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Hormone Replacement increases Death from Lung Cancer

>> Sunday, May 31, 2009

Another negative effect of hormone replacement therapy (HRT) in postmenopausal women has emerged: HRT has now been shown to increase the risk of death from non-small-cell lung cancer.

At yesterday's meeting of the American Society for Clinical Oncology in Orlando, an analysis from the Women's Health Initiative (WHI) was presented by UCLA's Dr. Rowan Chlebowski. The WHI was a study of over 16,000 healthy postmenopausal women, in which half received HRT (estrogen + progesterone) while the other half received placebo. While there was not a significantly increased risk of getting non small cell lung cancer (NSCLC) in the HRT group, women who had NSCLC who were taking HRT were 60% more likely to die from the disease, compared to women who had NSCLC but were taking placebo.

For current smokers using HRT during the 8 year study, there was an excess risk of death of 1 in 100, compared to smokers not using HRT.

The WHI has previously shown that while HRT (with combined estrogen + progesterone) does decrease the risk of colon cancer and bone fractures, this is outweighed by the increased risk of heart attack, stroke, breast cancer and blood clots. Therefore, HRT is not generally recommended, unless it is required in the short term for severe menopausal symptoms, or for treatment of osteoporosis when other options are not feasible.

We can now add death from non-small-cell lung cancer to the list of risks of HRT. Because smoking is a risk factor for getting NSCLC, and because of the higher mortality of smokers in this study, smoking and HRT are clearly a bad combination. © 2009

Coming soon: a brand new tantalizing recipe, straight from my kitchen!


Using the Diet Plate

>> Tuesday, May 26, 2009

There is no magic, or even rocket science, to using The Diet Plate ® ™ ! This is the great thing about this system – it is so easy to use. Here are the basics of how it works:

1. Use the plate for the biggest meal of the day, every day. For most people, this is supper time. Take note that there is a male plate and a female plate (yep, it's a down side to being a woman – men get to eat more!! Truthfully, men generally burn more calories in a day than a same-sized woman, mostly because men have more lean body mass (ie muscle, which is more metabolically active), and less fat mass (less metabolically active), than women. )

2. The plate has 4 portions on it: protein, carbohydrate, a sauce circle, and a cheese square. Choose what you would like to have to eat, and simply portion it inside of the boundaries on the plate! The boundaries for protein and carbs are the areas outlined by the tape measures on the plate, and at the edge, where the white meets the blue on the plate.

3. There is no height restriction to the plate’s portions, with the exception of the cheese square, which is a cube. Yes, you could technically build the Leaning Tower of Mashed Potato in the carb section, but some might consider that defeatist. :) The carb and protein portions should stay inside of their boundaries without being held in there by your hand. So, if you ladle up some pasta and it slips outside of the boundary, put some back until it stays inside the boundaries on its own.

4. You can use the protein or carb part of your meal to hold the sauce inside the sauce circle. For example, if you are having spaghetti with tomato sauce, portion the noodles into the carb section first, then move them so that they surround the sauce circle. Finally, pour the sauce into the circle!

5. Once you have portioned out your meal according to what you have desired to eat that day, push it to the side, and fill the rest with vegetables. Veg are unlimited and can go anywhere on the plate, as long as they are Free Veg and devoid of sauces. Watch out for the Sneaky Veg: peas, corn, carrots, potatoes, and yams. These veggies are actually quite high in carbohydrates, therefore they are not free, and they should be portioned in the carb section.

6. You should only portion food once per meal - no second helpings – except for Free Veg, of which you can take as much as you like!

That’s all there is to it! The beauty behind this portion control system is two fold: It is simple to use, and it allows you the freedom to choose what you like to eat. There will be no falling off the wagon of this diet because of the temptation of forbidden foods, because nothing is forbidden! I always recommend making healthy food choices, but once in a while it is ok to have that special treat. This plate also has great success because it is an attractive plate – it is something that you can be proud to put on the dinner table!

The female plate will provide approximately 650 calories at one sitting (of course this depends upon what you eat, but this is the average figure, averaged over many different types of meals). The male plate wil provide an average of 800 calories per meal.

Bon appetit!

:) Dr. Sue © 2009


Savory Spring Cherry Tomato Salad!

>> Monday, May 18, 2009

Here is a personal creation, modified from my good friend Linda's kitchen! Linda uses broccoli instead of asparagus - the choice is yours. Goes great with...well...just about anything! It's a perfect side salad for the first BBQs of the season. And being composed of nothing more than FreeVeg, it is barely worth counting... Read on!

6 cups cherry tomatoes, halved
6 cups asparagus spears, cut into 1 inch pieces
1 bunch of green onions, sliced
2 tsp lemon juice (+ extra to taste)
dried chili flakes
2-3 packets of Splenda (1g)

Mix it up and enjoy! Add more lemon juice, pepper, and/or dried chili flakes to taste.

Nutritional Info: (per 2 cup serving; recipe as written makes 6 servings)
Only 55 calories per serving! I'm serious. :)
Calorie content is unchanged whether you use asparagus or broccoli - mix it up!
(Aaah, the beauty of the FreeVeg....)

Dr. Sue © 2009


The Diet Plate Trial!

>> Tuesday, May 12, 2009

The Diet Plate trial, which I conducted at the University of Calgary, was the first trial in the world to study a portion control tool to help people lose weight... and it worked! Let me tell you the story of how the trial came to be.

Knowing how oversized the portions available to us are, and knowing how much they have grown in recent years, I went in search of a portion control plate that I thought contained appropriate portions, would be easy to use, and would be appealing enough that it could join a home dinnerware collection! With these criteria in mind, I reviewed the portion control tools that were available, and I settled on The Diet Plate ® ™ to study, because it fit all of these criteria nicely.

I contacted Kay Illingworth, the CEO of The Diet Plate ® ™ in Britain, and asked her if she would donate plates that I could use in my study. Kay is the inventor of these plates, which she designed to combat her own struggle with overweight. She tells a pretty funny story about the day the plates came to be: she got incredibly frustrated with her inability to control portions, which led her to take her entire kitchen plate set out and to use a marker to draw all sorts of various test portions out on them. Little did she know, it was not a water soluble pen! However, it was worth the ‘investment’: with her final portion determination created, she proceeded to lose weight using the plate. Same for her mother. Word soon spread about these successes... and the rest is history!

Suffice it to say, when I contacted Kay about my study, she was more than happy to oblige...and soon thereafter I had my clinical trial underway.

In this study, we looked at the effectiveness of The Diet Plate to help obese people with Type 2 Diabetes lose weight. Half of the study participants received The Diet Plate and The Diet Bowl to use for a 6 month period, and we compared their weight loss to the weight loss of a control group, who did not receive the plate products. We found that the group using the plate were almost 4 times more likely to lose 5% body weight, compared to controls! This ‘magic number’ of 5% is very important, because studies have shown that if an overweight individual can drop 5% of their body weight, they decrease their risk of getting diseases related to being overweight, and also decrease their risk of dying from these diseases (bluntly put). When we looked at people who were committed to using the plate on 80% or more of study days, we found that they were SIX TIMES more likely to lose that 5% of body weight compared to people who were not using the plate system.

Remembering that all of the participants in the study had type 2 diabetes, the other important thing that we found was that people using the plate system were over twice as likely to require a decrease in their diabetes medication over the 6 month trial compared to people not using the plates. Conversely, people who were not using the plates were over twice as likely to need an increase in their diabetes medication, compared to the plate group! The tendency of T2DM is to get worse with time, as insulin resistance worsens, and the ability of the pancreas to combat this resistance wears with time. So, we were seeing the typical progress of diabetes in the control group, but the plate system was able to put a halt to the progress of diabetes in many of these people, and even to reverse it and improve it in many! This is a powerful testament to the efficacy of portion control.

Given that the entire group that we studied were Type 2 Diabetics, our results are even more impressive, because this is a group of people in whom it is notoriously difficult to achieve weight loss. Much of this has to do with the medications that they are taking, in that most medications that treat diabetes cause weight gain as a side effect. In our study, 94 out of 130 people were taking medication for their diabetes that causes weight gain as a side effect, and STILL we were able to show that this plate system was a success! Individuals who are not diabetic are as likely, if not more likely, to have success with this plate system.

This plate system makes sense because they are simple to use, and because they give you the freedom to choose what you would like to eat. Of course, I always advocate for healthy food choices, but this system does allow you the freedom to choose what you would like to have – you just have to portion it according to the boundaries on the plate!

There are many, many different types of portion plates and similar tools out there. ‘Would a different portion control tool work just as well?’ you might be wondering. Well, at this point in time, the Diet Plate ® ™ is the only one that has been studied and proven to work in a randomized, clinical trial fashion (the ‘gold standard’ type of trial). I am certain that a number of the other tools out there would work, but they need to be studied in a similar fashion for the evidence to be there to recommend them.

Keep an eye on this site for more information on how these plates work, and how to use them. In the meantime, you can check out the website

I would also like to point out that I have no financial interests in The Diet Plate ® ™ company.

Dr. Sue © 2009


Hydroxycut Recall

>> Thursday, May 7, 2009

As of May 1, the FDA has ordered a nation wide recall of several Hydroxycut dietary aid products, due to reports of severe liver injury.

In all, there have been 23 cases of liver injury reported, occurring in persons between 21-51 years of age. The liver injury reported ranged from mild to severe, and resulted in one death of a 19 year old man. In the majority of cases, no preexisting medical condition that would predispose the individual to liver injury was identified. In some cases, discontinuation of Hydroxycut usage resulted in recovery of liver function, but some sustained permanent damage. Although the liver damage appears to be relatively rare, FDA believes consumers should not be exposed to unnecessary risk.

Products recalled include Hydroxycut Regular Rapid-Release Capsules, Hydroxycut Hardcore Liquid Caplets, Hydroxycut Caffeine-Free Drink Packets, and Hydroxycut Carb Control, amongst others. Check out the FDA website link for the complete list.

The learning point in this unfortunate turn of events is that herbal products are not necessarily safe just because they are 'natural'. These products are not regulated in the strict fashion that prescription medications are. Prescription meds must go through extremely rigorous testing before they are permitted on the marketplace; therefore, we know a lot about their side effect potential before we start using them. It may sometimes seem like herbal remedies are safer, only because the research had not been done to understand how they work, or what their side effects may be. Remember that cocaine is derived from a natural product; then again, so is digoxin, a medication we use to treat heart arrythmias. My point is not that all herbal based treatments are bad; my point, rather, is that taking a herb or drug that does not have a known risk vs benefit profile is... well.... a risky business, indeed.

With regard to the struggle to get that extra weight off, there are some people for which treatment with prescription medications such as sibutramine (Meridia) and orlistat (Xenical) can certainly be appropriate and helpful. If you are looking for help to lose weight, or to treat any other condition for that matter, please, please, seek your physician for help, rather than the unknown domain of inadequately researched herbal remedies.

Dr. Sue © 2009


The Benefits of Fibre!

>> Saturday, May 2, 2009

With all the attention we need to pay to choosing foods that are low in calories, low in saturated fat, portion controlled, and high in vitamins and minerals, do we really need to care about fibre content as well?

Yep - fibre is the indigestible portion of plant food in your diet, and it is crucial to maintaining good health. There are two different types of fibre:

Soluble fibre is simply fibre that dissolves in water. It is not digestable, but it is fermented by bacteria as it passes through the intestine. Examples of soluble fiber sources include oats, rye, many types of beans, broccoli, and psyllium.

Insoluble fibre does not dissolve in water, and passes through the intestine unchanged. Examples include whole grains, wheat bran, flax seed, cauliflower, and green beans. Some types of fruits and veg contain both soluble and insoluble fiber.

The benefits of fibre are many:

Eating fibre decreases your risk of heart disease by as much as 50%! Soluble fibre helps to control your total cholesterol and your 'bad' cholesterol (LDL) levels. It also slows the absorption of carbohydrates from your intestine into your bloodstream, which helps to maintain your blood sugar at a more constant level.

Insoluble fibre decreases the transit time of food through the digestive system, reducing constipation. The speedier transit of food through your intestine also reduces the time that toxic waste products are in your system, thereby decreasing the risk of these toxins inducing colon cancer.

As if that wasn't enough - fiber also helps to keep weight under control! High fiber food leaves you feeling full on less food, and for longer. It shows in the comparison of different populations around the world - people living in countries with high fiber intake tend to weigh less than those living in countries where fiber intake is low. Take Denmark as an example, where I am currently on research sabbatical. Denmark's traditional diet is quite high in fibre, with whole grains such as rye bread being a daily staple in most homes. The truth is in the numbers: the rate of obesity in Denmark is less than half of what it is in Canada!

Health Canada recommends 25 grams of dietary fiber per day, but most of us get less than half of that. One of the best ways to improve your fiber intake is to eat a high fibre cereal such as All Bran or Fibre1; I suggest aiming for 10-12 grams of fibre intake from these breakfast cereals each day (about half of your dietary requirement). This can be accomplished by eating 1/2 cup of All Bran, 1/3 cup of All Bran Buds, or 1 cup of Fibre 1.

If you don't like those cereals, try adding some Benafibre into your diet (2 tsp twice a day), with the same goals in mind.

Eat whole grain products rather than white. Eat lots of vegetables! And rather than drinking juice, eat the fruit instead.

Dr. Sue © 2009



I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!

Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!

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