Crinkle, Pop, Fizz...

Did you ever stop to consider whether the act of actually opening a wrapper, or stirring a drink, made a difference as to how much you enjoy the food or beverage?  Here's an interesting bit of human food psychology - a recent study shows that these actions actually do enhance the pleasure of the food or drink itself.

The study found that a group of people who unwrapped a chocolate bar following a specific set of instructions enjoyed the chocolate more than those who were not given specific unwrapping instructions.  They also found that if there was a longer time between the food preparation 'ritual' and consumption of the food (time to drool?), the food was enjoyed more.  Finally, they found that enjoyment was higher if the food was prepared by another person, it was not enjoyed as much as if the food was 'ritualized' by the person eating the food.  So for example - watching someone else mix a pitcher of lemonade does not make the lemonade as tasty as when you do the mixing yourself.

So, it seems that the rituals of food preparation enhance the enjoyment of consumption because we are more involved in the food experience.  This comes back to the principle of avoiding Mindless Eating  - we end up feeling more satisfied with less food if we are involved in, and thinking about, the process of eating, from start to finish!

www.drsue.ca © 2013 @drsuepedersen

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Seven Risk Factors for Obesity at Age 3

A recent study looked for risk factors that influence a child’s likelihood of being overweight by age 3.  The study looked at over 13,000 children aged 6-12 months in the UK, and followed their data to age 3 to determine whether any factors could predict the risk of being overweight at age 3. 

Out of 33 different possibilities studied, they found seven characteristics that were associated with an increased risk of childhood obesity at age 3.

The 7 factors that are associated with a higher risk of a 3-year-old being overweight are:

• Mother smoking in pregnancy increased the rate of the 3-year-old being overweight by 33%
• Children who are not breastfed were 25% more likely to be overweight at age 3 than those who were ever breastfed
• Mom being overweight before pregnancy
• Dad having obesity
• A higher weight at birth
• Gender: girls were more likely to be overweight at age 3 than boys
• Early weight gain: babies who rapidly gained weight during their first year were 4 times more likely to be overweight at age 3 than those who grew at an average weight

So why do we care if a 3 year old is overweight?  Doesn’t the weight just balance out over time?  While many kids will go through different phases of body fat storage as they grow, it is a fact that overweight in childhood does increase the risk of that individual being overweight in adulthood.  So while it would not be appropriate to get carried away with intense weight management of a three year old, what we can learn from this study is that there are things we can look at in our own lives that could be modified to improve the health of our offspring. 

While some of the above risk factors are modifiable (eg smoking), others are not.  Knowing that there are many benefits to breastfeeding, most mothers these days do choose or try to breastfeed, but it isn’t always successful.  Parental obesity has been shown to be associated with weight struggles in their offspring, both in childhood and as those children become adults, so it is important to reach out for help with a weight struggle not only for a person's own health and well being, but also for that of their kids.  

Dr Sue Pedersen www.drsue.ca © 2013 drsuetalks@gmail.com

Follow me on Twitter for daily tips! @drsuepedersen 

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Breakfast Like a King.... Will It Help You Lose Weight?

As part of weight management counseling, we often advise patients to eat 'breakfast like a king, lunch like a prince, and dinner like a pauper'.

A new study, by Jakubowicz and colleagues, tested this approach in a clinical trial.  They randomly assigned a group of overweight women to have more of their daily food intake at breakfast (700 calories at breakfast, 500 calories at lunch, and 200 calories at supper), or to have more of their daily food intake at supper (200 calories at breakfast, 500 calories at lunch, and 700 calories at supper) for three months.

Not only did the women eating more at breakfast lose more weight than the women eating more at supper, but the breakfast group also had a greater improvement in blood sugars, insulin resistance, and a type of cholesterol called triglycerides.  In addition, the breakfast group reported less hunger and more fullness after a meal, and their ghrelin (hunger hormone) levels were lower than the supper group.

So why does eating more food at breakfast work?  Previous studies have shown that eating breakfast may help to regulate brain activity to control eating behaviours later in the day, especially if the breakfast is high in protein. Contrast this with a day we have probably all experienced at some point, where you skipped breakfast, ate very little for lunch, and upon coming home at the end of the day, you were just so hungry that you had to eat and eat NOW - does that feeling sound familiar?   In that setting of intense hunger, we often overeat, as food is often eaten quickly - remember that it takes 10-15 minutes for the fullness hormones to start to kick in.  So, people who don't eat enough during the day will often eat their entire day's calories (and then some) at the end of the day.

So, prepare your shopping list to include healthy, bodacious, proteinaceous breakfast foods, like Egg Beaters, skim milk, no-salt-added cottage cheese, and lean cuts of deli meat - and enjoy!

Thanks to Obesity and Energetic Offerings for the heads' up on this study!



Dr Sue Pedersen www.drsue.ca © 2013 drsuetalks@gmail.com

Follow me on Twitter for daily tips! @drsuepedersen 

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Could Soap Increase Our Risk of Diabetes?

What!? we exclaim as we race into the bathroom to grab the bottle or bar that we use without thinking every day.  It's not like we're eating it.  But it may be true - chemicals called phthalates, which are found in soaps, hair spray, nail polish, creams, perfumes and other beauty products, may increase our risk of diabetes.

A recent study, published in the journal Environmental Health Perspectives, lends more suggestive evidence to this interesting area.  They measured the urine phthalate levels in over 2,000 women, and found that women who were in the top 25% for urine phthalate levels were nearly twice as likely to have diabetes, compared to women in the bottom 25% for urine phthalate levels.

While the association between higher urine levels of this chemical and diabetes doesn't necessarily mean that one causes the other, the overall collection of studies in this area is certainly suggestive.

While scientists are busy sorting out what phthalates actually do to our metabolism and risk of diabetes, it makes sense to try to avoid perfumes and other scented beauty products, which often contain higher levels of this chemical.

Dr Sue Pedersen www.drsue.ca © 2013 drsuetalks@gmail.com

Follow me on Twitter for daily tips! @drsuepedersen 

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Does Obstructive Sleep Apnea Cause Low Testosterone in Men?

I've been thoroughly enjoying my second day of completely geeking out at The Endocrine Society meeting in San Francisco!  I've been attending session after session until it feels like my head is going to explode (and loving every minute!).  As always at this conference, my head is swimming with new ideas, new research findings, and as always, important clinical pearls.

One of the most interesting talks I went to today was about the link between obstructive sleep apnea (OSA) and low testosterone levels in men, given by Dr Gary Wittert from Australia.  We know that men with OSA are at risk of having low testosterone, and Dr Wittert helped to clarify this relationship for us.  

The summary of Dr Wittert's presentation is that the common link here seems to boil down to obesity.  We know that both sleep apnea and obesity are associated with low testosterone levels, and when you pick apart the data, obesity appears to stand alone as a risk factor for low testosterone.  In other words, sleep apnea itself is not a risk for low testosterone levels - the risk is mediated by obesity.  We often see low testosterone levels in men with obesity - while there are many possible causes that need to be checked for, we often end up with the finding that the pituitary's control of testosterone seems to be relatively suppressed in obesity, for reasons that remain somewhat unclear.

Dr Wittert described that when you treat a patient who has sleep apnea with a CPAP machine, use of the CPAP in and of itself does not result in improved testosterone levels. However, weight loss in the patient with obesity and low testosterone does clearly improve testosterone levels (and improves sleep apnea as well).  By the way, untreated sleep apnea can be a barrier to effective weight loss, so CPAP may well be needed to start the cycle of weight loss, thereby improving the sleep apnea and, by virtue of the weight loss, helping to normalize the testosterone levels.

So, the bottom line here is that weight loss is the important key to treatment in the man who has sleep apnea and low testosterone levels, as that weight loss can improve both conditions.

You can read about whether you are at risk of obstructive sleep apnea here.


Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Food Porn - How it Affects Your Hunger Hormones

It's a funny term, but it's out there - there's even a wiki definition - food porn is a very real entity that permeates our daily life.  It's tough to get through an hour, let alone a day, without being assailed by all manner of delectable, touched-up photos of mouth watering food in a magazine, on TV, at the grocery store, or just walking by a billboard on the street.


An interesting study from Germany evaluated the response of 8 healthy men to pictures showing food, compared to pictures showing something other than food.  They found that the only known human hunger hormone, ghrelin, was higher during the 30 minutes after the food pictures were presented, compared to the 30 minutes before the pictures were presented; and, that the ghrelin levels after the food pictures were presented were higher than after non food pictures were presented.

So, this shows us that there is a very real hormonal effect to flashy food photos, that drives our hunger and tells us to eat.  As for avoiding them... well, that's the tricky part.  Choosing active pursuits over TV is a good one.   Please leave a comment at the bottom of this blog post to share your ideas!

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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How Can We Know if Dietary Supplments are Safe?

I opened this week's JAMA Internal Medicine table of contents to find a short editorial note that I would like to share.  It's written by Dr Michael Katz, in response to this study by Zarel and colleagues, which reviewed dietary supplement recall data in the US over the last decade (sexual enhancement, body building, and weight loss products were amongst the high hitters on the recall list).


Dr Katz writes:

Americans spend over $20 billion annually on

dietary supplements. Although supplements

are regulated by the US Food and Drug

Administration (FDA) under the Dietary Supplement

Health and Education Act, there is no requirement for

supplement manufacturers to demonstrate efficacy or

safety of their products prior to marketing them. However,

companies may not include unapproved ingredients.

It turns out that even this minimal requirement

is not fulfilled. Harel et al identified 237 dietary

supplements that were recalled by the FDA owing to

inclusion of unapproved drug ingredients. Given the

limited regulation of these products, it is likely that

the number of recalls grossly underestimates the number

of products on sale with unapproved ingredients.

Dietary supplements should be treated with the same

rigor as pharmaceutical drugs and with the same goal:

to protect consumer health.

The mechanism by which the FDA identifies and recalls potentially dangerous dietary supplements is haphazard: either through spot inspection of manufacturing plants; tips from retailers; or reporting of adverse events by patients or physicians.  The stringent regulatory process required for prescription medications to be approved is not in place for dietary supplements.

As the Zarel article writes:

To protect the health and

safety of the public, increased efforts are needed to regulate

this industry through more stringent enforcement

and a standard of regulation similar to that for pharmaceuticals.

Keeping the status quo may taint the dietary

supplement industry as a whole.

The bottom line:  As it stands now, we cannot know if dietary supplements are safe. 

Dr Sue Pedersen www.drsue.ca © 2013

Follow me on Twitter for daily tips! @drsuepedersen

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