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Thursday, December 27, 2018
Front-and-centre nutrition alert labels on the way
Health Canada's food labelling
proposals should help Canadians deal with an epidemic of obesity and
diet-related chronic diseases
By Fabio Gomes
Contributor EvidenceNetwork.ca
But nutrition labeling is about to change in Canada. That's good news for our health and for informed consumer decision-making.
Health Canada is developing
new "high in" nutrition alert labels for the front of food packaging.
This is consistent with best practices and evidence of how to provide
consumers with quick and easy information about the levels of saturated
fats, sugars and/or sodium in food and drink products.
How does it work?
When
a product has more than a specified level of certain nutrients, it must
have a prominent black label on the front of the package that says
simply, depending on the nutrient in question: "high in sugar," "high in
fat" or "high in sodium." There are no numbers or symbols that require
further interpretation.
Importantly,
the simple but powerful words "Health Canada/Santé Canada" should also
be on the label to convey that the alert symbol has legitimacy and
authority.
This is an excellent step forward and will make Canada the first G7 country to mandate such labelsif the plan proposed by Health Canada is approved and implemented.
Why did Health Canada choose this option?
Research, including work awarded the Nobel Prize,
has consistently demonstrated that consumers don't spend a great deal
of time and effort in purchasing situations, especially when it comes to
repetitive decisions, which is the case when buying food. Current
nutrition facts, unfortunately, don't sufficiently influence shoppers' choices towards healthier products.
Why is this the case?
Because
food and drink nutrition labels are frequently difficult to find, hard
to read and obscured by competing claims on the packaging.
There
are often prominent but misleading claims by manufacturers on the front
of the packages that may be at odds with the nutrition label on the
back. Images of natural foods, such as fresh fruits and cartoon
characters, as well as colourful designs, can also distort consumer
perceptions about certain foods.
A good nutrition label needs to cut through the hype.
The
key to an effective front-of-package labelling system is that it must
be both simple and interpretive. Simple means that it shouldn't require
that the consumer have any nutritional knowledge for the label to be
understood. Interpretive means that information should be given in the
form of guidance to the consumer, rather than simply providing numbers.
Consumers invest little time in making a purchasing decision, so the system has to also facilitate quick recognition and processing of the information.
Various other promising front-of-package labelling systems
have been developed to help consumers make better food choices. Some
involve traffic lights - green, yellow and red to indicate low, moderate
or high levels of nutrients. Others use numbers and percentages to
depict the level of nutrients, and some use stars - the more stars, the
healthier.
But research has generally found that these systems are not as effective
at helping consumers steer away from foods that are "high in" sodium,
sugar or saturated fat. And these ingredients are linked to the diseases
that are the major causes of death and loss of years of healthy life in
Canada, such as cardiovascular diseases, cancer and diabetes.
Health Canada was also able to rely on international experience when making its decision. The "high in" labelling approach is used in Chile, and approved for use in Peru and Uruguay.
Evaluation
of the first year of use in Chile shows that 93 per cent of Chileans
reported they understand the labels and 92 per cent found it influenced
their purchasing decisions. Manufacturers may also be improving the
nutritional content of their products to avoid the negative labels. Food
manufacturers in Chile reformulated 18 per cent of their products prior to the implementation of the labelling system in order to avoid having the label on their products.
Canada
and many other countries face an epidemic of obesity and diet-related
chronic diseases with serious and expensive health consequences for
individuals and societies. Front-of-pack "high in" nutrition labels will
help consumers make healthier and more informed food choices.
Dr.
Fabio da Silva Gomes is an Advisor in Nutrition and Physical Activity
with the Pan American Health Organization/ World Health Organization and
a Contributor with EvidenceNetwork.ca based at the University of Winnipeg. |
Monday, December 24, 2018
Friday, December 21, 2018
Holiday Peppermint Smoothie
Peppermint can reduce headaches and help you feel rejuvenated. And
this smoothie makes a tasty alternative to eggnog. Garnish it with a pretty rim
of crushed candy cane.
11/2
cups (375 mL) skim milk
11/2 cups (375 mL) low-fat vanilla yogurt
11/2 cups (375 mL) ice cubes
5 peppermint leaves, torn
1 Tbsp (15 mL) ground cinnamon
A few drops peppermint extract (optional)
11/2 cups (375 mL) low-fat vanilla yogurt
11/2 cups (375 mL) ice cubes
5 peppermint leaves, torn
1 Tbsp (15 mL) ground cinnamon
A few drops peppermint extract (optional)
Blend
all ingredients and serve in cups garnished with a pretty rim of crushed candy
cane.
Serves four.
Serves four.
Per
serving: 114 calories, 8 g protein, 1 g fat (1 g saturated fat), 19
g
Chocolate Almond Smoothie
http://www.besthealthmag.ca/recipe/chocolate-almond-smoothie
http://www.besthealthmag.ca/recipe/chocolate-almond-smoothie
Thursday, December 20, 2018
Let's make Canadian hospitals more senior-friendly Hospitals need to identify vulnerable patients with complex needs so they can quickly address and minimize complications (FREE)
By George Heckman
and Paul Hébert
EvidenceNetwork.ca
and Paul Hébert
EvidenceNetwork.ca
Canadians are living longer. Unfortunately, our hospitals aren't ready for them.
Canadians over 65 years old use more than 40 per cent of hospital services, a demand that continues to rise.
But as they age, Canadians hope to stay at home as long as possible.
| |
George Heckman |
If hospitals are meant for getting well, why does this happen?
Our
health-care system was designed in the 1950s and focused on hospitals.
Back then, it was about unexpected emergencies, like pneumonia or
injuries. Conditions like heart attacks had few beneficial treatments,
so most patients didn't survive very long.
Today,
advances in medical science and public health mean that more people
survive with conditions that would have killed their grandparents.
Conditions that can be treated but not cured are called chronic
diseases. The biggest risk factor for chronic diseases is aging. As
Canadians get older, they usually acquire not just one but many chronic
diseases.
Many
older Canadians also develop other age-related problems such as
dementia, making simple everyday tasks more difficult. Many lose muscle
strength, becoming less active and more disabled.
Over
time, the burden of these problems grows and affected persons become
increasingly vulnerable. Simple health challenges like influenza,
nothing more than a nuisance to young people, will incapacitate or kill a
vulnerable older person. This vulnerability is called frailty.
| |
Paul Hebert |
What can be done?
First,
hospitals need to identify vulnerable patients with complex needs so
they can quickly address and minimize complications. Detection requires
that the right information be collected efficiently and reliably at the
right time.
Ideally,
information about complex needs and frailty should be identified early,
in all health-care settings, using a common approach. That would mean
that important information can be gathered and acted upon even before a
hospitalization. Most of the pieces for this approach are in place in
Canada but not in hospitals. Existing hospital documentation systems are
bloated and inefficient, collecting some information repetitively but
missing other important data.
Yet
knowing who's at risk ensures that patients with mobility issues don't
stay bedridden a minute longer than needed. It means that patients with
dementia are regularly oriented to place and time, and maintained on a
stable daily routine. It means aggressive de-prescribing programs to get
rid of harmful or useless medications. It also means a more efficient
health-care system.
An international not-for-profit group of researchers
called interRAI has carefully designed and studied instruments for just
this purpose. Its assessment tools are already used in home care,
nursing homes and mental health settings across Canada. Unfortunately,
they aren't used yet in primary care and hospitals, where measuring
frailty is typically an afterthought, if done at all.
Along with colleagues, we recently studied
the interRAI Hospital Suite used in 10 Canadian hospitals on over 5,000
older adults, supported by the Canadian Frailty Network. The
instruments were easy to use and reliably predicted, within 24 hours of
hospitalization, which older patients would develop complications in
hospital, which were at risk of a long hospital stay and which were at
risk of ending up in a nursing home.
Efforts
are already under way to make our hospitals senior friendly, but the
lack of systematic assessment in the system overall leaves us all
vulnerable as we age. By the time frail patients need hospital care,
it's often too late to address their complex needs.
Reliable
information is a fundamental requirement to make our health-care system
and especially our hospitals senior friendly, allowing better targeting
of programs to respond to needs along the entire trajectory of life.
Dr.
George Heckman is the Schlegel Research Chair in Geriatric Medicine and
an associate professor at the University of Waterloo, and an assistant
clinical professor of Medicine at McMaster University. He is an interRAI
Fellow, a researcher with Canadian Frailty Network, and a contributor
with EvidenceNetwork.ca.
Dr. Paul Hébert is a senior scientist at the Centre de recherche du
Centre hospitalier de l'Université de Montreal (CRCHUM), and a full
professor in the Department of Medicine of the Université de Montréal.
He is also a researcher with Canadian Frailty Network and a contributor
with EvidenceNetwork.ca.Tuesday, December 18, 2018
Trooper Black Eyeliner Obsession
A limited-edition vault which features five of Kat Von D's long-wear, high-pigment liquid eyeliners.
- Available at Sephora, $110.00 CAD
Monday, December 17, 2018
Butternut Squash + Sweet Potato Soup
Butternut squash, pear, and sweet potato blend well together and make a filling low-calorie soup you'll savor.
3 slices center-cut bacon, chopped
3 leeks, white and light green parts only, chopped, 2 cups
2 pounds butternut squash, peeled, seeded, and chopped
1 pound sweet potatoes, peeled and chopped
2 pears, peeled, cored, and chopped
2 carrots, chopped, ½ cup
1 teaspoon chopped fresh thyme
⅛ teaspoon ground nutmeg
4 cups lower-sodium, fat-free chicken broth
½ cup light cream
¼ teaspoon salt
⅛ teaspoon ground black pepper
3 leeks, white and light green parts only, chopped, 2 cups
2 pounds butternut squash, peeled, seeded, and chopped
1 pound sweet potatoes, peeled and chopped
2 pears, peeled, cored, and chopped
2 carrots, chopped, ½ cup
1 teaspoon chopped fresh thyme
⅛ teaspoon ground nutmeg
4 cups lower-sodium, fat-free chicken broth
½ cup light cream
¼ teaspoon salt
⅛ teaspoon ground black pepper
1. Heat a large saucepan over medium-high heat. Add the bacon and cook until crisp, 5 to 6 minutes. Stir in the leeks and cook until they start to soften, 2 to 3 minutes. Add the squash, sweet potatoes, half of the pears, the carrots, and thyme; cook, stirring occasionally, until the vegetables are slightly softened, about 9 to 10 minutes. Stir in the nutmeg and cook for 30 seconds. Pour in the broth; bring to a boil, reduce the heat to medium-low, cover, and simmer until the vegetables are tender, about 30 minutes. Remove the saucepan from the stove and cool for 10 minutes.
2. Transfer the soup, in batches, to a blender and puree. Return the soup to the saucepan over medium heat. Stir in the cream, salt, and pepper and heat until hot, 1 to 2 minutes. Divide the soup among 8 bowls and garnish each with some of the remaining pear.
Friday, December 14, 2018
Common surgical knee procedure doesn't provide much benefit
A growing body of research shows that most older adults will get the same long-term outcomes from less invasive treatment
By Eric Bohm
and Ivan Wong EvidenceNetwork.ca
Nearly half
of Canadians aged 65 and over experience osteoarthritis in their knees.
Osteoarthritis is the most common form of arthritis and occurs when the
protective cartilage on the ends of bones wears down over time leading
to pain, stiffness and decreased mobility. It frequently occurs in the
hips and knees - and can be quite painful.
To
help improve mobility and treat joint pain, it has been common for
older adults with osteoarthritis of the knee to be referred to an
orthopedic surgeon, like us, for a knee arthroscopy.
Arthroscopy
of the knee for arthritis involves making several small cuts to insert a
small camera and instruments to view the joint and trim loose cartilage
and wash the joint out.
Now there is a growing body of
research showing that this procedure may not be necessary for most
older adults since it usually has the same long-term outcomes as
non-operative and less invasive treatment.
Alternative
treatments can include weight loss, physiotherapy, exercise,
over-the-counter pain medicines such as Tylenol, anti-inflammatories and
pain-relieving joint injections.
Knee
arthroscopy, on the other hand, is a surgical procedure that typically
requires spinal or general anesthetic; there's always a risk of
infections or structural damage to the joint.
Does this mean that all arthroscopy shouldn't be performed?
No.
Rather, arthroscopy needs to be done for the right conditions and on
the right patients. For example, meniscus repair surgery for a younger
person with a knee injury can help improve function, treat pain and
increase mobility.
What's at stake?
For older patients with osteoarthritis in the knee, arthroscopy is more often than not the wrong choice.
As
surgeons, we advise our patients on alternatives to surgery and reflect
on our own practice habits. We're also championing the Choosing Wisely
Canada campaign to our colleagues and patients far and wide. Recently,
the Canadian Orthopaedic Association, the Canadian Arthroplasty Society
and the Arthroscopy Association of Canada joined to release a set of recommendations on best practices.
The first recommendation is against arthroscopy for initial treatment and management of osteoarthritis in the knee.
It's well established that physicians tend to overestimate the benefits of our procedures and often underestimate harms. Recent research shows that the same misconceptions about harms and benefits of common procedures are held by patients.
A
culture shift is needed for surgeons, patients and the public on
treatment expectations for knee osteoarthritis. Saying no to
arthroscopic surgery, and instead undertaking non-operative management,
is a challenge for clinicians and patients alike.
Thoughtful, evidence-based utilization of our health-care resources will help to improve appropriate care for all Canadians.
Dr.
Eric Bohm is a professor at the University of Manitoba and an
orthopedic surgeon with the Concordia Joint Replacement Group in
Winnipeg. He is also a contributor with EvidenceNetwork.ca,
which is based at the University of Winnipeg. Dr. Ivan Wong is an
associate professor at Dalhousie University and an orthopedic surgeon at
the QEII Health Sciences Centre in Halifax. He is also the president of
the Arthroscopy Association of Canada. |
Thursday, December 13, 2018
Wednesday, December 12, 2018
Perfect Cranberry Sauce Recipe | Food Network Kitchen | Food Network Food Network
Empty a 12-ounce bag of fresh or frozen cranberriesinto a saucepan and transfer 1/2 cup to a small bowl.
Add 1 cup sugar, 1 strip orange or lemon zest and 2 tablespoons water to the pan and cook over low heat, stirring occasionally, until the sugar dissolves and thecranberries are soft, about 10 minutes.
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