Her Excellency Alexandra Volkoff, Canada's Ambassador to Sweden and Arya Sharma, Scientific Director of the Canadian Obesity Network

Since its inception in 2006, the Canadian Obesity Network has grown into an organisation that brings together over 4000 Canadian obesity researchers, health professionals, decision makers and other stakeholders interested in reducing the mental, medical and economic burden of obesity on Canadians.

As many of the problems faced by Canada are not unlike those faced by other countries and much of the Canadian research and experience in obesity prevention and management may well be applicable to tackling obesity in other countries, the Canadian Obesity Network has always sought to promote Canadian research beyond our borders.

This why, at the ongoing XI International Congress on Obesity in Stockholm, the Obesity Network partnered with the Canadian Embassy to Sweden to host a “Meet the Canadians” reception. This networking event, attended by well over 150 participants, provided a perfect opportunities for Canadians attending the conference to meet each other but also to interact with friends and collaborators from other countries.

In her welcome address, her Excellency Alexandra Volkoff, Canada’s Ambassador to Sweden (picture), highlighted the importance of the work that the Canadian Obesity Network is doing to address the obesity epidemic and emphasized the commitment of the Canadian Government to help build international partnerships and collaborations to reduce the global burden of obesity through excellence in obesity research and practice.

Judging by the many Obesity Network members attending and presenting at this World Conference, there is no doubt that Canadian obesity research is highly competitive, well respected and certainly relevant to the many issues related to the prevention, management and control of obesity.

AMS
Stockholm, Sweden

Anyone working in academia is well familiar with the slogan, “publish or perish”.

Indeed, the quantity and quality of scientific publication continues to be a major measure of academic achievement. But how relevant are these publications really? Research shows that the vast majority of publications appearing even in top journals often have little if any measurable impact on decision makers or policy.

Is this because the science is truly irrelevant or is the science largely ignored because it faces a world of non-scientists who do not understand its significance and simply couldn’t be bothered?

This is the topic of a most interesting book that I just finished reading.

Unscientific America: How Scientific Illiteracy Threatens Our Future, is a short text written by Chris Mooney and Sheril Kirshenbaum, which explores the roots and consequences of the increasing divide between what science reveals and a population that largely ignores these revelations.

As Mooney and Kirschenbaum point out,

“For every five hours of cable news, less than a minute is devoted to science; 46 percent of Americans reject evolution and think the Earth is less than 10,000 years old; the number of newspapers with weekly science sections has shrunken by two-thirds over the past several decades. Meanwhile, only 18 percent of Americans have even met a scientist to begin with; more than half can’t name a living scientist role model.”

But rather than simply blaming schools or parents or politicians or the media or an increasingly anti-intellectual public, the authors point a finger directly at the scientific community itself - a community that is clearly failing to make itself relevant or interesting to policy makers or the general public (who will ultimately determine what policy makers care about).

Not only do Mooney and Kirshenbaum deplore the fact that very few scientists have communication skills that allow them to effectively convey the relevance and importance of their work to “outsiders” but that “there are too few collaborations between scientists and journalists, screenwriters, politicians, and religious leaders”.

They quote Preston Manning, who argued that scientists need to “establish a relationship with the political community on grounds other than the milk cow - milking machine relationship” and not only reach out to politicians when they want research funding. Rather, they should establish long-term mulitdirectional relationships, where they are helping as much as they are being helped.

In terms of communicating science, Mooney and Kirshenbaum are also not very happy with science bloggers (to which I dare count myself). They point out that the vast majority of science blogs serve rather specialised audiences - often preaching to the converted and can hardly be considered part of mainstream discourse.

Indeed, the fact that today anyone can find any information supporting any view is exactly one of the main problems with the new media. Like-minded readers congregate to whatever media best represents their opinions or beliefs, thereby essentially eliminating the need for serious discourse, the key to true understanding of any issue.

The authors have several pieces of advise on how to address this scientific illiteracy. One solution may be to train a small army of ambassadors who can translate science’s message and make it relevant to the media, to politicians, and to the public in the broadest sense. Another may be to stoke a cultural change at academic institutions that will specifically reward scientists for their public outreach and communication endeavours - efforts that will hopefully make all of society more scientifically engaged.

Certainly a book all scientists should read.

AMS
Stockholm, Sweden

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As most smokers are well aware, smoking cessation is often accompanied by a variable amount of weight gain, and there is some evidence that some people (particularly young women) primarily smoke to control their appetite and weight.

Indeed, as blogged previously, the progress on fighting tobacco in the US may be eroded by the gains in obesity rates, as over the past 15 years, smoking rates in the US have declined by 20%, whereas obesity rates have increased by 48%..

So do policies that address tobacco consumption increase the prevalence of obesity?

This question was addressed by Anindya Sen and colleagues from the University of Waterloo, Ontrario, in a paper just published online in the journal Health Policy.

In this study, the researchers used the the substantial cross-province differences that exist between Eastern and Western Canada to estimate the effects of higher cigarette taxes on aggregate health region and individual level data from the 2003 and 2005 waves of the Canadian Community Health Surveys (CCHS).

According to their estimates, a 10% higher cigarette tax is correlated with a 4% lower rate of smoking but also a 4-5% higher prevalence of obesity. These findings were robust across several models that took into account various demographic variables and potential confounders.

The researchers conclude that health benefits from higher cigarette taxes and lower smoking rates may be partially offset by a corresponding increase in obesity levels.

However, given the tremendous negative impact of smoking on health, one would need to gain quite a considerable amount of weight to fully negate the many potential benefits (less heart disease, COPD, cancers, amputations) of smoking cessation.

Smoking cessation programs and anti-tobacco policies should probably actively promote measures to prevent excessive weight gain.

As blogged before, this may be easier said than done.

AMS
Edmonton, Alberta

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Sen A, Entezarkheir M, & Wilson A (2010). Obesity, smoking, and cigarette taxes: Evidence from the Canadian Community Health Surveys. Health policy (Amsterdam, Netherlands) PMID: 20570008

University of Leipzig Faculty of Medicine

Currently, I am in Leipzig, Germany, home of the latest Integrated Research and Treatment centre funded by a substantial grant (~24 Million Euros) from the German federal ministry of research and education.

As you may guess, this centre will focus on obesity, an area in which the University of Leipzig already has considerable expertise.

As part of the International Advisory Board to this centre, it is my role to advise the board of this project regarding the best ways to ensure that this substantial grant is put to the best possible use.

There is no doubt that the project is highly innovative, cutting straight through Germany’s traditional hierarchical and archaic academic structures, where the “Herr Professor”, once appointed for life, pretty much has the final say on anything that happens in a given department.

The integrated Research and Treatment centres are specifically designed to cut through these bureaucratic and often ineffective feifdoms, a concept which may well revolutionize medical practice and research at German universities.

I definitely had the pleasure of hearing about a wide range of novel ideas and was very much impressed by the many cross-sectorial research projects ranging from cutting edge work on the biological function of adipose tissue to the psychiatric issues that patients face after bariatric surgery.

To top things off, our most generous hosts invited us to a fabulous evening at the 500 year old Auerbach Keller, which apparently was a regular hang out for Goethe during his time in Leipzig and currently ranks #5 under the most visited restaurants in the world (after Munich’s Hofbräuhaus, Caesar´s Palace in Las Vegas, Café Sacher in Wien and the Hard Rock Café in LA).

Of course, as to be expected at this historical venue, the evening was accompanied by a recital from Goethe’s Faust in the typical Saxonian dialect.

I congratulate Michael Stumvoll and his colleagues on their success in acquiring a substantial amount of funding to establish, what I can only assume will soon be Germany’s leading Centre of Excellence in obesity research and management.

Apart from the honour of serving on their International Advisory Board, I certainly very much look forward to future interactions, especially given the recent collaboration agreement between the German Freestate of Saxony and the University of Alberta.

AMS
Leipzig, Germany

Yesterday, I attended an Obesity Reduction Strategy Stakeholder Forum hosted by the Provincial Health Services Authority in Vancouver, British Columbia.

The aim was to provide feedback on the proposed recommendations for changing the obesogenic environment as well as addressing issues around food, physical activity, treatment and disease surveillance.

Although, by many measures, British Columbia may be Canada’s healthiest province, the annual direct and indirect costs of obesity on British Columbians is conservatively estimated at $ 1 billion. In fact, over 100,000 people in British Columbia may already have obesity that is severe enough to warrant surgery.

As a clinician, I was allocated to the treatment discussion group. This group championed the proposal to develop a continuum of obesity management services that address the needs of uncomplicated overweight to morbidly obese people, ranging from clinical prevention to bariatric surgery.

Of course, other groups focused on population wide prevention strategies including recommendations to change the food landscapes in schools and workplaces as well as a range of suggestions on how to make everyone more physically active.

There was also considerable time allotted to pointing out that there would need to be very specific considerations for dealing with obesity amongst British Columbia’s substantial and diverse First Nation, Metis, and Inuit population.

While it is certainly a long way from this discussion to actually implementing policy and providing services, it is certainly a promising step towards recognizing and addressing this issue.

Although there were some interesting discussions in the room about the complexity of the whole problem and what exactly to do next, there was clear consensus on one point: doing nothing is not an option!

AMS
Edmonton, Alberta