Vaccines

My wife asked me to send some professional information to a friend of hers.  This friend has a new baby and wants to get him vaccinated but is conflicted because of all the information she receives from the Internet, popular media, and most importantly, family, telling her that she shouldn't because vaccines are dangerous.  Thankfully my wife shot back to her a quick e-mail that laid out the whole MMR-autism fiasco and told her not to worry about that because it has been so thoroughly discredited it is barely worth even discussing.  But she felt she needed more info, because this lady's mother was particularly concerned as she had been told that vaccines contain mercury and formaldehyde.  So I did what I always do.  I totally went overboard.  My response is below.

"Besides breastfeeding, there is no other childhood intervention that has as much medical evidence supporting its safety and efficacy in preventing debilitating diseases than routine immunizations.  Great article below outlining a well done study on the bottom line on vaccines.  Bottom line is, vaccines are one of the greatest public health discoveries of modern humanity and we choose not to use them at our own peril.


http://besthealth.bmj.com/x/news/648516/news-item.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+besthealth%2Fnews+%28Best+Health%3A+Latest+news%29

As for components of vaccines, they are in the vaccines that are used in the studies and still they show VERY low rates of adverse reactions.  Pentacel (DTAp-IPV-Hib), one of the first vaccines given, does contain formaldehye, but in trace amounts. 

Excipients:
Aluminum Phosphate (adjuvant)
2-phenoxyethanol
Polysorbate 80
Tris (hydroxymethyl) aminomethane
Sucrose
BSA, formaldehyde, glutaraldehyde, neomycin and polymyxin B are present in trace amounts.

Should you be worried about that?  No.  The ingredients are in such small amounts they are of no concern.  Besides, the attached document shows that formaldehyde occurs in high levels naturally in some foods. 

Then there is Prevnar, pneumococcal vaccine for babies.  Contains the following, besides the vaccine components of course.

sodium chloride, polysorbate 80, succinic acid and aluminum as aluminum phosphate adjuvant.

Meningitec: Meningitis vaccine
Non-Medicinal Ingredients
Sodium chloride
Aluminum phosphate
Water for Injection

Priorix-Tetra (measles, mumps, rubella, varicella)
Amino acids for injection
Lactose
Mannitol
Neomycin Sulphate
Sorbitol
Water for injection

Fluviral (influenza vaccine)
sodium chloride
potassium chloride
disodium hydrogen phosphate heptahydrate
potassium dihydrogen phosphate
water for injection

That covers the main routine immunizations for kids. 

And in case those ingredients still scare the hell out of you, consider the ingredient list from:

McDonald's French Fries
Potatoes, canola oil, hydrogenated soybean oil, safflower oil, natural flavour (vegetable source), dextrose, sodium acid pyrophosphate (maintain colour), citric acid (preservative), dimethylpolysiloxane (antifoaming agent) and cooked in vegetable oil (Canola oil, corn oil, soybean oil, hydrogenated soybean oil with THBQ, citric acid and dimethylpolysiloxane).

Big Mac
Beef Patty: 100% pure beef.
Big Mac® Bun: Enriched wheat flour, water, high fructose corn syrup and/or glucose-fructose and/or sugar, yeast, vegetable oil (soybean and/or canola), salt, sesame seeds, calcium sulphate, calcium propionate, monoglycerides, enzymes, azodicarbonamide, AND MAY CONTAIN ANY OR ALL OF THE FOLLOWING IN VARYING PROPORTIONS: diacetyl tartaric acid esters of mono and diglycerides, BHT, sodium stearoyl-2-lactylate, wheat starch, calcium peroxide, wheat gluten, sorbitol, dextrin, malted barley flour, ascorbic acid, citric acid, calcium stearate, calcium iodate, silicon dioxide. CONTAINS: WHEAT, BARLEY, SESAME SEEDS
Big Mac® Sauce: Soybean oil, relish [pickles, sugar, glucose-fructose, vinegar, glucose, salt, xanthan gum, potassium sorbate, spice extractives), prepared mustard [water, vinegar, mustard seed, salt, sugar, colour (caramel, turmeric), spices], water, frozen egg yolk, vinegar, onion powder, salt, mustard flour, xanthan gum, potassium sorbate, spices, garlic powder, hydrolyzed plant protein (corn, soy, wheat gluten), colour (paprika, caramel), calcium disodium EDTA. CONTAINS: MUSTARD, EGG, WHEAT, SOY

And of course through wizardry allowed by Health Canada, food companies do not have to list the components of flavors, only to say that it may contain artificial flavor.  Well, here is what is in strawberry flavor:

amyl acetate, amyl butyrate, amyl valerate, anethol, anisyl formate, benzyl acetate, benzyl isobutyrate, butyric acid, cinnamyl isobutyrate, cinnamyl valerate, cognac essential oil, diacetyl, dipropyl ketone, ethyl acetate, ethyl amylketone, ethyl butyrate, ethyl cinnamate, ethyl heptanoate, ethyl heptylate, ethyl lactate, ethyl methylphenylglycidate, ethyl nitrate, ethyl propionate, ethyl valerate, heliotropin, hydroxyphrenyl-2-butanone, alpha-ionone, isobutyl anthranilate, isobutyl butyrate, lemon essential oil, maltol, 4-methylacetophenone, methyl anthranilate, methyl benzoate, methyl cinnamate, methyl heptine carbonate, methyl naphthyl ketone, methyl salicylate, mint essential oil, neroli essential oil, nerolin, neryl isobutyrate, orris butter, phenethyl alcohol, rose, rum ether, gamma-undecalactone, vanillin, and solvent.

Oy vey. 

My running journey

In 2007 we were still living in northern Ontario, many miles from our families in Alberta.  We ventured home for a short visit in late August or early September.  I honestly can't remember the exact date.  What I do remember though is speaking with my mom about her recent accomplishment.  At the age of 50, she had completed her first half-marathon in what was then known as the ING Edmonton Marathon.  She completed it in 2:30:25, which is an impressive time for a first-time half-marathoner, no less at 50 years of age.  I didn't realize it at the time, but I hurt her that day.

You see, I was so excited to see her and had so much I wanted to share with her about what was going on in my life, that I made light of her achievement by abruptly acknowledging her finishing medal and moving on in the conversation.  It was not until this weekend when I completed my own first half-marathon that I realized just how much that race meant to her and just how much my lack of interest in her story really stung.

Of course, even though it seemed I made light of her accomplishment, it blew my mind.  I had been into running sporadically for many years, due in no small part to her commitment to the sport.  I'd done some fun runs, most memorably the Beat Beethoven 8K in Edmonton (Ludwig kicked my ass in case you're wondering).  But it wasn't until last year, when I was talking to her on the phone about the run she'd put in that morning that I started taking it more seriously.  If she can run four half-marathons (her best time was in 2009 in Edmonton at 2:22:55, an age-adjusted time of 1:59:37 which is smoking fast for a recreational runner) it must be within the realm of possibility to finish one.

So I set out in my mind to complete the Edmonton half in August 2012.  My first step was, as always when I start something new, getting out a book from the library.  Called The 16-Week Marathon Method by Tom Holland, it is a great starter book and lays out detailed training plans for beginners to advanced runners for anything from the 10k to a full marathon.  And I figured since I was a beginner, I better finish off two 16-week training cycles before the race. So began my journey in December 2011 (an incredibly moronic time of year to START a running regimen in Canada).

In my first two weeks, I could already tell I was going to love this.  I was doing great and didn't miss a single one of the eight prescribed runs from the training program.  Then came my first two lessons: when you start running, be cautious not to do too much too fast AND respect the elements.

It was a mild winter so night runs were oddly enjoyable, the crisp winter air making for a refreshing run.  So it was little surprise when I found myself pounding out a 3-miler in freshly fallen snow just one week out from Christmas.  Unfortunately, although it was a beautiful night, when fresh snow falls on a sidewalk, it has a nasty habit of hiding the edge of said sidewalk.  Only 3/4 of a mile into my run, I brought my left foot in for a landing right smack halfway on the edge of the sidewalk.  The force of the landing was enough to wrench my ankle at an ungodly angle and bring me crashing down in agony.  And then the swearing began.

I knew I was done for awhile.  Laying in pain, writhing in the snow, dragging myself to my mother-in-laws front door to have her drive me home, it was all I could do not to cry.  Even though I was only 2 weeks in, I was already visualizing the finish line in August.  I was proud I'd gone from nothing to regular physical activity in a short time and had stuck with it more than one night.  And now it was over because I'd been stupid enough to run in freshly fallen snow.

I remember when I got home, I was sure it wasn't that bad.  And then I took off my sock.  Oh sweet merciful crap.  It was MASSIVE.  When I saw it, I started crying, punched the wall, and rattled off a string of F-bombs.  Then I swallowed my pride and went to emerg.  It was a bad sprain and would take months before I could be back running on it.  I got fitted for the robo-boot, signed up for physio, and went on my way to wallow in my misery for 2 months.

But I couldn't give up.  My mom had suffered setbacks in her training before and kept plugging along every time.  Of all the injuries and emotional ups and downs she'd had all those years, she still completed those 4 races, and she still ran incredible distances every single week.  I took all my motivation from her and reset my training cycle to 16-weeks out from the race.  It wouldn't be easy.  In the meantime I had to study for and write my Certified Diabetes Educator exam, adjudicate the national pharmacy board exam, act as president of our local Chamber of Commerce, and work full time.  Oh, and still be a father to my 3 kids and a husband to my lovely wife.  Nothing to it.

At the halfway point of my training I was having a brilliant 6-mile run.  Near the end I was looking to beat my personal best time and I sprinted for the last 200 meters.  Two days later I tried to run 3-miles and could barely limp my way through the first 400 meters.  I had done something to my knee, and I'd done it good.

The next week all I could manage was running on my elliptical.  I had to do this for almost 3 weeks before I could run again, at which point I was able to manage a 10-mile run with very little pain.  I thought things were looking up.  In the meantime I had it looked at by a nurse practitioner and went to physio twice.  I thought this would be it but then I tried to run a few days later and the pain was excruciating.  Would I be put out by injury AGAIN?  Would I have to give up my dream of completing this race?

I spent a week on the elliptical but still, the pain would not subside.  Finally, only 3 weeks out from the race, I did something crazy.  I did absolutely NOTHING for a whole week.  Well, not nothing.  I read. A lot.  About running.  Born to Run by Christopher McDougall and, on the tails of that read, countless resources about barefoot running including some YouTube videos.  Could it be that I'd been running incorrectly this whole time?  Now, while I'm not dumb enough to make the transition from shod running to barefoot 3 weeks out from a 13 mile race, I did walk around in bare feet that whole week of rest and did some of the posture and strengthening exercises recommended by some of the resources.

I don't know if it was the week of rest or the exercises I did, but when I started on my final two weeks of training, my knee pain was GONE.  Completely.  Not just less or tolerable, but gone.  The next week I completed 4 runs totalling 15 miles with absolutely no problems.  Not only that, but my stride and posture felt better and I was faster than I'd been before.  I was one run from pulling out of the race, but when I completed that run exactly two weeks out from race day and it and felt like a million bucks, I decided to risk it and stay in.

And I couldn't be happier.  When I got to Edmonton on Sunday morning, I couldn't believe the amount of people running in that race.  Between the half and the full marathons, over 1500 people ran.  And nothing can prepare you for the intensity of corralling yourself into the starting area with all these people and having them all move as a unified mass when the starting gun goes off.

I knew from the get go that it was going to be a great race.  I was running comfortably, breathing easy, and my muscles did not even begin to tire until mile 10.  Not only that but I was running 30 sec/mile under my training pace.  So when I came in view of the finish line, I was PUMPED.  Maybe a little too pumped.  I started my kick a little early.  1 km is a painfully long distance when you start a full out sprint!

When I was 100 meters out from the finish, I was hurting, my breathing was rapid, and I was getting this strange tingly feeling in my head.  But then I looked up and saw that the clock time said I was at 2:09.  I don't know how, but I burst as fast as I could and got across under 2:10, my goal time from the outset.  It was then and there that I realized just how much my interest in her accomplishment meant to my mom 5 years ago.

Over the course of my training I suffered two injuries, one severe, one not so much, but still capable of preventing me from completing the race.  I ran a total of roughly 230 miles (368 km), averaging about 15 miles per week.  I had so much emotion and time invested in this run, to complete it was a feeling I can't explain unless you've done it yourself.  I wanted to run to the top of the grandstand and show my medal to everyone willing to look.  But I didn't because my wonderful family was there, waiting to congratulate me, hug me in all my sweaty glory, and tell me how proud they were.  My kids, my wife, my grandmother, my mother-in-law, my father-in-law.  But most meaningfully, my inspiration, my reason for doing it, my hero: my mom.

She was there for me.  She got up at 5am that day to drive me there and spent the whole morning waiting for me to finish.  She did this despite the fact that no one but her mom was ever at the finish line for her all those times she completed the half.  (Well, maybe not "no one", but certainly not me.)  Despite the fact that I never really told her how proud I was of her accomplishments and how much of an inspiration she was for me.  And she did this despite suffering from what the doctors think is severe sciatica which has all but halted her running for the last couple months.  The pain she felt when I didn't fully acknowledge her achievement in 2007, the pain she felt when she saw all those runners take off at the start of a race in which she desperately wished she could run: none of it could keep her away from the finish line to show me how proud she was, to show me that she understands why I do it.

And finally, crossing that finish line, I understood just how much that first race meant to her.  And I couldn't be happier that I now share that understanding with her and my oldest sister.  An experience and bond that cannot be explained but is none the weaker for it.

Now if you find yourself wondering why someone could be so sentimental about something so simple as running, next time you are in your car on a longer drive, set your trip odometer to 0 and just take the time to truly perceive the distance that a half-marathon represents.  21.1 km. And then imagine yourself running that.  Or better yet, do it.  Because you'll never truly appreciate how amazing it feels to complete a half-marathon until you've done it yourself.  And I have my mother to thank for giving me that gift.

Miracle weight loss products

After reading an excellent post by Scott Gavura at Science-Based Medicine I posted a link to it on my Facebook wall, along with a fairly unequivocal statement regarding "miracle" solutions for weight loss.  It went something like this.

"Yet another useless "miracle" diet. There is no easy quick fix to losing and KEEPING OFF weight. None. Period. Anyone that tells you otherwise is either lying, delusional, or the CEO of a company that sells weight loss products."


After thinking about it for a bit, I felt it necessary to provide at least a bit of empirical support for my statement.  I can tell you from my experience that every single weight loss product sold where I work is not worth your time or money.  And I have yet to see a single evidence-based, realistic article in popular grocery store magazines regarding how to sustainably lose weight.  Of course, it wouldn't sell many magazines if you tossed on the headline "Lose 1-2 pounds per week by counting all the calories you eat, eating way less than you do right now and once you've lost the weight, working out an average of one hour a day."  If you can sell that, you should be in marketing.

But my experience is no indicator of truth.  So I decided to generate a research hypothesis.  It goes something like this.  If the massively popular sports nutrition and weight loss products and programs sold to millions of individuals struggling with weight every year are actually effective, we should see their use go in lockstep with rates of obesity.  But we all know that rates of obesity have been steadily climbing for the last 10 years.  And, of course, so have sales of sports nutrition and weight management products and services.  In fact, the similarity between the two growth curves is so similar, it is almost frightening.

Now it stands to reason 100% that this would be so.  As more and more people struggle with weight and seek solutions to their struggles, the market for these products grows.  As such, the marketing of them grows and, in turn, their sales.  It makes sense.  But if they were actually effective, it would be a self-limiting relationship as they would work themselves right out of a job.  But they're not effective.  They're useless and probably contribute at least partially to societal obesity itself.

The graph below is based on OECD obesity data for the US and market data for the sports nutrition and weight management industry.  Obviously, there are a million holes in this approach, but it is certainly a question worth pursuing in more scientific circles.  (In case you are a stats nerd like me, the correlation in the below graph is 0.99)

A treasure trove

Since I started training for my first half-marathon, I have come to love running.  I always knew I might, but never stuck at it long enough to find out.  With my race less than 2 months away, I'm about at the half way mark of training.  Things have been going well enough that I plan on continuing to long-distance run and aim for longer average distances over time.

Being a medical science nerd, I was interested to find out what exactly the health benefits of long distance running are, since people invariably point to the reported cases of deaths during marathons every year.  I assumed this must be a case of recall bias, that being that things which you've read frequently or can easily recall seem more common than they really are.  But where to find the data to support it?  Turns out, I'm not the only one who wants an answer to this question.

Paul Williams, a researcher at Lawrence Berkeley National Laboratory, has published TONS of data from his National Runners' Health Study.  I just searched his name on Pubmed and came across the following data supporting the health benefits of long-distance running.

1.  Risk for stroke is substantially reduced in those who exceed recommended physical activity levels, even after controlling for consequent reduction in blood pressure, diabetes, cholesterol, and body weight.
2.  Higher fitness levels reduce the odds of high blood pressure, high cholesterol, and diabetes.
3.  Risk of high cholesterol declines in step with increasing average running distance.
4.  Incidence of diabetes declines significantly with increasing average weekly running distance, even when adjusted for age and body mass index.
5.  Of interest, although many assume that fitness leads to weight loss, study after study after study has failed to prove this association.  One of the National Runners' Health Study reports shows that pre-study BMI accounted almost entirely for the association between BMI and fitness levels.  That is, those who are already lean are more likely to be faster runners and run more often and, not surprisingly, have the lowest BMIs at the end of the study as well.  So the association between fitness and body weight can be almost entirely explained by ones existing body weight.  Meaning that it is correlational and not causative as many would assume.
6.  While consistent long distance running does not seem to promote weight loss, it does seem to protect against the weight gaining effects of North American diets.  So it may not make you lose weight, but it will prevent you from gaining.
7.  An interesting study looked at active vs. non-active monozygotic twins.  It showed that vigorous physical activity attenuated the genetic "risk" of obesity.  Meaning that whatever genetic component contributes to obesity risk and body weight, it should be equal in identical twins.  So if one is a long distance runner and the other is not, and the active one has a lower BMI than the sedentary one, you can assume it is the running helping out the situation (they controlled for cigarette use, diet, education, etc.)
8.  Just in case the news stories still have you worried, take it from André Picard, the best health reporter in Canada.  From his article, you find out the following:
Donald Redelmeier, a professor of medicine at the University of Toronto, examined records from marathons where there were 3.3 million participants over a 30-year period. There were 26 deaths. That’s a death rate of one in 126,000 – roughly the same as the death rate in the general population. Stated plainly, people die of heart disease, not running.
9.  And, in case you are still not convinced, this study conclusively shows that despite a massive increase in marathon participation in the last 30 years, deaths on the course have not become more common and continue to be rare.  


So, here I am, happy with my decision to pursue a recreational activity that I not only enjoy but that has myriad health benefits.


(As an aside, although the plural of "anecdote" is not "proof" I am certainly the embodiment of science's failure to find a weight loss effect of exercise.  Since April 30, I have run almost 100 miles, averaging 13 miles per week.  I have gained almost 5 pounds in that time.  Boo!)

"Whole" Smoke and Mirrors

I follow a blog called Fooducate.  Today there is a post on the lack of "wholeness" in Whole Foods pastry offerings.  I'd like to draw attention to a few problems with this line of reasoning.

First of all, Whole Foods may have started out with a humble and worthy mission.  However, it is now a major corporation with $10 billion in annual sales, $350 million in profit, and a $16 billion market capitalization, with 304 locations.  The fact that they don't hand make all of their baked goods in store, from scratch, with only pure ingredients that any home baker could access should not surprise anyone, no less someone who has supposedly worked in the industry for 15 years.

Secondly, since when is it a crime to use white flour in baked goods?  Go ahead and use unrefined whole wheat flour in cookies next time you make them.  Let me know how it turns out for you.  Wholeness should refer to the fact that it has been made from whole ingredients without a bunch of crap added to it.  That is, in the example given, snickerdoodle cookies, if you get past all the "legal" ways the ingredients are reported, it really breaks down to this:
-flour
-sugar
-butter
-eggs
-baking powder
-cinnamon
-sea salt
-pure vanilla
I don't know about you, but that's about how I'd make snickerdoodles.  The only ingredient that doesn't make sense is palm oil.  Why wouldn't they just use canola oil?

And if you look at the other examples given, they really aren't that bad.  Next time you are in a non-Whole Foods grocery store, grab a pastry item from the bakery area and read out the ingredients.  That will show you what non-whole really means.

The bigger issue here is not that this consultant is focusing on a very narrow problem, which really isn't a problem, if you ask me, but that even these products should be considered a substitute for what are really whole foods.  I guarantee you if you walk through a Whole Foods market you can still find a bunch of processed crap that you could find in any other grocery store.  It will just have fancier names to make you forget about what you are really doing: substituting convenience for healthy, homemade cooking.

Again, I will go back to the example of bread as I have so often before.  Since learning to love the practice of bread baking at home (and no, I don't have a bread machine, and no, it doesn't take me exorbitant amounts of time, and yes, I do work full-time and have 3 children at home to care for on my days off), I can count on one hand the number of times we have bought store bread in the last 2 years.  Now, let's take the authors line of reasoning and apply it to bread.

If I go to my local grocery store I can buy Dempster's Ancient Grains Bread.  And hooray, the first listed ingredients are whole grain whole wheat flour, whole grain flax, whole grain millet, whole grain spelt flakes, whole grain kamut flakes, whole grain barley flakes, whole grain poppy seeds, whole grain amaranth, and whole grain quinoa.  Good start.  Then rye flakes, sugar, yeast, wheat gluten, vinegar.  Ok.  I can get all those.  Raisin syrup.  Hmmm.  Not sure where I'd find that.  Salt, vegetable oil.  Oh, I recognize those.  Monoglycerides, acetylated tartaric acid esters of mono and diglycerides, calcium propionate, sodium stearoyl-2-lactylate, calcium carbonte.  Baking aisle maybe?  Chemistry laboratory nearby?

What about the bagels she lambastes because the vendor doesn't list the "type" of flour besides calling it "high-gluten flour".  Here is the ingredient list for Dempster's Cinnamon Raisin Bagels.  They do list the "type" of flour.  Good for them.  Enriched wheat flour, water, raisins, sugar/ glucose-fructose, cinnamon flakes (sugar, hydrogenated soybean and/or cottonseed oil, cinnamon, soybean lecithin), cornmeal, salt, yeast*, wheat gluten, cinnamon, malted barley flour, calcium propionate, monoglycerides, vegetable oil (soybean or canola), sorbic acid. May contain potassium sorbate.  Fail.  


As far as I'm concerned, the "whole" offerings at Whole Foods look preferable to me over those at a "traditional" grocery store.  However, even if all the examples given contained whole wheat, whole grain flour, they would still not be a substitute for the homemade version.  


It is a sign of our nutrition-obsessed industrial food culture in North America that we are dwelling on such an issue.  What we should be discussing is why we need a multi-billion dollar corporation to make our breads, pizzas, and pastries for us in the first place.  All the whole grain flour in the world can't replace what we've lost in culinary knowledge in our culture.  When did a grocery store become a place where you buy meals instead of ingredients to make meals?

Maybe my grandkids?

I just finished a fantastic book by Jeannie Marshall entitled Outside the Box: Why Our Children Need Real Food, Not Food Products.  If you have kids and are concerned about what they are eating, or you don't and are just concerned about the North American way of eating, you should get this book.  The author moves to Italy from Canada for work and raises her son there.  It is part story of living in a different culture but also part evaluation of the North American and, increasingly, global food system that is contributing to ever higher rates of overweight and obesity.

As a family, we try very hard to eat a healthy, simple diet consisting of mostly whole foods, only using processed crap sparingly.  And we are trying to raise our children to see food as something to enjoy, not as a commodity to consume.  Having them help us with our vegetable garden is part of that, but so is the way we cook, having them help in the kitchen, and ensuring they try something new every day.  We still let them have fun foods from time to time, but they do not form the centrepiece of their diets.

School lunches have always posed a huge challenge for us, particularly me.  I am always at a loss as to what to put in Sacha's lunch each day he goes to kindergarten.  When Sarah packs it, I'm pretty sure he has the healthiest lunch at the school, and he loves it.  His favorite lunch food is cut up red peppers.  Go figure.  I am slowly learning from Sarah.  But it is a good thing there are no short cuts available in our pantry, because I'd be pulling them out more often than I'd like.

But we are focused on this and make it a priority.  What about other parents?  Maybe they have healthy breakfasts at home and relatively healthy suppers, but lunch is where things can really go to hell.  I've seen kids with lunches full of nothing but processed food products.  Intelligent parents who cook healthy at home and who mean perfectly well and assume that what they are sending their child to school with is "healthy" end up doing just the opposite.  So when I read the following excerpt from Outside the Box, I knew I had to share it.  Because every parent of school-aged kids needs to read this to know, #1, how broken our system is and, #2, that it doesn't have to be that way.  That we could raise our children in a more healthy food society.  All it takes is demand.

1.  Lunch time at a Canadian school
"The children are given twenty minutes in a crowded, noisy room to wolf down whatever their parents have packed for them.  Elizabeth said that Aiden finds it stressful, so whenever it's possible for her to do so, she brings him home for lunch or at least tries to check in on him.  I watched the other children as Elizabeth went to find her son.  I saw a girl with a Thermos full of soup and a bag of Cheezies; a boy with a bottle of water, a ham and cheese sandwich on a white bun and a small container of Pringles chips; and another boy eating a slice of cold pizza.  There were lots of juice boxes, chocolate milk and yogurt drinks.  I saw two girls around seven or eight years old drinking Diet Coke, and a boy with a can of Sprite.  Another boy had a processed cheese sandwich on whole wheat and a silver bag that he sucked at with a straw.  I saw a few apples and one banana and quite a bit of fruit leather.  I was surprised to see a girl eating spaghetti with tomato sauce from a Thermos and another eating a takeout Caesar salad in a clear, plastic container with a bottle of vitamin water.  The children sat at long tables, some together and others trying to eat alone.  There were two adult monitors...but the room was incredibly noisy and most of the children wouldn't sit down....
There was no coherence to the food, since the children all brought their own.  Some of it was healthy-ish but there were a lot of food products and loads of actual junk food.  But what bothered Elizabeth the most was that the children were so unruly..."

2.  Lunch time at an Italian school
"In Italy all the schools, public and private, prepare a two-course lunch with vegetables for all the children.  Some schools might offer dessert once a week, but most don't offer it at all.  I went to Nico's school...to watch the children at lunch one day.  Several classes at a time came to the mensa.  The children sat around a table and each of them set their own place with a placemat, napkin, spoon, fork, and cup that they brought from home.  The cook, a young man whom the children adore, rushed out with a big bowl of pasta with ragu...for each table.  The teachers served the children and then themselves, and sat down to eat with their class.  The teachers engaged in casual discussions with the children about whatever the children wanted to talk about.  They also helped them to hold their forks properly, insisted that they wipe their hands and faces with their napkins and required them to stay in their seats throughout the meal.  When they were finished eating their pasta, the cook brought a large pan of scrambled eggs with Parmesan and a bowl of green salad to each table.  Each child took a plate with a little of each.  He also offered them ortiche (nettles) that he had picked that morning from their terrace garden and cooked and dressed with olive oil, salt, and lemon, and also some fresh, giant cranberry beans to taste...Some of the children asked for more.  There were pitchers of water on the table, along with bowls of freshly grated Parmesan.  When they were finished, they were offered bread that had been delivered that morning from a nearby bakery....
The school does not accommodate picky eaters or vegetarians, though it will make allowance for genuine food allergies.  There's no dessert, except during cherry season....There are no fruit juices and certainly no soft drinks, and the children don't expect them.  When everyone is finished, which is usually after about half an hour to forty minutes, the children clear their places and go outside to play.
The standard form of lunch at this school is a first course of soup, risotto, or pasta and a second course of fish, meat, eggs or cheese and a vegetable.  I've seen the children eat pumpkin risotto; sauteed zucchini flowers; meatballs made with ground chicken, Parmesan and lemon zest; and fish with tomatoes and capers....It's not only the food that is important, but the social skills the children pick up by sitting around the table with their peers and their teachers.  They learn to take turns speaking, they learn to share, and they learn to pass the water pitcher.  They learn to stay seated until everyone has finished their meal."


Read both and think about which you would prefer for your children.  And then think about what it would take to make this a reality.  Given the glacial pace at which regulatory change occurs in Canada, I have little hope this will come to fruition for my children.  But I can hold out hope for my grandkids.  Do you too?

My Norwegian Dream

I've written here before about one thing Norway does very well: managing their sovereign wealth fund.  But Norway does a lot else really well and this came to light in a recent discussion I had with my first year pharmacy student.

He was totally incredulous when I told him I am typically an NDP supporter in federal elections, and usually in provincial elections, although I will admit to voting PC this time around.  He didn't understand how someone who is in a high tax bracket and is pro-business could also support the NDP, a party that many mistakenly assume is in bed with Communists.  He then threw out a common refrain voiced by those who oppose the NDP.  "You know if they ever came to power you can kiss half of your paycheque goodbye, right?" 

It is a commonly held myth that democratic socialism means less disposable income.  While it is true that, in general, nations governing by this dictum often have higher personal tax rates, that does not translate into less disposable income.  If everyone throws a little more money into the pot and that is efficiently and intelligently used to pay for services for the entire population, a practice which often reduces the price of providing those services due to the impact of bulk purchasing power, then a larger portion of the remainder of the paycheque is available for wants, not needs. 

But my student is an intelligent young lad so he deserved a well thought out response.

So here it is.  I analyzed the most recent data from the OECD for the following countries: Australia, Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Japan, Korea, Luxembourg, Mexico, Netherlands, New Zealand, Norway, Poland, Portugal, Slovakia, Spain, Sweden, Switzerland, United Kingdom, and United States.  I analyzed disposable income per capita, government expenditure as a % of GDP, VAT rate (similar to GST; basically sales tax), total government tax revenue as a % of GDP, total personal tax wedge, Gini coefficient, Human Development Index, and various income tax figures after he made a comment about the impact of taxation on higher wage earners.  I looked at the income tax rates of singles and married couples in the highest tax brackets, looking at the base rate, base rate plus social security contributions, and marginal rate, or the percentage in tax paid on the last $ of earned income.  (If you are a sucker for punishment, feel free to ask me for the original data).

I wanted to see how each factor correlated with three other factors: disposable income per capita, Gini coefficient, and Human Development Index. 

Disposable Income Per Capita most strongly correlates with the income tax level on singles and married couples in the highest earnings bracket.  As well, as you can imagine, it correlates quite strongly with HDI, as the more money people have to themselves, the more developed a nation is likely to be.  The other correlations are quite weak aside from a moderate correlation between disposable income and total government tax revenue.  This may not be intuitive but when individuals pay more taxes, they are essentially being forced to save their money by spending it into a pool that is used to purchase services for the whole population.  Thus, they have to pay out of pocket for fewer goods and services and thus a larger percentage of what they earn is disposable because their needs are taken care of by the tax pool.  As an aside, the Gini coefficient correlates negatively with disposable income per capita, which makes sense, because as disposable income goes up, the Gini coefficient goes down, representing movement towards perfect equality.  This stands to reason since the more free money people have to spend PER person, the less likely it is that all the earned income in that nation is concentrated in the hands of a few.



Right away, the data conflicts with the preconceptions of most Canadian conservatives.  They would have you believe that if the government collects less taxes, we will all have more money in our pockets.  I hate to cloud the issue with facts, but it doesn't appear that way, at least not in the 28 OECD nations I analyzed. 

How about Gini coefficient?  What makes a country equal?  There is a very strong correlation between government expenditure as a % of GDP, total government tax revenue, and total personal tax.  Again this stands to reason as the more is put in tax coffers and then spent on the population, the more likely is equality.  This also holds for the tax rate paid by the highest wage earners.  Also makes sense since the more tax we take from them, the more we spread the love throughout the country.

What about HDI?  There are almost no strong correlations here EXCEPT the income tax rate on the highest wage earners, whether they be single or married.  So it seems the more we tax the highest wage earners, the more developed our nation is.  Even when I ran a regression analysis and took out the impact of all the other factors and looked at the impact of these rates alone, rate of income tax collected from highest wage earners in a country is still significantly positively correlated with HDI.

Now to top it all off.  Where does the United States, that bastion of free market capitalism and the poster child for fiscal conservatives everywhere, stand in the rankings for the various factors? (Out of 28 OECD nations)

1.  Disposable Income Per Capita: 3rd
2.  Government Expenditure as % of GDP: 23rd
3.  Tax Revenue as % of GDP: 27th
4.  Total Personal Tax Wedge: 21st
5.  Gini coefficient: 27th (it is only less unequal than Mexico)
6.  12th highest income tax rate for high earning singles
7.  About middle of the pack for the other high earning tax figures
8.  HDI: 4th

So, since the disposable income per capita is quite high, but the Gini coefficient is so high, it stands to reason that large amounts of wealth are concentrated in the hands of a small percentage of the population.  This drives the DIPC up but is not shared equally.  For someone like Warren Buffett or Bill Gates, that is fantastic news.  But for the average Joe/Jane, not so great news.

Is there a better way?  In my opinion, yes.  Sure, if you want to make lots of money as a balls to the wall entrepreneur, you are best off in the States.  But if you are just a regular Joe working in a profession or trade and trying to raise family, that doesn't mean a hill of beans to you.  Which nation has the highest DIPC, highest HDI, and lowest Gini coefficient? Norway

Their DIPC is more than $5000 MORE than the US.  So instead of the general population making peanuts but a few people making buckets of money, everyone makes a decent living.  And they are not even that reckless with their tax and spend policies.  They are only the 16th highest spending government, have the 5th highest tax revenue, and "burden" their citizens with the 14th highest total personal tax wedge. 

Just to make their system more attractive they also elect their legislative representatives by proportional representation.  And they get around the mess that could create in Canada by, believe it or not, working together.  Weird right?  How do they do this?  Legislation that says their parliament CANNOT be dissolved in the four-year span between fixed-date elections.  So if you can't agree on something, you are going to work together until you get it figured out.  Because you are stuck with each other for four years.  THAT is what we need to do in Canada.

Don't get me wrong.  I love Canada.  Always have, always will.  But over the years the impression has been creeping across the border that we need to take all the power away from government and leave as much money in the pockets of wage earners as possible.  This is thought to be the only way to true success and economic prosperity. 

Nations like Norway, Sweden, Finland, and Denmark show us that there is another way.  It is time we start taking some of their great ideas and working them into this amazing country we have to make it all the better.  Who wouldn't love to see Canada one day sitting with the highest disposable income per capita, HDI rating, and income equality?