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Plan Your Personalized Program For The Canadian Obesity Summit Now

Summit15appIf you are planning to attend the 4th Canadian Obesity Summit in Toronto next week (and anyone else, who is interested), you can now download the program app on your mobile, tablet, laptop, desktop, eReader, or anywhere else – the app works on all major platforms and operating systems, even works offline.

You can access and download the app here.

(To watch a brief video on how to install this app on your device click here)

You can then create an individual profile (including photo) and a personalised day-by-day schedule.

Obviously, you can also search by speakers, topics, categories, and other criteria.

Hoping to see you at the Summit next week – have a great weekend!

@DrSharma
Gurgaon, Haryana

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Workshop: Obesity in young people with physical disabilities

special needs kidsThe prevalence of overweight and obesity in children with physical disabilities (CWPD) is 2-3 times that of their non-disabled peers, threatening the increased life expectancy made possible by other medical advances.

Many clinicians report substantial challenges in assessing, discussing and managing the weight of CWPD and there appears to be a tension between a desire to address weight-management, attending to children’s other (sometimes considerable) medical and psychosocial needs, and fear of causing harm.

This is the topic of a half-day workshop on Wednesday, April 29th, 2015, at the Canadian Obesity Summit, which will provide an overview of current research on the identification, management and prevention of obesity in CWPD.

The impact of obesity on service utilization and outcomes will be examined, as well as key weight-related issues faced by clinicians working with CWPD.

Research detailing the self-identified needs of children and their parents will be presented, grounding the workshop in the patient voice. The presenters and their research teams represent leading multi-disciplinary researchers, who are also members of a newly formed network of Canadian researchers working in health promotion and childhood disability.

This network is one outcome of a CIHR- funded, international consensus-building workshop, aiming to build knowledge-generating capacity within Canada around weight-related issues for CWPD.

This workshop therefore offers a critical opportunity to share knowledge, raise awareness and build capacity in this vastly under-researched area.

For more information on this workshop at the Canadian Obesity Summit click here

@DrSharma
Gurgaon, Haryana

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Kimchi For Weight Loss?

kimchiDisclaimer: no actual weight was lost in this study! Nevertheless, according to a Han Kyungsun and colleagues, in a paper published in Molecular Nutrition and Food Research, daily ingestion of fermented (but not unfermented) kimchi may result in a potentially beneficial change in the gut bacteriome profile with changes in the expression of multiple metabolic pathways (at least in circulating blood cells).

This study on 8-weeks of fermented vs. unfermented kimchi in 24 women with obesity, was prompted by the widely held assumption that fermented preserves (e.g. kimchi, sauerkraut, etc.) can have positive metabolic effects and has optimistically been linked to weight loss (although evidence for this is rather anecdotal at best).

Be that as it may, the fact that the researchers did find an effect on the relationship of firmicutes to bacteroides populations in the gut at least demonstrates that fermented foods (in this case kimchi) can indeed have a significant on gut bacteria.

How and if this results in any clinically relevant metabolic changes remains to be seen.

@DrSharma
Gurgaon, India

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What Happens To Patients With Severe Obesity In Hospitals?

bariatric patient in bedWith the increasing number of Canadians living with severe obesity (BMIs 50+), it is not unexpected that more of them will be seen in healthcare settings.

However, whether or not Canadian hospitals are ready to look after these patients with in the right setting with the right equipment and whether healthcare providers are aware of and sensitive to the special needs of these patients is not clear.

This is why, Mary Forhan and her team at the University of Alberta is currently conducting a qualitative and quantitative assessment of exactly what problems patients with severe obesity face in healthcare settings.

The study, funded by Alberta Innovates Health Solution (AIHS) will look at the special challenges that these patients present in a range for settings – acute care, cancer, cardiology and rehabilitation.

A substudy will also examine the issues faced by kids and adolescent with severe obesity in healthcare settings.

Together, this project should lead to a better understanding on how healthcare systems better prepare themselves to deliver compassionate and professional care to adults and children living with severe obesity in Alberta. The learnings will likely also inform healthcare systems elsewhere.

For more on this study visit the AIHS website.

If you are someone living with severe obesity, who has experienced issues in your healthcare that could have been prevented or addressed with appropriate equipment and/or training, I’d love to hear your story.

@DrSharma
Edmonton, AB

Conflict: I am a co-investigator on this project.

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Adolescents Undergoing Bariatric Surgery Are Severely Ill

sharma-obesity-bariatric-surgery21The recently released Canadian Practice Guidelines on the prevention and management of overweight and obesity in children and youth released by the Canadian Task Force on Preventive Health Care (CMAJ 2015), rightly recommended that surgery not be routinely offered to children or youth who are overweight or obese.

Nevertheless, there is increasing evidence that some of these kids, especially those with severe obesity, may well require rather drastic treatments that go well beyond the current clinical practice of doing almost nothing.

Just how ill kids can be before they are generally considered potential candidates for bariatric surgery is evident from a study by  Marc Michalsky and colleagues, who just published the baseline characteristics of participants in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study, a prospective cohort study following patients undergoing bariatric surgery at five adolescent weight-loss surgery centers in the United States (JAMA Pediatrics).

While the mean age of participants was 17 with a median body mass index of 50, the prevalence of cardiovascular risk factors was remarkable: fasting hyperinsulinemia (74%), elevated hsCRP (75%), dyslipidemia (50%), elevated blood pressure (49%), impaired fasting glucose levels (26%), and diabetes mellitus (14%).

Not reported in this paper are the many non-cardiovascular problems raging from psychiatric issues to sleep apnea and muskuloskeletal problems, that often dramatically affect the life of these kids.

While surgery certainly appears rather drastic, the fact that these kids are undergoing surgery is merely an indicator of the fact that we don’t have effective medical treatments for this patient population, which would likely require a combination of behavioural interventions and polypharmacy to achieve anything close to the current weight-loss success of bariatric surgery.

That this cannot be the ultimate answer to obesity management (whether for kids or adults), is evident from the rising number of kids and adults presenting with ever-higher BMI’s and related comorbidity – not all of these can or will want surgery.

Thus, while current anti-obesity medications cannot compete with the magnitude of weight-loss generally seen with surgery, medications together with behavioural interventions may well play a role in helping prevent progressive weight gain in earlier stages of the disease.

Unfortunately, I am not aware of any studies that have explored the use of medications in kids to stabilize weight in order to avoid surgery. This would, in my opinion, be a very worthwhile use of such medications.

@DrSharma
Edmonton, AB

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