Obesity Prevention Starts In Your Mother's Belly

With the struggles our societies face in the battle against obesity, we need to look not only at treatment strategies for people who already struggle with their weight, but also at how we can prevent obesity in the first place.  As we look earlier and earlier in life, risk factors have emerged going all the way back to not only infancy, but even to before we were born, when we were just lil' wee blobs of cells inside our mothers' bellies.

The New England Journal of Medicine recently published an excellent article describing the power of some of the risk factors during fetal life and infancy on obesity later in childhood.   They discuss a study that looked at 4 risk factors for childhood obesity in a group of children aged 7-10 years:

• mother smoked in pregnancy
• mother gained excessive weight during pregnancy
• breast feeding for less than 12 months
• slept less than 12 hours per day during infancy

They found that only 6% of kids who had none of these risk factors were obese, compared to 29% of kids who had all four of these risk factors. 

So how can factors before we are even born influence our risk of obesity?  These observations can be explained at least in part by epigenetic changes - in other words, changes to our DNA that happen while we are growing inside our mother's belly.  (Exposure to toxins besides smoking in the environment play a role as well - read more about this here.)

While not every mother is able to breastfeed, it is recommended to try, as there are a number of health benefits including a lower risk of obesity later in childhood - read more on this here.

As for sleep, there is a rapidly expanding body of evidence teaching us about the powerful connection between sleep deprivation and obesity - go to my main page www.drsue.ca and type 'sleep' in the search box for more reading on this. 

Another interesting risk factor for childhood obesity is being born by C-section.  This may be partly due to the fact that the infant's gut is colonized with normal, healthy bacterial at the time of passage through the vaginal birth canal.  We are learning that the type of bacteria we have in our gut have an influence on our body weight as well, so it may be that the healthier bacteria acquired during vaginal birth leave us less prone to developing obesity later in life. 

The good news is that some of the above risk factors are at least partially under our control - especially not smoking during pregnancy - and some of them can often be improved upon, with the appropriate care, support, and education of expecting mothers and new parents.  

Follow me on twitter: @drsuepedersen

www.drsue.ca © 2013

Read more...

Sugars 101 - Fructose, Glucose, Sucrose, Agave, and High Fructose Corn Syrup Demystified

There is so much information (and misinformation) out there about sugar, sweeteners, high fructose corn syrup, and so on, that it's hard to know which way is up sometimes. ...

A question that has come up frequently is whether fructose is better or worse for you than regular sugar.

A few key points:

1.  Table sugar is sucrose.  Each sucrose molecule is made up of one glucose and one fructose molecule.

Sucrose (table sugar) = glucose + fructose

2.  High fructose corn syrup (HFCS) is not much different from table sugar.

Sucrose (table sugar) = 50% fructose + 50% glucose

HFCS = 55% fructose + 41% glucose + 4% other sugars

The calorie content of table sugar and high fructose corn syrup are about the same.


3.  Fructose is handled differently by the body than glucose.

Glucose causes a rise in blood sugar (when we say 'blood sugar', we actually mean 'blood glucose' - I know, confusing, right?).  This causes us to release insulin to deal with the glucose - insulin allows our cells to take up glucose to use as fuel or as energy storage.

Fructose does not cause a rise in blood sugar (as it is not glucose) and does not stimulate us to release insulin.  Fructose goes to the liver, where it it used to store energy in the liver in the form of glycogen, or, if there is enough glycogen in the liver already, the liver turns fructose into triglycerides (a form of fat).  Triglycerides can accumulate in the liver, potentially causing damage; triglycerides in the blood stream can contribute to build up of plaque on the walls of your arteries.  (Note: the science is still sorely lacking on the exact nature and extent of the effects of fructose on the liver in humans. Scientists who want to read some of the biochemical and proposed mechanistic details can start here.)


So, because the calorie content of sugar and fructose containing sweeteners are similar, you are not doing your waistline any favors by selecting fructose sweeteners.  Agave syrup, which is a popular sugar substitute in the raw food community, is another example of a sweetener heavy in fructose compared to glucose (the proportion varies by brand).   Agave is still calorie containing and is not going to benefit you from a weight loss perspective.  I have seen sites on the internet advertising agave syrup with as much as 92% fructose - this would be of particular concern to me given that excess fructose could be damaging to the liver (as above).

 (agave plant)

Fructose is often touted as a preferred sweetener for diabetics because it does not cause blood sugar or insulin to rise.  Again, because of the concerns of the effects of fructose on the liver, this is NOT a recommended approach.  Also, again, fructose is still calories and will not be an improvement to a weight struggle.  And, remember that 'fructose' sweeteners are still almost identical to table sugar in their composition (see above #2).



The bottom line is this:  We get more than enough carbohydrates through a regular diet.  We should avoid adding additional carbohydrate calories to our food (be that table sugar, high fructose corn syrup, agave, or other) on top of the sugars and carbohydrates we already get.  Period.


PS This post is dedicated to my mom - thanks for asking the great questions! :)



Follow me on twitter! @drsuepedersen

www.drsue.ca © 2013

Read more...

Do Hormones Play A Role in Weight Loss Failure After Bariatric Surgery?

Obesity surgery is currently the most effective treatment available for severe obesity.  While the smaller stomach reservoirs that are created by these surgeries play a major role in the weight loss seen, it is becoming increasingly evident that there are many other contributors at work, one of which is thought to be alterations in various hormone levels after surgery.

I was asked to write a review article discussing what we know about hormone changes in relation to weight loss failure and weight regain after bariatric surgery, which was recently published in the journal Gastroenterology Research and Practice.  In the article, I review eight of the key hormones thought to be involved in the weight changes after bariatric surgery (from GLP-1 to PYY to oxyntomodulin, bile acids, and others), as well as what we know about the hormone changes that occur after the four main types of bariatric surgery (gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion).

In summarizing what we know about hormonal associations with weight loss failure and weight regain after bariatric surgery, there was painfully little to discuss - there is unfortunately very little data in this area.

What became poignantly clear to me from compiling this review is that more research is desperately needed to help us understand how hormones may contribute to weight loss failure or regain after obesity surgery.  As I noted in the article,

In the future, with a better understanding

of this complex arena, assessment of hormone status

could potentially be helpful in understanding the hormonal

contributors to a patient’s postoperative weight loss failure

or recidivism, potentially aiding the clinician in utilizing

appropriate targeted hormone therapy to help them achieve

successful or sustained weight loss.

This is probably not a wish I should expect to see fulfilled anytime soon - after all, pinpointing hormonal predictors of weight regain after 'regular' dietary-induced weight loss has proven evasive as well.  However, with a dedicated body of bariatric researchers worldwide, I hope that we will learn more about this important area with time. 

Follow me on twitter! @drsuepedersen

www.drsue.ca © 2013

Read more...

The Interactive!! Flavor Connection Taste Map

I know, this graphic looks boring, complex and frankly overwhelming... but I promise you, it's so cool!  Read on...

Ever wonder why certain foods just seem to belong together?  For example, fish tastes great with lemon; beef goes well with potatoes.  It turns out that these foods share flavor related chemical compounds, and a new interactive map from Scientific American can show you which foods and flavors may mix best together when you are experimenting in the kitchen!


On this map, you'll find around 200 commonly used foods, spices, drinks and other ingredients, with bigger dots on the map representing ingredients with greater popularity based on a recipe database.  The higher the food is on a page, the greater number of foods that are connected to it by having flavor related chemicals in common.  Click on one of your favorite ingredients on the map, and the program will show you not only which other foods are connected to it, but also how strong that connection is (see the program's excellent explanatory guide that pops up when you first open the page).

Have fun!  My motivation in sharing this, of course, is to encourage more cooking from the home - there are no 'hidden ingredients' (such as loads of extra oil) in home cooked food that can sabotage a healthy lifestyle!

Thanks to my friend Priti for the heads' up on this awesome program!

Follow me on twitter: @drsuepedersen

www.drsue.ca © 2013

Read more...