Friday, January 17, 2014

The tide may be changing.... in the UK

This past week I came across two very different articles from England that suggest that some people over there are beginning to speak out about the role fruit sugars play in diabetes and obesity. 

The first is an article from The Guardian quoting a government adviser and obesity expert who believes fruit juices should be excluded from the "five a day" recommendation.  According to her, 

"Fruit juice isn't the same as intact fruit and it has got as much sugar as many classical sugar drinks. It is also absorbed very fast so by the time it gets to your stomach your body doesn't know whether it's Coca-Cola or orange juice, frankly."

Maybe nothing groundbreaking, but it's a start.

The second article is more of an eye-opener and comes to us via the CBC. Apparently a zoo in Devon decided to ban their monkeys from eating bananas. It's not news that much of the fruit that we eat has been selectively bred to make it sweeter and more appealing, and bananas are no different. The bananas in our stores are not the kind that animals in the wild would be likely to ever find. So much so, that staff said:
Bananas, and other fruits, are bad for the monkeys' health and can rot their teeth, according to staff at Paignton Zoo in Devon.
"They simply are much more sugary than the sort of fruits that monkeys would have access to in the wild," said Amy Plowman, the zoo's head of conservation and advocacy.
The monkey's high sugar diet led to problems similar to those seen in humans, namely tooth decay, diabetes, and issues related to obesity, such as heart problems.
"What we found is that the monkeys are maintaining a much healthier weight, which is really good. In zoos, animals tend to perhaps put on a little more weight than they should because they've got very easy access to lots of food and they don't as much exercise as in the wild," she said.
A low-sugar diet also slightly improves the animals' behaviour, especially among smaller monkeys, who tend in live in packs and tend to squabble a bit, she added.
You would think that if this holds true for monkeys in the zoo, the same would apply to humans.  While the low carb community links high carb fruits with blood sugar control, it's still rare to find mainstream health experts prepared to speak out against nature's candy.  After all the work done to teach people to eat more produce, the last thing they want is for them to go back to a diet devoid of fresh unprocessed stuff.   And yet, in doing so, many if not most, health-conscious people are totally convinced that eating plenty of fruit can never be a bad thing.

The increasingly popular vegan raw food movement certainly doesn't seem to have a problem with eating many fruits every day - I may be mistaken but I get the impression that there's little said about how many smoothies are too many.

At least the monkeys are being provided with realistic restrictions!

Wednesday, October 23, 2013

Choose Butter over Margarine, ditch the low-fat foods

Butter and cheese better than trans-fat margarines, says heart specialist Aseem Malhotra says saturated fat is not a problem, low-fat products are often full of sugar and statins are over-prescribed. Read the full article in The Guardian.

Here is the link to the abstract for the BMJ study that the article refers to.

Wednesday, October 16, 2013

Sugar in Chocolate Milk

I've written about the high sugar content in chocolate milk before, but it was a while ago, so I don't think it hurts to revisit the topic.

Just to recap, the sugar content in 250ml of chocolate milk is 26g.  The same quantity of 2% white milk provides 12g of sugar, which means that each cup of chocolate milk is spiked with 14g of sugar.

That is the equivalent of 3 1/3 teaspoons of sugar that does not naturally occur in cow's milk.

I was at a nutrition workshop last week, where we heard a nutritionist pooh-poohing Dr. Yoni Freedhoff's anti chocolate milk stance.  Dr. Freedhoff, if you don't know already, is the Ottawa physician behind the popular blog, Weighty Matters.

She thought he was rather extreme in his views, because didn't he realize that much of the sugar in chocolate milk is naturally occurring?

Actually, I think he is well aware of this.  Seemingly, the nutritionist, employed by our local Health Unit, is not particularly concerned about children consuming more than 3 teaspoons of sugar in a drink.  She appeared to be much more concerned about ensuring that children eat plenty of "heart healthy whole grains" and cut their fat consumption - you can imagine what I think about children eating reduced-fat cheese, which she wholeheartedly endorsed, but that's a topic for another day.

My son is 14, and I witness daily how being a teenager causes quantities to be supersized.  When a teenager takes a drink on the go, we're not talking about just a cup.  A 500ml serving is more likely to be the minimum that he'll chug down.    This means a teenager who purchases a chocolate milk drink from the school vending machine is quite likely to consume over 6 1/2 teaspoons of added sugar.

This is why I agree more with Dr. Freedhoff than the accommodating nutritionist at our local Health Unit.

And yes, I do buy chocolate milk from time to time - as an occasional treat.  My children like it, even though I am very uncomfortable with the sugar content.  When they were younger, I used to top up a glass of chocolate milk with regular milk, but nowadays they help themselves to whatever they find in the fridge.  Most of the time they drink water or milk instead though. Or they make their own smoothies with fruit or cocoa.

Sunday, October 13, 2013

Statins Cut Stroke Risk by 40%?

The source of the article, written by a certain Jenny Hope, was a study published online this month in the journal Stroke.  The print version will be coming out in December. The title of the study is Age and Ethnic Disparities in Incidence of Stroke Over Time, and the authors are Yanzhong Wang, PhD; Anthony G. Rudd, FRCP; Charles D.A. Wolfe, MD, FFPH.

The Mail Online's screaming headline would have you believe statins were responsible for a massive 40% decrease in stroke risk.  What's not to like about that?

Quite a bit, as it happens.  The big problem I have with the headline is that the cause of the reported decrease doesn't appear anywhere in the actual study!  The only reference is this little sentence:

Improvements in prevention could come from any number of interventions, which may or may not include statin drug prescriptions.

But there are other aspects that are disturbing.  A 40% improvement in stroke incidence is great, but doesn't apply to blacks, or people aged 15 to 44.  

More people are now getting strokes at a younger age.  The mean age dropped from 71.7 to 69.6, which I expect is due to the higher proportion of younger stroke patients:

The fact that the glowing results were not across the board, is a strong suggestion that statin usage was not the simple causal factor for the decline in stroke incidence that the Mail would like you to believe.  Of course, it is possible that on average, younger people and blacks did not receive the same proportion of preventative health care interventions, including statin prescriptions, that white elderly people were provided with.  

I am curious to know whether black people were, on average, given similar interventions.  Were the drugs they were prescribed less efficacious, were they even offered statins, or were other factors at play?  This is very important to know if you are black and your doctor wants to prescribe a statin to you.

Statins are not the only drugs used to reduce the risk of stroke.  Hypertension is a major factor too, and blood pressure medication also plays a large part.  Why were statins and not blood pressure medication singled out in the headline as the cause underlying the changing trends?

The study authors point out that they are not sure why stroke risk rose among younger people, particularly blacks, though they did recognize that there is a general rise in cardiovascular risk factors:

Lastly, the types of stroke changed, which a shift from hemorrhagic to ischemic strokes.  I am curious why this might be.

What does this mean?  In my opinion, it is a good example of why it is important to refer to the actual studies when newspapers quote dramatic cause and effect results.  The journalists writing the articles have an uncanny facility for jumping to conclusions that are not at all mentioned in the studies they quote.  It can take some detective work to distinguish important statistical outliers from the overall results.

The public is often quick to suggest that studies are biased because of who is funding them;  however, in this case, it is not the study that is flawed or biased, but the media hype surrounding the study.

Edit:  After posting this, I found Zoe Harcombe's take on the same study.  She was also baffled by the attribution of cause in the newspaper headline that wasn't noted anywhere in the actual study.  In Zoe's words, the headline "is a lie. It is simply not true. It is disgraceful ‘journalism.’"

Friday, August 30, 2013

Not so angelic baking

I just came across a recipe that, in my opinion, exemplifies what is wrong with our culture of baking.

The caption "WW Peach Angel Food Cake - only 2 ingredients!" piqued my interest.

I don't think I have made angel food cake since I was a teenager, but off the top of my head I would have thought at a minimum that it would need egg whites, sugar, flour and peaches.

"WW" usually refers to Weight Watchers, so this should be a good one, I thought.

Imagine my surprise when the recipe listed the two ingredients as a 16 oz package of angel food cake mix and a 15 oz can of peaches, with juice. Technically these may be two ingredients, but in reality, you'd probably be getting a whole lot more than if you were to bake an angel food cake from scratch.

Canned peaches are relatively simple. For example, a can of Del Monte sliced peaches in 100% juice contains:

Peaches, Peach Juice, Pear Concentrate, Water, Natural Flavors.

Note that the pear concentrate is probably there as a natural alternative to sugar. Technically it's natural, but in reality is just as sweet as sugar.

And here is the lengthy ingredient list on a box of Duncan Hines angel food cake mix:

Sugar, Enriched Bleached Wheat Flour (Flour, Niacin, Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Wheat Starch, Powdered Egg Whites (Egg Albumen, Sodium Lauryl Sulfate [Whipping Aid]), Leavening (Monocalcium Phosphate Monohydrate, Sodium Bicarbonate, Potassium Bitartrate). Contains 2% Or Less Of: Corn Starch, Maltodextrin, Natural and Artificial Flavors, Modified Cornstarch, Partially Hydrogenated Soybean and Cottonseed Oil

That's not bad for a two ingredient cake!

But wait, there's more! Take a look at the nutrition label for one tenth of this fluffy light cake, and please be honest, do you think you would stop yourself after such a small piece, or like me, could you easily polish off a quarter or more?

If you were a nutritional angel, you might be content with an 87g sliver. But trust me, that's not much.  
Then there's the carbs. They are another matter altogether: you would be consuming 42.6g in that one slice! And when you're eating something that's as light as air, it's hard to resist the urge for seconds.

But just take a look at these gushing comments:

WOW - great, easy, low fat dessert recipe.

Fabulous! Easy, low in fat and very delicious!

Thanks so much for a great low calerie (sic) dessert.

Do you see why I think this recipe epitomizes what's wrong with a baking culture that reveres low fat concoctions while disregarding other nutritional measures, especially one that loves recipes conveniently made from purchased and processed mixes?

Could we get any further from eating real food?

Friday, August 23, 2013

What if obesity is not the cause of insulin resistence?

Dr. Peter Attia give an excellent TED talk explaining his hypothesis surrounding metabolic disease and obesity.  I usually find what he writes to be fairly technical and lengthy, yet this 15 minute talk is all in plain English, that anyone can understand.  He talks about why the medical establishment is letting its obese and diabetic patients down in a time when the incidence of diabetes is exploding:

Saturday, August 10, 2013

Reversing Diabetes by going Vegan

If you've been active on the internet at all in the last couple of years, you must have noticed the increasing popularity of veganism.  I have long been fascinated by Dr. Neal Barnard's premise that a vegan diet is what is needed for health.  Of course this is completely contrary to the way we eat at our house, and I am intrigued as to how Dr. Barnard supports his beliefs.

So I borrowed his book, "Dr. Neal Barnard's Program for Reversing Diabetes"  from our local library.

It's a quick read, full of examples of patients who lost weight and improved their health dramatically by following his vegan approach.  I'm not diabetic myself, but I thought it looked interesting nevertheless.  He claims his patients are thrilled to embrace a plant-based diet.  What I am not sure about is what percentage of people succeed on his diet plan, even though the cover loudly (but vaguely) proclaims that it is "3 times more effective than other diet plans."

I have no quarrel with several of Dr. Barnard's premises.  Let's get these out of the way first:  Like proponents of ancestral eating, he rejects processed foods, refined starches, hydrogenated fats, and sugar.  Vegetables and fruits are in.  He is firmly against dairy products, as are many (though by no means not all) supporters of the Paleo diet.

But that's where the similarities end.

Dr. Barnard reveals himself to be severely fat-phobic.  He believes dietary fat is very, very bad for you.  He claims that sufficient essential fatty acids can be obtained by eating vegetables (though he's not an avid eater of avocadoes, nuts and coconut), and that dietary fat causes inflammation and disease.  For example, on page 25 we read that:
You have eaten fatty foods, and, as a result, tiny bits of fat have accumulated in your muscle cells.  This fat interferes with the normal workings of the cells, including their ability to respond to insulin.  If insulin is unable to work, glucose cannot get into the cells, and it builds up in the bloodstream.  Then, those fatty foods actually seem to disable your genes that would produce the mitochondria you need to burn up this accumulating fat.  Your ability to eliminate fat inside your cells seems to be slowed down when you eat fatty foods.
There is no discussion of the role of carbohydrates in this process.  All the blame is placed squarely at the feet of fat containing foods.

Similarly, he is quite adamant that dietary cholesterol is the cause of high cholesterol in the bloodstream. Throughout, he writes about LDL cholesterol, qualifying it as "bad cholesterol" each time.  Since dietary cholesterol is only found in food derived from animal sources, he writes on page 59 that:
Your new diet is not low in cholesterol;  it has no cholesterol at all.  It also has no animal fat, which is important because animal fat (like other sources of saturated fat) encourages your body to make cholesterol. 
Frankly, I am amazed that a medical doctor with a special interest in diet can make these claims.  I would have thought that everyone in this field realized by now that dietary fat doesn't just lodge itself in the arteries, and that the consumption of cholesterol is known to play only a very minor role in the cholesterol in the blood.  I was so surprised that I double-checked when the book was published -- maybe it was a very old edition.  But no, it was published in 2007.  That is sufficiently recent for there to be little excuse for such an oversight.

Another oddity is his claim that animal protein is bad for the kidneys.  Here is the paragraph on page 43 where this is discussed:
Now, you will notice that the diet I recommend is not just free of animal fat;  it is also free of animal protein.  That is important because animal protein can harm the kidneys, and protecting them is a key goal.  Protein from plant sources is the way to go.
Do you get that?  I didn't.  I have no idea why animal protein is damaging to the kidneys but plant protein isn't.  Surely, protein is protein?  If not, why would there be a difference?  Why doesn't the quantity of protein consumed play a role?  According to Dr. Barnard, even small quantities of animal protein are potentially harmful.  I was very disappointed that this wasn't fleshed out (sorry, I had to use that!) a little better.

I am fully aware that diabetics are at higher risk of kidney impairment than people who are not diabetic.  So it makes sense to be careful around this subject in a book aimed at diabetics.  But I can't help thinking that Dr. Barnard's firm vegetarian convictions played a role in defining what kind of protein is acceptable on his diet plan.

I do agree with him that there are some very serious problems with the way that meat is brought to the market.  I also find the treatment of animals in CAFO (concentrated animal feeding operations) very disturbing.  It is precisely for this reason that we buy our meat from a small local farmer, and we raise our own chickens for their eggs.  In my opinion the abhorrent treatment of animals in these massive CAFO operations is a great justification for being vegetarian, if consumers are unable to find alternative sources that meet their approval.  However, to say that animal protein is harmful to the kidneys, while vegetarian protein is not, makes no sense to me.

I think by now that you have an idea of what I think of Dr. Barnard's plan.  I should add that is puzzling to me that he claims to be very successful with his approach.  Perhaps veganism does work for some people, just as a paleo diet works for others.  It certainly seems to work for Dr. Barnard, who looks very healthy on the cover of the book.  Could it be that either a low carbohydrate or a low fat/protein approach to losing weight could be successful, but that it is the combination of carbohydrates with fats that leads to problems at the cellular level?

Dr.  Barnard's diet is not likely to work for me.  "Frying" onions in water, which is what he recommends, is most unappealing.  I do cook plenty of vegan dishes, but they are almost exclusively low carbohydrate dishes.  I feel far too healthy eating a variety of fats from both animal and vegetable sources.  I'm also not about to give up my almost daily omelettes made from eggs from pastured chickens.

But even if the idea of giving up dietary fat and animal protein doesn't hold much appeal, I think what is more disappointing is that Dr. Barnard does not support his dietary approach with convincing scientific research.  I am quite willing to believe that it can work for some people, but the problem is that his book doesn't explain very well why it works, and because of this, the book left me feeling quite confused and not at all convinced.

Thursday, July 18, 2013

Optimal meal frequency for weightloss

A guest post on Robb Wolf's Paleo site discusses the optimal spacing of meals for weight loss and metabolic health:  
Eating 3 meals a day seems to be an effective way to avoid the stressors of undereating or going too long without food while allowing for our fat burning hormones to do their job.  I would encourage these meals to be spaced apart every 5 hours.  This allows for equal time between insulin and glucagon and an equal work to rest ratio for our liver and pancreas.  If hunger persists try eating more at the previous meal, especially protein, or try taking some digestive enzymes with each meal. People who partake in IF rave about its ability to stimulate fat loss, and show some studies to support this.  I personally believe 16 hours between two meals is too long.  You can have the same weight loss effects spacing out dinner from the night before and breakfast 10-12 hours.  This decreases the risk of causing excess stress and allows for substantial time in the fat loss area.
It's worth reading because, while not overly long, it provides a plain-English explanation of the metabolic processes that occur before, during and after a meal.  

If you're looking for more reading material on the subject of intermittent fasting and weight loss, do check out The Fast Diet, which provides a different spin on the subject.  Extremely popular in the UK, the 5:2 approach recommends five days of normal eating a week, interrupted by two non-consecutive days of low calorie intake (500-600 cal):
The idea is to capture the benefits of fasting without overly sacrificing the comfort of eating because you're never more than 24 hours away from a full meal.  I haven't read the book, but I have been following the hype around it in the media.  I am interested in the concept, though I firmly believe that sugar control is necessary even on the 5 "normal" days.  I think the slice of pie for pudding might be a poor example.

I would be interested to see what Kevin Cann, the author of the Robb Wolf piece, makes of the 5:2 diet.  With some in the Paleo camp convinced that intermittent fasting is the way to go, and the more traditional establishment serving more regularly-spaced meals, perhaps the 5:2 approach provides an optimal balance along the food frequency spectrum.

Wednesday, July 3, 2013

The Causes and Management of Diabetes

The Weston A. Price website has a refreshingly readable explanation of the causes and management of diabetes, the disease that has become so commonplace in North America:
If we run a marathon every day, a balanced diet would probably include about 300 grams of carbohydrates per day, the amount contained in 20 potatoes or 6 brownies. If we sit on the couch all day, obviously our requirement for energy food will be less. In this case a balanced diet would include only about 65-70 grams of carbohydrate per day. Any more, and our bodies are forced to make more insulin and the whole vicious cycle begins.
The problem of diabetes can be summarized by saying that the western diet has us eating like marathon runners, when in fact most of us simply sit on the couch. When we regulate the carbohydrate intake to match our exercise level, type II diabetes cannot develop, and in fact, I have found that most cases of type II diabetes respond well to treatment when these basic principles are kept in mind. Type I diabetes responds equally well to a high-fat, low carbohydrate diet. In fact, before insulin was available, the only way to treat type I diabetes was a high-fat diet from which carbohydrate foods were completely excluded because the body does not need insulin to assimilate proteins and fats.

Read the full article here.

Wednesday, June 19, 2013

Risk Management: Seeing the Wood for the Trees

In case you haven't heard about Joel Salatin before, he is a hero to the organic farming movement.  Not only a charismatic speaker, he claims to be a grass farmer.  In fact, he owns a farm that produces highly prized free range chickens, eggs, cows and pigs, and he makes good money doing so.

This little vimeo clip is specifically relevant to this blog, because of the comments he makes towards the end about the underlying causes of the problems in our food system. Joel claims the government's overarching belief with regard to managing risk in the food system is that sterile = safe.

Thus highly processed sugary breakfast cereals are given the go-ahead, but tomatoes grown with organic compost are regarded as potential sources of toxicity.

This is something I see all the time in our schools, where our local school board is resisting the creation of school gardens.  For the past two years, they have been working on a policy to ensure the safety of students.  For example, they are grappling with the issue of washing all produce before eating it, because dogs may have peed on it.

Meanwhile, our children face numerous examples of suboptimal food choices all the time, with little political will to put a stop to them.  Yet, cumulatively, these poor food choices lead to long term health problems which somehow don't factor nearly as much into the risk assessment models.

For example, my children's teachers regularly use candy to reward good behaviour, and we see parent councils serve serving sugars and highly refined carbohydrates at school fundraisers.  Parents, quite correctly, in my opinion, are free to pack whatever they like in their children's lunch boxes.  However, when I look at what children bring to school, I am constantly saddened by the high percentage of processed and packaged foods that most children eat at school every day.  It rubs off on my children too, who sometimes wish they could have packaged granola bars or tetrapack sugary juice boxes.

Take a look at Joel's video.  He puts his finger on the crux of the problem:  a healthy food system is not sterile.  It's natural and alive.  Conventional food and farming policy aims to reduce risk, and this, paradoxically, is the source of much of the risk to our food system.

The conventional food system misses the wood for the trees.

Monday, June 10, 2013

Parental Cognitive Dissonance

Dr. Yoni Freedhoff is a Canadian physician who runs a popular blog named Weighty Matters that looks at issues surrounding overweight.  This morning I was intrigued to see a post discussing the issue of junk food offered for sale at track meets.  We are in the middle of track meet season at the moment, and with two children competing in our district finals later this week, it's a subject that is close to my heart.  It is highly likely that hot dogs and sweet beverages will be on sale and my children will ask me for a couple of dollars to buy their lunch.

Ontario introduced provincial legislation in 2010 (also known as PPM150) restricting what may be sold at schools.  In my opinion, the legislation doesn't go far enough to restrict sugar and refined carbohydrates, and focuses far too much on restricting fat and salt;  however, it's a start.

While this legislation is fairly toothless in reality, I'm motivated more by my desire to be a good parent than as an upholder of the law in my opposition to what I see going on in my childrens' school on a regular basis.

In my opinion the execution of this legislation falls far short of what could be done.  Many of the parents on the parent council of our school don't feel nearly as strongly as I do about good nutrition.  When they organize school events, the koolaid jammers and hot dogs tend to creep in.  The teachers also frequently use candies, pizzas and freezies to reward good behaviour and academic achievement.  I have often heard poor food offerings rationalized away by comments that there's nothing wrong with giving children a treat from time to time.

I'm painfully aware that this is a delicate situation.  It's embarrassing to teenage children when their parents continuously challenge the majority opinion.  I am also conscious of not wanting to drive a wedge between my children and their teachers, who have a difficult job to do, and who spend many hours every week with their charges.  I don't envy them their job and admire the fact that they are able to control such large groups of children, many of whom have behavioural issues that can make classroom control quite difficult.

I probably also have more time than they do to read and think about subjects like childhood nutrition.  It's quite possible that many of my kids' teachers simply haven't considered the harms of sugary food to the same extent that I have.

So my approach is to be careful. I volunteer a lot of my time and have helped coordinate many school fundraisers that involve innovative food offerings that easily match the spirit of PPM150, and just as important, are crowd pleasers too.   I am not afraid to speak up from time to time, though sometimes my approach is simply to not participate in fundraisers I don't believe in.

Big Food's strategy to counter legislative restrictions is to form fake grass-roots organizations designed to appear to support consumers' freedom to choose for themselves.  New York's recent push to limit soda portion sizes, for example, was framed by the beverage industry as a libertarian issue.  I am not optimistic that common sense and nutritional standards will ever win out against the relentless marketing efforts that children are exposed to without legislation to curb Big Food.  Yet at heart, I am drawn to libertarianism as an ideology, and the industry is aware of this dichotomy.

It occurred to me that there is a certain cognitive dissonance in our school system.  We can probably all agree that our kids should be allowed treats from time to time.  But surely we should be the ones to decide when and how to do this, not other parents or teachers?

It would be a better idea if children were exposed only to uncontroversial food choices at school or at school sponsored events.  Let parents decide for themselves when and if to give their children sugary and processed treats.

Healthy food certainly can be delicious.  Done properly, it can be cost effective and lucrative too, but it takes a little more imagination to put it together.   Rather than resisting healthy offerings, why don't we, as parents and teachers, spend that energy planning better options?  There is a learning curve, but I do know from experience that it can be done.

Sunday, May 19, 2013

Statins do not reduce heart disease risk.

I'm not a regular reader of Mercola's site, though this article on cholesterol and statins piqued my interest.  It explains why our society's focus on lowering cholesterol levels is nonsensical. Instead:
  • Your triglyceride/HDL ratios: This ratio should ideally be below 2.
The second half of the article explains why taking statins will not reduce your heart disease risk and lists a number of sensible steps everybody can take to avoid CHD.

Read the full article here.

Wednesday, May 1, 2013

The Whole 30

The Whole 30 is a 30 day online eating challenge that cuts out sugar, grains, dairy and legumes.  It might sound daunting, but I like the way it's structured.  For example, although there's no calorie counting involved, and there are no restrictions on the healthy foods, the approach is slightly different than many diets, which allow cheat days or tell you that it's not a big deal if you eat something from the forbidden list - just get up, dust yourself off and carry on.  No, the Whole 30 is pretty hard core about cheating, and expects you to be serious about the challenge.  I must say it reminds me a little of the different approaches to religion:  some people think it's ok to ask forgiveness after sinning, which allows them a more easy-going lifestyle, whereas more puritannical types don't allow themselves to even come near to temptation.

For example:


What I really like about the approach is that it doesn't allow ingredient substitutions that enable you to continue eating foods that are substantially similar to forbidden ones.  You wouldn't believe how irritated I get seeing endless recipes online for foods like paleo bread or grain free pancakes and muffins.  This is about healthy eating and avoiding the culture of baking
I could see that this approach wouldn't work for everyone, and since I haven't given up dairy yet, it might be a challenge I should try myself.  I always maintain that you need about 2 weeks to get over the worst of the grains and sugar withdrawal symptoms, so presumably the second half of the challenge is usually easier to maintain than the initial fortnight.  

Check it out here.  It's a program, like so many others, that you can follow for free on the website.  There is also a paid component that offers premium services, but that part is optional.  There appear to be plenty of free resources to take advantage of.