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What's The Beef on Processed and Red Meat?

>> Wednesday, October 28, 2015

BIG NEWS in the nutrition world this week - the World Health Organization's International Agency for Research on Cancer (IARC) has stated that processed meat causes colon cancer

The science:  IARC assessed more than 800 epidemiological (population based) studies to evaluate the link between red meat, processed meat, and cancer, giving the greatest weight to prospective cohort studies, and taking additional evidence from high quality population based case-control studies.  They made a point of focusing on data that included large sample sizes and controlled for possible confounding factors (these are other factors that could be responsible for the same result, for example smoking).   Their meta-analysis found:

1.  An 18% increased risk of colon cancer per 50g of daily processed meat consumption (with confidence that there was no confounding or other explanation for the results);

2.  A 17% increased risk of colon cancer per 100g of daily red meat consumption (with less confidence that there was no other explanation for the results)

3.  Positive associations between consumption of processed meat and stomach cancer;

4.  Positive associations between consumption of red meat and cancers of the pancreas and prostate.

Based on these results, they have classified processed meats as being carcinogenic (cancer causing), and red meat as 'probably carcinogenic' to humans. 

It seems that how meat is cooked or processed is relevant to this discussion.  Meat processing, such as curing or smoking, can result in the formation of cancer causing chemicals such as N-nitroso-compounds and polycyclic aromatic hydrocarbons (PAH).  Cooking meat can produce chemicals also suspected of causing cancer, including heterocyclic aromatic amines and PAH.  High temperature cooking (pan frying, BBQ, or grilling) produces the highest amounts of these chemicals.

While red meat does contain lots of good quality protein and important nutrients such as B vitamins, iron and zinc, these nutrients can be found in other, healthier food choices.

So, meat lovers: you're best off to limit your intake of processed meats and red meats; consider healthier alternative such as poultry or fish.

A scientific discussion of the evidence can be found in The Lancet Oncology, and you can read more about the IARC (if interested) here.

Follow me on twitter! @drsuepedersen © 2015 


Secrets To Success - Keeping Weight Off

>> Friday, October 23, 2015

Have you ever wondered what the secret to success might be, for people who have lost weight and have been able to keep it off?

While the answer to this question will be different for each individual, the American National Weight Control Registry was established in 1994 to try to identify behaviors associated with long term weight loss success.   It is the largest prospective observational study of weight maintenance out there, and includes individuals who have maintained a weight loss of at least 30 lbs for at least 1 year.

Some interesting facts about NWCR members:
  • 80% are women, 20% men
  • average age is 45-50 years
  • 45% lost weight on their own, and 55% with a program

Here are the winning patterns of NWCR members:
  • 98% modify their food intake in some permanent way: portion control, low fat diet
  • 90% exercise at least 1 hour per day, burning at least 400 calories per session
  • 78% eat breakfast every day
  • 75% weigh themselves once a week
  • 62% watch less than 10 hours of TV per week
  • average daily calorie intake for women = 1306 cal
  • average daily calorie intake for men = 1685 cal

While the causes and contributors to excess weight, and the challenges in maintaining weight loss are different from person to person, it would be worthwhile to consider these permanent habits to improve the likelihood of long term weight management success!

Follow me on twitter! @drsuepedersen © 2015 


Canadian Medical Association Recognizes Obesity As A Chronic Disease

>> Friday, October 16, 2015

Finally, finally!  Canada has joined in with other nations to FINALLY recognize obesity as a chronic disease.

On October 9th, the Canadian Medical Association (CMA) officially declared obesity to be 'a chronic medical disease requiring enhanced research, treatment and prevention efforts'. 

As CMA president Cindy Forbes states:

"It is important for health care providers to recognize obesity as a disease so preventive measures can be put in place and patients can receive the appropriate treatment.  This move by the CMA speaks to the importance of addressing obesity and dealing with the stigma that is often associated with the condition."

I couldn't agree more.  There is an urgent need to shift society's thinking away from the idea that obesity is a lifestyle choice, and towards understanding the complex physiologic mechanisms that underlie this medical condition.

The CMA now joins other organizations, such as the American Medical Association and the World Health Organization, in recognizing obesity as a chronic medical condition.  With this important recognition, Canada has taken an important step towards supporting patients with obesity, and abolishing the obesity stigma that plagues not only our society, but also health care.

The way forward is now for improvements in access to important treatment options for patients with obesity - from nutritional counselling, to psychological support, to medications, to bariatric surgery.

Follow me on twitter! @drsuepedersen © 2015 


Could Antibiotics Cause Diabetes?

>> Friday, October 9, 2015

The more we learn about type 2 diabetes, the more we appreciate that there are many, many factors that play into the development of this complex medical condition.  The bugs that live in our intestines (called microbiota) are falling under increased scrutiny in how they affect our metabolism.  A new study suggests that antibiotic use (which changes our microbiota) increases the risk of type 2 diabetes.

The study, conducted by Mikkelsen and colleagues and published in the Journal of Clinical Endocrinology & Metabolism (a journal that we endocrinologists love to geek out over) looked at 12 years of data from the entire population of Denmark.  They found that those who had filled 2-4 prescriptions for antibiotics has a 21% higher risk of having type 2 diabetes, compared with those who had filled 0-1 antibiotic prescriptions.  The higher the frequency of antibiotic usage, the higher the risk of having type 2 diabetes. The higher use of antibiotics in type 2 diabetes patients was seen for up to 15 years before the diagnosis of type 2 diabetes, as well as after the diagnosis of diabetes.  

So does this clearly tell us that antibiotics destroy our gut bacteria and cause diabetes?  No.  The data could also be interpreted to reflect that diabetics (diagnosed or not yet diagnosed) are at higher risk of infection, therefore more likely to need antibiotics.  That being said, the fact that the association between antibiotic use and diabetes was seen for up to 15 years before diabetes was diagnosed, makes it unlikely that these data simply reflect diabetics needing treatment for infections. (while diabetes has often been present 5-7 years before diagnosis, 15 years of undetected diabetes is unlikely). 

We are still in the early stages of understanding how our gut bugs affect our metabolism, but there is increasing evidence that they play an important role not only in the development of obesity, but also potentially in the development of type 2 diabetes. I will be watching this area with interest!

Follow me on twitter! @drsuepedersen © 2015 


Mediterranean Diet With Olive Oil Prevents Breast Cancer

>> Friday, October 2, 2015

It's tough to navigate all of the health claims of various food products out there.  Many claims are unsubstantiated, and those that have evidence behind them are often not derived from high quality data.  In that context, I was impressed to see a recent randomized controlled clinical trial, suggesting that a Mediterranean diet supplemented with extra virgin olive oil reduces the risk of breast cancer in postmenopausal women.

The PREDIMED trial randomized 4,282 women to receive either a Mediterranean diet supplemented with extra virgin olive oil; a Mediterranean diet supplemented with nuts; or a control diet with advice to reduce dietary fat.

After 4.8 years, they found that the olive oil supplemented diet reduced the risk of breast cancer by 62%, and the nut supplemented diet reduced the risk by 41%, compared to the control diet.

While these numbers look super impressive, the absolute numbers are actually fairly small: rates of breast cancer per 1000 person years were:

  • 1.1 for the extra virgin olive oil group
  • 1.8 for the nuts group
  • 2.9 for the control group
Still: what this means is that if 1000 women eat following the Mediterranean + oil diet, roughly 2 cases of breast cancer would be prevented.

While the total number of breast cancer cases in the entire study was small (35 total), and only included postmenopausal caucasian women at high risk of vascular disease, the results are certainly interesting and worthy of further research in broader and larger populations.

A word of caution: One must also be careful not to eat too many calories in oil or nuts - these are highly calorie dense foods which can quickly add up and contribute to weight struggles if eaten to excess, and obesity is a known risk factor for breast cancer.

Follow me on twitter! @drsuepedersen © 2015



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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