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July Long Weekend Picnic Salad - Asian Style!

>> Saturday, June 30, 2012

Perfect for your July Long Weekend picnic or barbeque, here's another delight from the Diabetes Association in Brooks, Alberta.  This recipe makes use of Napa cabbage, also known as Chinese cabbage, which is available in almost any supermarket.  As it contains lots of chicken as a healthy protein source, this easy-to-make salad is a meal in itself!

  • 12 oz cooked, skinless, boneless chicken breast
  • 2 cups finely shredded Napa cabbage
  • 1 cup slivered green and red bell peppers
  • 2 tbsp chopped green onions
  • 1/4 cup slivered, toasted almonds, for garnish
  • 1/2 cup plain low fat yogurt
  • 1/3 cup rice vinegar
  • 1 tbsp canola oil
  • 1/2 tsp sesame oil
  • 1 tsp lite soya sauce
  • 1/2 tsp grated fresh ginger root


1.  Mix the dressing ingredients in a large bowl. 

2.  Add the chicken and veggies. 

3.  Toss!

4.  Top with the almonds and let the dressing soak through the layers. 

5.  Enjoy!

Makes 4 servings.  PER SERVING: About 241 calories, 24g protein, 16g carbs, 9g fat.  

Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen


Caffeine May Be Affecting Your Sleep More Than You Think

>> Thursday, June 21, 2012

As a society, we are sleeping less than ever before.  There are many factors that contribute to sleep deprivation, from longer work hours, to higher stress, and a long list of other contributors.  While some of us don't lay our heads down long enough, for others, sleep time is short because of difficulty falling asleep.  If this is you, consider whether caffeine could be sabotaging your efforts to get in the winks you need.

Caffeine is absorbed into the bloodstream, peaking anywhere between 30-120 minutes after you take it in (depending on the source).  It diffuses through the entire body and crosses all membranes, including the placenta and the blood-brain barrier.  In the brain, it affects areas of the brain that control sleep and wakefulness by blocking adenosine receptors.

It takes on average 18.5 hours, but as much as 50 hours (count 'em!) for caffeine to completely leave your body after ingestion. (For scientists in the audience: the half life is 3.7 hours, but ranges from 2-10 hours).  This time is shorter in smokers, and longer in pregnant women and women using the birth control pill.   Our genetics also affect how quickly we metabolize caffeine.

The approximate caffeine content of some common beverages is as follows:

Coffee and Tea:

  • 8 oz cup of generic brewed coffee: 100-200 mg
  • Starbucks Grande: 320 mg
  • 1 oz espresso: 30-90 mg
  • 1 Starbucks Via: 130-140 mg
  • 8 oz decaf coffee: 4-8 mg
  • 8 oz cup of tea: 50mg (range 40-120 mg)
Cold Drinks:
  • 16 oz Snapple: 42 mg
  • 12 oz Nestea: 26 mg
  • 1 can of diet Coke: 47 mg
  • 1 can of Diet Pepsi: 36 mg
  • 1 can of Red Bull: 80 mg

Consider also the caffeine in chocolate (per 50g):

  • milk chocolate: 2-25 mg 
  • dark chocolate: 8-60 mg 
  • extra dark: 30-120 mg

Be cautious of over the counter pain medications, which can contain caffeine as well, often in the range of 25-65mg per tablet: Excedrin and Anacin are examples.

So: could caffeine be affecting your sleep?

Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen 


Ricotta Muffins!

>> Saturday, June 16, 2012

I was recently invited to speak at a Diabetes Expo held in the lovely town of Brooks, Alberta.  I was so impressed by the Diabetes Association of Brooks & District, who runs this event - this is a group of people who are REALLY passionate about the care of their diabetics!  They are so excited about diabetes care, in fact, that they have their own publication (pictured above) called the Healthy Choices Guide.  Amongst many other pearls, this book has a great collection of diabetic-friendly recipes.    A huge thanks goes out to the Brooks team, who have graciously agreed to allow me to share a few of their delicious creations.

The first recipe I'd like to share with you is just AWESOME - low in calories, rich in protein, and nearly carb free, meaning that one of these delicious muffins won't have a big impact on blood sugar.


  • 8 eggs
  • 1 cup part skim ricotta cheese
  • 1/2 tsp salt
  • 1/2 cup minced green onion
  • 2 tbsp grated parmesan cheese
  • freshly ground black pepper, to taste


1.  Preheat the oven to 350F.  Spray the bottom and sides of a 12 muffin cup tray with cooking spray. 

2.  Combine eggs, ricotta, and salt in a blender, or whip with a beater, until smooth.  Stir in the green onion and pepper.  

3.  Bake for 10 minutes, then remove tray from the oven and sprinkle the top of each muffin with a litle grated parmesan.  Bake for another 10 minutes or until the tops are puffy, golden, and just barely firm to touch. 

4.  Remove the pan from the oven, and let the muffins cool in the pan for about 5 minutes.  Muffins will deflate a bit while cooling.  Run a knife around the edges of each muffin and removed them from the pan.  Serve warm, or at room temperature!

  • 90 calories
  • 7g protein
  • 5g fat
  • 2g carbohydrates
  • 180mg sodium
Enjoy!    Stay tuned over the coming months for more from this outstanding collection. 

Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen


Obesity Surgery: What Type is Best?

>> Saturday, June 9, 2012

This weekend, I've had the pleasure of attending and being invited to speak at the inaugural meeting of the Canadian Association of Bariatric Physicians and Surgeons in Toronto.  While I will share with you the information from my talk in an upcoming post (which was about the treatment of diabetes with obesity surgery), what I would like to share with you today is a fantastic debate held this morning, about which type of obesity surgery is the 'best' overall surgery.

The three main types of bariatric (obesity) surgery were compared:

1.  Gastric Banding:  This is an inflatable band that is placed around the upper part of the stomach.  It works by making the reservoir of the stomach smaller, so that only small amounts of solid food can be consumed, resulting in a sense of fullness after only a small amount of food.  The band can be adjusted to make it looser or tighter by filling or deflating it with salt water via a port that lies just under the skin.

2.  Sleeve Gastrectomy:  In this surgery, most of the stomach is removed, and the shape of the remaining stomach looks like a 'sleeve' - hence the name.

3.  Gastric Bypass:   This surgery is the most complex of the three.  First, the stomach is made smaller (though the rest of the stomach is not physically removed).  Next, the small intestine is rerouted so that food bypasses the first part of the intestine, and absorption of nutrients first begins about 1.5 meters further down the intestinal canal.

Dr David Urbach of the University of Toronto began the debate with a discussion of the laparascopic adjustable gastric band.    On the positive side, the early complication rate of gastric bands is lower than for sleeve gastrectomy or gastric bypass.  However, the gastric band is not as effective to produce weight loss, and it's not as good to improve complications of obesity (eg diabetes, high blood pressure, sleep apnea).  Over the long term, gastric banding is not looking very good - as blogged previously, at 12 years after gastric banding, one study showed that 60% of people who had gastric banding needed a reoperation of some kind.  At 10 years, about half of patients have had their band removed (either because of complications, or because it was not effective).  While some people do have sustained weight loss over the long term with a band, a substantial proportion regain weight as well.

Dr Urbach concluded that gastric banding is probably not a good long term treatment for obesity, nor for the medical problems that go along with obesity.  He went so far as to say that the band is perhaps best considered only as a cosmetic procedure for patients wishing for weight loss.

Dr James Ellesmere of Dalhousie University reviewed sleeve gastrectomy.    He started off by noting that the sleeve is also quite a safe procedure to perform, with a low complication rate and a low risk of needing reoperation in the future.  In terms of short term risk of surgery, the risk is a bit higher than the short term risk of gastric banding, but lower than the risk of gastric bypass surgery.  The success in weight loss falls between banding and gastric bypass, and the improvement in complications of obesity (diabetes, sleep apnea, high blood pressure etc) also falls between banding and bypass.  An important down side of sleeves is that it is a newer procedure, and therefore, not much is known about long term efficacy (very few studies over 5 years exist).   The few studies that do exist show that there is variability in long term results - as with all of these surgeries, weight regain can occur.

Bottom line of sleeve gastrectomy:  It falls between gastric bands and gastric bypass in terms of benefits and risks, and we don't yet have a lot of long term data (though this data is coming).

In regards to gastric bypass surgery, Dr John Hagen of the University of Toronto reviewed data that show that gastric bypass is the most effective of these surgeries to cause weight loss, and to improve diseases associated with obesity (diabetes, sleep apnea, etc).  As such, it is considered the gold standard surgery in many centres.  However, there is a significant downside as well: as it's the most invasive surgery, there is higher short term operative risk.  In addition, because food is not digested in the first part of the intestine, many crucial nutrients are not sufficiently absorbed from a regular diet - therefore, the patient undergoing this surgery must be prepared to take a mandatory array of vitamins and nutrients for the rest of their lives.

Bottom line:  Gastric bypass has the highest success rate, but also the highest risk.

My take on this discussion?  As always, the decision to undergo obesity surgery is a very serious one, and every person is different.  Risks and benefits not only of the types of surgery, but of surgery in general, must be carefully weighed by the patient and their health care providers.  In terms of which type of surgery to choose, gastric banding does not appear to be a good long term treatment strategy; gastric bypass surgery and sleeve gastrectomy appear to be the best options to consider.

Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen


Roasted Fennel with String Beans!

>> Saturday, June 2, 2012

Here's a great spring veggie recipe made with fennel!  I must admit that it doesn't often occur to me to use fennel in my cooking, but it sure does count as a Free Veg at only 27 calories per cup!  Likewise for the string beans in this recipe, at 34 calories per cup.  Thanks to Food Blogga for this great recipe, and to Deb for finding it!


1 fennel bulb, cut into 8 wedges
1/2 pound string beans, trimmed
1 tablespoon olive oil
The zest of 1/2 lemon (about 1/2 teaspoon)
The juice of 1/2 lemon (about 1 teaspoon)
1/4 teaspoon salt
1/4 teaspoon fresh black pepper
2 tablespoons chopped fresh parsley, divided


1. Preheat oven to 400 degrees F. Cut the fennel stalks off of the bulb, and cut the bulb into 8 wedges. Place the fennel wedges and string beans in a large baking dish.

2. Whisk together the olive oil, lemon zest, lemon juice, salt, and pepper. Pour over vegetables and toss until coated. Cover tightly with tinfoil and bake for 10 minutes. Remove the tinfoil. Add 1 1/2 tablespoons parsley and toss. Cook uncovered for 15 to 20 minutes, or until vegetables are tender and a few brown spots appear.

3. Transfer vegetables to a platter or large bowl and drizzle with juices from the baking dish. Sprinkle with a little salt and freshly ground black pepper and remaining 1/2 tablespoon parsley.

This recipe makes 4 servings, and only 70 calories per serving!

Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen



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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