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Lessons From My Bento Box

>> Wednesday, February 27, 2013

During a recent trip to Japan, I found myself digging into more than one bento box meal with absolute delight!  These to-go boxes are readily available everywhere - train stations, local shops, even 7-11.  Although they are not as easy to find in North America,  it occurred to me that there are actually several lessons within the bento box experience that we can learn from:

1.  Portion Control.  (enough said!)

2.  Avoid Mindless Eating:  A term coined by Brian Wansink, PhD and author of over 100 academic articles and books on eating behavior, Mindless Eating essentially refers to eating without paying attention.  Have you ever reached back into a chip bag to find it empty, or looked down at your plate to be surprised that it is already clean?  The bento box seems to decrease the likelihood of Mindless Eating, because there are several things to pick from in the box, each of which taste quite different.... you have to actually think about what you're going to taste next.  (note that with multiple things to choose from, portion control *#1 above) is key!)

3.  Strong Flavors tend to lead to lower calories consumed.  In bento boxes, there are often a few strongly pickled vegetables, or some pickled ginger that give you pause to think about what you are eating, and the strong flavor also helps to keep portions under control.  Using hot sauce is a great way to exercise this point in western cooking.

4.  Thoughtful Preparation: Though often easier said than done, taking time to prepare a quality and varied meal allows you to enjoy a healthy, balanced meal..... rather than hitting the drive thru for something overportioned and often less healthy on the way home from work.

5.  Have Fun With Your Food!  Food can be healthy and still be exciting and fun.  Travel your tastebuds - try a local oriental food market to find some neat new options.

Dr Sue Pedersen © 2013 

Follow me on Twitter for daily tips! @drsuepedersen


Health Smart Toilets?

>> Thursday, February 21, 2013

On a recent trip to Japan, I, like most Westerners, had a great sense of intrigue (and careful respect!) for the toilets in Japan.  This wasn't my first adventure to this wonderful country, but it did take me until the last day of this trip to finally get up the guts to try it.  Fascinating to say the least!  They provide all manner of washing options, and sound accompaniment ranging from repeated flushing sounds to your classical favorites - endless entertainment, provided you can figure out exactly how to work it.

What is really interesting, though, is that the upcoming models are apparently going to be able to check sugar content of urine, and will even measure your body composition while you sit.

It should be pointed out that measuring urine sugar content is NOT a replacement for measuring blood sugar, as sugar is usually only present in the urine if blood sugar is quite high.  As for body composition, I imagine that this would be similar to body composition scales like the Tanita, that many people have in their home.

Who knew a toilet could provide something of a health check up!  I can't wait to see what they think of next.

Dr Sue Pedersen © 2013 

Follow me on Twitter for daily tips! @drsuepedersen


Exercise and Food - Choose Your Own Adventure!

>> Wednesday, February 20, 2013

Check out this article in the Chicago Tribune by Calgarian columnist James Fell.  He does a great job of describing how eating as a reward for exercise can hamper weight loss efforts.

Which adventure will you choose?

Dr Sue Pedersen © 2013 

Follow me on Twitter for daily tips! @drsuepedersen


Survival of the Fattest? The Obesity Paradox in Diabetes

>> Tuesday, February 19, 2013

We know from population studies that obesity is a risk factor for the development of a long list of medical problems, including heart disease.  Interestingly, a number of research studies suggest that obesity actually has a protective effect in patients who already have established heart disease, and a recent study shows that this protective effect includes patients with type 2 diabetes and heart disease.

The study by Doehner and colleagues, which is an analysis of data from the PROactive trial (a study of a diabetes medication called pioglitazone, vs placebo), they found that over a follow up period of almost 3 years, patients with type 2 diabetes and heart disease had the lowest mortality rates if their body mass index (BMI) at the start of the study was between 30-35.  (A BMI of 30 or greater is considered as 'obese'. You can calculate your own BMI in the right hand column of .)

They also found that weight loss was a predictor of mortality, and that weight gain was NOT associated with increased death rates.  In patients taking pioglitazone, a medication that is known to cause weight gain, those who did gain weight on pioglitazone had improved survival compared to those who did not gain weight.

This phenomenon, which has also been shown in several studies of nondiabetics, is what we refer to as the Obesity Paradox - that people with cardiovascular disease seem to be protected by higher body weights.  How is this possible?

The theory is that people who are sick are often losing weight, because they have lost their energy or appetite to eat, or because their illness causes such a high calorie burn that they can't keep up with food intake (this is seen in cancer patients as well).  Thus, the people who gained weight or didn't lose weight in the study were likely more 'well' in general, whereas the people who were thin or losing weight were likely to be sicker with their heart disease, and therefore had a higher rate of death during the study period.   Perhaps it could also be a better 'starting point' to have extra fat tissue on board before a person becomes sick - thereby giving that person more energy stores to draw from while overcoming a period of illness.

All in all, this information reminds us that fat tissue isn't all bad - it actually evolved over millions of years to help us survive periods of famine, and probably periods of illness as well.

Dr Sue Pedersen © 2013

Follow me on Twitter for daily tips! @drsuepedersen


How Many Calories are Burned During Sex? (and other obesity Mythbusting)

>> Monday, February 11, 2013

Anyone out there of the opinion that minutes logged getting busy in
the sack count towards the day's cardio workout? Sorry for the bad
news, but - think again.

The New England Journal of Medicine has just published a very
interesting read about the myths, presumptions, and facts about
obesity. Amongst the myths is one about sex: while lore has it
that 200-300 calories are burned during sex, the average (6 minute)
romp in the hay for a 70kg man only burns about 21 calories (based on
3 METs, a metabolic equivalent of energy output). As the article
points out, watching TV for the same 6 minutes burns about 7 calories,
so the net burn is actually only 14 calories.

Now that I've got your attention - the other myths in the article are
definitely worth a read and are equally 'hot' topics of discussion!

Dr Sue Pedersen © 2013 

Follow me on Twitter for daily tips! @drsuepedersen


HCG Does Not Cause Weight Loss

>> Wednesday, February 6, 2013

Anyone out there who is using HCG to lose weight - put your money back in your wallet.  As summarized in an excellent position statement just released by the American Obesity Society, HCG does not work to help people lose weight - and - it could be dangerous.

The package insert that now must accompany HCG in USA summarizes it well:

“HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity.  There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.”  

In regards to the possible dangers of HCG, the position statement points out the following:

Safety: Although the dose of HCG used in the Simeon obesity treatment program may be at placebo 
levels, it is unclear whether HCG for weight loss could be associated with safety concerns.  HCG in 
relatively low doses does have effects on the human endometrium, and the effect of a human 
pregnancy hormone in males is also of some concern, particularly with regard to adverse effects on 
prostate and male breast tissue.  In addition, the quality, dose, and composition of “HCG” used by many HCG weight loss clinics are unknown. 

Also, as blogged previously, HCG is usually prescribed by weight loss clinics in addition to a very low calorie diet, which are not long term solutions to weight management, and can be dangerous in their own right.

Dr Sue Pedersen © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

Read more... Product Review - AspireAssist Stomach Drain for Weight Control

>> Monday, February 4, 2013


'Eat what you want and lose weight' - this is how I've seen this product reviewed on various online websites.

It's called the AspireAssist - it's a tube implanted in the stomach, with a port leading to the outside of the abdomen through the skin in your belly.  It basically acts like a tap - twenty minutes after you eat, you go to the bathroom, turn the tap on, and it drains about a third of what you've eaten directly into the toilet.     Ironically, it's a similar set up to the PEG tube, which is a tube that has been use for a long time to FEED patients who can't take in enough food by mouth (the direction of flow in the tube, of course, is in reverse).

Clinical trials have been done showing successful weight loss, and it has been approved for use in Europe.  

My take on this:  I'm concerned for the following reasons:

1.  The most important part of treating obesity well is to deal with the underlying root causes of the weight struggle.  Are you an emotional eater or stress eater?  Is there limited access to physical activity in your life?  Are you sleeping enough?  Although lifestyle counseling is mentioned on the device's website,  these concerns need to be central to any weight loss plan.

2.  I am worried that the message that this device will convey is that it's ok to just continue eating for the same unhealthy reasons or in the same unhealthy pattern - just turn the tap on afterward to drain it out - which is clearly NOT an OK message to convey.

3.  I'm concerned that the device could become an enabler of unhealthy eating patterns.   Some web reviews have suggested that this is, or could induce, a form of bulimia - I agree that this is a danger as well.

You might ask, how is this different from currently available obesity surgeries? (you can read more about these here).  The main difference is that by decreasing the size of the stomach, the current surgeries do teach about lifestyle change, markedly decreasing the amount of food that can be consumed.  Gastric bypass and sleeve gastrectomy also alter hormone levels that help to decrease hunger, whereas the AspireAssist and the gastric band do not.  That being said, addressing the root causes of the weight struggle are crucial to the success of any type of bariatric surgery.

BOTTOM LINE:  Draining the food you eat back out of your stomach doesn't count as a positive lifestyle change!

Dr Sue Pedersen © 2013 

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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