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Pumpkin Banana Spiced Custard

>> Saturday, October 29, 2011

As Hallowe'en is soon upon us, many of our houses are undoubtedly filled with tempting treats to hand out to the kids on Monday night.  Here's a tasty dessert alternative from the Heart & Stroke Foundation, perfect for fall!   I'd be interested to know how you think it compares to the Crustless Pumpkin Pie recipe from Hungry Girl that I suggested previously.

  • 1 egg
  • 2 egg whites
  • 1 cup (250 mL) canned pure pumpkin
  • 1/3 cup (80 mL) mashed banana - about 1 medium
  • 1 cup (250 mL) evaporated skim milk
  • 1/4 cup (50 mL) packed brown sugar
  • 1/2 tsp (2.5 mL) ground cinnamon
  • 1/4 tsp (1 mL) ground ginger
  • 1/8 tsp (0.5 mL) allspice
  • 6 walnut halves
*editorial comment: I would personally use a little extra cinnamon and allspice for a stronger taste - I often find myself doubling these spices in pumpkin recipes


1.  Preheat oven to 325F (160C).

2.  Place 6, 1 cup (250 mL) ramekin bowls (also known as bouillion bowls) in a glass 13 x 9 inch (3.5L) baking dish.

3.  In a large bowl, combine all ingredients except for the walnuts.  Pour into the ramekins.  Pour boiling water around the ramekins in the aking dish to a depth of 1 inch (2.5 cm).   Place 1 walnut half in the centre of each custard.

4.  Bake for 40 minutes.  Serve warm.   Consider sprinkling some extra cinnamon and allspice on top!

Makes 6 custards.  Each custard contains:
  • 111 calories
  • 6g protein
  • 20g carbohydrate 
  • 1g fat
  • 83mg sodium
  • 1g fiber

Enjoy! Thanks to my friend Patti for the heads' up on this great recipe.

Dr Sue Pedersen © 2011

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Denmark's Saturated Fat Tax - Should We Follow Suit?

>> Sunday, October 23, 2011

There is much discussion in Canada and globally as to what approaches can be taken to try to curb the obesity endemic.  Many are of the opinion that regulations must be implemented at the government level in order to be effective.  Denmark has become the first nation to implement a hotly debated tax on saturated fat - should Canada and the rest of the world follow suit?

As of October 1st, Danes now face a 'fat tax' when they get to the checkout of the grocery store or pay up at a restaurant. (Of note, Denmark was also the first country in the world to restrict trans fats in 2003.) The fat tax varies depending on the percentage of saturated fat in a particular product, and equates to about $3.00 CDN per kilogram of saturated fat.  The resultant cost increase is about 15 cents CDN on a burger, or $1.20 on a pound of butter.  The overall cost is expected to increase annual food costs by the equivalent of about $190 CDN per family.

As expected, there are numerous criticisms to this approach to try to curb obesity.  First of all, taxing saturated fat does not necessarily mean healthier eating, as it depends on what alternate food is selected by people who make other choices to avoid the tax.  Purchasing highly processed white bread as an alternative, for example, would not be subject to the tax, but is not a healthy alternate choice.  Dark chocolate, which has antioxidant properties with possible health benefits in limited quantities, is subject to the tax, where as some gummy candies (also very popular in denmark), which have no putative health benefits, are not.   (This is all aside from the fact that Danes stocked up with mass amounts and record sales of saturated fat containing products in the weeks leading up to implementation of the tax - the thought of kilos of butter flying off of shelves makes me shudder!)

There are also criticisms that this approach, or any approach that comes from a government level for that matter, is a direct infraction of our freedom as consumers to choose what we want to buy and consume.  The tax may also have a particularly challenging financial impact on low income families, as the tax may preferentially affect many lower cost food items.

The global response to Denmark's leading step on the fat tax issue is varied.  France was quick to follow one week later with an announced tax on sugary soft drinks, and debate is now at an all-time high in many other countries.

So what is the right answer to this very difficult question?  Personally, I think that government-level regulations are necessary to curb obesity in our society over the long term, as our environment is extremely toxic and conducive towards weight gain, and unlikely to change substantially unless those changes come from above.  However, the changes that are made have to be selected and cultivated carefully, so as to ascertain that the impact is the intended one.  In Canada, many different regulations are being considered, including taxation of junk food, banning certain ingredients or foods outright, regulating sodium content of foods, and regulating the number and density of fast food restaurants (these considerations are nicely summarized in an article by Dr MJ Eisenberg in the Canadian Medical Association Journal last month - a free download).

I'm interested to hear what my readers think about this very controversial issue.

Dr Sue Pedersen © 2011

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Genetics Influence Response of Body Weight to Gastric Bypass Surgery

>> Saturday, October 15, 2011

Gastric bypass surgery is an increasingly utilized treatment option for severe obesity worldwide.  While this surgery can be very successful to result in substantial and sustained weight loss over the long term, individual results from person to person are highly variable.  A recent study suggests that a person's genetics may be the primary factor responsible for this variation.

The study, just published in the Journal of Endocrinology and Metabolism by Ida Hatoum and colleagues, examined the DNA of 848 patients undergoing gastric bypass surgery at the Massachusetts General Hospital.  Amongst these patients were 13 pairs of first degree relatives, none of whom were living together.  An additional 10 pairs of patients were identified who were living together but not related (thus allowing a comparison of the effect of environment on the efficacy of surgery). The remaining 794 people in the study were randomly paired for a non-genetic, non-environmentally connected comparison group. 

Interestingly, the study found that first degree relatives had a similar response to surgery, with an average of only 9% difference in the excess weight lost between members of each pair.  In contrast, there was a 26% difference in excess weight lost between cohabitating, unrelated individuals, which was no more similar than unrelated randomly paired individuals, who had a 25% difference in excess weight.

These results suggest that genetics have a strong influence on the effect of gastric bypass surgery on body weight.  Interestingly, they also suggest that the home environment does not have an influence on the efficacy of gastric bypass surgery.

We are certainly becoming increasingly aware of the strong genetic influence in obesity.  Dozens of genes which contribute to obesity risk have been identified so far, and this number continues to climb as our knowledge base grows.  It is therefore perhaps unsurprising to learn that genetics play a strong part in the response to bariatric (weight loss) surgery as well.

The current study examines the influence of genetics on the lowest weight reached (called the 'nadir') after gastric bypass.  I would be very interested to know if genetics has an equally strong influence on the risk of weight regain after hitting the nadir weight postoperatively, as there is also quite a substantial variation in weight maintenance vs weight regain in the long run after bariatric surgery.  More study is needed in this area.

Although this study was too small to be able to identify the specific genetic contributors to weight loss success after gastric bypass surgery, larger scale studies could be undertaken to examine the entire human genome to try to identify the relevant genes.  It is likely that there are many genes involved here, and their interactions are likely to be extremely complex.  Discovery of new genetic mechanisms involved in the response to surgery may teach us something not only about surgery but about obesity in general, possibly leading us down the path to other discoveries that will assist us in non-surgical treatment of obesity as well. 

As for people currently contemplating gastric bypass surgery, this study is too small to make definitive conclusions, but if you have a first degree relative (parent, sibling, or child) who has had the surgery, the success they experienced may be predictive of your own.

Dr Sue Pedersen © 2011

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Video Blog - Highlights from American Obesity Society Conference

>> Friday, October 7, 2011

In this video blog, Dr Sue discusses just a few of the many highlights from this week's Obesity Society meeting in Orlando, Florida.

Some of the highlights include:

1.  A focus on learning more about the genetics of obesity;

2.  Food Reward: Do differences in how we desire, and how we enjoy, food, affect our risk of weight gain?

3.  Lifestyle interventions:  a focus on building environments that are conducive to more exercise and healthy eating

4.  Medications: nothing new currently, but many interesting possibilities on the horizon...

5.  Bariatric surgery: more data on longterm success rates, and novel technologies being studied.

Watch to learn more!

Dr. Sue © 2011

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Video Blog - Childhood Obesity

>> Saturday, October 1, 2011

In this video blog, Dr Sue discusses the childhood obesity epidemic we are facing, which is the focus of the Fall 2011 Conduit magazine, a publication of the Canadian Obesity Network.  (available as a free download here:

Dr Sue discusses the important contribution of genetics to the childhood obesity epidemic, and the serious consequences of the stigma of obesity to the child.    She talks about things that we can do, from avoidance of smoking in pregnancy to decreasing TV time, to help our kids grow up with a more healthy weight!

Dr. Sue © 2011

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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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