Does Canada Need a National “Stop to Smell the Flowers” Day?

Yesterday, I was quoted in the media regarding a private members bill introduced by MP John Weston calling for municipalities to provide cheap access to fitness centres, as considering this idea rather ‘simplistic’. Not that I don’t think Canadians should be more active or that we must not do all we can to reduce the epidemic of sedentariness. I just don’t believe that a) this needs to happen at fitness centres and b) that this is necessarily a bill that should be offered as a solution to the obesity problem. If anything, these type of proposals do little else but perpetuate the myth that a bit of more physical activity will reduce body weights or prevent weight gain. Rather, with, for example, the emerging evidence on the role of sleep deprivation on metabolism and body weight, we may as well be calling for a national “Let’s All Sleep In Late” day or (even better) a national “Let’s All Stop To Smell The Flowers” Day. The point is not that I am against exercise or don’t believe in its benefits. The point is that it will take more than getting more Canadians into fitness centres to combat obesity. Not that we should be stopping anyone from getting more active. MP Weston apparently is a sports buff himself, has three kids who are sports buffs, and a wife who is a personal fitness trainer – great for them, but hardly a model for the Canadians that I see in my practice. It is certainly not the monetary cost of visiting a fitness centre stopping them – if anything, it is lack of time, low self-esteem, poor body image, depression, sheer exhaustion after a stressful day, and perhaps far too little restorative sleep. The last thing they need is yet one more obligation (read: visit to a fitness centre) in their already busy and overscheduled days. If they did have the extra hour or so to actually dedicate to going to a fitness centre my advice would probably be to rather get an extra hour of sleep or perhaps just an extra hour of mindful relaxation – read a book, go for a walk, play an instrument, paint a picture, or just take the time to have a meaningful conversation with your kid or partner – or, perhaps, just pause to smell the flowers. The problem is not that Canadians are too lazy… Read More »

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MP proposes National Health and Fitness Day

Dr. Arya Sharma, chair of obesity research and management at the University of Alberta, called the bill “simplistic.” “Policies to get Canadians moving and eating better are great – but reducing obesity simply to a matter of diet and exercise is far too simplistic and does a disservice to the many people struggling with excess weight,” he said.

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BC’s Northern Health Takes an Enlightened Position on Obesity

British Columbia’s Northern Health authority has released one of the most balanced and enlightened public health position document on obesity that I have yet seen from any public agency. Moving well beyond the populistic, but simplistic, stereotype-promoting focus on shaming, blaming, banning, taxing and other ‘negative’ responses to the obesity epidemic, this document takes an almost post-modern position on obesity prevention and control that could (and probably should) serve as a Northern ‘light’ to other agencies. Just to quote some of the far-reaching statements that one certainly does not often read in such documents on obesity (hold your breath – here they come): • Health can occur at a variety of sizes. Support the development and maintenance of eating competence across the life cycle. Promote enjoyable, active lives and support building lifestyles that integrate active transportation, active play and active family time. Support the achievement of positive body image for all. Support the message that healthy bodies exist in a diversity of shapes and sizes. • Weight is not a complete and inclusive measure of health. Support a health-promoting approach; prioritize reducing risk factors and weight-related complications. Support optimal growth and development of children and youth. In children and youth, support longitudinal growth monitoring as part of primary care. Weight divergence, particularly weight acceleration (rather than an absolute weight or percentile), requires further investigation. Promote that all sizes are accepted and treated with respect. Support that weight bias is a bullying issue; it may be overcome using awareness, education and other supportive measures. Promote a do no harm approach in measures to support health at all sizes to prevent increases in negative body image, disordered eating and disordered activity. • Obesity should be prevented, treated and managed using a do no harm approach. Support and promote healthy eating: make the healthy eating choice the easy choice. Support and promote active lifestyles: make the active choice the easy choice. Support drawing attention to obesogenic environments where we live, work, learn, play and are cared for. Support a graduated approach to healthy lifestyles; encourage actions toward improved health and well-being at all weights. Support and promote the use of the Edmonton Obesity Staging System as a medical approach to manage obese patients. Promote success as improved health and stabilized weight with attention to competent eating, active living and positive body image. Management Principles Focus on improving health and achieving best weight. Obesity prevention is easier than management. Employ a do-no-harm approach… Read More »

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Milking Weight Loss?

Despite much debate on the potential merits of increasing dietary dairy intake in term of increasing protein and calcium intake, its ultimate impact on body weight regulation remains controversial. A systematic review and meta-analysis by Abrguouel and colleagues, published in the International Journal of Obesity, appears to bring some clarity to this issue. The paper reviews and analyses data from 16 randomised controlled trials on the the effect of dairy consumption on weight, body fat mass, lean mass and waist circumference (WC) in adults. While there was no overall effect of increasing dairy intake on on body weight (-0.61 kg), there were some positive effects on reducing fat mass (0.72 kg), gain in lean mass (0.58 kg), and reduction in waist circumference (2.19 cm). However, subgroup analysis showed that simply increasing dairy intake without also restricting energy intake has little to no effect on these paramerters. It is only when dairy intake is increased in the context of a calorie-restricted diet that one sees a greater fall in body weight (1.29 kg), decrease in fat mass (1.11 kg), and decreased in waist circumference (2.43 cm) than in controls. Thus, it appears that any beneficial effects of increasing intake of dairy products on body weight and composition is limited to the inclusion of dairy products in energy-restricted weight loss diets. Simply increasing your intake of dairy products may not be enough to decrease body weight. On the other hand, whether or not ingesting an adequate (eucaloric) amount of dairy products may also help prevent weight gain remains to be seen. AMS San Antonio, TX photo credit: tj.blackwell via photopin cc Abargouei AS, Janghorbani M, Salehi-Marzijarani M, & Esmaillzadeh A (2012). Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. International journal of obesity (2005) PMID: 22249225

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Weekend Roundup, September 21, 2012

As not everyone may have a chance during the week to read every post, here’s a roundup of last week’s posts: Warding Off Obesity At The Alamo Does Vitamin D Help Prevent Diabetes? What’s Happening in After-School Programs? Sleep Yourself To a Leaner You? Obesity Does Not Increase Mortality in Gastric Cancer Have a great Sunday! (or what is left of it) AMS San Antonio, TX

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