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Two health physiology researchers discuss the latest obesity news, research, and weight loss products.

Travis Saunders, MSc
109 posts

Peter Janiszewski, PhD
4 posts

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December 10, 2010
07:00 AM
2,743 views

Sedentary Physiology Part 5 – Future Directions

by Travis Saunders, MSc, CEP in Obesity Panacea

Image by kaibara87
Welcome to our 5-part series delving into the fascinating research being performed in the emerging field of sedentary physiology. In Part 1 we discussed the basics of sedentary physiology, in Part 2 and Part 3 we looked at the association of sedentary time with both death and disease, and in Part 4 we looked at the mechanisms underlying these relationships. Today we will look at where future work in the field of sedentary physiology is heading.
Given the research that we have reviewed this week, I personally find the evidence pretty convincing that too much sedentary behaviour is bad for your health. But as several readers have pointed out, what qualifies as “too much” sedentary behaviour? And as others have asked, what can be done to reduce or prevent the negative impact of excess sedentary behaviour? Is simply standing every few minutes enough, or do we need to be exercising at a relatively high intensity? Or is the only option to simply cut down dramatically on the amount of sitting that most of us perform on a daily basis? Unfortunately, no one knows the answers to any of these questions, but as I have mentioned earlier, several lab-based studies are going on in Australia and the USA which will hopefully be published in the next year and shed light on these issues.
However, regardless of the findings of the studies that are currently ongoing, there is a need for many more studies in this emerging field. With this in mind, I thought it would be worth pointing out a number of important issues and possible directions for future research, should anyone feel inclined to take the advice of a lowly grad student working in this area. Here are some of the issues that I feel are important to consider, in no particular order (as always, I’d love to hear other suggestions in the comments!):
1. Think twice before you define an individual as “sedentary”.
Are they really “sedentary” (e.g. they sit too much) or are they just insufficiently physically active? When most exercise physiology papers refer to an individual as being “sedentary”, it simply means that they are not meeting physical activity guidelines. But as we discussed Monday, sitting too much (e.g. being sedentary) is not the same as being insufficiently physically active, and it is important that we differentiate between these two distinct behaviours. This may seem like a trivial issue, but from personal experience I can tell you that it is incredibly difficult to stay up-to-date on research in the field of “sedentary physiology” when everyone defines “sedentary” in a different way. I think that the definition that we outlined in this recent paper makes a lot of intuitive sense, but we really need to ensure that everyone starts using a common terminology, whatever that may be.
2. Don’t just ask about sedentary behaviour – measure it directly.
As you may have noticed this week, a lot of the research on sedentary behaviour has used self-report data. For example, the most common “assessment” of sedentary behaviour simply involves asking people how much TV they watch. Since TV watching typically involves sitting, this is thought to be a reasonable proxy for sedentary behaviour. And while this is better than nothing, a recent paper using a nationally representative sample of more than 5700 Americans suggests that self-reported TV watching is only weakly associated with directly measured sedentary time using accelerometers. This is not a huge surprise since self-reported data is generally less accurate than direct measurement, especially for socially desirable behaviours like TV watching. And even if people could accurately recall how much time they spend watching TV every day, this is still only one of several common sedentary behaviours. So while I would strongly suggest that people use direct measures of sedentary behaviour (such as accelerometers) whenever possible, it is also important that we develop questionnaires that are valid and reliable at assessing sedentary behaviours other than simply TV watching (driving, computer time, etc).
3. We need more lab-based studies

As readers have also pointed out in the comments earlier this week, several of the studies that I have discussed in this series have been cross-sectional epidemiological studies. These studies are interesting, but they can’t really explain whether excess sedentary behaviour causes health problems, or whether health problems cause people to engage in more sedentary behaviour. There have been a few notable longitudinal studies examining the relationship between sedentary behaviour and mortality (as discussed in Part 2 of this series), as well as a number of interesting lab-based studies in animals and humans (as discussed in Part 4). And yet there seems to be an almost unending flood of papers reporting cross-sectional relationships between body weight and TV watching, despite the relationship already being well characterized by numerous studies and reviews (seriously – we know there’s a relationship between TV watching and BMI… it’s time to move on to bigger and better things!).
If we are to advance our understanding of sedentary physiology, it is time that we focus our efforts on understanding the mechanisms underlying these relationships, which will require lab-based interventions that examine the physiological impact of controlled doses of sedentary behaviour. In other words, it is time that we apply the exercise physiology paradigm of lab-based interventions to this new field of sedentary physiology. Along with longitudinal observational studies, and randomized trials which aim to reduce sedentary behaviour among free-living individuals, these studies will dramatically improve our understanding of the relationship between sedentary behaviour and chronic disease.
4. We need a better understanding of the determinants of sedentary behaviour
While it is now reasonably clear that sitting “too much” is bad for your health, we don’t really know what factors influence the amount of time that you spend sitting. And until we understand the determinants of sedentary behaviour, it is obviously difficult to implement public health interventions that will help reduce sedentary time. Just as ecological models have been used to help us improve our understanding of the determinants of physical activity, we now need to develop similar models that can be applied to sedentary behaviour. And once we know the determinants, we can attempt to modify them and assess whether there is a noticeable impact on sedentary behaviour and/or health outcomes.
—
And that brings us to the end of this series of sedentary physiology! As I mentioned earlier in the week, several colleagues and I recently published a review paper on the field of sedentary physiology, which is what led me to write this series in the first place. The publication of this paper has been a pretty exciting moment for me since it was my first peer-reviewed publication with my current lab group here in Ottawa, and also because the paper was a collaboration with two members of the AusDiab study team in Australia who have published some of the most influential papers in the field of sedentary physiology (including the “breaks in sedentary time” paper that we focused on in Part 3 of this series earlier in the week). This series on sedentary physiology can be thought of as the Cliffs Notes version of the paper, and I’d encourage anyone looking for a more detailed discussion of sedentary physiology ... Read more »

Tremblay, MS, Colley, RC, Saunders, TJ, Healy, G, & Owen, N. (2010) Physiological and health implications of a sedentary lifestyle. Applied Physiology, Nutrition and Metabolism. info:/

December 14, 2011
09:00 AM
2,327 views

Contributors to the Pediatric Obesity Epidemic Part 3: Sleep, Maternal Age, Pollution & Breastfeeding

by Travis Saunders, MSc in Obesity Panacea

In Part 1 we examined the impact of changes in physical activity and sedentary behaviour, and in Part 2 we looked at changes in food intake. Today we look at the evidence (or lack thereof) linking sleep, pollution, maternal age and breastfeeding with the pediatric obesity epidemic.... Read more »

Saunders, T. (2011) Potential Contributors to the Canadian Pediatric Obesity Epidemic. ISRN Pediatrics, 1-10. DOI: 10.5402/2011/917684

September 1, 2010
01:00 PM
1,577 views

What Hurts Fitness More: 30 Years of Aging or 3 Weeks of Bed Rest?

by Travis Saunders, MSc, CEP in Obesity Panacea

I recently came across a very interesting study published in Circulation in 2001. In it, authors Darren McGuire and colleagues perform the 30-year follow-up on a group of 5 men who had taken part in the Dallas Bed Rest and Training Study (DBRTS). The DBRTS took place in 1966, when all 5 men were healthy 20 year-olds. They were assessed extensively at 3 different time points: baseline, following 3 months of bed rest, and following 8 weeks of physical training. In 1996 these same 5 men were assessed for a fourth time, allowing the researchers to compare the influence of 3 weeks of bed rest and 30 years of aging on markers of fitness.... Read more »

McGuire DK, Levine BD, Williamson JW, Snell PG, Blomqvist CG, Saltin B, & Mitchell JH. (2001) A 30-year follow-up of the Dallas Bedrest and Training Study: I. Effect of age on the cardiovascular response to exercise. Circulation, 104(12), 1350-7. PMID: 11560849

March 8, 2010
10:05 AM
1,516 views

Exercise and Body Weight

by Travis Saunders, MSc in Obesity Panacea

Image by atomicjeep

I came across a very interesting article in the Ottawa Citizen this weekend, unpleasantly titled "For Canada's obese, exercise alone isn't going to cut it". The crux of the article is this - exercise will not help you lose weight. Every few months it seems that this issue pops up, including a cover article in TIME magazine last year, which Peter has previously dissected. This is a complicated issue, and given the sensational title, I wasn't expecting much from the Citizen article. But the article is actually very well written, and includes interviews with a number of excellent researchers (including Bob Ross, who supervised my MSc, and Tim Church, who has co-authored papers with both Peter and I), as well as physician Yoni Freedhoff of Weighty Matters. Since this issue comes up so frequently, and because of its public health importance, I thought this would be an excellent opportunity to "weigh in" with my opinion.

So, does exercise reduce body weight? To be completely honest, it depends on the situation. Read the rest of this post... | Read the comments on this post...... Read more »

Church, T., Earnest, C., Skinner, J., & Blair, S. (2007) Effects of Different Doses of Physical Activity on Cardiorespiratory Fitness Among Sedentary, Overweight or Obese Postmenopausal Women With Elevated Blood Pressure: A Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 297(19), 2081-2091. DOI: 10.1001/jama.297.19.2081

Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R, & Janssen I. (2000) Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Annals of internal medicine, 133(2), 92-103. PMID: 10896648

March 8, 2010
12:04 AM
1,514 views

Human Chorionic Gonadotropin (HCG) for Fat Loss: "Fallacy and Hazard"

by Travis Saunders, MSc in Obesity Panacea

Photo by Todd Huffman.

One of the great things about this site is that people often bring products or research to our attention that we otherwise might have missed. This occurred yesterday in the comments section of Peter's recent post on Acai berry scams, when one of our readers brought up the use of Human Chorionic Gonadotropin (HCG) in the treatment of obesity. The website that we were provided smacks of weight loss gimmickry - notably the promise of an obesity "cure" and "near 100% success rate", but we thought it best to review the evidence before making a judgement one way or the other.

The use of HCG to treat obesity was first suggested by ATW Simeons in a 1954 Lancet paper. He reported that injection of HCG resulted in rapid mobilization of body fat stores and induced feelings of well-being. He also claimed that HCG reduced weakness and hunger during very low calorie diets (500kcal/day) and that HCG treatment could be used to prevent the protein and vitamin deficiencies which are a frequent side-effect of such low caloric intake. Finally, he suggested that HCG could be used to successfully treat a range of ailments ranging from diabetes and gout to ulcers and skin diseases. However, it is important to note that no actual study was performed - these were just subjective observations. Naturally, Simeons' observations spurred actual research into HCG.

Unfortunately for Simeons' pet theory, the vast preponderance of studies examining the effectiveness of HCG in the treatment of obesity found absolutely no effect. For example, a 1976 paper in the Journal of the American Medical Association performed a rigorously controlled, double-blind crossover study examining the effects of HCG on weight loss in obese individuals undergoing very low calorie diets. In a double-blind study, neither the patient, nor the physician, knows whether the patient is receiving HCG or a placebo. What were their results? Both groups lost a significant amount of weight (not surprising given subjects were only consuming 500 kcal/day), however there was no difference in weight loss between the HCG and placebo treatments. Read the rest of this post... | Read the comments on this post...... Read more »

Lijesen GK, Theeuwen I, Assendelft WJ, & Van Der Wal G. (1995) The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. British journal of clinical pharmacology, 40(3), 237-43. PMID: 8527285

May 18, 2010
11:32 AM
1,498 views

Canadian Health Authorities Release New Physical Activity Recommendations

by Travis Saunders, MSc in Obesity Panacea

Last week ParticipACTION and the Canadian Society for Exercise Physiology (CSEP) released recommendations for updated Canadian Physical Activity Guidelines. The previous guidelines were released between 1998 and 2002, and although they were based on the best research available at the time, from what I understand there simply wasn't a tremendous amount of evidence to draw on in some situations. Since then there have been a number of advances in physical activity research, allowing for the creation of updated, and increasingly evidence-based guidelines. ... Read more »

Janssen I, & Leblanc AG. (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. The international journal of behavioral nutrition and physical activity, 7(1), 40. PMID: 20459784

June 4, 2010
11:45 AM
1,468 views

Increased Physical Activity Prevents the Accumulation of Abdominal Fat

by Travis Saunders, MSc in Obesity Panacea

One of the most interesting things about exercise is that it results in important health improvements even in the absence of weight loss. For example, just a single session of exercise can result in improved insulin sensitivity, increased levels of HDL cholesterol (aka the "good" cholesterol) and reductions in plasma triglyceride levels - all tremendously important markers of disease risk. In addition to these metabolic changes, new research by our friend and former labmate Lance Davidson suggests once-again that exercise can also prevent the accumulation of abdominal fat, independent of changes in overall body fat percentage.... Read more »

Davidson, LE, Tucker, L, & Peterson, T. (2010) Physical Activity Changes Predict Abdominal Fat Change in Midlife Women. Journal of Physical Activity and Health. info:/

March 30, 2010
11:50 AM
1,419 views

Are Probiotics the Cure for Abdominal Obesity?

by Peter Janiszewski, PhD in Obesity Panacea

Nope, not even close, although I doubt it will stop big food from marketing Activia yogurt and others as a solution for expanded waistlines.... Read more »

Kadooka, Y., Sato, M., Imaizumi, K., Ogawa, A., Ikuyama, K., Akai, Y., Okano, M., Kagoshima, M., & Tsuchida, T. (2010) Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial. European Journal of Clinical Nutrition. DOI: 10.1038/ejcn.2010.19

May 13, 2011
11:52 AM
1,367 views

The Science of Starvation: How long can humans survive without food or water?

by Peter Janiszewski, Ph.D. in Obesity Panacea

Rita Chretien, a Canadian woman survived being stranded inside a vehicle in Nevada for 48 days, by eating only some trail mix and candy, and drinking water from a stream. Apparently, she and her husband were following their GPS instructions on their way to Las Vegas from British Columbia when they took a rural road that essentially turns to a bog in the winter months. Their van eventually got stuck in the mud in the middle of nowhere, and they both waited for help for 3 days without sighting anyone. At this point, Albert Chretien, the husband, left to seek out help, while Rita remained inside the van. When she was found by a group of hunters just last week, she was nearly dead and had lost some 30lbs. Her husband remains to be found.
This recent story of near complete starvation highlights the human ability to survive for long periods of time without sustenance.
Due to obvious ethical concerns, there is not a whole lot of credible scientific data on the topic of starvation and survival. Instead, there are many accounts of either voluntary or involuntary cases of complete or near-complete starvation that allow us to make some very general conclusions.
One of the most well known cases of voluntary starvation, is the hunger strike of Mahatma Ganhdi. During his protest, Gandhi ate absolutely no food and only took sips of water for 21 days, and survived. What extraordinary about this case is the fact that Gandhi was very lean when he started his hunger-strike, thus not having much energy reserve from the outset. Also, it must be noted that during his life, Gandhi is reported to have performed a total of 14 hunger strikes.
In a 1997 editorial in the British Medical Journal, Peel briefly reviewed the available literature regarding human starvation. Generally, it appears as though humans can survive without any food for 30-40 days, as long as they are properly hydrated. Severe symptoms of starvation begin around 35-40 days, and as highlighted by the hunger strikers of the Maze Prison in Belfast in the 1980s, death can occur at around 45 to 61 days.
The most common cause of death in these extreme cases of starvation is myocardial infarction or organ failure, and is suggested to occur most often when a person’s body mass index (BMI) reaches approximately 12.5 kg/m2.
Of course, one would expect marked variability between 2 individuals in their ability to endure starvation. As suggested in a Scientific American article by Alan Lieberson,
The duration of survival without food is greatly influenced by factors such as body weight, genetic variation, other health considerations and, most importantly, the presence or absence of dehydration.
I would add that body composition would also likely play a key role; for the same body weight, the individual with a greater percentage of body fat has a greater on-board storage of calories. Also, a lower muscle mass would generally be associated with reduced caloric consumption. This by extension would suggest that females may have a survival advantage over males due to their greater relative fat stores.
Most important factor of all, however, appears to be hydration.
In the example that started this post, Rita Chretien survived her 48 day ordeal in large part due to the availability to some melted snow for drinking. Indeed, had no water been available, Rita may not have fared as well. In examples of hospitalized individuals who are in a persistent vegetative state, who become cut off from artificial sustenance, death ensues within 10-14 days. Keep in mind that these individuals are in a coma and completely immobile, thereby consuming the lowest amount of energy possible. It can thus be surmised that the same conditions (no food or water) in a person who is at least somewhat active, and who may perspire, would only lead to a much swifter end.
For individuals who like to get out into the wilderness, and who upon reading accounts of other’s misadventures (Into the Wild, 127 Hours, etc.) are not in the least discouraged from following suit (present company included), ensuring to always have a reasonable supply of water should be priority number one. Additionally, as is well documented in the eventual demise of Christopher McCandless (Into the Wild) the avoidance of eating unknown plants and shrubs can also be a key survival strategy.
Peter
Peel M (1997). Hunger strikes. BMJ (Clinical research ed.), 315 (7112), 829-30 PMID: 9353494
... Read more »

Peel M. (1997) Hunger strikes. BMJ (Clinical research ed.), 315(7112), 829-30. PMID: 9353494

March 24, 2010
11:31 AM
1,365 views

Physical Activity Reduces the Risk fo Childhood Fat Gain

by Travis Saunders, MSc in Obesity Panacea

Over the next few months, Peter and I will be re-posting some of our favourite posts from our Obesity Panacea archives. The following article was originally posted on December 2, 2009.

Image by Mike Baird.

There is a surprising amount of controversy about the ability of physical activity to prevent the development of obesity. Sure, obese individuals tend to perform less physical activity than their lean counterparts, but that doesn't prove causation. And almost every week it seems that there is a news story reporting that the obesity epidemic is caused by diet. Period. If you believe these articles, physical activity plays a minor role, if any role at all. Some have even (erroneously) suggested that physical activity increases the risk of weight gain (for a thorough debunking of a recent TIME article on this subject, click here).

One of the problems of trying to untangle the role of physical activity in the development of obesity is that most studies use indirect measures of physical activity, like self-report questionnaires. Not surprisingly, there is a lot of error when people are reporting a socially-desirable behaviour like physical activity, as they tend to err on the positive side. And questionnaires also often give several fixed options, for example "Are you normally active for 15, 30, 45, or 60 minutes per day?". If you are active for 20 minutes per day, would you pick 15 or 30? Either way, it introduces a lot of error, which makes it very difficult to determine the specific role that your current physical activity levels play in the development of obesity down the road.
Read the rest of this post... | Read the comments on this post...... Read more »

Riddoch, C., Leary, S., Ness, A., Blair, S., Deere, K., Mattocks, C., Griffiths, A., Davey Smith, G., & Tilling, K. (2009) Prospective associations between objective measures of physical activity and fat mass in 12-14 year old children: the Avon Longitudinal Study of Parents and Children (ALSPAC). BMJ, 339(nov26 2). DOI: 10.1136/bmj.b4544

June 25, 2010
11:23 AM
1,361 views

Grow More Fat and Improve Metabolic Health: Insights from TZD Treatmen

by Travis Saunders, MSc in Obesity Panacea

By now, readers of Obesity Panacea have hopefully learned that excess weight is not directly predictive of health risk, and that excess fat mass is not in itself unhealthy. Recall that approximately 30% of individuals who are classified as obese by their body weight turn out to be metabolically healthy, and in fact seem not to get much metabolic benefit (or may even get worse) when they lose weight. Also consider that individuals who have NO fat tissue (e.g. lipodystrophy) have extremely elevated metabolic risk factors, meanwhile others who can apparently indefinitely grow more fat mass (multiple symmetric lipomatosis - think Michelin man) have metabolic profiles we'd all like to have. Read the rest of this post... | Read the comments on this post...... Read more »

McLaughlin, T., Liu, T., Yee, G., Abbasi, F., Lamendola, C., Reaven, G., Tsao, P., Cushman, S., & Sherman, A. (2009) Pioglitazone Increases the Proportion of Small Cells in Human Abdominal Subcutaneous Adipose Tissue. Obesity. DOI: 10.1038/oby.2009.380

February 25, 2011
10:48 AM
1,352 views

Turn down your thermostat to lose weight, suggests new study! (Dripping with sarcasm)

by Peter Janiszewski, Ph.D. in Obesity Panacea

So now that I’ve got your attention, let me tell you off the bat that making your home cold is not the most viable weight-loss strategy - despite what the headlines might suggest.
A recent study was published in the International Journal of Obesity which looked at a number of uncommonly explored potential contributors to obesity, including sleep restriction, house temperature, television watching, consumption of restaurant meals , use of air conditioning and use of antidepressant/antipsychotic drugs.
The authors followed up a sample of 1282 normal weight individuals for a total of 6 years to see who became obese, and tried to tease out factors that may have contributed to the development of their obesity.
Over 6 years of follow-up, 103 of these folks became obese. When the researchers looked back to the beginning, the individuals who eventually would become obese were different from those that maintained their normal weight in a number of ways:

Greater saturated fat intake
Greater frequency of eating out at restaurants
More time spent watching television
Lower fiber intake
Less physical activity
Greater use of anti-depressants
Less hours of sleep
Greater home temperature as well as greater use of air-conditioning (this combination is a bit counter intuitive)

In subsequent regression analyses, the authors tried to examine which of these factors was a significant predictor of becoming obese after controlling for all the other factors. In this analysis, low physical activity, frequent restaurant meals, having a high home temperature and not sleeping enough were all significant predictors of becoming obese.
What should be the take home message from this study? As we and others have suggested on numerous occasions: limit eating out, screen time, and saturated fat intake and get some regular physical activity, decent sleep, and keep up your fiber. And you should do these things regardless of your weight status – your health is also important.
Essentially we’ve learned NOTHING NEW here.
What has the media taken away from this study?
Keeping your home temperature higher than average leads to obesity, so we should all turn down our thermostat.
In a few of these articles, well known obesity researcher, David Allison, is quoted and it is quite amusing how his commentary nicely reflects the real lack of significance to these new findings the media are seething over.
Here is an example:
“I wouldn’t say to anyone that if you turn down your thermostat, you’ll lose weight.”
As to the potential benefit of reducing your thermostat, he says: “You’ll almost certainly reduce your energy bills.”
I couldn’t agree more.
Have a great weekend.
Peter
Bo, S., Ciccone, G., Durazzo, M., Ghinamo, L., Villois, P., Canil, S., Gambino, R., Cassader, M., Gentile, L., & Cavallo-Perin, P. (2011). Contributors to the obesity and hyperglycemia epidemics. A prospective study in a population-based cohort International Journal of Obesity DOI: 10.1038/ijo.2011.5
... Read more »

Bo, S., Ciccone, G., Durazzo, M., Ghinamo, L., Villois, P., Canil, S., Gambino, R., Cassader, M., Gentile, L., & Cavallo-Perin, P. (2011) Contributors to the obesity and hyperglycemia epidemics. A prospective study in a population-based cohort. International Journal of Obesity. DOI: 10.1038/ijo.2011.5

September 6, 2010
11:02 AM
1,317 views

Nintendo Wii – Is It Really Physical Activity?

by Travis Saunders, MSc, CEP in Obesity Panacea

http://www.flickr.com/photos/abbynormy/ / CC BY 2.0

Earlier this year, Peter wrote a post about Wii-related injuries which generated some interesting discussion. Essentially, some readers felt that we were being too hard on the Wii, with one commenter going so far as to suggest that the post was “anti-Wii” (hard to dispute, given that the post was focused on Wii-related injuries!). Although we’ve mentioned the Wii in passing on Obesity Panacea before, we’ve never had a full discussion of the pros and cons, and I thought that this would be an excellent opportunity to do so. So – should we really consider the Nintendo Wii as a form of physical activity?
People who feel that the Wii is a good source of physical activity often point out that it raises your heart rate and/or body temperature. I have played the Wii several times, and Peter has a Wii himself, so I don’t think either of us would try to dispute those two facts – when you play the Wii intensely, you can work up a sweat very quickly. This is also backed up by empirical research. For example,in a paper in the British Journal of Sports Medicine, Graves and colleagues report that teenagers expend nearly twice as many calories when playing Wii tennis or Wii boxing as they do when sitting passively.
So we can all agree – playing the Wii is better than sitting quietly – but this is not necessarily a ringing endorsement. Keep in mind, the same could be said about jumping jacks, running on the spot, or even walking. In fact, in another paper in the journal Pediatrics, Graf and colleagues report that Wii boxing burns roughly the same number of calories as walking on a treadmill at a moderate pace of 5.7 kilometers (3.5 miles) per hour. Not exactly an intense workout! And in their paper in the British Journal of Sports Medicine, Graves and colleagues point out that Wii bowling, Wii tennis, and Wii boxing all burn roughly half as many calories as performing those same sports in the real world. Further, the authors report that if the teenagers in this study were to replace sedentary videogames with the Wii, they would have increased their weekly physical activity by just 2%! Certainly not a panacea for the childhood inactivity epidemic!
And this is why the Wii is such a controversial topic for those of us working in the field of physical activity. Yes, it can get your heart pumping, but is that all that really matters? An editorial in Pediatrics points out that only a few exergaming activities can even be considered as moderate physical activity, and no clinical trial has assessed the impact of exergaming on child health. Certainly we can come up with other creative and engaging ways of increasing physical activity (including turning off the television!) that have the potential to build a life-long love for physical activity, rather than a love for video games.
In fact, this is the real concern for many of us – we fear that exergames like the Wii are far more likely to get kids interested in video games than in physical activity. Keep in mind that screen time in children is a strong predictor of all sorts of negative outcomes, from obesity to the metabolic syndrome. Is it worth giving children one more reason to sit in front of a TV, just because it might involve some physical activity?
Now this post is likely to come off as very anti-Wii, but I realize that the Wii is just a tool. In many situations – including physiotherapy, or improving balance or motor skills in the elderly or those with physical or mental disabilities – I feel that the Wii could prove to be incredibly useful. And as one commenter pointed out Friday, the Wii can be used to get a great workout when heading to the gym is not an option. This is very similar to the way that I use my bike trainer, and the Wii makes perfect sense to me in that context. But as a means of increasing physical activity in inactive children, I feel that the Wii is unlikely to create any tangible benefit, and may even cause real harm by replacing more vigorous forms of physical activity. Evidence from clinical trials could certainly make me change my tune, but I am a firm skeptic in their absence.
So that’s what I think about the Wii – what about you? Is it worth exposing children to video games just so they can exercise at an intensity akin to walking? Or is any increase in physical activity an important increase? Should we place Wii’s in our schools and rec centers to attract inactive children, or should we stick with more traditional forms of physical activity (which may or may not engage the most at-risk kids)? It’s a complicated issue, and one that I know is being dealt with by many schools and recreation organizations. This is going to be an increasingly important issue in the coming years, and I would love to hear what you think!
Travis Saunders
Graves, L., Stratton, G., Ridgers, N., & Cable, N. (2007). Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross sectional study BMJ, 335 (7633), 1282-1284 DOI: 10.1136/bmj.39415.632951.80
Daley, A. (2009). Can Exergaming Contribute to Improving Physical Activity Levels and Health Outcomes in Children? PEDIATRICS, 124 (2), 763-771 DOI: 10.1542/peds.2008-2357
This post originally appeared on Obesitypanacea.com on February 8, 2010.

... Read more »

Graves, L., Stratton, G., Ridgers, N., & Cable, N. (2007) Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross sectional study. BMJ, 335(7633), 1282-1284. DOI: 10.1136/bmj.39415.632951.80

Daley, A. (2009) Can Exergaming Contribute to Improving Physical Activity Levels and Health Outcomes in Children?. PEDIATRICS, 124(2), 763-771. DOI: 10.1542/peds.2008-2357

June 23, 2010
12:20 PM
1,313 views

Are High Glycemic Index Carbs Worse Than Saturated Fat?

by Travis Saunders, MSc in Obesity Panacea

Most people know that consuming too much fat, and especially saturated fat, is bad for your health. That's why there has been a concerted push for several decades to get people to reduce the amount of saturated fat that they consume, and to replace it with complex carbohydrates. Now unfortunately people often misinterpret that to mean that fat is evil, but carbs are ok. This is problematic since consuming too many simple carbs is also likely to increase the risk of obesity, diabetes, and cardiovascular disease - exactly what we are trying to prevent in the first place. So this raises the important question - in order to minimize the risk of heart disease, is it better to reduce the intake of saturated fat, or the intake of simple carbs? An interesting new study in the American Journal of Clinical Nutrition examines this issue and while it doesn't provide a definitive answer, it suggests that refined carbs are pretty bad indeed.... Read more »

Hu FB. (2010) Are refined carbohydrates worse than saturated fat?. The American journal of clinical nutrition, 91(6), 1541-2. PMID: 20410095

Jakobsen MU, Dethlefsen C, Joensen AM, Stegger J, Tjønneland A, Schmidt EB, & Overvad K. (2010) Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. The American journal of clinical nutrition, 91(6), 1764-8. PMID: 20375186

December 20, 2010
08:04 AM
1,312 views

Sneezing your way to a big belly: Do allergy medications make you fat?

by Peter Janiszewski, Ph.D. in Obesity Panacea

“Achoo!!”
Some folks have seasonal allergies.
But if you’re like me, battling your allergies is a year-round affair.
Some days are certainly better than others, but overall, I have been a chronic user of anti-histamines since my teens. Cleratin, Reactine, Aerius, and Life Brand versions thereof have all at one point or another helped me breathe.
So you may imagine my concern when I came across a recent paper published in the journal Obesity discussing a possible link between the use of anti-histamines and body weight.
During a graduate course in neuro-endocrinology I took a couple of years ago, I learned about numerous central signals than control energy balance.
Histamine was not one of those.
Apparently, histamine is a neurotransmitter which, in addition to mediating the inflammatory response, and thus symptoms of allergies, is known to suppress appetite.
Thus, antihistamines, which work by blocking the H1 histamine receptor, may remove this appetite suppressing signal. Indeed, the authors of the current study point out that increased appetite and weight gain is a reported side-effect of antihistamines. (I just checked the packaging of my antihistamines and there was no mention of increased appetite or weight gain.)
To investigate this link, Ratliff and colleagues used data from the National Health and Nutrition Examination Survey during the 2005-2006 years.
“268 adults (174 females and 94 males) reported use of an H1 antihistamine and completed all outcome measure components. 599 age- and gender-matched controls (401 females and 198 males) were used as a comparison for body measurements, plasma glucose, insulin concentrations, and lipid levels.”
What did they find?
“After adjusting for gender, prescription H1 antihistamine users had significantly higher weight (P < 0.001), BMI (P < 0.001), waist circumference (P < 0.001), and insulin levels (P < 0.005) compared to healthy controls.”
Specifically, controlling for age and gender, those who take anti-histamines were 55% more likely to be overweight than their non-allergy-suffering peers.
However, the increased risk of overweight with antihistamine use was more pronounced for men than women (70% vs 21% increased likelihood).
No differences between the groups were observed for any of the other metabolic risk factors studied.
Of course, this is only a correlative study, and countless other confounding factors may be playing a role. Nevertheless, the preliminary observation is intriguing.
I have tried to think back to times when I take antihistamines and recount whether I had an increased appetite, and I’m not sure my personal experiences corroborate this observation.
Thus, for the sake of proper breathing, I’ll stick to my anti-histamines for the time-being.
I wonder if any of our readers have noted a change in appetite when taking antihistamines.
Peter
Ratliff, J., Barber, J., Palmese, L., Reutenauer, E., & Tek, C. (2010). Association of Prescription H1 Antihistamine Use With Obesity: Results From the National Health and Nutrition Examination Survey Obesity, 18 (12), 2398-2400 DOI: 10.1038/oby.2010.176
... Read more »

Ratliff, J., Barber, J., Palmese, L., Reutenauer, E., & Tek, C. (2010) Association of Prescription H1 Antihistamine Use With Obesity: Results From the National Health and Nutrition Examination Survey. Obesity, 18(12), 2398-2400. DOI: 10.1038/oby.2010.176

March 19, 2010
12:15 PM
1,299 views

Not enough, rather than too much fat, causes metabolic problems of obesity

by Travis Saunders, MSc in Obesity Panacea

That's right - contrary to what many religiously believe, it is the inability to grow more fat during times of energy surpluss, rather than the excess of fat which appears to directly contribute to the metabolic consequence often associated with obesity.

A recent article in the New Scientist shines some light on this issue;

Obesity kills, everyone knows that. But is it possible that we've been looking at the problem in the wrong way? It seems getting fatter may be part of your body's defense against the worst effects of unhealthy eating, rather than their direct cause.

While the article goes on to discuss some interesting new research, I feel the author misses an opportunity to really challenge the overwhelming dogma that too much fat, per se, is the cause of metabolic consequence of obesity. From my experience, it is much easier to get the point across by investigating the obvious anomalies or outliers to the often thought direct relationship between excess adiposity and disease.... Read more »

Bays, H., & Dujovne, C. (2006) Adiposopathy is a more rational treatment target for metabolic disease than obesity alone. Current Atherosclerosis Reports, 8(2), 144-156. DOI: 10.1007/s11883-006-0052-6

March 26, 2010
11:55 AM
1,299 views

Is Jesus Making You Overeat?

by Peter Janiszewski, PhD in Obesity Panacea

Well, in fairness, Jesus' twelve Apostles should also share in the blame.

An incredibly quirky and yet fascinating study was just published in the International Journal of Obesity which investigated the size of the food and plates that have been depicted in paintings of Jesus' Last Supper over the last 1000 years.
... Read more »

Wansink, B., & Wansink, C. (2010) The largest Last Supper: depictions of food portions and plate size increased over the millennium. International Journal of Obesity. DOI: 10.1038/ijo.2010.37

April 1, 2010
11:25 AM
1,293 views

Junk Food Tax or Health Food Subsidy - Which Results in Healthier Food Purchases?

by Travis Saunders, MSc in Obesity Panacea

In the past few years several prominent researchers have argued for the adoption of taxes on junk food as a means of reducing their consumption. Often, as in a recent editorial in the New England Journal of Medicine, the argument is made that money collected through the tax could then be used to subsidize healthier foods. This is an idea that I've found very appealing - we make the bad foods more expensive, the good foods less expensive, and people will probably shift at least some of their purchases to those healthier options. But a very interesting new study by Leonard Epstein and colleagues suggests that things might not be so simple.... Read more »

Epstein, L., Dearing, K., Roba, L., & Finkelstein, E. (2010) The Influence of Taxes and Subsidies on Energy Purchased in an Experimental Purchasing Study. Psychological Science, 21(3), 406-414. DOI: 10.1177/0956797610361446

March 7, 2010
11:59 PM
1,288 views

Ten Simple Ways to Increase Your Physical Activity

by Travis Saunders, MSc in Obesity Panacea

Photo by pugetsoundphotowalks.

Regardless of your shape or size, physical activity has been shown to add years to your life, and life to your years. But believe it or not, the benefits of physical activity are not restricted to exercise performed in the gym. In fact, one of the easiest ways to improve your health may be through increasing the amount of low intensity physical activity you perform throughout the day. For example, simply increasing the number of steps that you take each day is very likely to reduce your risk for diseases like diabetes and cardiovascular disease. It's still uncertain if this light intensity physical activity can reduce body weight, but it is clear that individuals who engage in high amounts of light intensity physical activity are healthier than those who do not. In fact, there is good evidence to suggest that simply reducing the amount of time spent sitting each day may reduce risk of death independently of other lifestyle factors (for my recent post on this topic, click here).

Peter and I have discussed the importance of daily physical activity in several posts over the past few months, so today we have decided to offer some practical ways that you can incorporate physical activity into your daily life. These are tips that we have found work well for us, and we think they may work well for you as well. Try one or two, and once they've become part of your routine try a couple more. We would also love to hear your own tips in the comments section below.

Withour further ado, here are ten simple ways to become more physically active:

1. Take the stairs as often as possible.

This one is as simple as it sounds. If you have to go up two floors or less, opt for the stairs. Ditto if you have to go down three floors or less. If you have to go up or down a distance that is too great for you to walk at the moment, walk the first few flights, then take the elevator the rest of the way. Remember, every time you take the stairs instead of the elevator or escalator, you are making a decision that will positively affect your long term health.

2. Drink plenty of water.

This sounds odd, but it's a trick that I've been using for years. If you are constantly sipping water throughout the day, you are going to have to pee at least once an hour. Every time you have to pee, you have a guilt-free excuse to go for a 5-minute walk to the washroom and back! To crank it up a notch, use a washroom in another part of your building, which may give you an opportunity to use the stairs as well. It's easy to forget to take a 5-minute walk-break every hour, but it's impossible to forget to go pee.

Added bonus - staying well hydrated may also reduce feelings of hunger, and can often reduce chronic back pain. So this is really a win-win-win.

Read the rest of this post... | Read the comments on this post...... Read more »

Ekelund, U., Brage, S., Froberg, K., Harro, M., Anderssen, S., Sardinha, L., Riddoch, C., & Andersen, L. (2006) TV Viewing and Physical Activity Are Independently Associated with Metabolic Risk in Children: The European Youth Heart Study. PLoS Medicine, 3(12). DOI: 10.1371/journal.pmed.0030488

Lachapelle, U., & Frank, L. (2009) Transit and Health: Mode of Transport, Employer-Sponsored Public Transit Pass Programs, and Physical Activity. Journal of Public Health Policy. DOI: 10.1057/jphp.2008.52

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