ON JANUARY 13th Statistics Canada released the landmark Canadian Health Measures Survey the results of which are readily available on line. The study tested 5600 Canadians aged 6 to 79 at 15 sites across Canada. They were able to compare the results with a similar, although less comprehensive study, conducted across Canada in 1981. The results made grim reading; Canadians of all ages were heavier, bigger bellied, weaker, less flexible and by every conceivable measure, less fit than they were a generation previously. Just as the 80's study marked a decline in all measures associated with fitness and health when compared with earlier surveys.
I braced myself for the headlines and the stories of our physical demise in the newspapers the next day. I thought my local paper, the Victoria Times Colonist, had missed the story altogether, until I found a slim half column tucked away on page 5 of the Life section. I couldn't help but compare this to the recent headlines and daily coverage of the H1N1 flu epidemic which has, to date, been a significant factor in the deaths of about 425 Canadians. That's a lot of people, until you compare it with the approximately 25,000 Canadians who die each year due to obesity and diet related diseases. Our National paper, the Globe and Mail, did a much better job of coverage. The Survey didn't make the front section of the paper, but it did get a fat headline on the front page of the Life section: “Fat Nation: Canadians Heavier, Wider and Weaker.”
IT'S WORSE THAN IT APPEARS
Before you read on I should warn you that because of normal research limitations the study was unable to tell us the whole truth.
The numbers, from children to seniors are all bad, but that's only part of the story. Participation in a Government survey is voluntary, and unfit, obese people are far, far less likely to volunteer to go to a location, do a fitness test and respond to a questionnaire. (Slightly over 30% of households declined to participate, and based on my own experience with this type of survey, I'm surprised it wasn't more) Of the people who initially agreed to participate 87% completed the questionnaire, reducing the numbers further, and of the remainder, 83.6% actually completed the fitness test. To quote the Report “The final response rate of 20 – 69 year olds, after adjusting for sampling strategy, was 51%!!”
Remember this ever diminishing sample was selected from people living in ‘private households’ thus eliminating many of our marginalized, less accessible and often unhealthy citizens. It also excluded ‘residents of Indian Reserves or Crown lands, institutions and certain remote regions’. Reference to Statistics Canada's “Indicators of Well Being in Canada 2005“ notes that the incidence of obesity among our First Nations people far exceeds the national average, and also that obesity is more prevalent in remote communities.
To summarize: Statistics Canada was able to complete tests on about half the sample of accessible Canadians who lived in ‘private households’ and agreed to show up for a fitness test. They didn't even try to test people on the reservations where, in many cases, obesity is rampant. Also given that they used a total of only 15 testing sites for the whole country, it is unlikely that much testing went on in the less accessible Northern communities.
So, with everything biased towards getting decent test scores, we still look bad. This is not a criticism of Statistics Canada who took on the difficult task of ACTUALLY MEASURING people rather than just asking for information over the phone. Personal reporting about diet and exercise is almost useless. I've been told by more than one leading epidemiologist that when it comes to weight, diet and exercise ‘everybody lies’.
WHAT CAN DONE?
There's an old saying that, “People don't change when they see the light, but when they feel the heat.” This applies whether it's obesity, with its attendant health problems, global warming, or overspending and subsequent debt. What's sad is that even though we are ‘feeling the heat’ of obesity, lack of fitness and increasing medical costs, there is no real National strategy to address these problems. Part of the problem lies in the fact that prevention isn't “sexy” in political terms, because the results will not show in the short term. (Politicians think of the next election, states people think of the next generation). We can be great in an emergency and can free up tens of thousands of dollars for a single dramatic heart transplant, but find it hard to raise a few dollars to keep hearts healthy.
‘THE WHO’ WROTE A SONG IN THE 60s TITLED, “THE KIDS ARE ALRIGHT”. IN TERMS OF HEALTH AND FITNESS THAT'S LESS TRUE TODAY.
I am going to focus on the well-being of children for the rest of this article and will begin by quoting the consistently excellent health writer, André Picard of the Globe and Mail. André ‘gets’ what's happening and doesn't propose simplistic solutions. Writing about the results of the recent Survey and Generation XXX he says the following:
Nobody chooses to be fat, and nobody wants to be unfit. It's unpleasant and it invariably leads to sickness, social limitations and hefty costs. The blame for our current Fat Nation lies with all of us. We have built an obesogenic society—one that encourages inactivity and weight gain at every turn (or, more accurately, at every sit). We have engineered activity out of our daily lives. Everything has a button, from the TV remote control to the pepper grinder. So determined are we to see our children succeed that we sit them on their behinds in a classroom seven hours a day and pretend that is a complete education. After-hours, there is homework and a bevy of regimented activities, from music lessons to hockey games. Free time is sitting at home in front of the TV, chatting on Facebook, or playing Xbox.
As we grapple for solutions, we too often forget that the solution to inactivity is not exercise (structured, regimented, goal-oriented), and it is not a token gym class crammed into a hectic schedule, it is making activity an integral part of everyday life. Running, jumping, cycling, skipping, tobogganing, playing tag, walking to school, taking the stairs — that's what children need to be healthy, physically and mentally. (Adults too).
But in the age of terrorists-around-every-corner, we have developed a strange set of phobias and misplaced priorities. There is a pervasive fear about the safety of children, so we don't let them walk to school, or play in the park or ride their bikes. But we let them sit in front of the TV for five hours eating processed foods.
Parents mean well but seem to have lost sight of what really matters. To have money to give their children everything they 'need' and then some, they work themselves to the bone and move to the long-commute suburbs for a “better life”. Hence, they have no time to play with their children, no time to cook at home (so take-out and processed food becomes the daily diet) and no time to care for themselves. Stranger danger—the fear a child will be harmed by a stranger—is exceedingly rare. But the danger done to our children's health by modelling unhealthy and unsustainable lifestyles is very real. The new Statistics Canada data scream out a sad reality: Our children have learned the lessons we have modelled all too well.
Mr. Picard accurately tells us that we are not dealing with a problem that can be fixed with a program, pill or a diet; we are dealing with a complete 24/7 lifestyle problem. In order to do this we need absolute clarity of thinking about what our children need and why they need it.
Children need lots of physical activity, not just a 30 minute phys. ed. class if they're lucky. They need to have an active lifestyle modelled by parents, teachers and other influential adults. Children's screen time should be limited, not because it's all bad, but because it steals movement from their lives. If they're wearing a pedometer the average pre-teen and young teenager should be getting 15,000 steps a day.
Physical activity has a positive influence, not only on health (which is reason enough), but also on academic performance and behaviour. I have shown the following graphs in two previous editions of “Well” (Summer 2003 and Spring 2007) but they need to be shown again and again until the message sinks in. The 2007 article is a brief summary of physical fitness and the performance of the brain. Herewith is my introduction to that article.
“Four years ago, in the Summer 2003 edition of Well, I featured one of the most important and the most under-reported and ignored pieces of research in modern education. In this study the measured fitness of nearly a million California children in grades 5, 7, and 9 was correlated with their performance in standardized academic tests. As you can see from the bar graphs below there was a perfect correlation between fitness and performance in math and reading.
If you need further convincing about the link between physical fitness and academic performance, a more recent study involving over three million Texas school children found exactly the same type of correlation.
As measured fitness improved (using the internationally recognized Fitnessgram testing protocol) so did performance on a standardized academic test. (TAKS Texas Assessment of Knowledge and Skills) See bar graph below:
The fitter children also evidenced fewer behavioural problems and better attendance. It is also worth pointing out that children's cardio-vascular fitness declines every year from grade 4 to grade 12:
John Ratey M.D., of Harvard Medical School, writes about physical activity and learning in his excellent book, “Spark. The Revolutionary New Science of Exercise and the Brain.” (2008) [See my review in a previous issue]. You can also check out the remarkable work of Allison Cameron at City Park Collegiate Institute in Saskatoon where she transformed the behaviour and academic performance of her ‘challenged’ students. (Her students were at City Park because they had experienced difficulties in a ‘regular’ school setting). Ms. Cameron's ‘Movement Matters’ program would not necessarily transfer to other schools, as it required a passionate teacher who persuaded people to donate fitness equipment, who came in early and talked kids into doing the same. Our teachers' unions would have something to say about that.
So we have a growing body of evidence that says regular physical activity is not only vital for overall health, but will sharpen minds, improve memory, help cope with stress and basically supercharge mental circuitry. Every parent who is aware of this should be modelling an active lifestyle and clamoring for more physical activity before, during and after school for their children.
THE BIG MISUNDERSTANDING ABOUT DIET, OBESITY AND EXERCISE
In his brilliant blog, Weighty Matters, Dr. Yoni Freedhoff predicted that the dire figures about increasing child obesity would lead to a call for more P.E. in schools. I'll certainly support any call for daily Phys.Ed., but agree with Yoni that this will probably have little or no impact on obesity, because you can't out-train or out-run a bad diet. In an average 30 minute P.E. class a child might burn about 100 calories, that is the caloric equivalent of a handful of Smarties or a couple of Tim Bits. (A Kit Kat has 220 cals., a Big Mac 1470 cals. and a Starbucks Latte Grande 350 cals.) Look at these superb YouTube video clips and you'll see why you can't out-train a bad diet.
If we want to address obesity issues in our children, they need to be taught to eat well and eat less, in a culture which is designed to persuade them to overeat junk; not an easy task. As Jamie Oliver discovered in his TV show Jamie’s School Dinners, the average child knew almost nothing about the nutritional value and calorie content of anything, so could easily be exploited by the advertising of the multinational conglomerates. The multinationals spend billions on advertising and their sole motivation is to make money. Health is not a primary concern, although they carefully construct a ‘health halo’ by marketing a few acceptable products and by buying associations with health related organizations or events. For instance Coca Cola has almost no nutritional value (A 12 oz. can of Coke has 200 cals., a Big Gulp of Coke 364 cals. and a Super Gulp 512 cals.) But Coke has burnished its ‘health halo’ by its association with numerous sporting events, including the 2010 Olympic Torch Relay. Coca Cola has also purchased an association with American Association of Family Physicians to support some of the “educational” content of the widely read familydoctor.org.
In conclusion, children need to understand the value of physical activity and be encouraged to practice it and enjoy it throughout the day. They also desperately need a nutritional education so they can make informed decisions about what they eat and drink because you can't out-train, out-run or out-exercise a bad diet.
Shocking new study on how TV causes pediatric obesity — maybe not so shocking.
In my talks on childhood obesity I'll always point out that the simple act of sitting on a sofa doesn't in and of itself cause weight gain and on my blog I'll also regularly point out that the rise in childhood obesity isn't a consequence of a lack of physical activity, but rather an increase in food. Putting those two together I've always presumed that TV watching was symptomatic of a less healthy lifestyle that included more calories than the lifestyles of kids who didn't watch much TV.
Well guess what? Maybe I was right. A fascinating study was recently published in the journal Obesity that specifically sought to answer what it is about watching TV that leads kids to gain weight. The study looked at the TV viewing habits, lifestyles and weights of 2,374 Greek children between the ages of 1 and 5.
The findings?
Those kids watching the most TV were indeed the heaviest and this relationship persisted even after controlling for potential confounders like physical activity. What this means is that kids who exercised and watched lots of TV still had the same rates of obesity as the kids who didn't exercise and watched lots of TV.
So what was the cause? The researchers studied many different variables but at the end it came down to the simple fact that the kids who watched the most TV consumed the most calories.
Now exactly what, when and why they're eating more isn't yet clear. Are they eating more junk because they see more commercials for junk? Do they sit there with a bag of chips in their laps (the researchers think indeed, it's food consuming while watching TV that makes the difference), or are they eating more in the hours they're not watching TV? The stuff for future research.
Bottom line? Once again it seems it's about intake and not output.
Manios, Y., Kourlaba, G., Kondaki, K., Grammatikaki, E., Anastasiadou, A., & Roma-Giannikou, E. (2009). Obesity and Television Watching in Preschoolers in Greece: The GENESIS Study Obesity, 17 (11), 2047-2053 DOI: 10.1038/oby.2009.50
DISINFECTANTS COULD EFFECTIVELY TRAIN bacteria to become resistant to antibiotics, research suggests. Scientists know bacteria can become inured to disinfectant, but research increasingly shows the same process may make them resistant to certain drugs. This can occur even with an antibiotic the bacteria have not been exposed to.
Writing in Microbiology, the National University of Ireland team, who focused on a common hospital bacterium, urges a rethink of how infections are managed.
Scientists in Galway found that by adding increasing amounts of disinfectant to cultures of pseudomonas aeruginosa in the lab, the bacteria learnt to resist not only the disinfectant but also ciprofloxacin—a commonly-prescribed antibiotic—even without being exposed to it.
The researchers report the bacteria had adapted to pump out anti-microbial agents—be they a disinfectant or an antibiotic—from their cells. The adapted bacteria also had a mutation in their DNA that allowed them to resist ciprofloxacin-type antibiotics specifically.
Pseudomonas aeruginosa is a bacterium most likely to infect those who are already seriously ill. It can cause a wide range of infections, particularly among those with weak immune systems such as HIV or cancer patients, as well as people with severe burns, diabetes or cystic fibrosis.
Surface disinfectants are used to prevent its spread—but if the bacteria manage to survive and go on to infect patients, antibiotics are used to treat them. Bacteria that could resist both these control points could be a serious threat to hospital patients, the study said. At the high concentration levels generally employed this was unlikely to be a problem—but “in principle this means that residue from incorrectly diluted disinfectants left on hospital surfaces could promote the growth of antibiotic-resistant bacteria,” said study author Dr Gerard Fleming.
“What is more worrying is that bacteria seem to be able to adapt to resist antibiotics without even being exposed to them.”
There is an increasing body of research that raises concerns about the effects on antibiotic resistance of disinfectants and antiseptics. An EU report published earlier this year stressed the importance of the “appropriate and prudent” use of disinfectants to minimise the risk that bacteria become resistant to both forms of defence.
It also emerged this year that treatments in hospitals in Brazil had been compromised by a bacterium, mycobacterium massiliense, which had developed resistance to a common sterilisation fluid and a number of antibiotics used to treat the subsequent infections.
“This was very significant because it was really the first incident related to resistance to a biocide which led to clinical failure, which is new,” said Dr Gerry McDonnell, a researcher in the field.
“This really needs to be an area of active investigation and debate. But it's worth bearing in mind that disinfectants may not just be the problem, they may also be the cure.”
Research was published this year showing that the disinfecting wipes used to protect against MRSA could in fact spread the bug, as the solution contained was often not sufficient to kill all the bacteria picked up, and hospital staff often used the same wipe to clean more than one surface.
ABOUT 17 PER CENT of Canadian adults are considered obese.(Kirsty Wigglesworth/Associated Press) Obesity is emerging as a greater threat to public health than smoking, a U.S. study suggests. The largest ongoing health survey interviewed more than 3.5 million American adults every year from 1993 to 2008.
As smoking rates tailed off in the U.S., the proportion of smokers among American adults fell from 22.7 per cent in 1993 to 18 per cent in 2008, while obesity rates rose from 14.5 per cent to 26.7 per cent over the same time period.
“This study estimated the overall burden of smoking and obesity over time and results indicate that because of the marked increase in the proportion of obese people, obesity has become an equal, if not greater, contributor to the burden of disease than smoking,” Haomiao Jia of Columbia University and Dr. Erica Lubetkin of the City University of New York, concluded in the February issue of the American Journal of Preventive Medicine.
Such data are important for setting targets to reduce health risks of obesity, they said.
“I think what the study is showing is that the burden to society from obesity is probably greater than that of tobacco use, which has been the yardstick that people used,” said Dr. Mark Tremblay, an international expert in child obesity research at the Children’s Hospital of Eastern Ontario in Ottawa. The burden to society from tobacco use is also substantial, Tremblay said in cautioning against pitting smoking against obesity. “We can no longer wait to act on strategies to put in place to promote healthy, active living in Canada, and prevent further increases in obesity,” he added.
The study was based on interviews and calculations of the number of quality-adjusted life years (QALYs) lost to obesity and smoking.
Self-scoring system
Quality-adjusted life year measurements allow a person to state their own views on quality of life, with higher scores assigned for perfect or good health, and lower scores for illness, injury and death.
Over the study period, smoking-related QALYs lost were relatively stable at 0.0438 QALYs lost per population and 0.0464 QALYs were lost to obesity. Smoking had a bigger impact on deaths while obesity had a bigger impact on illness, the researchers found.
Such extensive studies haven't been conducted in Canada. In 2008, Statistics Canada reported that 51 per cent of adults were overweight or obese, and 17 per cent were obese, based in self reports of heights and weights. The highest rates were among 55- to 64-year-olds, with 22 per cent in that age group wrestling with excess weight.
A study presented in October at the Canadian Cardiovascular Congress in Edmonton found obesity, high blood pressure and high cholesterol are hitting Canadian teens at alarmingly high rates and are increasing.
“This generation of children will have shorter lifespans than their parents,” said Dr. Glenn Berall, who specializes in treating childhood obesity at North York General Hospital in Toronto. “They will die sooner because of obesity.”
Health experts say successful anti-smoking campaigns should be adapted for fighting obesity to help Americans and Canadians face aggressive marketing for fast food and couch-potato lifestyles.
“POM Wonderful” is a juice that we enjoy on occasion because it tastes great. The tart and sweet flavor mix is an acquired taste, but served very cold it is just lovely. Perhaps, even wonderful. And you’ve got to love the original bottle shape, not to mention the overall amazing marketing this company does.
But what about all those superfruit health claims? Will it really make us healthier?
We decided to take a deeper look inside the label.
What you need to know
To POM’s credit, their juice is 100% pomegranate juice. Nothing else added. Nice.
The nutrition facts panel is not as great:
The most popular 16 oz bottle of POM actually contains two 8 oz servings. Each of those servings is 160 calories, of which 136 are from sugar.
The 34 grams of sugar per serving amount to over 8 teaspoons! Double that if you’re guzzling down the whole bottle, which most people do. To be perfectly clear: with each POM bottle you drink, you’re ingesting 17 teaspoons of sugar and 320 calories!
Next up, fiber — the nutrient we all look to in fruits and vegetables, but oh so woefully depleted once juiced. The fiber count in POM is Zero. Ditto for vitamin C, vitamin A, calcium, and iron.
So just what does the juice provide? Plenty of superpower antioxidants, according to the health section of POM’s website. POM boasts that it has spent $32 Million dollars in research to show how pomegranate juice is healthy (here’s a link to the research). The money was spent at universities that ran clinical studies that showed that people who consumed daily doses of pomegranate juice got better in certain health parameters.
That just may be, but a similar study can be done on apples, grapefruits, açai, mangosteens, and virtually any juice producing fruit with similar results. In the past, Marion Nestle, a nutrition expert from New York University, author of What to Eat, and blogger at Food Politics, said that pomegranates are no better than any other fruit, “They’re just brilliantly marketed.”
Compare POM’s juice to a real pomegranate — ‘only’ 25 grams of sugar, 1 gram of fiber, and 16% of the daily value of vitamin C. But eating an entire pomegranate is not so simple. Peeling the rind, removing the albedo (white membrane), and separating the hundreds of arils (those juicy sacs with the seed inside) is quite the chore, and yes — the juice stains clothes.
What to do at the supermarket
We should thank POM for bringing pomegranates to our attention. They are a lovely fruit, and do provide vitamin C, potassium, and antioxidants. Hardly any fiber though — one pomegranate has less than 1 gram of fiber, compared to 3.5 for a medium apple. Other fruits have more of some nutrients, less of others. All fruits and vegetables are good for us.
Fruit Juice is a different story. It loses much of the nutritional potency of the original fruit, especially the fiber. What it does gain is a very concentrated dose of sugar.
So, if you are looking for a superdrink to consume regularly — go for tap water. As an occasional treat, virtually any juice is fine, but then again so is a soft drink. If you like POM’s tart n’ sweet flavor, as we do, by all means enjoy.
Just don’t let excellent marketing confuse you into thinking you’re consuming a healthifying elixir.
CHECK THIS OUT—here's a quote from a Health Check promotion,
“Health Check is trans fat free! All Health Check grocery products and restaurant menu items meet the trans fat levels recommended by a federal task force of health professionals, government and industry including the Heart and Stroke Foundation. The Health Check criteria are in line with the recommendations of the Trans Fat Task Force: trans fat in vegetable oils and soft margarines be no more than 2% of total fat and for all other foods that trans fats be limited to no more than 5% of total fat.”
Gee, and here I thought trans-fat free meant zero grams of trans fat.
You wanna know who managed to set a more stringent trans fat requirement?
You know, while I realize that the removal of trans-fat can be challenging, given that Sally Brown's Heart and Stroke Foundation actually administers the Health Check program, what exactly is stopping them from creating nutritional criteria that are justifiably laudable? Why would they cater to Big Food to allow even 1%, let alone 5% trans-fat in Health Check approved products (excepting of course naturally occurring trans-fat)? And if they're so concerned with your health and well being, why is it I even have to ask?
Pacific Rim Wellness has obtained permission from the following blogs to reproduce some of their material in our WELL Newsletter. Please visit their sites.
Dr. Yoni Freedhoff: Obesity expert and medical director of the Bariatric Medical Institute in Ottawa, Dr. Freedhoff is one of Canada's most outspoken nutrition watchdogs and appears regularly in national media to advocate for healthier living. bmimedical.blogspot.com.
Dr. Arya M. Sharma: Widely recognized as one of Canada's leading obesity experts, Dr. Sharma was recently appointed Professor of Medicine & Chair in Obesity Research and Management at the University of Alberta in Edmonton, Canada. Dr. Sharma passionately believes in educating the public on this chronic disease. drsharma.ca
Peter Janiszewski: 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 www.obesitypanacea.com.
Fooducate: Providing practical advice for buying healthy food at the supermarket. NOT selling pills, supplements, or diets. NO industry affiliations, visit the website at www.fooducate.com/blog/.
John Ratey M.D., of 
It also emerged this year that treatments in hospitals in Brazil had been compromised by a bacterium, mycobacterium massiliense, which had developed resistance to a common sterilisation fluid and a number of antibiotics used to treat the subsequent infections.
Compare POM’s juice to a real pomegranate — ‘only’ 25 grams of sugar, 1 gram of fiber, and 16% of the daily value of vitamin C. But eating an entire pomegranate is not so simple. Peeling the rind, removing the albedo (white membrane), and separating the hundreds of arils (those juicy sacs with the seed inside) is quite the chore, and yes — the juice stains clothes.
