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Preventing Childhood Obesity - Jamie Oliver on TED Talks

>> Friday, June 26, 2015





In a world where not only adult obesity, but also childhood obesity, is a common and serious health concern, strategies are urgently needed to help to combat this epidemic.

Jamie Oliver, chef and advocate against childhood obesity, has provided a riveting TED talk about childhood obesity that is well worth watching.   A few points that really caught my attention:


1.  He interviewed a classroom of kids and asked them if they could recognize certain vegetables.  Cauliflower was mistaken for broccoli, a beet for an onion, and a little boy didn't recognize a potato.  Jamie's comment:  If a kid can't even recognize a food product, how likely is it that they are going to want to eat it?

2.  Kids spend roughly 180 days at school in a year.  So, doesn't it seem important that the food they get fed at school is healthy?

3.  Jamie speaks of the lengths we go to to stay safe from violence in our society.  He then shows a graph of the deaths from homicide vs deaths from obesity related complications - of course, deaths from this serious health concern are top of the chart by a long shot.

It's an interesting and powerful perspective in this 21 minute TED talk - check it out, share it, and let's all give it some serious thought.

Many thanks to my dear friend, colleague, and fellow 'obesity warrior' Dr Shahebina Walji for the heads' up on this TED talk.


Follow me on twitter! @drsuepedersen


www.drsue.ca © 2015




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Keeping Kids Active This Father's Day - And All Year!

>> Saturday, June 20, 2015




In the fight against childhood obesity, it's important to promote an active lifestyle for kids.  Studies show that family based interventions work best to prevent and treat childhood obesity.  Recently, I participated in a fantastic family-oriented triathlon weekend, where kids raced one day and adults the next.  What a great way to get kids interested and enthusiastic in not one but three sports - and adults got to be great role models at the same time!

So this Father's Day weekend, grab your kids and embrace a fun, family-oriented activity - and keep the theme going all year long!



Follow me on twitter! @drsuepedersen

www.drsue.ca © 2015


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We Think Fat. Why?

>> Sunday, June 14, 2015


While the balance between calories in and calories out is closely monitored by our brains, our brains tend to ‘think fat’ – meaning that this regulation favors an accumulation of fat stores.  The extent to which our brains ‘think fat’ is very different from person to person – genetics may in fact underlie as much as 70% of human obesity.   So exactly how and why do our brains think fat?

The answer to this question is exquisitely complex, and we are only beginning to get an understanding of what is going on.  We know that there are many nerve cells throughout the brain that sense glucose and fatty acids, and some that can sense amino acids (the building blocks of proteins) as well.  While these nutrient signals may signal us to stop eating, the drive to start eating is much less clear.  Leptin and insulin, hormones that signal us to stop eating, decrease in the fasting state, and it is thought that the withdrawal of these two powerful hormones (as well as an increase in the hunger hormone ghrelin) are the main physiologic stimuli for hunger.   That being said, in human obesity, leptin and insulin levels are both high, yet people with obesity certainly still feel hungry – it appears that people with obesity become resistant to the effects of both leptin and insulin, which also means that these hormones lose their gusto to tell the person that they feel full. 

However, it is much, much more complex than that, as it is not only hunger that drives us to eat.  For example, why can we go all night without food and not be hungry, whereas during the day, we often become hungry just a few hours after the last meal?

There are many factors playing in here, including the circadian (day/night) rhythm of several hormones, as well as social cues to eat.  Although we have the ability to make conscious decisions and choices, many of our actions have a subconscious component that escapes voluntary control.  This is why we might eat a tasty treat like chocolate, even if we are not hungry, even if we recognize the negative consequences of the extra calories.  These subconscious urges are driven by a complex interplay of emotional, sensory, and cognitive information from several parts of the brain.  The rewarding properties of food, which stem from the dopamine system in our brain, are so powerful that they can easily override the neurons involved in sensing nutrients which rather weakly try to send the message that we are full while our dopamine system puts our brain into a state of nirvana.

The next question is, why is it so hard to keep weight off after a person with a weight struggle loses the weight?    With short term calorie deficits (=weight loss), leptin and insulin levels fall precipitously, resulting in a powerful drive to eat and regain weight.  To make matters worse, low insulin and leptin levels also lead to a reduction in the body’s energy expenditure (calorie burn).  This state persists for years in humans, and is only alleviated when the previous body weight is regained.  In other words, our bodies have a metabolic memory, such that our bodies spend potentially the rest of our lives trying to get back to the highest weight we have ever been. 

So why does it seem that our metabolism is set against us?  This is genetically powered and evolutionarily driven – our bodies were designed as super efficient systems to help us keep calories on board so that we would survive a famine.  Our brains and bodies are so good at this, in fact, that there is much redundancy in this system – if one system promoting weight gain fails or is blocked (eg by an obesity medication), there are backup systems ready to take over and drive weight gain in other ways.  The learning point here is that a single obesity medication, for example, may not be successful in resulting in large amounts of sustained weight loss – multiple targets may need to be approached simultaneously.  This of course depends on the individual, their genetic background, and the myriad of other factors that are playing into their weight struggle.

It seems we have our work cut out for us to find successful ways to treat obesity.


Follow me on twitter! @drsuepedersen


www.drsue.ca © 2015





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Chew Your Smoothie!

>> Sunday, June 7, 2015





I came across the interesting concept of chewing a smoothie in my online travels, and I feel it's a concept well worth sharing!

In my weight management counselling, one thing I will often mention to my patients is not to drink calories (with the exception of skim milk).  There are a number of reasons for this:

1.  It takes about 15 minutes for our fullness hormones to kick in.   The consequence is that if we eat quickly, we may reach for more food before these hormones have a chance to tell us we are full. Liquid meals are usually consumed very quickly (as drinking a meal bypasses the time it takes to cut, chew etc), so it leaves us vulnerable to drinking more than we would otherwise feel we need, and also leaves us vulnerable to perhaps eat something additional on top of the quickly consumed liquid meal.

2.  Solid meals fill more.  There are stretch receptors in our stomachs that contribute to telling our brains that we feel full.  Having a solid meal is literally better to fill our bellies than a liquid.

3.  Chewing is part of the enjoyment of a meal.  Throwing a liquid smoothie back really causes us to miss out on much of the flavour of food, which is enjoyed by having it chewed and broken down inside the mouth.  Taking the time to cut and chew our meal also causes us to focus more on the enjoyment of eating, which helps in release of the endorphins or 'happy hormones' that give us satisfaction when we eat.  Having a liquid meal may not provide that same endorphin release, giving us cause to reach for something else to give that sense of satisfaction.

I get that many people like the idea of smoothies to get the nutritional value of all those healthy greens, fruits etc down the hatch.  My suggestion is to rock out all those awesome foods - but skip the blender step!

Follow me on twitter! @drsuepedersen

www.drsue.ca © 2015

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Peeing At Night? Could Be Sleep Apnea

>> Saturday, May 30, 2015






Many people get up to pee at night.  This could simply be a reflection of drinking water before bedtime, caffeine, or alcohol, or it could be a symptom of a medical problem, one of which is sleep apnea.

Obstructive sleep apnea (OSA) is a condition where the upper airway is obstructed during sleep, causing pauses in air intake despite an effort to breathe.  The severity of OSA is determined by the number of apnea (no airflow) or hypopnea (decreased airflow) events during an hour, measured during overnight testing:
  • mild OSA: 5-15 events per hour
  • moderate OSA: 15-30 events per hour
  • severe OSA: over 30 events per hour

Obesity is a common cause of OSA, but it can also be caused by decreased muscle tone of the upper airway (due to neurologic conditions or substances such as alcohol, sedatives, or muscle relaxants), or variance in the structure of the upper airway. 

So how does OSA cause a person to pee excessively at night?  Research has shown us that the negative pressures generated in the chest by trying to inhale against a blocked airway cause increased blood return to the right side of the heart.  This, in combination with other pressures placed on the heart by OSA, cause the heart to release a hormone called atrial natriuretic peptide (ANP) that tells our kidneys to excrete more sodium and water.  

Other common symptoms of OSA include daytime sleepiness, morning headaches, difficulty concentrating, restless sleep, and snoring. OSA is not thought of or tested for enough, and as a result, many people suffer from OSA but don't know that they have it. 

There are many other medical problems that can cause a person to pee at night, ranging from bladder issues, to prostate problems, to uncontrolled diabetes, to congestive heart failure, to several others.   For health care providers, it's important to consider obstructive sleep apnea on this list when a patient tells us they are urinating often at night.   If you are a patient urinating excessively at night, be sure to speak to your doctor about it.


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2015



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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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