New App for Troubleshooting Statin Intolerances and Other Cholesterol Gems

The University of British Columbia has come out with an excellent tool for physicians to help assess cardiovascular risk and manage cholesterol issues, which is a free app which can be downloaded here.

This is a fabulous program which has a number of highlights:

1.  Framingham risk score can be calculated with recommendations based on the 2012 Canadian Guidelines provided;

2.  Statin doses likely to be required to achieve the target LDL are suggested;

3.  There is a drug dosage chart which also shows the LDL lowering expected with all of the various cholesterol treatments at all of the available doses;

4.  Statin Adverse Effect/Intolerance support - this is my favorite part of this app - you can enter characteristics of your patient that is not tolerating their statin, and the program will summarize relevant factors to consider, as well as make suggestions for a possible management approach.

Thanks to my friend Kwene for the heads' up on this app!

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Health Benefits of Nordic Walking!

Think those people who look like they are walking outdoors with ski poles look a little goofy?  Well, think again - those people are taking strides towards better health.

It's called Nordic Walking - quite simply - walking with poles.  It was originally developed in Scandinavia as an off-season ski training activity, and didn't become an official sport until 1997.

A recent review looked at studies of Nordic walking in over 1,000 study participants, and found beneficial effects on blood pressure, heart rate, and exercise capacity.  They also noted that studies have shown that compared to walking briskly without poles, Nordic walking burns about 20% more calories.    Health and quality of life benefits were also found in people with a wide range of chronic diseases, from cardiac rehab patients, to fibromyalgia, emphysema, peripheral arterial disease, and pain in general.

So why would Nordic walking result in better heart health and higher calorie burn than walking without poles?  Simply because, by using the poles as you go, you are engaging your upper body muscles, increasing your cardiac and respiratory response, and boosting your energy burn.

So, add a pair of poles to your exercise regimen and enjoy the health benefits!  Remember to speak to your doctor before making any changes to your workout routine.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Let Cows Eat Candy?

Due to last summer's droughts, some farmers have had to resort to feeding cows with - believe it - candy and cookies to keep them from losing weight and keep their milk production up.

Hands up if you are grossed out right now?  Hands up if you feel this is truly unrighteous and unfair to the cow?

As pointed out in Wired magazine, this is not exactly the diet that nature intended cows to eat, although it is apparently possible for cows to draw calories out of candy.

When I asked around to hear what others thought about this, one person said to me that it is disgusting to think that the beef she is eating might come from a cow that was fed candy.

I think the giraffe in the room here is pretty obvious.

That's it for today, folks - I'm putting away my M&Ms and heading to the gym. ;)


Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Grilled Fish Tacos!

Here's a delicious Mexican-inspired recipe, with thanks to Pamela Salzman - I've modified the recipe to keep the calories low but the taste factor high!


INGREDIENTS:

1 pound halibut fillets

8 6-inch corn tortillas, warmed either on grill or heated griddle pan until pliable

1 fresh lime, cut into wedges

White sauce:

• 3 Tablespoons low fat mayonnaise
• 7 Tablespoons plain light unsweetened greek yogurt
• 1 Tablespoon freshly squeezed lime juice
• 1 teaspoon hot sauce or ¼ teaspoon ground chipotle powder (optional) 
• pinch of sea salt

Dry Rub:

• 2 teaspoons paprika
• 1 teaspoon garlic powder
• 1 teaspoon chili powder
• 1/2 teaspoon sea salt

Veggie filling for tacos: as you wish-

• shredded napa cabbage
• coleslaw
• radishes
• red onion
• salsa

DIRECTIONS:

1.  Whisk together ingredients for white sauce, and refrigerate until ready to use.

2.  Mix dry rub spices together and sprinkle on both sides of the fish.

3.  Preheat grill to medium-hot.  Brush grate grill very lightly with oil, minimum necessary to prevent sticking. Grill fish until fish is just cooked through, about 3-5 minutes per side.

4.  Remove fish from grill and break into pieces.

Makes 8 soft shell tacos!

NUTRITIONAL INFO:    I have calculated the nutritional info here to include the fish, the soft shell taco, the dry rub, and the white sauce.  The number of calories, carbs etc in the veggies and salsa that you decide to include is going to depend on how much and what kinds you choose.  However, the calories in these veggies is almost negligible.  Salsa can vary, and I'd suggest going easy on salsa because it is very high in salt (ever wonder if you eat too much salt in a day - calculate your intake here).

It's also extremely difficult to estimate how much of the oil brushed on the grill absorbs into the fish - one of the limitations of using oil to create a non stick surface.  As it's almost impossible to estimate, I have not included the oil used to brush the grill in my calculations.  If you bake your fish in the oven instead, you can use a bit of non stick cooking spray on tin foil and avoid this problem.

Per taco: (approximate, including fish, dry rub, soft taco, and white sauce)

CALORIES: 163
CARBS:        13 g
PROTEIN:    17.5 g
FAT:             4.6 g

Enjoy!

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

  

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Excess Skin After Bariatric Surgery

On the second day of the Canadian Obesity Summit, I had the honor of being asked to act as a judge for a number of excellent research presentations during the poster session.  First, a heartfelt congratulations to all of the presenters - I was truly impressed by all of your efforts and studies, and I enjoyed each of our stimulating conversations!

A study that really struck a chord with me, and which I feel is really important to share, was a study looking at the impact of excess skin on physical activity in women who have had bariatric surgery.  The reason for doing this study is that over 70% of patients who have bariatric (obesity) surgery are left with excess skin that interferes with physical and social functioning. The research, conducted by A Baillot and colleagues at the University of Sherbrooke in Quebec, administered questionnaires to 26 women who had had bariatric (obesity) surgery at least 2 years prior, asking women about how their excess skin impacted them physically, psychologically, and socially.

They found that 77% of patients reported that their excess skin was making mobility during physical activity difficult, and that almost half were avoiding physical activity because of their excess skin.  What really hurt my heart was that when these women were asked why the excess skin caused them to avoid physical activity, the most common reason cited was that they were concerned about people staring at them (other reasons were hygiene concerns, weightiness of the excess skin, and a feeling of 'sloshing' of the skin).

My take home message from this study is that the likely development of excess skin after obesity surgery is something that needs to be discussed in detail with patients prior to having surgery, such that they are prepared for the physical, psychological, and social challenges that they may perceive or encounter.

And, as always, it is my hope that with education of our society, that any obesity related stigma that may exist out there will continue to decrease until it disappears entirely.  I was asked a lot at the summit as to why I blog - this reason would be amongst the highest.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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