Thursday 27 May 2010

Monday 10 May 2010

Stay in the Game... Check Your Balls!

Testicular cancer accounts for a small % of all cancers in Canada- only 1.1% . However, in 2006, the Public Health Agency of Canada reported that steadily increasing rates were alarming; in the last 3 decades alone, incidence has increased by 59%. Testicular cancer is often referred to as a young man's disease and is currently the most common type of cancer, and leading cause of cancer death, in men in their 20s and 30s!

Because men in the at-risk age-group remain largely unaware of testicular cancer, its symptoms, the importance of TSE, and the role of early detection on survival rates, I developed a Social Marketing Campaign and Public Service Announcement (PSA) for an assignment. Thought I'd share my PSA with you (Thanks for your help guys!). (The website on the PSA doesn't really exist).





What causes testicular cancer?

It's not well understood what causes testicular cancer, but risk factors include a family history, cryptorchidism (undescended testicle), previous testicular cancer, age (15-49 years old), and race (incidence is 4 times higher in Caucasians than African American, for example). Nonetheless, many men will develop testicular cancer without any of these risk factors.


Testicular Self Exams (TSE)

Testicular cancer is one of the most curable types of cancer when detected before it has spread (the cure rate is 99%). So, testicular self examination (TSE) would be the obvious recommendation.

Controversy:

Recommending TSEs is still a bit controversial- critics state that population-wide recommendations shouldn't be made until it can be proven that TSE reduces mortality. Given the low incidence though, this is probably not possible.

Both the American Cancer Society and the Canadian Cancer Society suggest that early detection can improve treatment and recommend that TSE be part of regular routine medical exams. However, research shows that not all health care providers perform testicular exams, or even talk to their patients about performing TSE. Moreover, men tend to delay going to the doctor, possibly delaying early diagnosis. Half of testicular cancer patients are currently diagnosed in advanced stages.

Other critics state that recommending regular TSEs would lead to a number of false-positive results, resulting in patient anxiety. This, however, has been refuted, and TSEs have been reported to be highly effective and sensitive in cancer detection.

How to Perform a TSE

According to the Testicular Cancer Resource Centre, and the Sean Kimerling Testicular Cancer Foundation, self exams should ideally be done once a month, either in front of a mirror after a warm shower, or in the shower - the warm water relaxes the skin of the scrotum. The thorough exam should take about 3 minutes.

Gently examine each testicle with both han
ds.

Place your index and middle finger under the testicle with the thumb on top. Gently roll the testicle between your thumb and fingers. You shouldn't feel any pain. It's normal for one testicle to feel a bit larger than the other.

Find the epididymis, a soft, tube-like structure behind the testicle that collects and carries sperm- once you're familiar with this structure, you won't mistake it for a suspicious lump. Cancerous lumps are usually found on the sides of the testicle but can also show up on the front.

What to Look For

See a doctor as soon as possible if you:


Have any pain in your testicles or scrotum.
Detect any hard lumps, nodules (smooth rounded masses), or abnormalities
Notice any swelling
Detect a significant loss of size in one testicle
Detect a significant enlargement of a testicle
Feel a dull ache in your lower abdomen or groin
Feel heaviness in the scrotum
Notice collection of fluid in the scrotum
Have pain or discomfort of the breasts.

When in doubt, see a doctor.

For more information:


http://www.tctca.org/
http://www.seankimerling.org/index.php/self-exam
http://tcrc.acor.org/tcexam.html

And for great PSAs!
http://www.carpetestes.org/






Friday 7 May 2010

What are the Dirty Dozen?



Researchers at the Environmental Working Group (EWG), a research and advocacy organization in Washington D.C., just came out with their new "dirty dozen" list of fruits and vegetables- the fruits and vegetables that have highest, and lowest, levels of pesticides.

Organic farming doesn't use pesticides and fertilizers, so it's the better choice for the environment, and for our heath. However, buying organic can be more expensive.

If you can only buy a few organic fruits and vegetables, choose from the dirty dozen list- according to EWG, this can help reduce pesticide exposure by up to 80%.






The Dirty Dozen
(starting with the worst)

1. Celery
2. Peaches
3. Strawberries
4. Apples
5. Blueberries
6. Nectarines
7. Bell peppers
8. Spinach
9. Kale
10. Cherries
11. Potatoes
12. Grapes (imported)

Clean 15 (the lowest in pesticides- starting with the best)

1. Onion
2. Avocado
3. Sweet corn
4. Pineapple
5. Mango
6. Sweet peas
7. Asparagus
8. Kiwi
9. Cabbage
10. Eggplant
11. Cantaloupe
12. Watermelon
13. Grapefruit
14. Sweet Potato
15. Honeydew Melon

The list isn't much different from last year's.

Click here for a PDF version of the shopping list.

To minimize consumption of pesticides, EWG reminds you to eat a varied diet, rinse all your produce and buy organic as much as possible.

*It should be noted that the group only refers to pesticides on the produce (and therefore ingested) and not the total quantity of pesticides used in agriculture. For example, corn falls in the "clean" list but non-organic corn farming may use a large amount of pesticides... Something that is important to consider from an environmental standpoint.

Thursday 6 May 2010

Dietitians of Canada & its Industry Partners

January 2013- Note- this post has broken links- see update below.



Dietitians of Canada (DC) is the "national voice of dietitians" and states that it is "the most trusted source of information on food and nutrition for Canadians". However, did you know that DC partners with industry, including Coca-Cola, McDonald's, Monsanto, Nestle, pharmaceutical industry, supplement industry (e.g., Centrum), etc etc. (The American Dietetic Association does as well).

Huh?!

How does this affect DC's message? How does this make dietitians look? Do you think they can be unbiased and critique the food industry, if they're getting money from it?
I decided to write a letter to voice my concern- (it was also an assignment!). I'd love to know what you think!

btw- I was inspired by American dietitian, Marion Nestle's, call to ADA members.

Dear Dietitians of Canada CEO and Board of Directors,

As a new Dietitians of Canada (DC) member, I am surprised by, and cannot condone, this organization’s long history of partnering itself with food, beverage, and pharmaceutical industries - regardless of the nutritional quality of their products, their history, or stated goals. DC professes itself to be “the most trusted source of information on food and nutrition for Canadians,” but these partnerships put into question this trustworthiness, the integrity of DC’s messages and research, as well as my own credibility as a member. I ask that you review your advertisement and sponsorship policies to recognize, and minimize, the many conflicts of interest that arise due to these alliances.

DC partners with, and receives funding from, a large number of companies that that do not align themselves with DC’s vision of “advancing health through food and nutrition,” e.g., McDonald’s Restaurants of Canada Ltd. - which has “a passion and a responsibility for enhancing and protecting the McDonald's brand” as a guiding principle; the Canadian Sugar Institute, whose ultimate goal is to “maintain a healthy and competitive sugar industry;” Coca Cola Ltd., whose mission is to “refresh the world” and vision includes profit and productivity; PepsiCo Canada, representing Pepsi-Cola, Frito-Lay, Tropicana, Gatorade and Quaker brands; NestlĂ© Healthcare Nutrition, a company with a well-documented history of promoting and distributing infant formula in developing countries; Roche, producer of Xenical, a weight-loss drug; and Compass Group Canada, whose national partners include Harvey’s, Tim Horton’s, Mr. Sub, and Pizza Pizza, among others.

While DC states that “an advertisement for a product or service does not constitute endorsement by Dietitians of Canada,” it definitely gives the appearance of one. Moreover, it is acknowledged that partnerships with industry can compromise credibility of organizations and its professionals, as well as the legitimacy of research.

The following are just a few of the many examples of industry sponsorship of DC activities that raise questions of conflict of interest:

-The Montreal 2010 DC national conference program acknowledges numerous industry sponsors, many with commercial interest in the topics discussed:
  • Kellogg’s - whose products include cereal brands All Bran and Raisin Bran, and All Bran and Fibre Plus cereal bars – is sponsoring a symposium on fibre, “exploring the breadth of science supporting the many health benefits of eating a diet high in fibre...”;
  • The Centrum Foundation is sponsoring ‘Prenatal Nutrition Guidelines,’ which includes the new recommendations for iron, folate, and omega-3 fatty acids;
  • Lallemand Institut Rosell, producer of yeast and bacteria, is sponsoring ‘The Role of Microbiota in Medical Nutrition Therapy’;
  • Campbell Company of Canada, with its line of gluten-free products, is sponsoring ‘The Gluten-Free Boom: Challenges and Opportunities’.
Whether sponsorship of conferences directly influences content or speakers’ opinions is up for debate; however, it does give the appearance of support, and may have an indirect influence by silencing critique of the product.

-As part of DC’s mission to support “ethical, evidence-based best practice in dietetics,” the Canadian Foundation for Dietetic Research (CFDR) was created. However, it becomes impossible to distinguish between independent evidence-based research and corporate involvement:

Five of the 11 CFDR Board of Directors are employed by industry groups Nestlé, Kraft, Compass Group Canada, Unilever, and Dairy Farmers of Canada.

CFDR’s 2009 Annual Report disclosed that it received over $220,000 from more than 20 corporations, including $75,000 from The Centrum Foundation and Wyeth Consumer Health Care Inc. Two of the seven research grants awarded by CFDR in 2009 were directly linked to supplementation:

How can all Canadian infants get the Vitamin D needed for optimal health?’ “examines how children of vegetarian parents can get the vitamin D they need through supplementation...”

Can thiamin supplementation help patients with heart failure?’ aims to “determine an effective dose of thiamin supplementation that will restore red blood cell thiamin levels, leading to better health for patients with heart failure.”

Centrum was also a benefactor in 2008, when CFDR featured a special collaborative research project investigating the use and barriers of vitamin and mineral supplements.

There are different sources of conflicts of interest in research, but financial conflicts of interest have been found to consistently produce a bias.



-A 2009 Ipsos Reid survey, done on behalf of DC and its partner, Dairy Farmers of Canada, sought to provide an informal 24-hour recall of over 2000 Canadians. Two of the four conclusions drawn included the mention of dairy products: “A significant number of Canadian adults had not consumed any milk and alternatives or any vegetables and fruit on the day prior to the survey...,” and “A majority of Canadian adults are not aware of the many health benefits of milk and alternatives....”

Coverage of the survey by the Canadian Broadcasting Corporation ended with a dietitian stating: "For people who say, 'I don't want to worry about the food groups,’ just look at your plate, and see if you can't throw in one veggie or some cheese.”

Corporate sponsorship is pervasive in the field of nutrition. Individuals and organizations engaged in such partnerships justify them in terms of advancing research and bettering the public’s health, maintaining that the relationships do not forfeit integrity; however, the above examples provide just a sampling of the many conflicts of interest that arise from the collaborations between DC and industry that compromise DC’s, and its members’, credibility. In fact, Health Canada’s Sodium Working Group was recently disparaged by the Center for Science in the Public Interest due to the involvement of DC representative Susan Barr, because of DC’s heavy involvement with industry.

Board of Directors, as long as DC continues to align itself with food, beverage and pharmaceutical industries, and rely on these corporations for funding, it will never be respected, and neither will I. As a member of the purported “nation-wide voice of dietitians,” I hope my voice, and my concerns, are heard, and that DC will carefully review its advertising and sponsorship policies to recognize the many conflicts of interest that exist, and their consequences, and take steps to minimize them in order to restore DC’s credibility. These steps may include, but are not limited to, beginning a conversation with members with regards to this issue, increasing transparency of use of corporate funds, being much more selective in choosing which companies to enter into partnerships with, and ensuring DC and CFDR Board Members have no corporate ties.

I look forward to hearing about the steps that will be undertaken in this important matter.

Thank you for your time.

Sybil


Feel as strongly as me?

To have your voice heard, copy and paste the paragraph below – feel free to personalize it - and send it to Marsha Sharp, the Chief Executive Officer of Dietitians of Canada ( msharp@dietitians.ca )

and to the member of the Board of Directors of your area, if your a member of DC:
Matthew Durant, Atlantic, matthew.durant@acadiau.ca
Barbara Khouzam, Quebec, North-East and Eastern Ontario, bkhouzam@uottawa.ca
Kerry Grady-Vincent, Central and Southern Ontario (email NA publicly).
Rosemary Szabadka, Saskatchewan, Manitoba and North Western Ontario, RSzabadka@wrha.mb.ca
Maureen Elhatton, Alberta and the Territories (email NA publicly)
Heather McColl, British Columbia (email NA publicly)
As well, cc. Georgette Harris, the front-line contact on sponsorship and advertising (gharris@dietitians.ca ).

and/OR by clicking here.


Dear DC CEO and Board of Directors,

I would like to express my concern towards the many partnerships DC has with food, beverage and pharmaceutical companies. These alliances, and reliance on their funding, gives the appearance of support, encourages perceptions that sponsorship prevents DC from criticizing the food industry, and makes it impossible for DC to be a trustworthy source of information for Canadians; by extension, as a DC member, I cannot be a credible source of information, or trusted as a professional.
I hope that DC will carefully review its advertising and sponsorship policies to recognize the many existing conflicts of interest, and their consequences, and take steps to minimize them in order to restore DC’s integrity.
I look forward to hearing about the steps that will be undertaken in this important matter.
Thank you.
Sincerely,


Other sources:
Gingras, J. (2005). Evoking trust in the nutrition counsellor:why should we be trusted? Journal of Agricultural and Environmental Ethics, 18, 57-7.

Nestle, M. (2001). Food company sponsorship of nutrition research and professional activities: a conflict of interest, Public Health Nutrition, 4(5), 1015-1022.

Lesser, L.I. (2009). Reducing potentital bias in industry-funded nutrition research. American Journal of Clinical Nutrition, 90(3), 699-700.

_____________________

Update (January 2013)

I had not revisited this post in a while and notice that many of the links are broken. Some updated facts : 


  • The Canadian Foundation for Dietetic Research (CFDR), created to support ethical, evidence-based best practice in dietetics, has a vision of enhancing the health of Canadians by contributing new knowledge about food and nutrition. In 2012, the CFDR received about $200 000 in revenue from corporate "partners". These included the Dairy Farmers of Canada and NestlĂ© (the two biggest donors, each giving CFDR $125 000 over 5 years), as well as The Centrum Foundation and Pfizer Consumer Health Care Inc., Campbell Company Canada, Compass Group Canada, Kraft Canada Inc., McCain Foods, McDonald's Restaurants of Canada Limited, Unilever Canada Inc, Abbott Nutrition Canada, Aramark Canada Ltd., Canola Council of Canada, Egg Farmers of Canada, General Mills Canada Corporation, Kellogg Canada Inc., Loblaw Companies Limited, Mead Johnson Nutrition, PepsiCo Canada and Sodexo Canada. 
  • They note: "CFDR is grateful to the many corporate partners and donors who believe in the value of dietetic and nutrition research in building a healthy Canada."
  • 8 of the 11 2011/2012 Board members have industry ties. 
  • I'm having trouble finding the program for the 2012 annual conference. The 2011 DC Ontario Regional conference one shows  a breakfast sponsored by Becel and Egg Farmers, a lunch by Unilever, a "special conference memento" courtesy of the Sugar Institute, and industry-sponsored talks.



Tuesday 4 May 2010

Jamie Oliver's Food Revolution


Hi!

Did you watch Jamie Oliver's Food Revolution?
I caught a few shows- the premise was that Oliver, a British chef who has successfully changed the British food program, went to Huntington, West Virginia, the unhealthiest city in America with nearly half of adults considered obese, to start a revolution:

Teach children what food is, and adults how to cook it,
Change the food that's fed to children in schools (french fries are considered a vegetable, pizza is served for breakfast, utensils are unknown),
Make the school system understand the importance of feeding children healthy food as part of their education,
Make people more aware of what they're eating and where their food comes from.

Sure, this is a British guy coming to America, basically telling people they're unhealthy and need to change... on tv. Motives may seem questionable.
The results of the school "intervention", based on answers from students, teachers, and cooks, weren't that great either:
77% students didn't like the food (66% did try it though), removing sugary, flavoured milk resulted in a 25% decrease in milk consumption, cooks had to work harder, and the food cost more.

Regardless, isn't the message such an important one?

It'll be interesting to see what will happen now that the TV crews are gone.
Will this revolution catch on?

Want to support it? (I did!).
Click here to sign the petition.

Below is the trailor of the show- in case you missed it, it's a great overview.
I also included one of my favourite scenes- a Food Flash Mob (flash mob: creating an unusual experience in a normal place)!


Jamie Oliver's Food Revolution- Trailer



Jamie Oliver's Food Flash Mob