Friday, October 24, 2014

Social Network Analysis of the Obesity Research Boot Camp

bootcamp_pin_finalRegular readers may recall that for the past nine years, I have had the privilege and pleasure of serving as faculty of the Canadian Obesity Network’s annual Obesity Research Summer Bootcamp.

The camp is open to a select group of graduate and post-graduate trainees from a wide range of disciplines with an interest in obesity research. Over nine days, the trainees are mentored and have a chance to learn about obesity research in areas ranging from basic science to epidemiology and childhood obesity to health policy.

Now, a formal network analysis of bootcamp attendees, published by Jenny Godley and colleagues in the Journal of Interdisciplinary Healthcare, documents the substantial impact that this camp has on the careers of the trainees.

As the analysis of trainees who attended this camp over its first 5 years of operation (2006-2010) shows, camp attendance had a profound positive impact on their career development, particularly in terms of establishing contacts and professional relationships.

Thus, both the quantitative and the qualitative results demonstrate the importance of interdisciplinary training and relationships for career development in obesity researcher (and possibly beyond).

Personally, participation at this camp has been one of the most rewarding experiences of my career and I look forward to continuing this annual exercise for years to come.

To apply for the 2015 Bootcamp, which is also open to international trainees – click here.

@DrSharma
Toronto, ON

ResearchBlogging.orgGodley J, Glenn NM, Sharma AM, & Spence JC (2014). Networks of trainees: examining the effects of attending an interdisciplinary research training camp on the careers of new obesity scholars. Journal of multidisciplinary healthcare, 7, 459-70 PMID: 25336965

 

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Wednesday, October 15, 2014

Disease Severity and Staging of Obesity

sharma-edmonton-obesity-staging-systemRegular readers will be well aware of our work on the Edmonton Obesity Staging System (EOSS), that classifies individuals living with obesity based on how “sick” rather than how “big” they are.

For a rather comprehensive review article on the issue of determining the severity of obesity and potentially using this as a guide to treatment, readers may wish to refer to a paper by Whyte and colleagues from the University of Surrey, UK, published in Current Atherosclerosis Reports.

This paper not only nicely summarizes the potential effects of obesity on various organs and organ systems but also discusses the use of staging systems (EOSS and Kings) as a way to better characterize the impact of excess weight on an individual.

As the authors note in their summary,

Using a holistic tool in addition to BMI allows highly informed decision-making and on a societal level helps to identify those most likely to gain and where economic benefit would be maximised.”

Not surprisingly, the Edmonton Obesity Staging System, which has been validated against large data sets as a far better predictor of mortality than BMI, waist circumference or metabolic syndrome, is being increasingly adopted as a practical tool to guide clinical practice.

@DrSharma
Merida, Mexico

ResearchBlogging.orgWhyte MB, Velusamy S, & Aylwin SJ (2014). Disease severity and staging of obesity: a rational approach to patient selection. Current atherosclerosis reports, 16 (11) PMID: 25278281

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Thursday, October 9, 2014

Are Smokers More Deserving of Treatment Than People Living With Obesity?

sharma-obesity-teen-smokingThis certainly appears to be the opinion of the majority of people living in Denmark, as reported in a study by Thomas Lund and colleagues published in the European Journal of Clinical Nutrition.

The study examined public support for publicly funded treatment of obesity (weight-loss surgery and medical treatment) and two pulmonary diseases strongly associated with smoking (chronic obstructive pulmonary disease (COPD) and lung cancer) in Denmark.

While a large majority supported treatment for lung cancer (86.1%) and COPD 71.2% (even when described as ‘smoker’s lung’ 61.9%), only one in three supported publicly funded weight-loss surgery (30%) and medical treatment of obesity (34.4%).

Not surprisingly, respondents beliefs about the causes of lifestyle-related diseases (external environment, genetic disposition and lack of willpower) and agreement that ‘people lack responsibility for their life and welfare’ influenced support for these treatments, especially in the case of treatments for obesity.

My guess is that these finding will not be significantly different in other countries that have publicly funded health care systems, including the UK or Canada, where treatments for cigarette-related lung and heart disease (as well as treatments for smoking cessation) are by far more accepted and accessible than treatments for obesity.

While I am all for treating and perhaps even further improving the care of people with smoking-related health problems, not having the same degree of concern or accessibility to treatments for obesity should be unacceptable.

@DrSharma
Edmonton, AB

ResearchBlogging.orgLund TB, Nielsen ME, & Sandøe P (2014). In a class of their own: the Danish public considers obesity less deserving of treatment compared with smoking-related diseases. European journal of clinical nutrition PMID: 25248357

 

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Friday, October 3, 2014

Obesity 5As At The Armed Forces

sharma-obesity-canadian-forcesThis morning I am presenting a workshop on the Canadian Obesity Network’s 5As of Obesity Management to members of the Canadian Armed Forces here in Ottawa.

As I discussed in a previous post, members of the Armed Forces are not immune to weight-gain – if anything, the considerable stressors encountered by military personnel make them perhaps even more prone to weight gain than civilians.

And, as for civilians, there are no easy solutions. Once the weight is on, military personnel face the same challenges in losing weight and keeping it off (if indeed their excess weight is affecting their health) as everybody else.

I look forward to an exciting discussion with the medical personnel on base about how best to apply the 5As of Obesity Management in their practice.

@DrSharma
Ottawa, ON

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Monday, September 29, 2014

Does Lean Tissue Have More To Say About Your Health Than Your Body Fat?

Carla Prado, PhD,  Assistant Professor and CAIP Chair in Nutrition, Food and Health, University of Alberta, Edmonton, Canada

Carla Prado, PhD, Assistant Professor and CAIP Chair in Nutrition, Food and Health, University of Alberta, Edmonton, Canada

The common assumption is that people with more body fat are at greater risk for illness and overall mortality.

Surprisingly, an increasingly robust body of evidence now suggests that how much lean tissue you have may be far more important for your health than the amount of body fat.

This evidence as well as the methodologies used to study lean body mass are discusses in a paper by Carla Prado (University of Alberta) and Steve Heymsfield (Pennington Biomedical Research Center), in a paper published in the Journal of Parenteral and Enteral Nutrition.

As the authors point out,

“The emerging use of imaging techniques such as dual energy x-ray absorptiometry, computerized tomography, magnetic resonance imaging, and ultrasound imaging in the clinical setting have highlighted the importance of lean soft tissue (LST) as an independent predictor of morbidity and mortality.

The paper discusses in depth the advantages and limitation of the many methods that can be used to assess body composition in research and clinical settings.

The paper also discusses the current definition and importance of sarcopenic obesity and notes that,

“The identification of different body composition phenotypes suggests that individuals have different metabolism and hence utilization of fuel sources.”

Thus,

“It is clear from emerging studies that body composition health will be vital in treatment decisions, prognostic outcomes, and quality of life in several nonclinical and clinical states.”

My guess is that it will not just be the absolute or relative amount of lean tissue mass that is important. Rather, similar to the increasingly recognised role of differences amongst fat depots, I would assume that different lean soft tissue depots may well play different roles in metabolic health.

@DrSharma
Charlottetown, PEI

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In The News

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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