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Multivitamin Results in Weight Loss in Chinese Women

>> Sunday, August 29, 2010

As my readers and patients know, I often emphasize the importance of vitamin and mineral supplementation (see previous blogs about multivitamins, and vitamin D). A recent randomized clinical trial has now shown that supplementation with a multivitamin was effective in inducing weight loss in a group of Chinese women.

This clinical trial, published in the International Journal of Obesity, enrolled 96 overweight or obese Chinese women, and randomized them to receive either a multivitamin & mineral supplement, a calcium supplement, or placebo. After 6 months, they found that women taking the multivitamin lost 8lb, compared with 2.5lb on calcium, and 0.5lb on placebo. Note that the weight loss seen with the multivitamin is similar to that seen with the weight loss medication orlistat (Xenical). The multivitamin group was found to have a higher metabolic rate compared with placebo, and both the vitamin and the calcium groups enjoyed some improvement in their cholesterol levels.

As noted in the accompanying editorial by my colleagues Drs Astrup and BΓΌgel at the Department of Human Nutrition, University of Copenhagen, Denmark, the rather impressive degree of weight loss seen in this study with a multivitamin is intriguing, and the study needs to be repeated, in greater number and in other ethnic groups, before we can draw any broad conclusions. However, there are some physiological mechanisms that can support the weight loss seen. Several vitamins and minerals are known to have a key role in the function of the mitochondria, which function as the 'power plants' of our cells. Therefore, repleting important nutrients with a multivitamin may improve mitochondrial function and result in increased caloric burn by each of our cells.

The bottom line is that it is difficult to obtain all necessary vitamins and minerals in our nutritionally deplete food supply, and therefore, a multivitamin is recommended for most people. The potential for weight loss is one more item to add to the list of potential benefits. Speak to your doctor to find out which multivitamin is best for you!

Dr. Sue Pedersen © 2010

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Obstructive Sleep Apnea: Are You or Your Bed Partner at Risk?

>> Sunday, August 22, 2010

Does this image seem familiar to anyone? A snoring bed partner is a common problem! However, the problem may go far beyond nighttime frustration: it may be an indicator of an important medical problem called Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a disorder that is characterized by periods of diminished breathing or pauses in breathing during sleep, caused by repetitive collapse of the upper airway.

Symptoms of sleep apnea include:

  • restlessness and snoring during sleep
  • awakening with a choking or gasping sensation
  • waking feeling unrested
  • daytime sleepiness or fatigue
  • morning headaches, dry mouth, or sore throat
  • poor concentration
  • waking frequently to urinate

The number one risk factor for sleep apnea is overweight or obesity: the risk of OSA increases with increasing body weight. Other risk factors include increasing age, male gender, abnormalities of the upper airway, medications that induce somnolence, and alcohol.

Obstructive sleep apnea can be a serious medical problem, as it is associated with an increased risk of high blood pressure, diabetes, heart attack or heart arryhtmias, congestive heart failure, and increased risk of accidental injury and motor vehichle accidents. In patients with untreated severe sleep apnea, the risk of death is 3 to 6 times higher than people without sleep apnea.

Sleep apnea is best diagnosed in a sleep lab, where breathing patterns during sleep are assessed. In-home portable monitoring devices can also be used to make the diagnosis.

In terms of treatment of obstructive sleep apnea, weight loss is an essential component. Weight loss has been shown to decrease the severity of OSA, decrease daytime sleepiness, as well as improve quality of life. Sleeping in positions other than on your back is helpful, but may be difficult to maintain all night. Avoidance of alcohol and sedating medications is of benefit as well.

The most effective mechanical treatment of OSA is a machine that provides positive airway pressure, applied during sleep. By blowing air gently into the airway, the pressure generated helps to keep the airway open and avoid obstruction during sleep. Oral or dental devices are also available that can help alleviate obstruction in some people. For a minority of patients, surgery on the upper airway to help alleviate obstruction can be helpful, but the success rate is generally less than 50%.

Be sure to speak to your doctor if you think that you or your bed partner are at risk!

Doctor Sue © 2010

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Contrave: The Next Weight Loss Drug?

>> Sunday, August 15, 2010

As blogged previously, there are a number of weight loss drugs currently under study. The latest study on a combination weight loss medication called Contrave shows good effect to induce weight loss, but with the potential for significant side effects that must be taken into careful consideration.

Contrave is a combination of two medications already on the market: bupropion, a smoking cessation agent and antidepressant, and naltrexone, which is used to treat alcohol or narcotic addictions. The study, published in a recent edition of The Lancet by Greenway and colleagues, compares the effect of this combination medication in two different doses compared to placebo. In this 56 week trial, participants taking the combination drug in higher dose lost 6.1% of their body weight, compared to 1.3% in the placebo group. This amount of weight loss rivals, or is superior to, weight loss seen with our currently available weight loss drugs, sibutramine and orlistat respectively.

As noted in an accompanying editorial in The Lancet by my colleague Dr. Arne Astrup, from the Department of Human Nutrition, University of Copenhagen, an upside of this proposed new weight loss combination drug is that both medications have been around since the mid 1980s, and as such, we are quite knowledgeable of the potential side effects of each individual drug. For example, it is known that both drugs can cause anxiety and a small increase in blood pressure. What is not known, however, is whether these particular side effects could be additive in nature. Though the current study did not find any increase in anxiety, they did find less blood pressure reduction at 1 year than would have been expected with the weight loss that was seen. Thus, it is exceptionally important that cardiovascular risk factors and outcomes are closely monitored as we gain more experience with this combination medication.

Overall, Contrave may represent an effective and generally well tolerated addition to our current sparse armamentarium of weight loss medications, if it is ultimately approved by regulatory agencies. However, as always, we must remain vigilant for the potential of unwanted side effects, and continually monitor and evaluate outcomes.

Dr Sue Pedersen © 2010

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Video Blog: Increase the Activity in Your Life!

>> Thursday, August 12, 2010

Did you know that 63% of Canadians don't get enough activity in their daily lives to reap the health benefits of exercise?

In this video blog, Dr Sue explores ways that you can increase the activity and calorie burn in your daily life, to achieve the 60 minutes of daily activity that is recommended. Learn about a lifestyle change that could burn the equivalent of 18 pounds of fat in a year!

Dr. Sue Pedersen © 2010

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Bean Salad with a Hint of Lime!

>> Saturday, August 7, 2010

Thanks go out to my best friend Deb for staking out this recipe! Give it a try and let us know what you think. From 'Full of Beans' cookbook by Violet Currie and Kay Spicier - thanks for the inspiration! A great way to enjoy the 'hint of lime' flavor fad.

  • 1 cup rinsed canned black beans
  • 1 cup rinsed canned kidney beans
  • 1 cup corn ( canned, thawed frozen or ideally cut right off the cob if it is in season(this is best!))

  • 1/4 cup lime juice
  • 1/4 cup fat free plain yogurt
  • 2 tsp sugar
  • 1 small clove minced garlic
  • 1/2 tsp salt
  • 1/4tsp cumin
  • 1/4 tsp pepper

Toss over the bean mixture and refrigerate for a couple hours. Just before serving, add:
  • 1 tomato, seeded and diced
  • 1 small cucumber, diced
  • 1 red, yellow or orange bell pepper, diced

Toss well and serve!

Makes 8 servings. Per serving:
  • 106 cal
  • 0g fat
  • 5g protein
  • 22g carb
  • 243 mg sodium

Keeps really well in the fridge and makes great leftovers. It's also really easy to tweak to your own liking...different types of beans, different proportions of beans to corn, extra bell peppers.. however you like it. Add a little extra lime juice to up the ante on the flavor scale!

This salad is so tasty that you may have to share...consider protecting yourself!

Dr Sue Pedersen © 2010


Menopausal Hot Flashes Improve with Weight Loss Program

>> Sunday, August 1, 2010

Hot flashes are a common concern of postmenopausal women, and adequate symptom control can be difficult to achieve. A new study shows that a weight loss program can help to decrease these troublesome symptoms.

Hot flashes are a symptom which occur due to low estrogen levels that are seen in menopause. They may last for a brief duration for some women, but for at least one third of women, symptoms persist for 5 years or more. Since we learned of the harms of hormone replacement therapy and no longer recommend it (due to the increased risk of breast cancer, heart disease, and blood clots), hot flashes have become more challenging to treat.

Interestingly, a number of studies have suggested that hot flashes worsen in both frequency and severity with increasing body mass index, though the reason for the association is not clear. With this background in mind, Huang and colleagues embarked on a study to determine whether a behavioral weight loss program would help to decrease symptoms of hot flashes amongst post menopausal women.

In this substudy of a larger randomized study looking at postmenopausal urinary incontinence, 154 women who reported menopausal hot flashes received either an intensive lifestyle and behavior change program designed to assist with weight loss, versus a structured education program. The intensive program included weekly meetings led by experts in nutrition, exercise, and behavior change, as well as instruction in following a reduced calorie meal plan. The control group received monthly sessions teaching about nutrition, exercise, and general health promotion.

The results of this study show that women in the intensive program lost more weight after 6 months (average 16.5 lb) than the control group (average 4.4 lb). As for hot flashes, the intensive group reported significantly greater improvement in flushing symptoms than the control group. Improvements in weight, body mass index, and waist circumference were associated with improvements in hot flash symptoms. Interestingly, however, self reported physical activity and caloric intake were not associated with an improvement in symptoms.

It remains unclear why overweight may increase the severity of hot flashes, or why weight loss may improve these symptoms; inflammatory chemicals secreted by fat tissue, neural changes, and psychosocial factors may all play a part.

I see two important messages from this study:

1. On balance, it seems that yet another health benefit to weight loss may be an improvement in menopausal hot flashes.

2. A more intensive lifestyle program, with more support and follow-up, provides better weight loss results than a less intensive program.

Dr Sue Pedersen © 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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