Thursday, August 28, 2014

Call For Abstracts: Canadian Obesity Summit, Toronto, April 28-May 2, 2015

COS2015 toronto callBuilding on the resounding success of Kananaskis, Montreal and Vancouver, the biennial Canadian Obesity Summit is now setting its sights on Toronto.

If you have a professional interest in obesity, it’s your #1 destination for learning, sharing and networking with experts from across Canada around the world.

In 2015, the Canadian Obesity Network (CON-RCO) and the Canadian Association of Bariatric Physicians and Surgeons (CABPS) are combining resources to hold their scientific meetings under one roof.

The 4th Canadian Obesity Summit (#COS2015) will provide the latest information on obesity research, prevention and management to scientists, health care practitioners, policy makers, partner organizations and industry stakeholders working to reduce the social, mental and physical burden of obesity on Canadians.

The COS 2015 program will include plenary presentations, original scientific oral and poster presentations, interactive workshops and a large exhibit hall. Most importantly, COS 2015 will provide ample opportunity for networking and knowledge exchange for anyone with a professional interest in this field.

Abstract submission is now open – click here

Key Dates

  • Abstract submission deadline: October 23, 2014
  • Notification of abstract review: January 8, 2014
  • Early registration deadline: March 5, 2015

For exhibitor and sponsorship information – click here

To join the Canadian Obesity Network – click here

I look forward to seeing you in Toronto next year!

@DrSharma
Montreal, QC

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Tuesday, August 19, 2014

Can a Non-Profit Urban Food Initiative Alleviate Food Insecurity?

Doug Rauch, former President of Trader Joe's

Doug Rauch, former President of Trader Joe’s

Healthy eating (especially produce) is well out of reach for many who have hungry mouths to feed (despite ivory tower experts who proclaim that you can eat healthy for under $2 a day if you only follow their “tips”).

As food insecurity is certainly one of the key drivers of obesity especially within the lower socioeconomic strata, I was very interested in a paper by Deepak Palakshappa and colleagues, who describe a non-profit initiative to address food insecurity, in a paper published in JAMA Pediatrics.

This initiative, that has yet to open its first store, is to be launched by Doug Rauch, former president of Trader Joe’s grocery chain, who believes that nonprofit supermarkets in low-income neighborhoods can help provide nutritious low-cost foods by selling food gathered from the fresh produce and perishables that are discarded from other supermarkets. (The first store, named the Daily Table, has been proposed to open in Dorchester, a low-income neighborhood in Boston, Massachusetts.)

Indeed, there is an incredible amount of food that goes waste because it either does not meet the high standards of appearance of supermarket chains or is close to or past its “best-before” date.

As the authors point out,

“While most people believe these dates are based on safety, manufacturers and retailers focus on a product’s shelf life, which is based on peak freshness, which is a function of how the food looks and smells. Many manufacturers date their products earlier because of concerns about protecting their brand image. The US Department of Agriculture states the labels are not safety dates and if food is handled and stored properly, it should be safe to consume even if it is past the date. The confusion specifically regarding date labeling is estimated to lead to 32 billion pounds of avoidable food waste a year.”

The paper also discusses whether such an approach would be deemed ethical. As the authors are quick to point out, the first store has yet to be opened so exactly how things will play out in real life awaits to be seen. 

However, there are good reasons to assume that this initiative has the potential to increase the consumption of fruits and vegetables and offers option of purchasing low-cost healthy foods rather than mandating their consumption of healthy foods. The location of these stores in low-income neighbourhoods should help addresses the disparity in access to healthy foods by providing a convenient place for individuals who otherwise may not have healthy foods readily available.

The stores will also offer cooking and health eating classes to promote the autonomy of clients to determine with items to purchase.

The authors also hope that this approach, rather than blaming the individual, will provide an environment conducive to healthier eating while also respecting local social and cultural values.

Of course, whether all of this will work and whether or not such an initiative can be economically viable in the long term remains to be seen. Nevertheless, the initiators of this idea should at least be commended on giving this a shot.

@DrSharma
Edmonton, AB 

Hat tip to Geoff and Ximena for bringing this article to my attention

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Tuesday, July 29, 2014

5th Conference on Childhood and Adolescent Obesity, Winnipeg, Sept 23-26, 2014

Jonathan McGavock, PhD, Assoc. Professor, Manitoba Institute of Child Health, Winnipeg, MB

Jonathan McGavock, PhD, Assoc. Professor, Manitoba Institute of Child Health, Winnipeg, MB

For readers interested in the prevention and management of childhood and adolescent obesity, there is still time to submit your abstract (deadline Aug 5) and to register for this event in Winnipeg.

Those of you, who have been to previous meetings in this series, will know that this meeting (interspersed biennially with the Canadian Obesity Summit) brings together clinicians, researchers, policy makers and other stakeholders for 4 days of intense networking and knowledge exchange.

This year’s conference is being organised by Jon McGavock from the Manitoba Institute of Child Health and is sure to be a blast.

Given Jon’s interest in this area, this year’s conference will include a strong focus on the burden of obesity among Indigenous Youth and showcase examples of the best and promising practices within Indigenous communities across Canada and the US.

This special theme will include presentations from Indigenous youth living in communities with a high burden of obesity, sharing circles with Indigenous leaders and stakeholders and will explore interventions designed to promote these strengths and enhance resiliency among children and adolescents.

Of course, the conference will also cover a wide range of other topics related to childhood obesity across the age and care continuum.

View CE Credits HERE.

Brochure is available HERE.

Register for the conference HERE.

Registration for the pre-conference only HERE.

Submit your abstract HERE.

Incidentally, I will be having the privilege of giving a keynote at the opening of the pre-conference.

While in Winnipeg, I will also be performing my “Stop Being a Yo-Yo” show at the Colin Jackson Studio Theatre on Sept. 24, Show time: 7:00 p.m. (click HERE for online tickets).

See you in Winnipeg!

@DrSharma
Edmonton, AB

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Tuesday, July 8, 2014

Does BMI Underestimate Adiposity in Kids?

sharma-obesity-kids-scale2Regular readers are well aware of my reservations regarding the use of BMI as a diagnostic parameter in clinical practice. After all, while BMI may tell us how big someone is, it certainly is not a good measure of how sick someone is.

But to be honest, BMI was never intended as a measure of disease – it was (at best) introduced as a surrogate measure of adiposity (fatness).

Nevertheless, supporters of BMI continue to argue that it is still a good measure of fatness and as such should remain part of standard assessment – even in kids.

Now, a paper by Javed and colleagues, published in Pediatric Obesity, examines how well BMI performs as a means to identify obesity as defined by body fatness in children and adolescents.

The authors conducted a systematic review and meta-analysis of 37 studies in over 53,000 participants assessing the diagnostic performance of BMI to detect adiposity in children up to 18 years.

While the commonly used BMI cut-offs for obesity showed showed a high specificity (0.93) to detect high adiposity, the sensitivity was much lower (0.73) – particularly in boys.

This means that kids who exceed the current BMI cut-offs are indeed very likely to have fatter bodies (for what it’s worth).

On the other hand, relying on BMI cut-offs alone will miss as many as 25% of kids whose body fat percentage exceeds current definitions of adiposity.

Thus, assuming that bod fatness or adiposity is indeed a clinically useful measure of health, the use of BMI alone will ‘underdiagnose’ adiposity in a significant proportion of kids (especially boys) who may well be at risk from excess fat.

A word of caution about fatness is certainly in order – as in adults, much depends on exactly where the fat is located (abdominal or ectopic vs. subcutaneous) and other factors (e.g. cell size, inflammation, insulin sensitivity, etc.).

Thus, even if BMI was a perfect measure of body fat, it would probably still require further examinations and tests to determine exactly whether or not this “extra” fat poses a health risk.

As in adults, a clinical staging system similar to the Edmonton Obesity Staging System may be a fat better indicator of determining which kids may need to worry about their body fat and which don’t.

@DrSharma
Edmonton, AB

Hat tip to Kristi Adamo for pointing me to this study

ResearchBlogging.orgJaved A, Jumean M, Murad MH, Okorodudu D, Kumar S, Somers VK, Sochor O, & Lopez-Jimenez F (2014). Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis. Pediatric obesity PMID: 24961794

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Wednesday, June 25, 2014

Social Anxiety As A Deterrent To Physical Activity

sharma-obesity-distored-body-image1Social anxiety, defined as persistent fears of one or more social situations in which the person is exposed to others and expects to be scrutinized, has been reported in as many as one in ten individuals with overweight or obesity.

Now, a paper by Abbas Abdollahi and Mansor Abu Talib, published in Psychology, Health and Medicine, examines the relationship between social anxiety and sedentary behaviour in this population.

The researchers surveyed 207 overweight and obese students (measured heights and weights) using a number of validated instruments to assess social anxiety, sedentariness and body esteem.

As one might expect, social anxiety was associated with lower body esteem and higher sedentary behaviour.

The key mediator in this relationship was body dissatisfaction and poor body esteem.

Thus,

“…obese individuals with poor body esteem are more likely to report social anxiety, because they are concerned about negative evaluation by others; therefore, obese individuals indicate avoidance behaviour, which, ultimately, leads to social anxiety.”

The implications of these findings are obvious,

“First, when assessing the social anxiety in individuals, it is important to account for the presence of sedentary behaviour in addition to other psychological risk factors. Second, reducing sedentary behaviour can alter the effect of social anxiety factors; this may be a significant factor to incorporate into social anxiety treatment programmes. Reducing social anxiety in individuals is a main part of any clinical intervention. Third, the findings of the current study suggest that health professionals should encourage obese individuals with social anxiety to reassure their value and abilities regardless of their weight or body shape, and assist them to recognize that everybody is unique and that differences between individuals are valuable.”

This will take more than simply telling people with overweight to be more active. It will certainly require targeted and professional help to overcome body dissatisfaction and low self esteem.

Or, even better, we need to do all we can to help people gain more confidence and be accepting about their own bodies in the first place.

@DrSharma
Vancouver, BC

ResearchBlogging.orgAbdollahi A, & Talib MA (2014). Sedentary behaviour and social anxiety in obese individuals: the mediating role of body esteem. Psychology, health & medicine, 1-5 PMID: 24922119

 

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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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