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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Friday, August 22, 2014

Do Bite Counters Count Bites?

bite counterWith the current electronic self-montioring craze, it was only a matter of time before someone would try to come up with a device that counts the number of bites it takes you to finish a meal.

The device (Bite Counter), is worn no the wrist of the dominant hand and contains a tri-axial accelerometer that detects an upward, arcing motion from the table to the mouth.

Now a study by Jenna Desendorf and colleagues from the University of Tennessee, tested the accuracy and validity of this device in 15 adults (23–58 years old) while eating a meal consisting of foods/beverages, each consumed with different utensils: meat (knife and fork), side items (fork), soup (spoon), pizza (hands), can of soda (hands), and a smoothie (straw), while being observed them through a one-way mirror and counted the number of bites taken.

As the paper, published in Eating Behaviors reports, the overall accuracy of the device was around 80%. However, this varied substantially between foods: meat (127%), side items (82.6%), soup (60.2%), pizza (87.3%), soda (81.7%), and smoothie (57.7%).

So, while this device may well underestimate the number of bites taken during a mixed meal, the real question is what people will start monitoring next – number of chews? (I joke about this on my show) Saliva flow? Numbers of swallows per bite? Oesophageal transit time?

I can perhaps see some research applications but as a way to help improve your eating?

The company claims that limiting your number of daily bites to 100 will help you lose weight.

I am yet to be convinced.

@DrSharma
Edmonton, AB

ResearchBlogging.orgDesendorf J, Bassett DR Jr, Raynor HA, & Coe DP (2014). Validity of the Bite Counter device in a controlled laboratory setting. Eating behaviors, 15 (3), 502-4 PMID: 25064306

 

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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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Monday, August 11, 2014

Open-Angle Keyboard Eases Typing Trauma for People Living With Obesity

goldtouch-ergonomic-keyboardThe ergonomics of standard QUERTY keyboards are bad enough for people of regular size – for larger people, the strain on the upper body is even worse resulting in significant upper-body muskuloskeletal discomfort and even injury.

Now a study by Matthew Smith and colleagues from the University of Georgia, published in Applied Ergonomics provides good evidence for the value of providing people with obesity ergonomically improved open-angle keyboards.

The researchers studied the use of these key boards in 22 office workers with overweight or obesity and found a significant decrease in lower back discomfort with no changes in overall typing performance.

The specific open-angle keyboards used in this study,

“…allows for up to 30° of angle in the keyboard as well as 30° of vertical inclination. The vertical inclination is referred to as a “tent” effect. These adjustments allow the user flexibility in the three-dimensional adjustment of the keyboard to allow for optimal hand placement while typing. These movement capabilities are intended to allow the users to make angular adjustments to the keyboard to minimize wrist supination and both radial and ulnar deviation, all of which are key factors in development of distal upper extremity musculoskeletal diseases.”

From this study the authors conclude that such relatively low-cost interventions can be introduced into the workforce to benefit workers without reducing short-term worker productivity.

@DrSharma
Edmonton, CA

ResearchBlogging.orgSmith ML, Pickens AW, Ahn S, Ory MG, DeJoy DM, Young K, Bishop G, & Congleton JJ (2014). Typing performance and body discomfort among overweight and obese office workers: A pilot study of keyboard modification. Applied ergonomics PMID: 25082778

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Friday, August 8, 2014

Healthy Obesity: More Questions Than Answers?

sharma-obesity-visceral-fat-mriRegular readers will be well aware of the evidence that a subset of people living with obesity can be remarkably healthy despite carrying a rather large amount of body fat.

This issue of “healthy obesity” was the topic of the 13th Stock Conference of the International Association of the Study of Obesity, the proceeding of which are now published in Obesity Reviews.

As the authors note,

“The ‘healthy obese’ phenotype was described in the 1980s, but major advancements in its characterization were only made in the past five years. During this time, several new mechanisms that may be involved in health preservation in obesity were proposed through the use of transgenic animal models, use of sophisticated imaging techniques and in vivo measurements of insulin sensitivity. However, the main obstacle in advancing our understanding of the metabolically healthy obese phenotype and its related long-term health risks is the lack of a standardized definition.”

The latter is a real problem because finding people with obesity, who are truly metabolically and otherwise healthy becomes harder the higher the BMI gets – this makes the study of this phenomenon rather challenging.

Nevertheless,

“One of the most consistent characteristics of metabolic health in obesity across studies in humans is reduced liver lipid. This is likely the consequence of increased capacity for storing fat coupled with improved mitochondrial function in adipose tissue and decreased de novo lipogenesis in liver. This can also result in decreased deposition of lipids, including bioactive species, in skeletal muscle. Decreased adipose tissue inflammation with decreased macrophages and a unique T-cell signature with an anti-inflammatory circulating milieu were also suggested to characterize metabolic health in obesity. Anecdotal data support a possible role for healthier lifestyle, including increased level of physical activity and healthier diet. It remains to be established whether a favourable metagenomic signature is a characteristic of metabolic health in obesity.”

Finland’s, Dr Kirsi Pietiläinen explained that,

“..three energy dissipation pathways, oxidative phosphorylation, fat oxidation and amino acid catabolism showed preserved pathway activities in subjects who are MHO at a level similar to their lean counterparts. In contrast, these pathways were significantly down-regulated in adipose samples from obese twins with metabolic disturbances. Another potential hallmark of metabolic health, a favourable inflammatory profile of the adipose tissue was also observed in the MHO twins. Also, the fat cells of the MHO twins were smaller with evidence of more active differentiation processes within the fat tissue. As multiple mitochondrial pathways are vital in adipocyte differentiation [29], it is possible that mitochondrial malfunction impairs the development of new fat cells, which in turn results in an inability of the adipose tissue to expand under conditions of energy excess. This failure of fat cell proliferation has long been suspected to constitute the framework for ectopic fat storage, insulin resistance and type 2 diabetes.”

Other speakers discussed other aspects including immune function and microbiata in this phenomenon.

Finally, the authors concluded that,

“identifying underlying factors and mechanisms associated with this phenotype will eventually be invaluable in helping the scientific and medical community understand factors that predispose, delay or protect obese individuals from metabolic disturbances. It is essential to underscore that the MHO concept presently only address the cardio-metabolic risks associated with obesity; it is therefore important that patients who are MHO are still very likely to present many other obesity-related complications such as altered physical and/or physiological functional status, sleep problems, articulation and postural problems, stigma, etc. Importantly, the MHO concept supports the fact that classification based on excess adiposity per se (e.g. BMI or body composition if available) should be supplemented with obesity-related comorbidities, e.g. with fasting insulin as proposed by the Edmonton obesity classification system.”

Certainly a space to watch as we learn more and more about the “healthy obesity” phenotype.

@DrSharma
Edmonton, AB

ResearchBlogging.orgSamocha-Bonet D, Dixit VD, Kahn CR, Leibel RL, Lin X, Nieuwdorp M, Pietiläinen KH, Rabasa-Lhoret R, Roden M, Scherer PE, Klein S, & Ravussin E (2014). Metabolically healthy and unhealthy obese – the 2013 Stock Conference report. Obesity reviews : an official journal of the International Association for the Study of Obesity PMID: 25059108

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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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