3rd National Obesity Student Meeting, Edmonton, June 20-23, 2012
Yesterday was the beginning of the 3rd Canadian Obesity Student Meeting here at the University of Alberta in Edmonton. Regular readers may recall previous posts on the 1st meeting in Laval and the 2nd at the University of Ottawa. This year’s meeting, organised by the Canadian Obesity Network’s Students and New Professionals (CON-SNPs), once again brings well over a 100 of Canada’s brightest and finest students and trainees from across Canada for three days of intense scientific and social exchange. The local CON-SNP organisers, Becky Mercer, Nicole Glenn, and Angela Coppola, have done a tremendous job of pulling the program together. Thanks also to their faculty advisors Bill Colmers and Kim Raine. The over 100 oral presentations and posters at this meeting cover every conceivable topic from sedentariness and physical activity in kids to school interventions, maternal and infant health, food insecurity and aboriginal health, fat tissue biology and neuroscience, body image and mental health, cancer, inflammation, fatty liver and cardiovascular disease, as well as behavioural, medical and surgical treatments. Accompanying the conference is an art exhibit ‘The Big Idea‘, featuring a visual exploration of contemporary culture and obesity by ten Canadian, US and UK artists (selected from over 60 submissions), curated by Julian Forrest. The opening reception for The Big Idea, featuring the noted US performance artist, writer and sociologist, Kimberly Dark, will be held at the Peter Robertson Gallery, June 21, at 7.30 p.m. I look forward to a couple of exciting and engaging days here in Edmonton, AMS Edmonton, Alberta
Unhealthy Waits?
One of the limitations of a publicly funded health system is extended wait times, not least for individuals, who struggle with severe obesity. How do such wait times affect these patients’ health and how do they feel about it? This is the topic of a paper we now publish in BMC Health Services Research. In order to better understand wait-listed patients’ health status and perceptions regarding the consequences of prolonged wait times, we used a cross-sectional study design nested within a prospective cohort study. Participants were 150 consecutive consenting subjects wait-listed for a tertiary care multi-disciplinary bariatric assessment in an Alberta population-based medical/surgical bariatric program. We measured health status using a visual analogue scale and used the Waiting List Impact Questionnaire (WLIQ) to look at the impact on employment, physical stress, social support, frustration, quality of life, and satisfaction with care. All analyses were adjusted for age, sex and BMI identified independent predictors of lower VAS scores. Over 90% of participants were women with a mean age of 43, mean BMI of 50 and an average waiting time (at the time of assessment) of 64 days. The mean health VAS score was 53/100), whereby independent predictors of lower VAS scores included a higher BMI, unemployment and depression (sleep apnea just missed statistical significance in this analysis). This level of VAS score is markedly lower than the average score of 85 previously reported in a random sample of community-dwelling adults drawn from the same population as our study sample and even considerably lower than those reported other chronic medical conditions such as diabetes and COPD with VAS scores of 66 and 65 respectively. Physical limitations were common, with 85% reporting reduced activity, 83% reporting activity limitations compared to previous activity levels and 69% reporting worsening physical limitations over time. The majority of subjects expressed concern over wait times (65%) and felt that waiting was very stressful (53%) and physically, emotionally and mentally taxing (62%). According to the WLIQ, 47% of subjects agreed or strongly agreed that waiting affected their quality of life, 65% described wait times as ‘concerning’ and 81% as ‘frustrating’. Of the respondents, 81% of subjects indicated that the wait for care was frustrating, 73% worried about the consequences of extended wait times on their health, 68% were frustrated with the allocation of resources and 59% felt that they should not have to wait for obesity treatment. Surprisingly, however,… Read More »
2010/11 Canadian Initiatives to Promote Healthy Active Living
In a paper just published in the Canadian Journal of Public Health, Mark Tremblay, Director of the University of Ottawa’s Healthy Active Living and Obesity Research Group at the Children’s Hospital of Eastern Ontario Research Institute, and one of Canada’s leading advocates for physical activity, reviews some of the major Canadian initiative to promote health active living. These 15 initiatives include: a Federal-Provincial-Territorial framework for action to promote healthy weights; implementation of a nutrition labeling initiative; launch of the CBC “Live Right Now” campaign; the Public Health Agency of Canada’s innovation strategy funding related to obesity; publication of the Canadian Health Measures Survey physical activity findings; release of new Canadian physical activity and sedentary behaviour guidelines; launch of ParticipACTION’s “Think Again” campaign; workshop on building trust to address the epidemic of obesity; start of the Canadian Pediatric Weight Management Registry; initiation of “Our Health Our Future: A National Dialogue on Healthy Weights”; release of the Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth; National Obesity Summit; Nature Play Day and Sports Day in Canada; development of the Canadian Assessment of Physical Literacy; and the creation of Active Canada 20/20 – A National Physical Activity Plan. As Tremblay points out, “The diversity and intensity of activity surrounding the childhood obesity and inactivity “epidemic” in Canada is encouraging” But he also notes that, “…it will be important to assess the impact and implementation of the programs listed in this brief review while also holding various sectors and agencies accountable for the implementation of existing and future recommendations for action.” While all of these efforts are commendable and, if they serve to sustainably increase activity levels of Canadians, will no doubt have their benefits, critics may point out that almost nothing in these activities are specific to addressing obesity – indeed, framing any of these initiatives (perhaps with the exception of the paediatric weight management registry and the National Obesity Summit) as being specifically tailored to target obesity prevention or management does little more than continue to frame obesity as a simple ‘lifestyle’ matter of eating less and moving more. Given the rather sobering long-term impact of even individually tailored one-on-one diet and physical activity interventions, it is hard to see how the even less intense, population based approaches to improving diet and physical activity will pan out. As I have noted before – appeals to simply Eat-Less-and-Move-More… Read More »
Mental health issues a missing link in the fight against weight gain
The interplay between obesity and mental health is complex, but “we have not had a public discourse on how tightly these two epidemics are linked,” says Dr. Arya Sharma, professor of medicine and chair in obesity research and management at the University of Alberta.
Beverage Consumption and Obesity in Canadian Kids
Readers may recall a previous post on the relationship between physical activity or TV viewing and obesity in Canadian kids – the result did not show much of a relationship – if anything, obese kids were probably doing more physical work than normal weight kids. Now, another study, challenges the widely held notion that, apart from not being as active, obese kids also spend most of their time guzzling sugar-laden beverages, reason enough for policy folks to tax, ban, blame and shame overweight kids into sticking with the water fountain. While that may well be ok (I grew up drinking little else than water), hoping that this will make a dramatic difference on childhood obesity rates may be more than such efforts may deliver. Thus, according to a paper by Adrienne Danyliw and colleagues from the University of Saskatchewan, published in Applied Physiology Nutrition and Metabolism, beverage intake patterns identified by cluster analysis of data from the cross-sectional Canadian Community Health Survey 2.2, does not reveal a strong link between beverage consumption and obesity in Canadian kids (with some caveats – see below). The analyses of beverage consumption of over 10,000 kids, included intake data obtained from a single 24-hour recall, measured height and weight, and sociodemographic data obtained through interviews. Cluster analyses resulted in two distinct groups of kids: those who drank mostly fruit drinks, soft drinks, 100% juice, milk, high-fat milk and those who drank low-volume and varied beverages (termed “moderate”). Overall, the researchers failed to find any significant relationship emerged between beverage pattern and overweight and obesity among the kids with one exception: in boys aged 6-11 years, drank more than half a liter (553 g) of softdrinks had a two-fold higher risk of being overweight or obese than kids with a ‘moderate’ beverage pattern. Thus, with the exceptions of young boys, who drink a fairly impressive amount of soft drinks, this national cross-sectional dietary intake data does not suggest that beverages are a major driver of excess weight in Canadian kids. This does not mean that drinking a large amount of softdrinks or fruit juices is good for you – it does mean, however, that blaming the obesity epidemic fully or even in part on increased consumption of these beverages may overly simplistic. Of course, I am more than aware (as are the researchers) about the limitations of these kind of studies. Not only is 24-hour recall… Read More »
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