Is Total Genome Testing the Answer?

Today has just started, but I already have a highlight from the Canadian Obesity Summit to share - this one is about whether personal DNA genome testing brings any positive health benefits. 

The riveting and entertaining talk, provided by Timothy Caulfield of the University of Alberta, reviewed some of the purported benefits of DNA testing that exist out there  - everything from tailoring your diet to 'scientific' matching on dating websites. There are a lot of outfits out there that charge a lot of money for genome analysis, stating that they can provide you with a comprehensive risk assessment for various diseases, plus help you tailor your diet and lifestyle to minimize your genetic risk. 

While there are certainly certain specific genes that are clearly associated with risk (eg the BRCA2 mutation that is associated with breast and ovarian cancer), Professor Caulfield's main point was that based on current data, we do not have any significant ability to make a difference to health or outcomes with total DNA genome analysis.  

For one, our technology is not at a point where it actually provides comprehensive, useful information about genetic risk.  For everything we learn about the genome, the picture becomes more complex and muddied rather than becoming clearer - for every answer, a dozen new questions are generated.  

For another, there is very little consistency in genome analysis - he pointed out that when one person's DNA is sent to 5 different companies for analysis, they will often get 5 different sets of results as to what they are at risk for. 

Also, the 'life-changing' advice that a lot of these genome analyses give you are remarkably familiar - advice like 'eat well', 'exercise', and 'stop smoking'.  Yeah... I think we already knew that.  

As far as appetite and obesity goes, the story is so very complex - it's not one that can be told with the primitive understanding of the human genome that we currently have.

The bottom line is that only 1 in 1000 of us actually stick to all of the Simple Seven steps to leading a healthy life - it seems that here is where our focus should be. 


Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Excess Skin After Bariatric Surgery

On this second day of the Canadian Obesity Summit, I had the honor of being asked to act as a judge for a number of excellent research presentations during today's poster session.  First, a heartfelt congratulations to all of the presenters - I was truly impressed by all of your efforts and studies, and I enjoyed each of our stimulating conversations!

A study that really struck a chord with me, and which I feel is really important to share, was a study looking at the impact of excess skin on physical activity in women who have had bariatric surgery.  The reason for doing this study is that over 70% of patients who have bariatric (obesity) surgery are left with excess skin that interferes with physical and social functioning. The research, conducted by A Baillot and colleagues at the University of Sherbrooke in Quebec, administered questionnaires to 26 women who had had bariatric (obesity) surgery at least 2 years prior, asking women about how their excess skin impacted them physically, psychologically, and socially.

They found that 77% of patients reported that their excess skin was making mobility during physical activity difficult, and that almost half were avoiding physical activity because of their excess skin.  What really hurt my heart was that when these women were asked why the excess skin caused them to avoid physical activity, the most common reason cited was that they were concerned about people staring at them (other reasons were hygiene concerns, weightiness of the excess skin, and a feeling of 'sloshing' of the skin).

My take home message from this study is that the likely development of excess skin after obesity surgery is something that needs to be discussed in detail with patients prior to having surgery, such that they are prepared for the physical, psychological, and social challenges that they may perceive or encounter.

And, as always, it is my hope that with education of our society, that any obesity related stigma that may exist out there will continue to decrease until it disappears entirely.  I've been asked a lot this week as to why I blog - this reason would be amongst the highest.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Longer Sleep (In Short Sleepers) Can Prevent Weight Gain

It is well known that both too little sleep, and too much sleep, are associated with obesity.  Reduced sleep in particular is a problem in modern society - I'm sure we can all attest to this!   The optimum amount of sleep is between 7-8 hours for adults.

A recent study led by my colleague Dr Chaput looked at people who habitually slept less than 6 hours per day, and divided them into two groups: those who increased their sleep to a healthier 7-8 hours per day, and those who kept their usual sleep habits.

At 6 years, they found that those who kept their short sleep patterns gained 2.4kg more fat mass than those who changed their habits to longer sleep.

So, for those of us who are certain that we can thrive on less than 6 hours of sleep - it may not be the best for our health in the long run.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Eating With Your Ears, Eyes, Mouth, and Hands

Think the soundtrack they play at Starbucks is random?  Think again.

It's an interesting concept called multisensory dining, and it's gaining momentum as research to support it continues to grow.

The principle of multisensory dining is that the enjoyment of food is not just affected by how it tastes, looks, and feels, but can even be affected by the sounds you hear when you are eating, and the texture and color of the dishes it's served up in.

Some interesting research findings can be read about here - for example, higher pitches of sound may emphasize sweeter flavors in food, and lower sounds may emphasize bitterness.  As previously blogged, music can also affect how much food we consume at a meal. 

Food may also taste different depending on what color of dish it's served in.  Color of plate can also affect how much we eat - having contrast between food color and plate color can help to keep portions under control (read more about this here).

The psychology behind eating patterns is fascinating, and there is still so much for us to learn!

Thanks to my friend Priti for the heads' up on this article.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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What's On Your Breath - And What Could It Mean For Your Body Weight?

It is increasingly recognized that the bacteria that grow in our guts (and yes, they are in there - around a kilogram of them in each of us!) have an impact on our overall metabolism and risk of obesity.  A new study shows that the type of gases in your breath (reflecting the type of bacteria you have in your gut) are associated with body weight.

The study looked at nearly 800 individuals, and classified them according to whether they had high levels of methane, hydrogen, both, or neither on breath testing.  They found that those who had higher methane and hydrogen on their breath had higher body mass index, and higher body fat percent, than the other groups.

The authors hypothesize that the high methane, high hydrogen breath is due to colonization with a bacteria called M smithii, a bacteria that may make food calories more available for absorption from our intestines.

Another lesson that it is so much more than calories in/calories out that factors in to our body weight.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Calculate Your Salt Intake!

Ever wonder how much sugar you take in in a day?  Check out this great new online sodium calculator - you may be shocked by your results!

The calculator was developed by researchers from the University of Toronto, in collaboration with the Ottawa Hospital Research Institute and and the Institute for Clinical Evaluative Sciences.  It takes about 3 minutes to calculate your salt intake using this fantastic tool.  A series of questions are asked about how often you eat out, eat canned foods, processed foods, etc, and based on this information, it estimates your average daily sodium intake.

I was surprised by my own results - apparently I consume an average of 2800mg of sodium daily, exceeding the recommended maximum of 2300 mg per day.  I learned that a whopping 35% of my daily intake comes from eating out, even though it's only 1-2 times per week for lunch and 1-2 times per week for dinner.  One quarter of my salt intake comes from dips and sauces (here I enjoy soy sauce, ketchup or salsa about once a day).  Looks like I've got some work to do!

Have a go at this yourself - please share your results and thoughts using the comments link at the bottom of this post!

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Complications Of Obesity - New Textbook

For a new online textbook entitled Complications of Obesity (editors Wieland Kiess and Arya Sharma), published in Best Practice & Research, Clinical Endocrinology & Metabolism, I was asked to contribute a chapter about the metabolic complications of obesity.   In this chapter, I focus on diabetes, prediabetes, gestational diabetes, the metabolic syndrome, and polycystic ovary syndrome.

The textbook as a whole covers topics written by colleagues from around the world about the societal impact of obesity (including weight discrimination and bullying), complications of obesity ranging from sleep apnea to cancer to mental health impact, with a third section focussing on management of obesity.   We sincerely hope that this is a collection of information that will be useful to the public and the health care profession!


Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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