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Western Bad Habits contribute to Diabetes Epidemic in China

>> Sunday, March 28, 2010

Modern day China provides an unfortunate example of the toxic effects of adopting more western-style habits of unhealthy eating and sedentary lifestyle: according to a new study, there are now nearly over 200 MILLION people affected by either diabetes or prediabetes.

The China National Diabetes and Metabolic Disorders Study Group published an article in this week's New England Journal of Medicine that spells out the details of this metabolic disaster. They conducted an impressively large study of over 46,000 adults from across China, and tested their blood sugars. They found that based on this sample, approximately 92.4 million Chinese adults have diabetes (more than half of these being undiagnosed), and 148.2 million Chinese adults have prediabetes.

When you consider that these numbers total over six times the entire population of Canada, the implications are simply staggering to try to comprehend.

The underlying contributors to this explosion of diabetes in China are several, but one of the dominant themes is the urbanization and 'westernization' of Chinese society. With the advent of fast food to this nation, obesity has exploded in this society in a likewise fashion. Similarly, Chinese urban centres are coming more and more to resemble our own: motorized transport, increased use of the internet, less focussed exercise.... all of these elements have sunk the activity levels to an all time, Western-style, low. So, it seems that the bad habits of the western world have had a seriously negative impact on the metabolic health of our Chinese friends.

To add to the difficulty of the situation, people of Chinese ethnicity have a higher risk of developing diabetes, due to a higher genetic disposition to develop insulin resistance at a lower BMI. Diabetes onset often occurs at a lower BMI compared to people of caucasian ethnicity (though this certainly varies from person to person).

The way in which people of Chinese background manifest high sugars also presents a challenge. According to this recent study and studies before it, Chinese people have a disposition towards having high sugars after a meal even if they have normal blood sugars in the fasting state. As the first step in screening for diabetes is with a fasting blood sugar, it is possible that some of these diabetes diagnoses could be missed if sugars are not tested after a carbohydrate challenge as well.

The situation in China raises yet another red flag: the global tendency towards a progressively more unhealthy lifestyle is having a serious toll on our health, and raises potentially grim prospects for our futures unless we turn things around.

Dr. Sue © 2010


Canadians have become More Overweight and Less Fit!

>> Sunday, March 21, 2010

It comes as no surprise that Canadians have become more obese and less sendentary over the last 25 years. However, statistics from the Canadian Health Measures Survey have now put some numbers on the scope of the problem, and the results aren't pretty.

In the 1970's and 80's in Canada, there was a period of time where fitness was taken more seriously, at least in part due to the governmental ParticipACTION campaign. In 1981, the Canadian Fitness Survey reported that 56% of Canadian adults were active in their leisure time.
In 2008, that number has dropped to only 33%. Even worse - only 13% of Canadian children meet guidlines for recommended amounts of physical activity. Muscular strength and flexibility have fallen in Canadian adults, and the proportion of young adults with a waistline that puts them at risk of cardiovascular and metabolic health problems has more than quadrupled.

The need for more action from the government is clear. Comparisons to Canadian anti-smoking campaigns are often made; while the stop smoking campaigns have been comprehensive and strong, the committment by our government to promote active living has waxed and waned over the past decades. ParticipACTION lots its federal funding in the early 2000s, but was resurrected in 2007.

An easy way that we can all engage in active living is simply to incorporate activity into our daily ttransport routines. Taking the stairs instead of the elevator to get to your office or apartment is an easy one (if this is difficult at the start, try taking just one flight of stairs, and hop on the elevator for the remainder; you can build it up over time!). Park your car blocks away from your office and walk the rest (you may even save on parking this way!).

I learned a lot from the year I spent working at the University of Copenhagen, Denmark last year, with regards to active transportation. In Copenhagen, there are more bikes than there are cars, and rush hour bike traffic is a way of life. I rode my bike to work every day, which was only 5km away - but by the end of the year, this amounted to 2,000 km of cycling! Clearly, the Canadian climate is not always conducive to cycling to work, but even doing this for 8 months of the year would be an important contribution to an active lifestyle. Interestingly, even back in 1973 when Canadian dedication to an active lifestyle was stronger, the fitness of our 30 year olds was comparable to the fitness of a 60 year old Swede, which is at least partly attributable to this active transport lifestyle.

Dr. Sue © 2010


Survival Guide to Eating Out!

>> Monday, March 15, 2010

Everyone likes to be pampered now and again, and eating out is no exception! It is a delightful social experience to take an evening out with your spouse, family, and/or friends, and the occassional night out should not be an obstacle to a successful weight loss plan! Here are a few tips to stay on your program while having a fun night out!

1. Choose a healthy restaurant.

Aim for a restaurant that specializes in a 'pure' variety of food - for example, sushi is an excellent choice. If fast food is more your style, Subway is known for its fresh ingredients. Avoid the places that are heavy on the meat & potatoes, or those where you can smell the oil before you round the corner.

2. Plan ahead of time.

If possible, choose your restaurant in advance, and check out their menu online. Many establishments indicate which meals are low fat or healthy choices, and some also have nutritional info online. Choose what you're going to have, and stick with it!

3. Portion Control.

In our consumer society, many restaurants still gear towards making the customer feel that they've gotten the maximum bang for their buck. Unfortunately, that bang packs extra calories! Ask your server how big the portion you've ordered is, and if it is large, ask for half of the meal to be served and the other half to be packed up to take home. Do this in advance of receiving the meal at your table, such that the large portion on your plate is not a temptation to overeat. To get an idea of appropriate portions, have a look here.

4. How is your food being prepared?

Despite your best efforts to choose the healthiest item on the menu, your plans can be foiled in the restaurant's kitchen. A salmon fillet is an excellent choice, but did you know that many restaurants will grill it with at least a tablespoon of butter to make it taste richer? That's 130 cal of saturated fat - for a typical woman trying to lose weight, that butter is 10% of her advised caloric intake for the entire day! Don't be afraid to be picky - ask for your meal to be prepared without, or with as little as possible, oil or butter. Entirely avoid anything that states 'fried', 'sauteed', or 'battered'; instead, go for 'baked', 'grilled', or 'broiled'.

5. Avoid drinking your calories

It is generally advised to eat your calories rather than drink them, as liquid calories are less satiating and leave you hungering for something else. For example, it is better to eat an orange than to drink a glass of orange juice. There are many hidden calories in beverages; that innocent after-dinner latte can easily be over 200 calories.

Dr. Sue © 2009


Trade Tricks: Sleuthing for Hidden Calories

>> Sunday, March 7, 2010

As I've talked about many times before, we are the unfortunate victims of a society that does everything possible to 'help' us get fat. Portion sizes are 2-5 times what they were 3 decades ago, teaching us to eat larger portions at meal times. Fast food restaurants infect nearly every street corner; though many do carry healthier options, it is still all too easy to belly up to a double cheeseburger and fries. Convenience stores packed to the rafters with King Sized chocolate bars are even easier to find when hunger hits.

We can also easily find ourselves living a full day, barely moving at all. We can shop for most things while actively 'surfing' from an armchair at home, computer in our laps. Many buildings (including my own) are built with stairs that you can only access to go down in case of emergency, with the elevator being the only option to go up. Communities have been built with sidewalks on only one side of the street, or in some places, no sidewalk at all!

When we try to circumvent these obstacles to live a healthy, active life, and make healthy food choices, it seems that the cards are stacked even higher against us, because food labels are often very misleading! For example:

1. 'Sugar Free' does not necessarily mean 'calorie controlled'. You may notice in some 'sugar free' food labels, that it may say in very tiny letters 'not a calorie reduced food' - this is a good hint that the product is laden with tasty fat in order to compensate for the lack of sugar. Other times, the label doesn't provide this warning.

Sugar Free chocolate is a classic example:

  • Reese's Mini Peanut Butter Cups (5 mini cups): 180 cal
  • Reese's Sugar Free Mini Peanut Butter Cups (5 mini cups): 160 cal
So, the sugar free version are only 11% lower in calories than the regular variety!

Having said that, I do want to point out that the sugar free variety are a better choice for diabetics, as they will cause less of an increase in blood sugar than the regular sugar choice. Other than that, the good thing about these peanut butter cups (sugar free or not) is that they are portion controlled - if you eat one or two, rather than eating the company recommended 'serving' size of 1 bag, which contains over 200 calories.

2. 'Fat Free' does not necessarily mean that a particular food is the lowest choice, either. For example:
  • Activia Fat Free vanilla yogurt has 72 cal per 100 g
  • Yoplait Source Fat Free has only 35 cal per 100 g
The difference? Activia is sweetened largely with sugar; Yoplait is sweetened with artificial sweetener.

So what is the solution? Check the calorie count!! Be careful to check nutritional labels and take a moment to do the math. You can calculate your daily caloric needs in the right hand column of - then take a moment to contemplate what you are about to eat, and how it counts in to your daily totals. With a little forethought, the cards that sometimes seem stacked against us can be overcome!!

If you have any tips for amazing foods that you have found that are tasty and calorie-wise, OR, foods that are advertised as healthy on the label but are laden with calories, please email your thoughts to me at !

Dr. Sue © 2010


Let's Move! The Obama Campaign against Childhood Obesity

Childhood overweight and obesity is a serious problem globally. One of the hardest hit countries is the United States, where half of children are overweight for their age. As such, First Lady Michelle Obama has launched an important program called Let's Move to try to find ways to deal with the problem - and it deserves a lot of attention!

Let's Move aims to help families manage and prevent childhood obesity from four vantage points:

This program is designed for Americans, but I think that countries around the world can benefit from the fabulous ideas and resources that are collected on this website. The links in the right hand column of each of these sections (which you can access directly by clicking on the purple links above) are particularly rich in important tips and ideas that any family struggling with obesity can become inspired by. Under the physical activity tab, for example, there are great ideas for making family time active and reducing TV time to grow a healthier, more active family. Please note that the physical activity and nutrition guidelines (including the USDA Food Pyramid) are specific to the American recommendations, and your own country's guidelines may differ in some respects.

There is a long way to go in combatting childhood obesity, but these are some great ideas to get started! I can't emphasize enough how important it is to tackle the problem of overweight as a family, and I love that this program really promotes the family approach. The age of 6 months to 2 years is a crucial window when the type of food parents choose to feed their kids can program what they eat for the rest of their lives, so don't wait until teenage years to get started. Use these helpful tools to raise your children in a healthy enviroment from day 1!

Dr. Sue © 2010



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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