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Obesity Rates Plateau in USA

>> Saturday, January 30, 2010



For at least the last four decades, we've watched obesity rates skyrocket, first in the developed world, and subsequently across the globe. The United States have been leaders in this department, with some of the highest rates of obesity in the world. For the first time, it appears that the rate of obesity has finally achieved a plateau in our southern neighbors.

In last week's issue of the Journal of the American Medical Association, Katherine Flegal and colleagues published a study examining the trends of obesity and overweight in the US from 1999 through 2008. Using a representative sample of over 5,000 people from the National Health and Nutrition Examination Survey in 2008, they found that 72.3% of American men were overweight, and 32.2% qualified as obese (by BMI >30). Women weighed in with a slightly lower rate of overweight at 64.1%, but a numerically higher rate of obesity at 35.5%. When these numbers are compared to data over the years previous, there is no significant rise in the rate of obesity over the last 10 years for women, or over the last 3 years for men.

In the same issue of JAMA, a similar study by Ogden and colleagues suggested similar stability in the prevalence of obesity in children, except amongst the very heaviest of boys, where the obesity rates do continue to increase.

So, does this mean that the world can breathe a sigh of relief that the obesity epidemic may be slowing? Well, it is surely a good thing that the rates in the US are topping out - if the rates of obesity in America had continued on its previous track, the World Health Organization predicted that almost half of US adults would be obese by the year 2020. Having said that, at the current prevalence of obesity of one third of the American adult population, the impact is still staggering. With obesity comes an increased risk of diabetes, heart disease, and cancer, to name a few; in 2008, obesity related disease was estimated to account for 10% of total American health care expenses. Thus, a plateau in obesity rates is not enough - the next necessary step is to effect a decrease in rates of obesity, in order to decrease the rates of these other dangerous diseases and create a healthier population overall.

The above data is not a sign for the rest of us in the world to relax, either. Obesity rates remain staggering in many countries around the world, and the prevalence continues to increase in many places, particularly in developing nations, where the introduction to unhealthy western eating habits is still relatively new. One also wonders whether the plateau in American obesity rates reflect a positive impact of health care initiatives to educate and prevent a further rise in obesity rates, or whether this may reflect a genetically determined saturation of obesity in that population. Regardless, one lesson that we can all take home from these observations is that in a sedentary environment with oversize portions and a plethora of unhealthy food choices, the majority of us will become overweight; let us hope that education, motivation and inspiration are truly powerful enough to stop it.


Dr. Sue © 2009 www.drsue.ca drsuetalks@gmail.com

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Getting Help in Losing Weight!

>> Saturday, January 23, 2010






There is no question that each and every one of us is different, and our approach to weight loss is no exception. Success with one weight loss program will be variable from one person to the next, depending on how well it is geared towards that person's strengths, weaknesses, and the areas where that person needs the most support. Some people need help in gaining a better understanding of what healthy food choices are; many need a re-education on portion control (as our toxic society oversizes portions everywhere we look, making it harder to know what an actual portion size should be). Some individuals prefer to design their own weight loss diet, whereas others will excel with a diet plan that is handed to them, and which they simply have to follow without thinking further about it!

In my mission to help my overweight patients achieve a healthy weight, I've come across two fabulous resources that you might consider if you are battling the bulge:

1. Reality Bites (www.mymealplan.ca)

This is a fabulous healthy eating program designed by Canadian dieticians. There is a special emphasis on helping people with diabetes, but the diet plans can be used by anyone who wants to lose weight or simply eat healthy! When you join, you need to select the small (1200-1500 cal), medium (1500-1800 cal), or large (1800-2100 cal) diet plan. To figure out which plan you need in order to lose weight (or maintain weight if you already at appropriate weight), use the BMR calculator on my main page in the right hand column (www.drsue.ca), or talk to you health care provider. This program will then provide you with a fabulous meal plan and a grocery list that makes it very easy to adhere to!

The meal plans are carb and calorie controlled, as well as fulfilling recommendations for intake of fiber, sodium, cholesterol, fat, and saturated fat. There are a plethora of excellent recipes and diabetes information on the site as well. Membership costs $20.95 per month.


2. TOPS (www.tops.org)

TOPS (Take Off Pounds Sensibly) is a nonprofit, noncommercial, weight loss support organization based in the US, with chapters located worldwide. It operates primarily by offering group support, and by accountability with weekly weigh-ins at chapter meetings.

New members should consult with their physician to obtain a goal weight, and then report it to their chapter Weight Recorder. A private weigh in occurs at each chapter meeting, followed by a program on a wide variety of topics pertaining to the weight loss journey and healthy lifestyle. Meetings provide members with positive reinforcement and motivation in adhering to their food and exercise plans.

Cost is $30 CDN per month, plus a few dollars per month in chapter operating costs. There are lots of chapters - I counted 36 within a 25 mile radius of my own postal code! You can locate a chapter here.


These are just a couple of suggestions - there are lots of great weight loss organizations out there. Find the one that's right for you!

Dr. Sue © 2009 www.drsue.ca drsuetalks@gmail.com

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Crunching the Numbers: Does Calorie Labelling at Restaurants Help?

>> Sunday, January 17, 2010








In an effort to enable us to know what we are putting in our mouths when we're eating out, there is a continent-wide push for better nutritional labelling at restaurants and fast food chains. New York City is a leader in this department - a mandatory posting law for chain restaurants went into effect last year.

The results of this labelling has had mixed results so far. There are at least three studies that have looked at this issue:

1. New York University researchers looked at purchases made by adults at fast food restaurants two weeks before, and one month after, the mandatory labelling went into effect. While over half of people entering the restaurants noticed the calorie information, only 13% said that it made them purchase less calories, and in fact there were no significant differences in the mean number of calories individuals purchased.

2. A study from Yale University published in the American Journal of Public Health found that when calorie information on a menu was provided along with reference values showing the recommended daily intake for the average adult, calorie consumption decreased by about 250 calories. Repeated twice a week, this calorie savings translates into 7.5 pounds less weight gain per year!

3. Stanford University researchers examined purchases at Starbucks in New York City after calorie count displays were mandated, and found that calorie posting did in fact decrease the number of calories per transaction at Starbucks by 6 percent! Revenue increased at Starbucks that were located in close proximity to Dunkin' Donuts restaurants in particular, likely because the knowledge of the high calorie content of donuts drove people away from the donut shop and towards Starbucks instead.

So on balance, it looks like posting caloric information at restaurants is having a positive effect. To understand how many calories you are consuming at restaurants compared to what you need, you can calculate your very own caloric prescrption on this website www.drsue.ca using the BMR calculator in the right hand column!

Dr. Sue © 2009 www.drsue.ca drsuetalks@gmail.com


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Get Fit in the New Year!

>> Friday, January 8, 2010

We're now just over a week into 2010, and the fitness centres are overflowing with people paying homage to their New Year's resolutions. It is interesting to watch the pattern that repeats itself year after year: by next week, crowds at the gym will start to noticeably diminish, and by the beginning of February, they will be back near baseline levels.

So how can you keep the motivation up, the interest peaked, and the energy levels high? Here are a few suggestions:

1. Vary your workouts. Engaging in a variety of activities gives you something different to look forward to each day. Pick 3 different activies and repeat each one twice a week, for a total of 6 exercise days a week. Each month, switch up one or two of these activities to keep things varied.

2. Embrace the great outdoors! There is nothing like grunging it out at the gym each day to make a person sick of the exercise routine. Find some activities outside to enjoy! Even in the depths of winter, there are many activities to choose from: ice skating, snowshoeing, cross country skiing are a few examples.

3. Distract yourself. Music is a great way to distract yourself from the workout at hand - it makes the time go faster! Find some upbeat music that you enjoy to listen to while you exercise. Television is another great option - if you work out at home, put on a good movie to watch while you're on your cross trainer. Reading is a good option as well, for example, while on an exercise bike.

If you do choose to read or watch TV, make sure you are not distracted to the point that you are unintentionally slowing your pace. You can do this by wearing a pulse watch to ensure you maintain your heart rate, or by exercising to the beat of the music you are listening to. Also, check yourself every few minutes to make sure that your technique is not suffering because you are thinking about something else. Improper technique can lead to injury!


4. Engage your brain! A workout that makes you think is the ultimate way to make the time whizz by in a flash. Dancing, yoga, pilates, and aerobics are all examples of these types of activities.

5. Exercise with a friend! It's always more fun to burn calories with company to talk, laugh with, and mutually motivate. Be clear with yourself, however, that you will work out regardless of whether an exercise companion cancels on you or not. Don't allow your exercise routine to become dependent on the presence of another - consider it a bonus instead!

With these tips, it is my hope that any New Year's resolutionists out there will feel empowered to overcome the typical ebb and flow of motivation to exercise, and will be able to stick with it and shed the excess pounds! Remember to talk to your doctor to plan an exercise regime that is safe for you.


And on a final note, here's a little bit of (unitended, I think) New Year's humor for you. This is the Canadian Tire New Year's ad that came out this week. I'm not sure that the ad for the pantry storage unit is in keeping with the theme of getting fit with home exercise equipment in the New Year!



Dr. Sue © 2009 www.drsue.ca drsuetalks@gmail.com

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Got the Low Carb Blues?

>> Saturday, January 2, 2010



There are many popularized diets out there. Most people who have tried their hand at a few of these have, at some point, come across a version of a low carb diet. While carbohydrates are not the most energy dense nutrient (that would be fat), carbs tend to be the most easily accessible (eg fast food, candy bars), and the easiest to eat in large quantities (eg pasta, rice, bread).

While weight loss is known to improve mood and psychological well being, little is known about the long term effects of these low carb diets on psychological function.


A recent study suggests that a low fat diet may be better to improve the blues than a low carb diet. This study, conducted in Australia and published in the Archives of Internal Medicine, randomized 106 overweight and obese participants to receive either a low fat, high carb diet, or a low carb, high fat diet for one year. Changes in weight, well-being, and cognitive functioning (thinking, learning and memory skills) were assessed during and after the study period.

After one year, the overall average weight loss was the same between the two groups, at 13.7 kilograms (about 30 pounds). After the first eight weeks, both groups experienced an improvement in mood. However, most measurements of mood revealed a lasting improvement in only those following the low-fat diet, while those on the high-fat diet returned to their initial levels. As regards cognitive function, both diets had similar effects on working memory and speed of processing over time.

Thus, it appears that the known mood-improving effects of weight loss may have been negated by the low carb diet over a 1 year period. There are several possible explanations for this finding. People adhering to a low carb diet may find it socially restrictive, in that carbohydrates, are a major component of the typical Western diet. It may be difficult to enjoy the pleasures of eating out if carbs are to be strictly avoided, and the challenges in finding foods that are strictly low carb may result in frustration. In addition, serotonin, which is a chemical in the brain that is closely linked to mood and psychological function, is decreased by fat and protein consumption, whereas carbohydrates increase these levels.

The bottom line, according to this study: A low fat diet may be preferrable to a low carb diet to allow your brain and mind to enjoy the improvement in mood that comes with shedding pounds!

Dr. Sue © 2009 www.drsue.ca drsuetalks@gmail.com


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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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