Wednesday, April 23, 2014

How Lifestyle Affects Your Gut Bugs

Dr. Jens Walter, Associate Professor and Campus Alberta Innovation Program (CAIP) Chair for Nutrition, Microbes and Gastrointestinal Health, University of Alberta

Dr. Jens Walter, Associate Professor and Campus Alberta Innovation Program (CAIP) Chair for Nutrition, Microbes and Gastrointestinal Health, University of Alberta

In my show, “Stop Being a Yo-Yo“, I joke about the notion that the bugs that live in your gut can be significant contributors to your weight problems.

All joking aside, the emerging recognition that your intestinal flora (a fancy term for gut bugs) can indeed affect your metabolism and other aspects of your health in rapidly evolving into one of the most promising avenues of nutrition and obesity research.

Reason enough for me to welcome Jens Walter, a new recruit to the University of Alberta as the Campus Alberta Innovation Program (CAIP) Chair for Nutrition, Microbes and Gastrointestinal Health.

Jens describes his research interest as follows:

“Dr. Walter’s research is primarily concerned with the microbial ecology of the human and animal gastrointestinal tract and the metabolic and immunological interactions between the microbiome and its host in relation to health. He views the interrelationship of gut microbes with their host as a symbiosis and is especially interested in the evolutionary processes that have shaped this partnership and the biological outcomes for both the host and the microbes. He is also interested in how environmental factors (such as diet and lifestyle) and historic processes impact the microbial communities in the gut and what consequences their effects have for the host. His research, which is inter-disciplinary and highly collaborative, has resulted in several publications on the evolution of the model gut symbiont Lactobacillus reuteri, the importance of environmental (diet) and host factors (host genotype) on the composition and functionality of the gut microbiota, and the impact of diet on gut microbial ecology in relation to health.”

As a regular reader you will appreciate my excitement in having Jens join our institution as we venture into studying the role that gut bugs may play in obesity.

On a personal note, the fact that Jens hails from Germany and we share an interest in music makes this recruitment even more attractive.

I certainly wish Jens all the best in his new position and look forward to future collaborations.

@DrSharma
Edmonton, AB

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Tuesday, April 22, 2014

Ten Years of Eating Organic Foods Does Little To Reduce Your Risk of Cancer

organic-logoThere is a widespread belief that conventional use of pesticides, antibiotics and other factors in “industrial” farming may promote the incidence of cancers – a risk that could be avoided by eating “organic”.

According to a paper by Kathryn Bradbury and colleagues, published in the British Journal of Cancer, this may not quite be the case.

The researchers examined prospective data of 620,000 middle-aged UK women on the relationship between the incidence of a variety of cancers and self-reported consumption of organic foods.

Over the 9.3 years of follow-up, there was no relationship between the consumption of organic foods and the incidence of all cancers.

In a subset analyses there was a statistically ‘borderline’ reduction in non-Hodgkin lymphoma, a finding that is perhaps more attributable to statistical chance than to any plausible biological hypothesis.

So, while eating “organic” may have a certain “healthfulness” appeal, a lower risk of cancer may not be a notable benefit.

@DrSharma
Edmonton, AB

ResearchBlogging.orgBradbury KE, Balkwill A, Spencer EA, Roddam AW, Reeves GK, Green J, Key TJ, Beral V, & Pirie K (2014). Organic food consumption and the incidence of cancer in a large prospective study of women in the United Kingdom. British journal of cancer PMID: 24675385

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Monday, April 21, 2014

Does Flying Fighter Planes Help Burn Calories?

topgunIf you are looking for a rather exclusive bit of energy metabolism trivia, this study may catch your attention.

The study by Mateus Rossato and colleagues from Brazil, published in the Journal of Exercise Physiology, looked at how many calories fighter pilots burn during combat flights.

The answer is about 3 kcals per minute – that’s about three times the number of calories most of us burn at rest.

Given that fighter pilots are strapped tightly into their seats, this increase in caloric expenditure is largely explained by increased stress levels (an indicator for this was the fact that their heart rates were at about 60% of maximum during flight).

This may be the most expensive way to burn an extra 135 kcals that I have ever heard of – wonder when we’ll see the first fighter pilot simulation app promising weight loss.

@DrSharma
Vancouver, BC

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Wednesday, April 16, 2014

Shame And Blame Has No Role In Addressing Obesity

Balancing the scales Kirk et alAs a regular reader you will be well aware of my recent excursions into the use of comedy to promote a better public understanding of obesity.

A very different (and I dare say more scientific) approach to harnessing the performing arts to promote a discourse on obesity is that taken by Sara Kirk and colleagues, Balancing The Scales, now described in a paper published in Qualitative Health Research.

Their approach is based on the recognition that,

“…individuals living with obesity are caught in the middle, facing judgment by society if they fail to manage their weight successfully and exposing themselves to health professionals who are unable to fully support them…if an individual is unable to make the changes prescribed for weight loss, resentment builds on both sides of the therapeutic relationship.”

This led Kirk and colleagues to extensively explore the issue of obesity from a variety of perspectives resulting in rather unique insights into similarities, differences, points of consensus, and tension associated with values, beliefs, perceptions, and practices among key stakeholders.

The 42 semistructured interviews were conducted in 22 individuals living with obesity, 4 policy makers, and 16 health professionals (8 dietitians, 4 family physicians, and 4 nurses).

Three major themes emerged from the analysis of the interviews:

Blame as a Devastating Relation of Power

“Individuals living with obesity shared feelings of shame and embarrassment with their inability to control their weight on their own. This blaming discourse can easily be seen in messages of “eat less, move more” promoted by health professionals, the health system, and wider society.”

“Individuals living with obesity spoke about the complexities of trying to lose weight, inclusive of cultural, social, and organizational barriers. Despite this insight, however, they placed the final explanation for their weight status on themselves and expressed immense feelings of guilt and shame.”

“All of the individuals living with obesity had tried multiple methods to manage their weight, with limited or no success. This was extremely frustrating for them and compounded their tendency, wholly or at least partially, to blame themselves for this perceived failure.”

“Similar to individuals living with obesity, health professionals struggled to understand the complexity of the issue, which often led to blaming the individual. Health professionals commented on the unrealistic expectations of people who wanted to lose weight quickly and how their role as a health professional could not possibly be supportive of this.”

“The health professionals we interviewed also blamed themselves for not having the answers, and described feeling ill-equipped to assist individuals to make successful changes.”

Tensions in Obesity Management and Prevention

“Both the individuals living with obesity and the health professionals did not feel supported by the health care system. Health professionals [and policy makers] also struggled to know how to approach the issue.”

“Individuals living with obesity also experienced exclusion when attempting to find appropriate support within the health care system. Most individuals in the study began to access this system when they believed they could no longer manage their weight by themselves.”

The Prevailing Medical Management Discourse

“Health professionals experienced many frustrations and contradictions in their experiences with obesity management, and at times questioned the notion of obesity as a disease. Being obese was often in itself not enough to receive health care. Health professionals in this study found it easier to work with individuals living with obesity when they also had another diagnosed chronic condition, such as diabetes or cardiovascular disease. They could then more confidently prescribe a specific treatment regime.”

As for policy makers,

“[One] policy maker questioned whether medical treatment for individuals living with obesity is necessary…. As an alternative to medicalizing obesity, the policy maker suggested addressing the issue of population health and using health promotion to support the majority of people who are not morbidly obese but are still struggling with weight problems.”

“Overall, individuals living with obesity sought validation for requiring support in a system that currently does not provide the support they need.”

Based on these findings, the authors note that,

“…our findings highlight the need to reframe the public debate on obesity. However, we suggest that rather than choosing one discourse over another (management vs. prevention; system vs. individual), we should engage aspects of both. This requires not only consideration of socioecological perspectives, but also a greater awareness among health professionals of the need to offer support, not advice.”

“Furthermore, relationships between patients and health care providers should be supportive (not blaming), recognizing the widespread prevalence of weight bias in society and working hard to challenge the stereotypes that dominate the discourse on body weight”

“It was also evident in the language and experiences provided by health care providers that training, resources, and support for weight management were a substantive part neither of their professional training nor of the health care system.”

To facilitate improved training of health professionals, the authors have developed the rich narratives obtained in this study into a dramatic presentation, depicting the relationship between a health professional and an individual living with obesity.

This narrative can be viewed here.

For interviews with the researchers – click here.

Clearly, it is work like this that is essential to understanding the current discourse (or rather lack of it) about obesity and finding strategies that do justice to those living with obesity.

There is simply no room for “shame and blame” in such a discourse.

@DrSharma
Edmonton, AB

ResearchBlogging.orgKirk SF, Price SL, Penney TL, Rehman L, Lyons RF, Piccinini-Vallis H, Vallis TM, Curran J, & Aston M (2014). Blame, Shame, and Lack of Support: A Multilevel Study on Obesity Management. Qualitative health research PMID: 24728109

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Tuesday, April 15, 2014

Energetic Offerings From Alabama

David Allison, PhD, Distinguished Professor, University of Alabama

David Allison, PhD, Distinguished Professor, University of Alabama

This week, I am paying a brief visit to my friend and colleague David Allison at the University of Alabama at Birmingham (UAB).

To those working in the field, David needs no introduction. He is certainly one of the most prolific researchers with hundreds of high-ranking papers covering an astonishing array of topics.

As some readers may recall, David was also instrumental in helping us validate the Edmonton Obesity Staging System in the NHANES population.

During my visit I will have the opportunity of meeting with several of his esteemed colleagues and will certainly leave with a number of stimulating insights into the obesity work happening here in Birmingham.

These are delivered weekly from David’s group in a compilation fittingly called Obesity and Energetics Offerings from the UAB Nutrition & Obesity Research Centre (NORC) – to subscribe to this newsletter click here.

@DrSharma
Birmingham, AL

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Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

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