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Blueberry Zucchini Loaf!

>> Sunday, May 21, 2017







This May long weekend, I'm sharing a delightful loaf that I concocted in my kitchen one Sunday afternoon.... I had a hankering for a healthy muffin, and I was fresh out of muffin cups after trying out an online recipe that produced something resembling a dough pellet (epic fail!).  I had just been to Costco and had way more zucchinis than I knew what to do with.... sooo... voilĂ !  And it turned out great.

Ingredients:
  • 1.75 cups whole wheat flour
  • 1/2 cup white sugar
  • 1/4 cup brown sugar
  • 1.5 tsp baking soda
  • 2 tsp cinnamon
  • 1/2 tsp nutmeg
  • 1/4 cup canola oil
  • 1/4 cup milk
  • 1/4 cup greek yogurt fat free
  • 4 tbsp egg white
  • 2tsp vanilla
  • 1.5 cups shredded zucchini
  • 1/2 cup blueberries

Directions: 

1.  Preheat oven to 350F. 

2.  Mix first 6 ingredients (the dry ones) together in a large bowl. 

3.  Whisk together canola oil, milk, greek yogurt, egg white, and vanilla in a separate bowl until smooth.  Stir into flour mixture until batter is just moistened.  Fold zucchini and blueberries into batter. 

4.  Spray a standard loaf pan (8.5" x 4.5") with non stick spray, and pour batter in. 

5.  Bake 35-40 minutes, until a toothpick inserted into the centre comes out clean.


Makes 12 slices.  Per slice: 
  • Calories: 169
  • Fat: 4.8g
  • Carbs: 28g
  • Protein 3.2g

Note: I think this would also be good with half the white sugar (1/4c instead of 1/2 cup) - if you try this, let me know how it tastes (post a comment at the end of this post). 



Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017





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Does Intermittent Fasting Work?

>> Monday, May 15, 2017




One of the diet approaches that has really taken off in popularity is Intermittent Fasting.  Essentially, this means that certain days/times you restrict eating (or don’t eat at all) and other days/times, you feast.  This can take the form of Alternate Day Fasting (fast one day and feast the next), restricting on some days (eg weekdays) and feasting on others (eg weekends), or restricting eating to only a few hours each day.

Most studies showing benefit of intermittent fasting have been of very short duration (less than 12 weeks) – and let’s face it, just about anything can work over this very short term.  Now, a one year randomized controlled clinical trial has investigated whether intermittent fasting works.

The study, published in JAMA Internal Medicine, is quite a beautifully conducted trial (in my opinion), randomizing 100 people with obesity to one of three groups:

  • Alternate day fasting: 25% of energy needs on fasting days, and 125% of energy needs on non fasting days
  • Daily calorie restriction: 75% of energy needs on all days
  • Control group: no intervention (they received 3 months of free weight loss counselling and a 1 year free gym membership at the end of the study)

Participants followed the above for the first 6 months of the study, which was the weight loss phase. 

For the second 6 months, the focus was on weight maintenance. Calorie needs were reevaluated (because we need less calories to maintain weight following weight loss), and the groups proceeded as follows:

  • Alternate day fasting: 50% of energy needs on fasting days, and 150% of energy needs on non fasting days
  • Daily calorie restriction: 100% of energy needs on all days
  • Control group: no intervention


For the scientists in the audience: Total daily calorie needs were assessed using doubly labeled water, assessed at baseline and again at the start of the weight maintenance phase (t=6 months).  Analysis was by intention to treat.

At 12 months, the rate of dropout from the study was highest in the alternate day fasters at 38%, compared to 29% in the daily calorie restriction and 26% in the control group.

They found that the weight loss between the alternate day fasting and daily caloric restriction were no different at 6 months or 12 months.  Weight loss was 6.0% greater than the control group at one year in the intermittent fasting group, vs 5.3% greater than the control group in those on daily calorie restriction.   Other than a slightly higher bad cholesterol (LDL) in the intermittent fasters, there were no differences in any metabolic parameter.

While the study is small, it is the longest and largest clinical trial of alternate day fasting to date. 


BOTTOM LINE: The results of this study suggest that alternate day fasting is no better than daily calorie restriction for weight loss, and that the likelihood of sticking to the diet is lower with alternate day fasting.


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017
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Let's Take ACTION - Barriers To Effective Obesity Management In Canada

>> Monday, May 8, 2017





Obesity is a chronic medical condition that affects 25% of Canadian adults. As we know from the recently released Canadian Report Card On Access to Obesity Treatment, we are doing very poorly in terms of providing publicly funded access to treatment for obesity.

So what are the barriers that are preventing people with obesity from getting access to obesity care?  In addition to collecting important statistics in the Canadian Report Card, we also need to understand barriers from the perspectives of people living with obesity as well as their health care providers.

The ACTION study is the first nationwide study in Canada to investigate barriers to effective obesity management from the perspective of people with obesity, healthcare providers, and employers who provide health programs or health insurance coverage.  This study aims to generate insights to guide collaborative action to improve care, education, and support for people with obesity, and to provide evidence upon which to change how patients, health care providers, and employers treat obesity.

The ACTION study steering committee (of which I am a member) has been working to construct questionnaires that will be deployed to patients, health care providers, and employers across the country, to gather information on these important topics.

By understanding these perspectives, we hope to improve communication, education, and break down barriers to allow better access and provision of care for people with obesity.

Stay tuned for the results of this study early next year!


Disclaimer: The ACTION study is funded by Novo Nordisk, the maker of anti obesity medication Saxenda (liraglutide 3.0mg). 

Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017

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Do GMO Foods Cause Obesity?

>> Monday, May 1, 2017






Genetically modified organisms (GMO) refers to any living thing that has had its DNA modified by genetic engineering techniques.  GMO foods have been developed to be resistant to pests and herbicides, and/or for better nutritional content.   With the introduction of GMO foods, we have seen a parallel rise in obesity rates.  Could GMO foods have a role in this?

There is very little data on this issue. One study looking at American food trends and obesity found that consumption of corn products correlates with the rise in obesity.  Most American corn that is grown is genetically modified - so is it an increased calorie intake from corn products, or that it is genetically modified, that may be responsible correlation?  Or is the correlation purely coincidental? More research needs to be done.

A comprehensive review of dietary and policy priorities for cardiovascular disease, diabetes, and obesity published in the journal Circulation in 2016 found that existing evidence does not support that GMO food causes harm, but that the data are limited.   They point out that any potential effect of a GMO food on human health (positive or negative) would relate to specific compositional changes in the food, not to the GMO method itself.

As these authors state:

Based on current evidence, whether a food is organic or genetically modified appears to be of relatively small health relevance in comparison with the overall types of foods and diet patterns actually consumed. 


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017






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Breaking News - Canada's Report Card On Access To Obesity Treatment

>> Tuesday, April 25, 2017


Obesity is a treatable chronic medical condition that affects over 25% of Canadian adults.  But how well are we doing at treating obesity in Canada?

Today, the Canadian Obesity Network has released the Report Card On Access To Obesity Treatment For Adults In Canada. This is the first rigorous assessment of the degree to which Canadians with obesity can access publicly funded treatments such as dieticians, psychological counselling/support,  medically supervised weight management programs, medications for obesity, and bariatric surgery.

The Report, not unexpectedly, showed that access to care for obesity in Canada is extremely limited.

  • There is very little publicly funded access to dietary counselling, mental health support, cognitive behavioural therapy, or exercise professionals. 
  • There is no public coverage for anti-obesity medication, and only about 20% of private medical plans offer coverage. 
  • Bariatric surgery is available to only 1 out of every 183 adult Canadians per year who may be eligible for it (this varies widely by province, with the best availability of 1/90 in Ontario, and the lowest availability of 1/1,312 in Nova Scotia).  


So why is access to obesity care in Canada so poor?

1.  Despite the Canadian Medical Association declaring that obesity is a chronic medical condition (and not a lifestyle issue) in 2015, neither Health Canada, nor the federal government, nor any provincial governments have followed suit. This results in a lack of policies that support obesity care.

2.  Medical schools have little to no formal obesity training, and very few Canadian doctors pursue additional obesity training of their own accord.   Only 40 out of 80,544 doctors in Canada have completed certification through the American Board of Obesity Medicine. (there is no formal obesity training equivalent in Canada)

3.  There remains a powerful and pervasive obesity stigma in Canada, which has been shown to be even worse in the medical community than in the general population.  Person-first language is often not used in government resources nor in medical literature - meaning that obesity is used as a description of a person rather than as a diagnosis. (The correct terminology is a 'person with obesity', not an 'obese person'.)

4.  Government programs tend to focus on health promotion and obesity prevention, which is important, yes, but with a lack of attention to helping people who have obesity and need treatment for it.


So, where does this leave us?  The Report recommends:

  • Government, employers and the insurance industry need to adopt the position that obesity is a chronic medical condition and orient their approach and resources accordingly;
  • Government needs to recognize and help break down weight bias and stigma;
  • Obesity training for health care professionals needs to increase;
  • Governments need to increase funding and access to interdisciplinary care, weight management programs, anti-obesity medications, and bariatric surgery; 
  • The Canadian Clinical Practice Guidelines, last published in 2006, need to be updated (and we are starting work on this!)

It seems we have a lot of work to do. 


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017









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A HEARTFELT WELCOME!

I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!


Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!




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