Glow Nutriton | Health

Advice and tips on travelling while eating low FODMAP.

Gisela RouxComment

Travelling can be a stressful time and the last thing you need is an IBS attack. One of the biggest fears before travelling is navigating airplane food. Luckily I've found that you can help keep symptoms settled by choosing low FODMAP food options, both in the airport and on the plane. 

If you have completed the reintroduction phase of the low FODMAP diet, then your newly gained understanding of trigger foods can give you more freedom when choosing an inflight meal or finding a snack.


In Flight Food Options

Unfortunately the aviation community hasn’t recognised our low FODMAP medical diet yet… this means inflight food options tend to be limited. One good thing about inflight meals is that they tend to be small and well balanced. Their portion control is in our favour, as many high FODMAP foods, like sweet potato, beetroot, and butternut pumpkin, have a low FODMAP serving size. This means you can often enjoy a small serve without triggering symptoms.

It’s also important to remember that airline caterers feed thousands of people every day and it normally isn’t possible for them to tailor your meal for you… so let’s have a look at what your options are:

A bland meal is often the best option while on the low FODMAP diet. These meals are generally prepared without herbs, spices, onion, garlic or sauces. This means these meals often contain plain meat, steamed or baked vegetables, and a carbohydrate like potato, rice or plain bread. It is also generally easier to pick the high FODMAP foods out of these meals.

It is often a mistake choosing the low gluten/gluten intolerant meal option. While this option does reduce the fructans from wheat, rye and barley, it often contains other high FODMAP ingredients like onion and garlic.

 If onion and garlic are your nemesis, then the Jain vegetarian option might be a good choice. The Jain option excludes onion, garlic, root vegetables, as well as honey and usually contains limited dairy products. Keep in mind that legumes like lentils and chickpeas are often used in this diet and they can be high FODMAP.

 The low-fat meal option could be useful if fat is an IBS trigger food for you, however the meal is unlikely to be low FODMAP.

Fruit platter options are generally a poor choice for FODMAPers as they are normally a mixture of high FODMAP and low FODMAP fruit. If this is the type of meal you would like on your flight, then consider packing your own low FODMAP version.

Lacto Ovo meals are vegetarian meals that contain egg and/or dairy products and are likely to contain high FODMAP ingredients.

Hindu meal options are generally spicy and likely to contain onion and garlic, but these meals have limited amounts of dairy so could be an option if lactose causes you the most problems.

Low lactose meal options are great if lactose is your major issue. However these meals could contain other FODMAP groups.

Can’t find a suitable meal?

Take your own snacks or a light meal with you.  Lunch box can include: Homemade chicken fried rice (ask for this to be heated in the food court and eat it just before boarding), hard boiled eggs, gluten free chocolate brownie, gluten free pretzels, banana (unripe), and pumpkin seeds. Lunchbox can also include: a chicken Cesar salad, plain potato chips, pretzels, homemade granola & rice milk (pack the milk separately in 100ml bottle), and an orange cut into slices.

Other lunchbox ideas include:

    •    Low FODMAP hummus with vegetable sticks, just make sure you eat these first (within four hours unless you can keep it cool) before the hummus goes off.

    •    Roast vegetable and quinoa salad (eat within a few hours unless you keep it cool)

    •    Hard boiled eggs (eat within a few hours unless you keep them cool)

    •    Curry & quinoa fritters (eat within a few hours unless you keep them cool)

    •    Carrot & corn fritters (eat within a few hours unless you keep them cool)

    •    Low FODMAP granola bar or muffin

    •    Low FODMAP trail mix (safe serve of dried cranberries, dark chocolate, pretzels, low FODMAP nuts or seeds)

    •    Serve of low FODMAP fruit  (banana (unripe), strawberries, blueberries, oranges, grapes, cherry tomatoes, kiwifruit, mandarin)

    •    Baby carrots

    •    Plain potato chips or popcorn

    •    Rice cakes with nut butter or seed butter (limit serve to 2 rice cakes & add banana to make it more filling)

    •    Low FODMAP cheese and rice crackers

    •    Dark Chocolate

    •    Lactose free yoghurt and low FODMAP granola. Make sure you freeze the yoghurt… it will thaw by the time you want to eat it

    •    Low FODMAP sandwich (eg leftover meat & salad) try and keep it cool

Hummus, yoghurt, nut butter, jam/jelly & salad dressings are considered liquids/gels so make sure you separate them and pack them according to airport regulations to avoid issues as you go through security. Normally these regulations are that the liquids/gels need to be in containers of 100mls (or less) and stored in a clear 1 litre ziplock bag. Check your local airport security guidelines before you fly.

Also if your flight is international make sure you throw out uneaten food before going through customs. Many countries have restrictions on what food can be brought into the country.  Domestic travel should not be a problem, unless you have fluids in too large amounts.

How to keep your food cold:

    •    Super-freeze your ice packs by popping them into the freezer for at least 24 hours before you travel.

    •    Consider making ice packs you can throw away by freezing water in ziplock bags. That way you can throw them out if they start melting before going through security.

    •    Pack extra ziplock bags that you can fill with ice after going through security. Make sure you double bag the ice so it doesn't leak when it melts. Ask a fast food outlet or bar for ice (I normally offer to pay them for it - often they won't charge you).Then use the ice for make shift icepacks. On the airplane you can throw out the melting ice pack, or drain the liquid in the bathroom and replace with fresh ice (ask your air host for help).

    •    Freeze other items going into your cooler bag to keep everything cold.

Final Thoughts

Take some time to prepare before you travel. Talk to your airline about a suitable inflight meal, and if you can’t find one, pack a low FODMAP picnic for the plane or eat before you board.


Are you a sweet tooth?

Gisela RouxComment

Some of us just crave that sweet stuff!  It can be difficult to calm that 'sugar monster' and keep it sleeping...zzzz

But being clever and try to snack on natural low carb sweets is possible.  There is such an abundant amount of recipe's and ideas from bloggers and facebook sites.  So why invent the wheel.  The most important thing is to know where and how much to fit into your daily eating to still have a healthy relationship with food and be happy about it!  I always say to my clients, we are not robot's, we are humans with feelings and cravings.  It is not to never eat sweets again, it is how to eat them...and be happy and healthy!

 Recipe's from 'Low Carb Yum

Recipe's from 'Low Carb Yum

Make your own Salad Dressing!

Recipes, Allergies, Low FodmapGisela RouxComment

It’s easy to make your own personalized salad dressings. There is a few basic rules to follow when comes to salad dressing...then the possibilities are almost unlimited.  The ratio of sour, sweet and oil is easily modified and you end up with inevitable fun salad dressing!  I promise....just try it yourself!

First understand the basics of a salad dressing:


 This Basic recipe makes enough for several salads because it’s just as easy to make a lot as a little and, once you taste your own dressings, you won’t be able to get enough.



1 cup extra virgin olive oil
1/2 cup any vinegar, lemon or lime juice
1/2 cup honey, maple syrup, or jelly
1 heaping Tablespoon Dijon mustard
1 heaping Tablespoon any fresh herb (optional)
a sprinkle or two sea salt and freshly ground pepper


Simply decide which ingredients you’d like to use and then measure everything into a Mason jar and shake vigorously until combined. Your personalized dressing will stay fresh in your refrigerator for several weeks, if it lasts that long.

If you have certain food intolerances or Allergies, you can easily adjust your salad dressing to only add ingredients you can have.  For instance if you follow a low FODMAP diet, avoid garlic and onion and rather add the green part of green onions or leeks or add some fennel.


1. Sherry Maple: sherry vinegar and maple syrup

2. Fennel Balsamic: balsamic vinegar, honey and ground fennel seed

3. Raspberry: red wine vinegar and raspberry jelly

4. Italian: red wine vinegar, no sweetener, minced garlic, oregano and thyme

5. Caesar: lemon juice, no sweetener, 1/2 cup of Parmesan cheese, 1 tablespoon of minced garlic, 1 tablespoon of Worcestershire sauce

6. Caribbean: lime zest and juice, honey and shredded coconut

7. Southwestern: lime zest and juice, honey, cilantro and hot sauce

8. Vanilla: white wine vinegar, honey and pure vanilla extract

9. Goat Cheese: 1 small 5 oz log of goat cheese, 1/4 cup of white wine vinegar, 1/2 cup of olive oil, 1 tablespoon of honey, and sprinkle or two of salt and pepper, puréed smooth

10. Tomato: 1 large ripe local tomato puréed with the zest and juice of 2 lemons and 1/2 cup of olive oil, seasoned with salt and pepper



My top ten food for weight loss.

NutritionGisela RouxComment

Managing your overall caloric intake is a very important consideration in weight loss and weight management.  The reality is , however, that we all like to eat and it can be challenging to sustain a dietary pattern that feels restrictive in the amount that we eat. 

Today, I will introduce  specific healthy and delicious  foods which are particularly low in calories ( even for healthy foods!)  or increase satiety.  This may be especially helpful for those who are looking to reduce their caloric intake in a way that is not overly restrictive in terms of quantity of food consumed.

These are NOT miracle weight loss foods but rather foods that can be effectively used to alternate with higher calorie options to aid in reducing your total caloric intake,  provide you the nutrients you need, and also help keep you satisfied. 

Top 10 Healthy Foods for Weight Loss

1. Strawberries:  As with all berries, strawberries are an exceptionally healthy and delicious option that contain only about 50 calories per cup, which is about half the calories that a cup of grapes contains. Other “per cup” fruits that are lower in calories include watermelon, honeydew and other berries. 

2. Celery & Carrots: These crunchy classics are probably among the best snack options for those looking to manage their caloric intake. Carrots sometimes get a bad reputation, but you can eat 3 medium sized carrots for under 100 calories and celery can pretty much be consumed until your heart’s content!  Bell peppers are also crunchy, delicious and low calorie fit here as well. 

4. Whole Eggs: Once feared for being high in cholesterol, whole eggs have been making a comeback.  New studies show that they don’t adversely affect blood cholesterol and don’t cause heart attacks What’s more they are among the best foods you can eat if you need to lose weight.  They’re high in protein, healthy fats, and can make you feel full with a very low amount of calories.

5. Air-Popped Popcorn:  No butter or sugar added, good old fashioned unprocessed popcorn. 3 cups comes out to less than 100 calories and is much better for you than chips any day of the week. 

6. Avocado's: Avocados are a unique type of fruit.  Whereas most fruit is high in carbs, avocados are loaded with healthy fats.  They are particularly high in monounsaturated oleic acid, the same type of fat found in olive oil.  Despite being mostly fat, they also contain a lot of water, so they aren’t as energy dense as you may think.  Avocados are perfect as additions to salad, because studies show that the fats in them can increase the nutrient uptake from the vegetables 2.6 to 15-fold .  They also contain many important nutrients, including fiber and potassium.

7. Almond Milk (enriched):  If you don’t need the additional dietary protein, enriched almond milk will provide you a similar amount of vitamins/minerals for a fraction of the calories of soy or cow’s milk. 

8. Red Snapper ( and white fish, herring):   These fish options contain about 50% less calories per 75 gram serving compared to salmon or trout, and contain a similar amount of vitamin D. You should still be consuming ~150 grams a week of fatty fish like salmon for the omega-3 content though.

9.Chia Seeds: Chia seeds are among the most nutritious foods on the planet.  They do contain 12 grams of carbohydrate per ounce, which is pretty high, but 11 of those grams are fiber.  This makes chia seeds a low-carb friendly food, and one of the best sources of fiber in the world.  Because of all the fiber, chia seeds can absorb up to 11-12 times their weight in water, turning gel-like and expanding in your stomach.  Although some studies have shown that chia seeds can help reduce appetite, they have not found a statistically significant effect on weight loss.  However, given their nutrient composition, it makes sense that chia seeds could be a useful part of a weight loss diet.

10. Leafy Green + Tomato Salad:  Leafy greens like spinach, kale and chard have a close to negligible caloric value and tomatoes are also very low in calories. These two foods go together well and if you stick to a vinegar-based dressing in the mix you can eat a significant amount of salad for very little caloric cost.  

Concluding Remarks

Weight loss is not the be all and end all when it comes to healthy eating, but the reality is that many people out there seek help to reduce their weight. The 10 foods that I have introduced today may be particularly helpful to those of you in that boat.  All else equal , incorporating these foods into your diet in place of higher calorie alternatives will likely confer some benefit in reaching your weight loss and weight management goals by slightly reducing your overall caloric intake.

I just love this years Nutrition Month theme! Do you feel confused why you're still feeling bloated or pain even though you are Gluten Free?

Gisela RouxComment


And, this year’s theme is to take the fight out of food.  I think this is probably THE best topic we have had for nutrition month because there has been no time like the present, where so many people are struggling with their food decisions.

Do you ever get frustrated by food and nutrition? Maybe you can’t figure out why you feel bloated after eating certain foods or are unsure about which foods are best for a particular health condition.  These “food fights” represent times when you struggle with yourself or others about what to eat.

read this great article by a colleague, Andrea Hardy.

When all you want to do is get control of your digestion and how you feel, it is completely understandable that you would be willing to try absolutely anything to feel better.  Being a dietitian living with celiac disease, I have personally experienced the “fight with food” when it comes to my own food choices and every single one of my clients has also experienced the “fight with food too.”  I really do get it.  Trust me, I do.

Eating should be joyful, not a source of frustration and confusion. Do any of these comments or situations sound familiar?


  • “I just ate something and I know it was gluten free, but now I feel bloated.”
  • “I don’t understand why I am gaining all this weight on the gluten free diet. I need to lose weight!”
  • “I am still SO tired.  I have no energy.  I thought my gluten free diet was suppose to make me feel better.”
  • “I was told that I need to eliminate (insert food list) these foods.  But, now, with my gluten free diet, I am at a loss of what to eat and feel just as bad, if not worse.”
  • “I’ve just been diagnosed with celiac disease and I feel overwhelmed.”
  • “I keep hearing that I should eliminate grains, beans, legumes, dairy.  Well, what is LEFT to eat?  Do I need to avoid those foods now too?”
  • “Food makes me scared.  I used to love food and now it causes me anxiety and worry.”
  • “I don’t want to go out and eat anymore, because I’m scared I will be ‘glutened.”
  • “I still feel unwell.  In order to heal the gut, I heard I should do the ketogenic diet.”
  • “I’m making two different meals at mealtime.  One regular for the family, and then gluten free for me.  But, I can’t keep up.  It’s so stressful, but I don’t know what to do.”
  • “My friend told me no one can digest dairy.  Dairy is meant for baby cows only and that I shouldn’t be consuming it. Do I need to be dairy free too?”
  • “I’m so confused, I have read so many things online and have no idea what I SHOULD eat to get rid of my digestive woes!”
  •  “I’m constipated on my gluten free diet.  My friend said she started taking (insert supplement) to improve constipation, should I do that?”
  • “I heard I can take a gluten enzyme and eat regular gluten containing foods, is that right?”
  • “Someone told me that even though I am celiac, I can eat gluten when I go to Italy.”
  • “I’m so scared to go out and eat because I don’t know how I will feel after or if I will make it home in time for the bathroom.”
  • “I don’t know how to prepare quick and delicious tasting gluten free foods. I’m in a food rut.”

Let’s bring back the joy to eating.  If you still aren’t feeling well on the gluten free diet, here are three tips for you.

1. Spot the problem:  Define what’s causing your fight with food first.

  • Have you just been diagnosed with celiac disease?
  • Are you struggling with continuing digestive symptoms such as gas, bloating, or intestinal pain while on your gluten free diet?
  • Are you gaining weight on the gluten free diet (when you don’t need to gain any weight)?

2.  Get the facts. Use facts from credible sources to decide what needs to be done to solve the problem.

3.  Seek support:

  • Get support from your registered dietitian to ensure your diet meets your nutrition needs and, most importantly, makes it practical and enjoyable for you to succeed in the long term.
  • Surround yourself with people who have positive influences (versus hinder or cause stress) over you.
  • Get in touch with advocacy groups associated with your condition (some noted above) that put you in touch with others who are going through the same thing as you.
  • Celiac Scene BC is a great resource too!

Do you want to learn more?  There are over 50 Dietitians providing free resources for nutrition month over at Nutrition Academy.  Sign up and learn more!

Dietitian's Canada Nutrition Month 2017

Gisela RouxComment

March 2017 is Nutrition month in Canada and I'm SO EXCITED to share this year's NutritionSummit 2017! 

We had around 50 RD's INTERNATIONALLY volunteer to contribute a little 'something something' to our Month Long VIRTUAL summit, celebratingNutrition Month 2017! Register here:

We would love love love it if you shared, it's a totally free event for the general public, to promote Nutrition Month and all the awesome work we as nutrition professionals do! 

You can also go to and take the Nutrition Month Pledge!

Share it in your social media platform #nutritionmonth #Dietitanapproved #takethefightoutoffood #Spottheproblem  #Getthefacts  #Seeksupport


Protein packed snack ideas.

Nutrition, RecipesGisela RouxComment

Snacks must be one of the most difficult dietary habits to consistenly plan for and adhere to long term.  So many times our snacks turned into unhealthy choices that's available at work...which unfortunately most of the time, is unhealthy choices of vending machines or a Tim Hortons donut.  Or we just totally forgo our snacks, which leads to overeating at supper or "rip down the fridge door-while preparing supper"-snacking!

Screen Shot 2017-01-23 at 2.11.03 PM.png

First you have to plan your snacks for the week ahead and shop accordingly.  

Here is some protein packed snack ideas.

1.  Greek Yogurt Dip with Veggies
17g protein
Mix a cup of unsweetened Greek yogurt with ranch seasoning or little salt and pepper with added finely chopped green onion to taste to taste, for a creamy, healthier dip for raw veggies. 

2. Tuna Salad Lettuce Wraps
15g protein

Spread 1/2 cup of tuna salad on lettuce leaves for a tangy, crunchy and satisfying snack. Just roll them up, throw them in a Tupperware and go!

3. Hearty Egg Muffins

10g protein
Make a batch of these convenient egg muffins to snack on all week long. They're easily customizable, and are great hot or cold! (Recipe below)

4. Mini Cheese Plate
11g protein
Mix and match flavors and textures for a satisfying snack! One ounce of cheese and 23 almonds will keep your hunger at bay from mid-morning until lunch. Throw in a few grapes for a little sweetness, too.

5. Cottage Cheese and Fruit
14 g protein
Top ½ cup low-fat cottage cheese with your favorite fruit (I like frozen) and mix together in a Tupperware container to grab and go!

6. No-Bake Chocolate Walnut Protein Bars
17g protein
Whip up a batch of these DIY protein bars in less than 10 minutes! These would be a perfect post-gym snack to toss in your bag. (recipe below)

7. Beef Jerky
11g protein
Beef jerky packs a whole lot of protein into a one-ounce serving, making it super easy to take on the go. If you're watching your salt intake, look for lower-sodium varieties and low sugar ones.

8. Hard-Boiled Eggs
12g protein
Make a big batch of hard-boiled eggs over the weekend, and you'll have a filling, nutritious snack to last you through the whole week! I like to slice up two of them, top with a pinch of salt, pepper and dill and toss 'em in a Tupperware container to take along.

9. Dry-Roasted Edamame
14g protein
Just ¼ cup of these crunchy, fun-to-eat soybeans will give you a hefty boost of staying power. Put Edemame on baking tray mixed with some olive oil and salt and pepper.  Bake at 400F for about 15 minutes, or until crispy.  Enjoy!

10. Turkey and Cheese Rollups
18g protein
Pair 3 ounces of turkey deli meat with 1 ounce of low-fat cheese for a seriously filling savory snack that you can take anywhere. (Make sure to look for nitrate and nitrite-free turkey breast.)

11. Chia Peanut Butter and BerryPudding
12g protein
This healthy pudding gets a protein punch from chia seeds and powdered peanut butter. Make it the night before so it's ready to go when you are in the morning. (Recipe below)

12.  Protein Shake
20g protein
A healthy protein shake! Simply blend it up and pour in a thermos to take with you.  

13. Celery with Peanut Butter
8g protein
Top crunchy celery with 2 tablespoons of peanut butter for a fiber-rich snack that packs plenty of protein and healthy fats. For easy transport, spread the peanut butter in the bottom of a mason jar. Put the celery sticks in the jar, screw on the lid and go.

14. Non-Fat Greek Yogurt with Berries
17g protein
Greek yogurt has long been touted as a protein powerhouse—and for good reason! Pack 1 cup of yogurt (or an individual tub) with a side of berries for a snack that will fill you up for hours.

15. Cheese and Crackers
8-9g protein
Top a serving of whole-grain crackers with 1 ounce of cubes or slices of your favorite cheese for a double-whammy of fiber and protein. 

16. Protein Bars
12g-20g protein
When you're really in a pinch for a satisfying snack, protein bars are a decent and convenient option that will tide you over until your next meal. Just be sure to read the label—some bars can have as much sugar as a candy bar! I opt for bars with 0-1g sugar.  You get some that is sweetened with Stevia too.

17. Overnight Oats
12.5g protein
These overnight oats make a filling snack when you need something more substantial. Just mix everything the night before in a Tupperware container and refrigerate to let everything come together. In the morning, add any other desired toppings and grab and go! (Recipe below)

Hearty egg muffins.

Screen Shot 2017-01-23 at 2.13.37 PM.png


15 Large Eggs
1 Green Bell Pepper
1 Cup Shredded Cheddar Cheese (low fat if possible)
1/4 Cup Feta Cheese (Optional)
Garlic Seasoning to taste


Preheat oven to 375 F. 

If using a silicone pan, spray with non-stick spray. If using a regular muffin pan, use 2 liners.

Beat eggs in a bowl. Add diced veggies and cheese.  Add garlic seasoning to taste. Pour into muffin tins filling 2/3 full. The muffins will rise.  

Bake 25-35 minutes until muffins have risen and are slightly browned and set.

Muffins will keep at least a week in the refrigerator without freezing. Egg muffins can be frozen and reheated. For best results, thaw in refrigerator before reheating. Microwave on high about 2 minutes to reheat.
Muffins will keep at least a week in the refrigerator without freezing. Egg muffins can be frozen and reheated. For best results, thaw in refrigerator before reheating. Microwave on high about 2 minutes to reheat.



Chocolate Walnut protein bars.

Screen Shot 2017-01-23 at 2.15.40 PM.png


4 scoops protein powder (chocolate)
2/3 cup ground flax
1/4 cup almond butter (or any natural nut butter)
2 tbsp dark cocoa powder
1/4 cup chopped walnuts
stevia (optional) to taste
1/4-11/4 cups water (varies, depending on protein powder)


Combine all ingredients ina bowl. Add water a bit at a time, until mixture holds together. You can either divide into mounds on saran wrap and roll into shape and refridgerate, OR you can spread into a glass pan and refridgerate until firm and cut into pieces.
Makes 8 bars.

Chia Peanut Butter and berry Pudding.


1 tbsp Chia seeds
1.5 serving PB 2 or plain almond butter
1/2 cup unsweetened coconut milk
1/2 cup berries of choice (blended or whole)
cinnamon to taste
stevia to taste


Mix all ingredients except berries.  If you use Blended berries, you can add it from start.
Let chia gel up for 10 mins then add berries

Protein Shake.


1 scoop Whey protein powder  (0g sugar) or Vegan protein powder if you prefer any flavour.

1 cup Almond milk or coconut milk

1/4 cup berries or whatever fruit you prefer

Blend all ingredients together.

Overnight Oats.


  • ½ cup old-fashioned oats

  • ½ cup Greek yogurt

  • ½ cup milk (use milk or plant-based alternative of your choice)

  • 1-2 tablespoons honey or Maple syrup or 1 teaspoon stevia

  • 2 tablespoons Almond butter

  • Some berries or fruit of your choice sliced up.


  1. In a medium-size bowl combine oats, yogurt, milk and honey.

  2. Spoon oat mixture into a wide-mouthed Mason jar or container of your choice.

  3. Top with Almond butter and Fruit slices.

  4. Cover with lid or plastic wrap and refrigerate overnight.  Or just put everything in Mason jar, ready to grab and go!

Interesting read!

Gisela RouxComment

Complex Multi-Factorial Problems Tend Not To Have Simple Singular Causes



Yoni Freedhoff

The Conversation 

February 3, 2017

Perhaps it is my medical training that has me scratching my head in regard to Taubes’ argument that the only way to stop an epidemic is to unambiguously identify its cause. Not knowing the cause certainly didn’t stop Dr. John Snow back in 1854 when he determined that the source of the epidemic of fatal diarrhea plaguing London was a public water pump - the well of which had been dug just 3 feet from a cesspool. Though the bacterium Vibrio cholera had yet to be discovered, shutting down the pump stopped its fatal spread. Similarly I’m glad that Taubes wasn’t around then to discourage British sailors from bringing limes on their sea voyages because scurvy’s root cause had yet to be identified.

My head also needs some scratching when considering Taubes’ assertion that ultra processed foods aren’t drivers of chronic disease because there are examples of populations who had sugar and white flour in their diets but didn’t suffer diabetes or obesity. Putting aside the fact that sugar and white flour by themselves don’t meet the definition of ultra-processed foods (they instead fall into the category of “processed culinary ingredients”), pointing one’s finger at specific traditional populations’ diets to make a point is akin to trolling PubMed to find a study that agrees with you. I’m certainly not about to point to Hadzas’ diets, with 68% of their total calories coming from carbohydrates and 22% of those coming from honey, as being a useful means to prove that diets high in carbohydrates and honey are protective, the Hadzas’ lack of diabetes or obesity notwithstanding.

Perhaps it is also my medical training that has me recognize that unlike Taubes’ strawman suggestion that my advice is meant to “maximize” my patients’ happiness, my patients’ happiness does in fact matter, especially in regard to their diets, as food is not simply fuel. Food as pleasure is part of the human condition. We use food for comfort, for celebration, and no doubt as the world’s oldest social networking tool. It’s for these reasons, and the fact that we can’t simply stop eating, that Taubes’ smoking analogy falls short.

And what of Taubes’ assertion, despite his not likely ever having worked with people on behavior change, that the way doctors help patients is to, “give them the knowledge and let them decide”? While Taubes’ apparent vision of a physician is as a finger-waggling patriarch that provides black and white absolutist advice, real clinicians take the time to understand their patients and their lives. Real clinicians also appreciate the benefits of harm reduction. We understand that healthy living is challenged both by our modern toxic food environment as well as by a patient’s personal, socio-economic, and medical realities. We tailor our advice to each patient accordingly. And no, doing so is not seen as condescending.

Coincidentally, just after reading Taubes response I had the pleasure of seeing a patient who has taken to heart the advice to live the healthiest life that he can enjoy. Now no doubt he’s received a great deal of other advice from my office, but we’ve never asked him to cut out sugar, and he’s not on a low-carb diet (though some of our patients are - the ones who enjoy low-carb diets enough to sustain them). I asked him if I could share a bit of his story and he agreed. When we met in August he weighed over 300lbs and had just been discharged from the hospital following his admission for out of control type 2 diabetes. He was on 70 units of long acting insulin, along with a number of oral hypoglycemic drugs. His sugars were a mess; even with those 70 units of insulin and multiple oral hypoglycemic drugs, they were regularly clocking in at over 4 times normal. Six months later, he has lost over 40lbs, increased his exercise, improved his diet, is totally off insulin, and has sugars that are in the normal range. Most importantly, he doesn’t feel deprived. He is enjoying his life, and consequently he is confident that he’ll be able to sustain the behaviors he’s adopted.  And his story is not even remotely unique. Sub-total weight loss, coupled with improved attention and guidance on big ticket healthy living behaviors, regularly leads to dramatic clinical benefits.

Which brings us, finally, to Occam’s Razor. Occam’s Razor dictates that the most plausible cause is likely the right one, but it’s important to point out that the most plausible cause is not necessarily the simplest. And here the most plausible cause for our rising rates of obesity and chronic non-communicable diet related diseases, as I elaborated in my first essay, is that we are eating much more than we ever have, that what we’re eating has changed dramatically, and that the world now more than ever markets and pushes nutritional chaff at every turn. These are causes that Taubes’ rebuttal did not address, and causes that would matter to anyone who understands that it’s not just the quality of calories that matter, but also their quantity.

While there’s no argument that sugar plays a real role in all of the above, and also no argument that it’s in public health’s best interest to work towards encouraging and enabling a societal reduction in the excessive consumption of sugar, dumbing everything down to one nutrient in an attempt to provide a simple solution to a highly complex and multi-factorial problem does a disservice to thoughtful public health strategies and to individual patient care.

Black and white is much more useful to dogma than doctors.

Don't be perfect!

NutritionGisela RouxComment

We all know diets don’t work.  We need to change.  

But how do I change?  How do I make change work?

Being it health goals, fitness, career or relationships - just like with dieting, a one-time change won’t do much. You have to create new habits and new patterns that you’ll stick with for the rest of your life.

In essence, if we want to direct our lives, we must take control of our consistent actions. It’s not what we do once in a while that shapes our lives, but what we do consistently.  I just love to quote Yoni Freedhoff (assistant professor of family medicine at the University of Ottawa and founder & medical director of the Bariatric Medical Institute).  “Whatever you decide to do to change, you have to keep on doing it for the rest of your life AND live a happy live in doing it.”  Otherwise it won’t last.  So if you’re going to go Vegan, stop drinking Pepsi or just want to try and eat a balanced breakfast 4 times a week… whatever you decide to do…you have to keep on doing it for the rest of your life AND it needs to make you happy in doing it, otherwise it won’t last!  You don’t have to be perfect because none of us are.  You just have to make that small change and stick to it.  Only one small change at a time and make that change an easy achievable change at first, so you can taste success 

Don’t strive for perfection.  Change your perspective. 

To help you change your perspective start with doing something that truly inspires you.  Then you’ll give it everything you have and do things you never thought you could. If you’re feeling stagnant in your career, it might be because you don’t really care about it all that much.  Or if you struggle to change your lifestyle, maybe you just don’t care enough to change.  You are not lazy, you simply have impotent goals… that is… goals that do not inspire you.  What inspires you?  Don’t aim to go on a diet, rather learn a new recipe or plant a vegetable garden or go for a walk in the park.  So go and start with goals that inspire you!  Don't try to be perfect!

Revamp & re-create.

Gisela Roux2 Comments

This is week 2 of the Glow Resolution Challenge 2017.  I hope you had a good first week of making one small change this past week.  Week 2, I want to talk about a very important part of your life - mornings.  How often do I hear "I don't have time in the morning", "Mornings are rushed", "I'm not a morning person".

I understand this, but if you want to change one part of your life in becoming more healthy - IT'S YOUR MORNING ROUTINE!

Revamp and re-create your morning routine to make time not only for yourself but also to eat a good balanced breakfast to start your day feeling good, energized and ready for whatever the day might bring.

To be able to recreate your morning routine, you will have to wake up half hour or an hour earlier. Sounds daunting?  Not so, if you go to bed an hour earlier.  That is it.  Go to bed earlier!

There are four points to consider:

  1. Have quiet/ alone/ "Me" time.  Get connected to what is most important before the day demands from you.  
  2. Create before you consume.  Leave the emails, Facebook, phones alone, so you can first connect with what is important before you consume from the world that influence our day.  This way you will have a better attitude and react more positive to life.
  3. Exercise or stretch.  Best time to get your healthy routine a kickstart.  Get it over and done with!
  4. Eat a good balanced breakfast before you go out the door.

When you start with a good morning routine you set yourself up to have a good attitude towards whatever you might face.

“The longer I love, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company...a church....a home. The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change our past...we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude...I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you...we are in charge of our attitudes.” 
― Charles R. Swindoll