados and olive oil, it’s not advisable at this point to increase our intake of saturated fats because of their negative effect on heart health. What we also know is that swapping saturated fat for polyunsaturated and monounsaturated fats is beneficial to our heart health.

Perlmutter does make some recommendations with which I whole-heartedly agree. For one thing, he recommends that we exercise more and more regularly (he recommends at least 30 minutes, five times a week). Secondly, he advises that we work on getting restful, routine sleep seven days a week. The bottom line though is that Grain Brain is a low-carb diet. Instead of cutting out carbs, my advice is to choose smart carbs like whole grains, vegetables and fruit as part of a balanced diet.

Book Review: MINDfull – by Carol Greenwood, PhD

In the growing trend of healthy aging, MINDfull is an easy-to-read cookbook that will appeal to anyone who wants to optimize their brain health. Greenwood, who is a senior scientist at Baycrest Centre Foundation, has been studying the link between diet and dementia for years.

As Greenwood describes it, the brain “has a wonderful capacity to refresh, to renew and to repair itself and to create new brain cells and new connections throughout a person’s life.” The goal of the book is to inspire healthy lifestyle and eating habits to promote successful aging and prevent the degeneration of one’s cognitive function.

To eat your way towards a healthy brain, Greenwood recommends choosing a balanced, high quality diet that is rich in fruits and vegetables (for polyphenols), whole grains and cereals (for fibre), nuts (for monounsaturated fats), spices (such as turmeric and black pepper for anti-inflammatory antioxidants) and fish (for omega-3 fats). Vitamin E, folate and vitamin B12 are important too. These foods and nutrients support the body and brain in many ways:
• strengthens our blood vessels, allowing more oxygen and nutrients to reach every cell in our body;
• nourishes the parts of our brain that are actively involved in speech, learning and reasoning;
• protects our body and brain against inflammation; and
• promotes the growth of new brain cells and neural connections.

Each chapter of the book features practical nutrition information, tips and science-based references. With over 100 brain-boosting recipes like Sweet Potato Waffles, Indian-Spiced Chickpeas, and Malaysian Fish Cakes, you’re sure to find a few new favourites. It’s a welcome addition to my cookbook collection.

What’s in store for 2014?

Happy New Year! Here’s a line-up of some top food and nutrition trends for the coming year.

Cauliflower. 2013 was the Year of the Vegetable, and the trend continues with cauliflower surpassing kale as this year’s most wanted veggie. What I love about cauliflower is its versatility – you can mash it boil it, roast it and even grill it. My fave recipe these days is quinoa salad with roasted cauliflower, sunflower seeds, diced avocado and avocado oil.

Foraging. Last summer, I was on a wilderness hike where the guide showed us how to identify and pick edible berries and leaves. It was an introduction to foraging! Our country’s backyard is a natural bounty for foraging. Think berries, fiddleheads, wild leeks, dandelion leaves and mushrooms (just make sure you know your mushrooms since some can be poisonous!)

Kañiwa. Say hello to quinoa’s cousin – kañiwa (pronounced “kah-nyee’wah). Also known as “baby quinoa”, kañiwa is a tinier grain than quinoa (ok, technically both are seeds), offers protein and grows in the Andes Mountains too. Cook kañiwa the same way you would quinoa. One difference is that kañiwa doesn’t contain saponins, so you don’t have to rinse it before cooking.

Mashups. It all started with the cronut – the hybrid croissant and donut. What’s next? Reportedly, we can look forward to ramen burgers (buns made from fried ramen noodles), macaroon ice-cream sandwiches and kale coladas!

Spices. On the radar is a range of spices inspired by Asian cuisines. First off is a Japanese “salt and pepper” spice called shichimi togarashi. It’s a blend of seven spices. Another biggie is gochujangi, a Korean condiment made from hot chili paste and fermented soybeans. I can taste the heat already!

Menu labelling – would you like 90 minutes of walking with that?

The conversations about menu labelling continue. Dr. David McKeown, Toronto’s Chief Medical Officer of Health supports mandatory menu labelling of calories and sodium, while some researchers wonder whether “physical activity equivalent” labelling is a more effective strategy.

McKeown urges the province to enact its own law, but if the province doesn’t do so by September, he plans to develop a Toronto-specific bylaw for chains with more than 15 restaurants. Critics say that calorie and sodium counts alone don’t allow consumers to make informed choices. A Diet Coke for example, has fewer calories than a glass of milk, while a bagel might have more sodium than a cookie.

Stephanie Jones, the Ontario VP of the Canadian Restaurant and Foodservices Association endorses British Columbia’s voluntary Informed Dining program, in which participating restaurants post nutrition information in a brochure or poster, rather than on the main menu.

And here’s another POV. Preliminary research shows that consumers may be more motivated to choose foods with fewer calories when restaurant menus show how much exercise is needed to burn off those calories. For example it would take 90 minutes of walking to burn off the calories in this hypothetical ham sandwich. It’s an interesting concept, indeed!

Sodium – what now?

Bill C-460, a Private Members Bill introduced last November by NDP MP Libby Davies, was recently defeated by a vote of 147 against versus 122 in favour. The Bill would have called for warnings on foods that exceeded Health Canada’s Sodium Reduction targets. Meanwhile, the Institute or Medicine (IOM) raises questions about the benefits of very low sodium consumption.

According to a new report by the IOM, studies support recommendations to lower our sodium intakes from the 3000+ mg currently consumed daily by Canadians. However, the evidence does not seem to support sodium intakes to below 2300 mg per day. Lowering sodium intake too much may adversely affect certain risk factors such as blood lipids and insulin resistance, and thus potentially increase the risk of heart disease and stroke.

So, what now? Based on the sodium reduction strategy experience of the UK, it will realistically take years for us to reduce our average sodium consumption to 2300 mg. As dietitians, we continue to recommend that consumers read nutrition labels to choose lower sodium foods. Cooking from scratch will also empower consumers to use low or no sodium ingredients and seasonings. Get more sodium reduction tips from Health Canada.

Highlights from SIAL 2013

The annual SIAL food and beverage tradeshow was held in Toronto. Here’s what caught my eye this year:

• Avocado oil – high proportions of monounsaturated fat and high smoke point
• Wild rice flour – gluten free flour, made in Canada
• Sea buckthorn tea – builds on the health potential of the super sea buckthorn berry
• Bison meat – lean protein choice coming soon to grocery stores
• Pea protein chips – vegan offering with 15 grams of protein per serving
• Mycryo – pure cocoa butter for cooking, 90 calories and 10 g fat (of which 6 g is saturated fat) per 5 tsp

Canadian Food Strategy

At the second annual Canadian Food Summit, held in Toronto on April 9-10, Dr. Michael Bloom shared a draft Canadian Food Strategy to stimulate change in our nation’s food system. The strategy is being developed as a comprehensive, evidence-based and action-oriented framework.

The five key elements of the Canadian Food Strategy are:
– Industry prosperity
– Healthy food
– Food safety
– Household food security
– Environmental sustainability

While most of the world’s national food strategies tend to focus solely on industry, Canada’s Food Strategy is more comprehensive and includes all stakeholders. Within each of the key five elements, the Strategy outlines specific goals, desired outcomes and key actions. When addressing the element of healthy food for example, one key action which I support is the development and marketing of new “better-for-you” foods and brands to help Canadians eat healthier and have balanced diets. Another key action is to implement public awareness programs, in partnership with media, to encourage people to choose foods to maintain a healthy weight.

The next draft of the Canadian Food Strategy is expected to be ready by June for an online consultation phase. Don’t miss out on this opportunity to shape the nation’s first ever food strategy!

Ontario Healthy Kids Strategy

One of the greatest public health concerns today is undeniably childhood obesity. In 1978, only 15% of children were overweight or obese. Almost 30 years later, in 2007, 29% of adolescents were at unhealthy weights. If current trends continue, by 2040, up to 70% of adults aged 40 and over will be either overweight or obese.

Last January, the Ontario government set an aspirational target to reduce childhood obesity by 20% in five years. Charged with this mandate, the Ontario Healthy Kids Panel outlined a three-part strategy in their recent report No Time to Wait: The Healthy Kids Strategy:

1. Start all kids on the path to health. A woman’s health and weight before she becomes pregnant and during pregnancy have a direct influence on her child’s health and weight. The Report recommends pre-natal and educational programs for all young women about the importance of healthy eating, active living, smoking prevention/cessation, and healthy weights. Support is also recommended to encourage women to breastfeed for at least the first six months.

2. Change the food environment. The healthy choices should be the easiest choice where kids live, learn and play. Some of the many recommendations for this strategy include:
• A ban on the marketing of high calorie, low nutrient foods/beverages/snacks to kids under the age of 12;
• A ban on point-of-sale promotions and displays of high-calorie, low-nutrient foods and beverages in retail settings, beginning with sugar-sweetened beverages;
• Mandatory calorie listing on menus at restaurants, fast food outlets and retail grocery stores;
• Nutrition rating systems for products in-store;
• Incentives for Ontario food growers and producers to support community-based food distribution programs;
• Access to safe, affordable, nutritious and culturally appropriate foods, especially in areas of low income and “food deserts”; and
• A universal school nutrition program for all Ontario publicly funded elementary and secondary schools.

3. Create healthy communities. A comprehensive healthy kids social marketing program is needed to focus on healthy eating, active living and active transportation, mental health and adequate sleep. The Report recommends implementing community based programs based on EPOCE (Ensemble Prévenons l’Obesité des Enfants – Together Let’s Prevent Childhood Obesity) which is used in 15 countries worldwide. The EPODE philosophy involves mobilizing all local stakeholders in an integrated, long-term obesity prevention program. The aim is to change the environment and facilitate the adoption of healthier behaviours and lifestyles into everyday life.

My take on the Report: Having just finished writing a series of key messages on healthy weights for children and teens, I was thrilled to see the Healthy Kids Panel Report acknowledge the key determinants impacting a child’s weight – healthy eating, food and nutrition skills, active living, adequate sleep, mental health, resilience and the influential role of parents, teachers and caregivers.

Given the recent controversy over NYC’s soda ban though, I wonder how a junk food ban would be received. Neither a junk food ban nor an advertising ban helps kids with media literacy or how to discern between truth and advertising. We don’t even have an official definition of “healthy food” in Canada, so where would we start in defining “unhealthy”?

I’d also love to see more dialogue on how to eat, not just what or what not to eat. Research tells us that mindless eating is an unhealthy habit which can have negative consequences on our satiety cues and overall intake.

Finally, let’s be careful not to point blame at anyone or anything. The Report acknowledges that some children are genetically predisposed to be heavier. There are over 50 different genes that contribute to obesity. All efforts in reducing overweight and obesity must be free of any weight stigmatization or bias, and involve all players – individuals, communities, politicians and food industry.

The Healthy Kids Panel has mapped out an incredibly ambitious goal – to reduce childhood obesity by 20% in five years. I’ll be watching, listening, helping and hoping that we’ll get there.

To read the full report, go to http://www.health.gov.on.ca/en/common/ministry/publications/reports/healthy_kids/healthy_kids.pdf

Food and Nutrition Trends for 2013

Here’s a line-up of food and eating trends for the year!

Year of the Vegetable. Vegetables, especially cauliflower and other nutritious cruciferous veggies will take centre stage this year. Expect to see vegetable plates and even veggies in desserts. Can’t wait!
Homemade snacks and DIY yogurt. It’s all about healthier homemade options of our favourite guilty pleasures.
Exercising to eat. Dieting is out. Consumers want to justify their indulgences and splurges by walking or running it off. Eating delicious food plus regular exercise – sounds like a win-win!
Brazilian cuisine. Inspired by World Cup 2014 to be held in Brazil, Brazilian fare is expected to “take the world by storm”. Anyone for Feijoada or Churrascaria?
Waste not, want not. According to Sylvain Charlebois, economics professor at the University of Guelph, Canadian households waste 38% of their food purchased in stores and restaurants. Consumers need to adopt better shopping practices and using leftovers in creative ways. Herein lies an excellent opportunity for your brand to help consumers better manage their food purchases and cooking habits

My Take on Junk Food Bans and Labelling

In August, New York City’s mayor Michael Bloomberg announced the ban of sugary beverages that are larger than 16 ounces at restaurants, mobile food carts, sports arenas and movie theatres. The ban would not apply to fruit juices, alcoholic beverages, diet sodas or dairy-based drinks such as milkshakes. Some have criticized Bloomberg as a state nanny.


Here at home, the Ontario Medical Association called for graphic warning labels to be placed on certain foods. This aggressive action is needed, they say, to tackle obesity which has become a “full-scale public health crisis”.

Personally, I am all for increased education and awareness about healthy choices and portion sizes. I like the idea of helping consumers understand that consumption of sugary beverages should be limited. And so, I see Bloomberg as a nutrition champion, not a nanny. But I’m not sold on the junk food tax. Denmark has just repealed its contentious fat tax just over a year after its implementation. Foods containing more than 2.3 percent saturated fat, such as butter and margarine, were subject to the tax. The tax impacted the economy and drove Danes into cross-border shopping into Germany and Sweden.

A big concern that I have with a junk food tax is that it villanizes food. It creates an environment of punishment rather than compassion when trying to help people deal with food and weight. It further stigmatizes those who are overweight or obese, blaming them for their food choices. We know however that obesity is a complex issue influenced by so many other controllable and non-controllable factors such as exercise and genetics.

Plus, a junk food tax isn’t as simple as it looks. How would we define “junk food”? Would it be based on calories or fat or both? Would healthy choices such as olive oil or nuts be labelled as “junk”? Surely not. And what about the idea of moderation? Should we not also consider how often the food is consumed, and how the food might fit into an overall healthy, balanced diet? Dr. Ayra Sharma, Professor of Medicine & Chair in Obesity Research and Management at the University of Alberta sums it all up nicely, “What matters is the context in which the foods are served and how much of it is consumed.”

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