EACH ISSUE OF THE WELL NEWSLETTER will feature one or more articles from health care professionals. Our contributing writers will be medical doctors, PhDs (or PhD students) and fitness trainers who will tackle issues that are important to your health and wellness.
OVER THE YEARS I've seen literally thousands of patients. While certainly many come to my office with a clear understanding of where their weight's come from, a significant percentage come in and truly can't understand why they're having difficulty losing weight or why they gained weight in the first place.
Indeed there are a myriad of sources of struggle, but here are my top 3 (in order):
1. Meal skipping
These folks often come in and tell me they barely eat. Looking at their weight and lifestyle inventory (WALI) these are the folks that skip breakfast, generally avoid daytime snacks, have soups or salads for lunch and then eat a large dinner and often struggle with cravings and impulse control in the evening. I can understand why they feel they barely eat as the vast majority of the day, they're not eating at all. Of course by the time they do eat, they're hungry. And of course when we're hungry our bodies crave calories. So what happens? While it's true they might only eating one substantial meal per day, during that one meal, due to the influence of hunger, they're eating more calories than their bodies burn the whole day and hence, gaining — not losing.
Simple try at home solution: To lose weight you can't be hungry. Eat every 2-3 hours and include protein with all meals and snacks.
2. Eating out
These folks often come in and tell me they only eat healthy. Looking at their WALI you'll see them eating out anywhere from 4-10 times per week. When I point out their frequent meals out these folks will often tell me that they're great at choosing healthy options at restaurants. Unfortunately for them, even healthy options at restaurants can contain ridiculous numbers of calories.
Simple try at home solution: Here's an easy way to think about meals out. Assume that every meal out you eat will result in a day you don't lose. If you eat out 4-5x per week and then add in a few days of normal life stress struggle you might well not lose a pound. Eat out more than that and you're likely to gain. It's important to point out that while I think zero is certainly too few meals out in the context of a realistic and enjoyable lifestyle, lose the convenience ones and keep only the truly celebratory ones and occasional social ones.
3. Liquid calories
These folks are often the most confused by their weight. They may be eating regular meals and snacks, eating in and watching their portions. Looking at their WALI you might see them having 2 glasses of milk, one glass of juice and one glass of wine a day. Put together that's roughly 40lbs of liquid, non-filling calories per year.
Simple try at home solution: Don't drink your calories. If you're drinking any beverage for health reasons (milk for calcium, juice for vitamins, wine for heart health, V8 for vegetables, etc.), stop. If you're looking for calcium — take supplements. If you're looking for vitamins — take a multi. If you're looking for heart health — take a 10 minute walk a day and if you're looking for vegetables — eat them. At roughly 10lbs per glass per beverage/day per year none of these so called health benefits are worth their weight.
THAT TEENS AND YOUNG ADULTS feel social and peer pressures to have movie-star bodies is well documented. But the study of some 4,200 Nova Scotia kids shows children as young as 10 and 11 are getting in on the weight-watching act, with many saying their happiness can hinge on being supermodel slender or built like Tom Cruise.
Based on surveys of Grade 5 children across Nova Scotia, it showed a disturbing number were concerned about their weight.
“For girls, the skinnier they are the happier they are with their bodies, and with boys it's more ... they don't want to be too skinny but they don't want to be overweight either,” Veugelers says.
Veugelers says aspiring to a perfect physique is usually futile for children and can lead to unhealthy, lingering anxieties about looks.
“The literature has also shown it is a risk factor for disordered behaviour related to eating,” he said.
“What I know from my research is that children as young as 10 are not only experiencing body image concerns, but they're engaging in unhealthy dieting practices to try to change their weight or shape,” says McVey, who is also director of the Ontario Community Outreach Program for Eating Disorders.
In a survey she conducted of 2,000 children aged 10 to 14, 30 per cent of girls and 25 per cent of boys were dieting to lose weight despite being in a healthy weight range. Although society has an obesity problem, she says “they're engaging here in unhealthy dieting practices.”
For one well-grounded boy, both his body and brains are important for gaining popularity.
“You have to have both to go with the flow,” he says.
Veugelers says the blame for body image concerns at a younger age is widespread.
“There's a role of the media, there's a role of the fashion industry, there's a role for the cosmetics industry making it important how we look, how we smell,” he says.
“And it starts already with toys like Barbie Dolls.”
by Peter Janiszewski, MSc, PhD Candidate Peter is a PhD candidate in the School of Kinesiology and Health Studies at Queen's University. For more health and fitness news, visit his website at obesitypanacea.com
ICAME ACROSS SEVERAL wonderful videos last week that I needed to share with everyone here. They are from a Kidsport advertising campaign, and nicely capture the many ways that sport can help children develop into adults who are healthy physically and socially.
The videos are very funny, but they also outline some very real truths. Children who lack fundamental movement skills (e.g. throwing, jumping, swimming or kicking) are extremely unlikely to participate in sports as adults, even if they would otherwise be interested. That can really narrow down the number of opportunities that they have for physical activity. Would you join an ultimate frisbee game if you can't catch, or go snorkeling if you can't swim? Of course not, and neither would many children. In contrast, kids who develop a wide range of fundamental movement skills have the ability to adapt those skills to a variety of sports throughout their lifespan. Since sports are inherently social, lacking fundamental movement skills can also result in social isolation. This is borne out by the research — children with poor motor skills not only engage in less physical activity, but they also suffer from increased psychosocial problems such as lower feelings of self-worth and poorer social support.
Not surprisingly, research also suggests that children who lack fundamental movement skills are at increased risk of overweight and obesity. For example, a study by John Cairney and colleagues at Brock University compared the risk of overweight/obesity in children whose motor skills are substantially lower than would be expected for their age, to that of children with normal motor skills. They report that the prevalence of overweight/obesity was 3 times higher in boys with low motor skills than in boys with normal motor skills. Interestingly, there was no relationship between motor skills and weight status in girls. These findings are limited — only 44 children were classified as having low movement skills, and since the study was cross-sectional, we obviously can't conclude that poor movement skills caused these children to become overweight or obese. And I have no idea what to make of the gender difference. But the findings are interesting to say the least, and suggest that boys who lack fundamental movement skills may be at increased health risk when compared to boys with normal movement skills. It has been suggested that somewhere between 5 and 10% of children exhibit poor movement skills, so it is important to find out if they are at increased risk health risk, and if so, how to improve their skills at a young enough age to reduce their risk.
Cairney, J., Hay, J., Faught, B., & Hawes, R. (2005). Developmental coordination disorder and overweight and obesity in children aged 914?y International Journal of Obesity, 29 (4), 369-372 DOI: 10.1038/sj.ijo.0802893
I'm not surprised — it comes from the Yale University's Rudd Center for Food Policy and Obesity which is certainly the world's most important source of research on weight bias.
The video below is designed for health care providers but really speaks to everyone.
If you've got a chance today, please have a peek — especially if your work involves the care of patients with weight.
AN INTERESTING PHENOMENON of our times appears to be the number of people who consume the majority of their daily calories in the evenings or at night. I have previously blogged about the importance of eating regularly and not skipping meals, as this can promote homeostatic hyperphagia (overeating in response to hunger).
But new research suggest that there may be more to night-time eating than just an increased chance of overeating — it may well be that calories eaten at night are more likely to be stored as fat than the same amount of calories eaten during the day.
This notion is supported by a fascinating new study in mice by Deanna Arble and colleagues from Northwestern University, Evanston, IL, to be published in next month's issue of OBESITY.
Based on a number of recent studies in animals linking energy regulation and the circadian clock at the molecular, physiological, and behavioral levels, Arble and colleagues examined the possibility that the timing of food intake itself may play a significant role in weight gain.
In their carefully conducted study, the researchers fed two groups of mice a high-fat diet with the same amount of calories for six weeks. The only difference between the groups was that one was fed at night (the normal eating time for mice, who are nocturnal), the other group was fed during the day (normally bedtime for mice).
Despite eating the same amount of calories and no change in activity, the mice fed during the day gained 20% more weight and ended up with about 8% more body fat than the night-fed mice.
Thus, this study shows that simply changing the time of eating, without changing the number of calories can greatly affect body weight.
Although total calories and activity were not statistically different, there was a small trend towards more food intake and less activity in the day-fed mice, which may in the end have explained some of the difference, but by no means all of it.
Although the mechanism behind day-fed weight gain in mice is unknown, body temperature, satiety hormones and (lack of) sleep could contribute to this finding.
These findings, suggest that the synchrony between circadian and metabolic processes may play an important role in the regulation of energy balance and body weight control. As pointed out by the authors, "this study is the first to show causal evidence that feeding at the "wrong" time can lead to weight gain".
If the same holds true in humans (and I can think of no reason why it shouldn't), then eating when you should be asleep could be a key factor in promoting weight gain — something that all evening and night eaters may have to consider.
2. Eating out
For one well-grounded boy, both his body and brains are important for gaining popularity.
by Dr. Arya Sharma
Despite eating the same amount of calories and no change in activity, the mice fed during the day gained 20% more weight and ended up with about 8% more body fat than the night-fed mice.
