Tuesday, October 14, 2014

Electronic Versus Pen And Paper Monitoring Of Food Intake

diet journalSelf-monitoring is one of the few proven strategies for long-term weight management (which is why all programs worth their weight use it).

But does it really matter how you self-monitor and are electronic forms more accurate than simply using pen and paper?

This issue was examined by Melinda Hutchesson and colleagues from the University of South Wales, Australia, in a paper published in the Journal of the Academy of Nutrition and Dietetics.

The researchers examined the acceptability and accuracy of three different 7-day food record methods (online accessed via computer, online accessed via smartphone, and paper-based) in 18 young normal-weight women.

Actual energy expenditure was measured using indirect calorimetry and physical activity levels derived from accelerometers.

All three methods revealed roughly the same amount of daily caloric intake, falling short by about 500 kcal of the actual measured expenditure.

Nevertheless, around 90% of the participants preferred an electronic method to the paper based method.

Thus, the author argue that,

“Because online food records completed on either computer or smartphone were as accurate as paper-based records but more acceptable to young women, they should be considered when self-monitoring of intake is recommended to young women.”

As far as I am concerned, you can use whatever method you want as long as you use some form of self-monitoring. After all, it is the act of self-monitoring that counts – as with diets, this only works when you actually do it.

@DrSharma
Edmonton, AB

ResearchBlogging.orgHutchesson MJ, Rollo ME, Callister R, & Collins CE (2014). Self-Monitoring of Dietary Intake by Young Women: Online Food Records Completed on Computer or Smartphone Are as Accurate as Paper-Based Food Records but More Acceptable. Journal of the Academy of Nutrition and Dietetics PMID: 25262244

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Tuesday, October 7, 2014

The Freshmen 15 Are Neither 15 Nor Limited to Freshmen

sharma-obesity-black-studentsAccording to popular belief, the first year of college can be associated with a 15 pound weight gain – often referred to as “the freshman 15″.

Now, a study by Micheal Fedewa and colleagues from the University of Georgia, look at the weight trajectory in college studies in a paper published in the American Journal of Preventive Medicine.

Their systematic review and meta-analysis includes 49 studies evaluating the effect of the first year of college (and beyond) on the dependent body weight and or %body fat.

While the researchers found a statistically significant change in body weight among students, the average weight gain was a rather modest 1.6 kg during a typical 4-year college career. Interestingly, this finding is similar to previous estimates suggesting average increases ranging from 1.1. to 2.1 kg in the first year of college.

Thus, the actual average weight gain comes nowhere close to the notorious “15″.

Also, the authors found that most of the weight gain is progressive and continues throughout college – there is little evidence that most of the weight gained (if any) happens in the first year.

Thus, despite individual anecdotal experiences of weight gain, that may sometimes approach or even exceed 15 lbs, there is little scientific basis or reason for concern about the freshman 15.

Or, as the authors put it,

These results suggest that the “Freshman 15” may not pose a significant risk to students’ health, but unhealthy behaviors throughout college may lead to unfavorable changes in body weight, as weight change does not appear to stabilize as previously reported.

Perhaps it is time to put this idea to rest and move on to study issues that may be more important than this.

@DrSharma
Guelph, ON

ResearchBlogging.orgFedewa MV, Das BM, Evans EM, & Dishman RK (2014). Change in Weight and Adiposity in College Students: A Systematic Review and Meta-Analysis. American journal of preventive medicine PMID: 25241201

 

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Monday, October 6, 2014

Obesity Tip Sheet For Occupational Therapists

OT obesity tip sheet AHS Oct 2014

October is Occupational Therapist Month, an event celebrated by the Canadian Association of Occupational Therapists in a nation-wide campaign involving billboards and bumper stickers.

Reason enough to turn my readers attention to a “tip sheet” developed by members of the Alberta Health Services’ Bariatric Resource Team that explains when to refer their patients with obesity to an occupational therapist.

The preamble to this sheet notes that,

“Occupational therapists promote health and well being for people with obesity by facilitating engagement in occupations of everyday life, including addressing occupational performance issues in the areas of self-care, productivity and leisure. This can impact quality of life, including how people with obesity participate in their daily lives and in health and weight management activities.”

Occupational therapy referral may be indicated for a person with obesity presenting with challenges ranging from occupational engagement to completing simple activities of daily living.

To download this OT referral tip sheet click here.

Happy OT month!

@DrSharma
Hamilton, ON

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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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