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Mythbusting Hoodia

>> Monday, May 29, 2017





I'm on the Mythbusting prowl again!  This time, it's about Hoodia, which I was asked about at a speaking engagement recently.  

On the shelf amongst dozens of consumer products marketed as weight loss agents, Hoodia is available in a wide array of pills, bars, powders or teas.




While often referred to as a cactus due to its appearance, Hoodia gordonii is actually a flowering plant unrelated to the cactus family that is native to Southern Africa.  It is traditionally used by the San people of South Africa and Namibia as an appetite suppressant on long hunting trips, or during times of famine.  The active component of Hoodia, called P57, was discovered and patented in 1995, and from there, we have seen an explosion of products touted under the plant's name.

Unfortunately, as for most commercially available weight loss 'remedies', there is little to no data on Hoodia or its chemical components for efficacy nor safety.   The study of Hoodia has been particularly limited due to conflict over the rights to it, which was ultimately settled in an agreement providing for the San people to receive royalties on Hoodia sales (though my understanding is that the San have yet to realize any royalties from this agreement).

The only existing human clinical trial I'm aware of was a small, 15 day randomized controlled study conducted in 49 women, showing no effect on food intake nor body weight, and a host of side effects including increase in some liver tests (bilirubin and alkaline phosphatase), EKG changes (prolongation of PR and QT intervals), increase in blood pressure, heart rate, dizziness, disturbance in skin sensation, dizziness, giddiness, nausea and vomiting.  Yowza.



So, similarly to Garcinia cambogia, raspberry ketones, and green tea extractHoodia does not have evidence as an effective weight loss treatment in humans, and may be dangerous.

Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017




 






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Blueberry Zucchini Loaf!

>> Sunday, May 21, 2017







This May long weekend, I'm sharing a delightful loaf that I concocted in my kitchen one Sunday afternoon.... I had a hankering for a healthy muffin, and I was fresh out of muffin cups after trying out an online recipe that produced something resembling a dough pellet (epic fail!).  I had just been to Costco and had way more zucchinis than I knew what to do with.... sooo... voilĂ !  And it turned out great.

Ingredients:
  • 1.75 cups whole wheat flour
  • 1/2 cup white sugar
  • 1/4 cup brown sugar
  • 1.5 tsp baking soda
  • 2 tsp cinnamon
  • 1/2 tsp nutmeg
  • 1/4 cup canola oil
  • 1/4 cup milk
  • 1/4 cup greek yogurt fat free
  • 4 tbsp egg white
  • 2tsp vanilla
  • 1.5 cups shredded zucchini
  • 1/2 cup blueberries

Directions: 

1.  Preheat oven to 350F. 

2.  Mix first 6 ingredients (the dry ones) together in a large bowl. 

3.  Whisk together canola oil, milk, greek yogurt, egg white, and vanilla in a separate bowl until smooth.  Stir into flour mixture until batter is just moistened.  Fold zucchini and blueberries into batter. 

4.  Spray a standard loaf pan (8.5" x 4.5") with non stick spray, and pour batter in. 

5.  Bake 35-40 minutes, until a toothpick inserted into the centre comes out clean.


Makes 12 slices.  Per slice: 
  • Calories: 169
  • Fat: 4.8g
  • Carbs: 28g
  • Protein 3.2g

Note: I think this would also be good with half the white sugar (1/4c instead of 1/2 cup) - if you try this, let me know how it tastes (post a comment at the end of this post). 



Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017





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Does Intermittent Fasting Work?

>> Monday, May 15, 2017




One of the diet approaches that has really taken off in popularity is Intermittent Fasting.  Essentially, this means that certain days/times you restrict eating (or don’t eat at all) and other days/times, you feast.  This can take the form of Alternate Day Fasting (fast one day and feast the next), restricting on some days (eg weekdays) and feasting on others (eg weekends), or restricting eating to only a few hours each day.

Most studies showing benefit of intermittent fasting have been of very short duration (less than 12 weeks) – and let’s face it, just about anything can work over this very short term.  Now, a one year randomized controlled clinical trial has investigated whether intermittent fasting works.

The study, published in JAMA Internal Medicine, is quite a beautifully conducted trial (in my opinion), randomizing 100 people with obesity to one of three groups:

  • Alternate day fasting: 25% of energy needs on fasting days, and 125% of energy needs on non fasting days
  • Daily calorie restriction: 75% of energy needs on all days
  • Control group: no intervention (they received 3 months of free weight loss counselling and a 1 year free gym membership at the end of the study)

Participants followed the above for the first 6 months of the study, which was the weight loss phase. 

For the second 6 months, the focus was on weight maintenance. Calorie needs were reevaluated (because we need less calories to maintain weight following weight loss), and the groups proceeded as follows:

  • Alternate day fasting: 50% of energy needs on fasting days, and 150% of energy needs on non fasting days
  • Daily calorie restriction: 100% of energy needs on all days
  • Control group: no intervention


For the scientists in the audience: Total daily calorie needs were assessed using doubly labeled water, assessed at baseline and again at the start of the weight maintenance phase (t=6 months).  Analysis was by intention to treat.

At 12 months, the rate of dropout from the study was highest in the alternate day fasters at 38%, compared to 29% in the daily calorie restriction and 26% in the control group.

They found that the weight loss between the alternate day fasting and daily caloric restriction were no different at 6 months or 12 months.  Weight loss was 6.0% greater than the control group at one year in the intermittent fasting group, vs 5.3% greater than the control group in those on daily calorie restriction.   Other than a slightly higher bad cholesterol (LDL) in the intermittent fasters, there were no differences in any metabolic parameter.

While the study is small, it is the longest and largest clinical trial of alternate day fasting to date. 


BOTTOM LINE: The results of this study suggest that alternate day fasting is no better than daily calorie restriction for weight loss, and that the likelihood of sticking to the diet is lower with alternate day fasting.


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017
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Let's Take ACTION - Barriers To Effective Obesity Management In Canada

>> Monday, May 8, 2017





Obesity is a chronic medical condition that affects 25% of Canadian adults. As we know from the recently released Canadian Report Card On Access to Obesity Treatment, we are doing very poorly in terms of providing publicly funded access to treatment for obesity.

So what are the barriers that are preventing people with obesity from getting access to obesity care?  In addition to collecting important statistics in the Canadian Report Card, we also need to understand barriers from the perspectives of people living with obesity as well as their health care providers.

The ACTION study is the first nationwide study in Canada to investigate barriers to effective obesity management from the perspective of people with obesity, healthcare providers, and employers who provide health programs or health insurance coverage.  This study aims to generate insights to guide collaborative action to improve care, education, and support for people with obesity, and to provide evidence upon which to change how patients, health care providers, and employers treat obesity.

The ACTION study steering committee (of which I am a member) has been working to construct questionnaires that will be deployed to patients, health care providers, and employers across the country, to gather information on these important topics.

By understanding these perspectives, we hope to improve communication, education, and break down barriers to allow better access and provision of care for people with obesity.

Stay tuned for the results of this study early next year!


Disclaimer: The ACTION study is funded by Novo Nordisk, the maker of anti obesity medication Saxenda (liraglutide 3.0mg). 

Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017

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Do GMO Foods Cause Obesity?

>> Monday, May 1, 2017






Genetically modified organisms (GMO) refers to any living thing that has had its DNA modified by genetic engineering techniques.  GMO foods have been developed to be resistant to pests and herbicides, and/or for better nutritional content.   With the introduction of GMO foods, we have seen a parallel rise in obesity rates.  Could GMO foods have a role in this?

There is very little data on this issue. One study looking at American food trends and obesity found that consumption of corn products correlates with the rise in obesity.  Most American corn that is grown is genetically modified - so is it an increased calorie intake from corn products, or that it is genetically modified, that may be responsible correlation?  Or is the correlation purely coincidental? More research needs to be done.

A comprehensive review of dietary and policy priorities for cardiovascular disease, diabetes, and obesity published in the journal Circulation in 2016 found that existing evidence does not support that GMO food causes harm, but that the data are limited.   They point out that any potential effect of a GMO food on human health (positive or negative) would relate to specific compositional changes in the food, not to the GMO method itself.

As these authors state:

Based on current evidence, whether a food is organic or genetically modified appears to be of relatively small health relevance in comparison with the overall types of foods and diet patterns actually consumed. 


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2017






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A HEARTFELT WELCOME!

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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