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The Perfect Push Up

The Perfect Push Up Exercise Gimmick Although push-ups are the most rudimentary exercise in existence, multiple companies have produced ridiculous gimmicks to help you do the Perfect Push-up!

Research Blogging Award Finalist!

Research Blogging Awards 2010 Finalist Obesity Panacea has been named a Finalist for the 2010 Research Blogging Awards! You can see all the nominees by clicking on the link below.

Big Breasts: An Indicator of Dangerous Fat Deposition?

Friday, October 30, 2009 Author: Peter Janiszewski, PhD 10 Responses

Back in June, I discussed the results of a large epidemiological study in women that showed that women with larger breasts have an increased risk of developing type-2 diabetes.

As soon as Travis and I read this study, we knew we had to do a follow-up study of our own to see if this finding was simply spurious or if there was actually something to large breasts that indicated health risk – beyond that explained by obesity per se.

The project that Travis and I began over a year ago has culminated in both a hot-off-the-press publication in the journal Obesity, as well as my presentation at this year’s Obesity Society meeting in Washington D.C.

In the study, we used body composition data acquired through MRI on about 100 premenopausal women to directly quantify breast size. By using MRI data we significantly improved the methodology used by the authors of the original study on breast size and diabetes risk, who relied on over 20 year recall of cup size as their key measure.

First, we sought to examine if breast tissue volume was associated with any cardiometabolic risk factors, such as glucose tolerance (a known antecedent to type 2 diabetes) and various blood lipids. Since the original authors found an association between cup size and diabetes risk, we expected to find an association between breast volume and cardiometabolic risk factors.

What did we actually find?

Breast volume was not associated with any of the cardiometabolic risk factors measured in any of the statistical models used. However, in these analyses, visceral or intra-abdominal fat was a strong predictor of numerous risk factors – a finding reported in numerous studies.

Next we decided to examine the associations between breast volume and other body fat depots. Here is where the story got interesting. First off, as one would predict, women with larger breasts had more subcutaneous (under the skin) fat in their thighs, abdomen, as well as more visceral and inter-muscular (or ectopic) fat. That is, bigger breasted women tended to carry more fat everywhere.

However, once we controlled for their level of obesity (body mass index and waist circumference) bigger breasted women were no more likely to have more subcutaneous fat in either lower body or abdomen, but were much more likely to have excess fat deposition in the dangerous visceral and inter-muscular depots.

Specifically, our study found that given the same age, body mass index (total obesity), waist circumference (abdominal obesity), women with the highest breast volume had approximately 1.1 and 1.3 kg more visceral fat and intermuscular fat in comparison to women with the smallest breast volume.

In other words, large breasts appear to indicate a phenotype characterized by the augmented deposition of fat in ectopic depots, such as visceral and inter-muscular fat – each of which is independently associated with increased cardiometabolic risk. The extrapolation of our findings suggests that excess visceral or intermuscular fat may be the conduit which explains the previously documented association between breast size and type-2 diabetes.

While our findings are intriguing (someone at the Obesity Society conference suggested I should get an award from the most “unique” study), there exist a couple clinical examples which corroborate our findings.

For example, approximately 40-50% of women undergoing liposuction of subcutaneous adipose tissue from the hips, thighs, or abdomen present with a paradoxical enlargement of breast size of at least one cup as well as a relative increase in visceral fat post-surgery. Additionally, highly active antiretroviral therapy among HIV-positive women is associated with a peripheral loss of functional subcutaneous fat but a compensatory increase in visceral and intermuscular fat (well documented lipodystrophy), in association with a significant enlargement in breast size.

Now before women with large breasts head out to get breast reductions, it is key to consider that our findings are quite preliminary, and furthermore that breast size only appears to be a proxy for other factors which are more likely to be causally related to health risk. Thus, further research in this area is clearly warranted before we begin screening disease risk by breast size. Nevertheless, when explaining our study findings at the conference, I heard many sighs of relief from women who perceived themselves to have smaller breasts.

Have a great Halloween weekend!


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Janiszewski, P., Saunders, T., & Ross, R. (2009). Breast Volume is an Independent Predictor of Visceral and Ectopic Fat in Premenopausal Women Obesity DOI: 10.1038/oby.2009.336

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How to change people's behaviour? Make the desired behaviour easy and fun!

Thursday, October 29, 2009 Author: Peter Janiszewski, PhD 0 Responses
Not that long ago I discussed how making certain behaviours such as being physically active and eating a healthy diet easier or more fun increases the chances that these behaviours are adopted by most people. For example, the use of cell phone texts to prompt you to park further from the grocery store door or to choose veggies over chips was shown to lead to some weight loss. Also, the video I posted a while back on the Piano Stairs, which has since gone viral, clearly shows that if the healthy choice becomes the easy or more attractive choice, people are more likely to take it.

I just got back from the 2009 annual meeting of the Obesity Society in Washnigton D.C., where I had the great pleasure to meet with many friends and colleagues such as Dr. Yoni Freedhoff of Weighty Matters blog as well as Dr. Arya Sharma of Dr. Sharma’s Obesity Notes blog.

While at the conference hotel, I was once again struck by how difficult it can be to make the healthy choice. For example, I had to ask the concierge where the stairs were so I could walk the 4 flights to my room instead of taking one of the 8 prominently displayed elevators. It turned out the stairwell wasn’t even marked – it was behind an unmarked door in the seating area of one of the cafes. Thus, it was virtually impossible for anyone to be able to take the stairs even if they wanted to (unless they were as oddly persistent as me). Additionally, the hotel restaurant basically had 1 option for breakfast – a buffet including plenty of high fat favourites such as sausages and bacon and lots of sugary cakes, muffins, cupcakes, not to mention “Vitamin D” milk which in fact had the same amount of vitamin D as the fat free variety but contained 70 kcals of fat in one serving (I guess “Fat Milk” doesn’t sound as enticing).

It turns out that the folks who created the Piano Stairs video have also tested their “Fun Theory” in other ways, so I thought I would share 2 more examples of how “fun and easy” leads to behaviour change. Below you will see two neat approaches to get people to throw garbage into a trash bin and to recycle bottles (email subscribers need to log onto Obesity Panacea to view). As I discussed with Dr. Freedhoff (while we waited at the airport for our delayed flights out of DC) – I believe this is the way that we may be able to get people to become more active and eating healthy – by making small but effective changes to their environment. Simply telling people to follow current guidelines for diet or physical activity when our environment is set up to make these behaviours impossible is not only short-sighted but frankly useless.

Enjoy the videos.


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Spark Together for Healthy Kids

Monday, October 26, 2009 Author: Travis Saunders 0 Responses

I thought I'd take a quick break from talking about research today to advocate for a new campaign which I think will interest many of our Ontario readers, especially those who are interested in childhood obesity.  The program is called Spark Together for Healthy Kids, and is being coordinated by the Heart and Stroke Foundation of Ontario in the hopes of reducing childhood overweight and obesity, which currently affects 28% of Ontario children.

A background document on the program is available here, which makes a strong case that childhood obesity is a society problem, and requires a societal solution.  Thus, the goal of the campaign is to encourage a public movement in support of a healthier future for Ontario's children, and individuals are encouraged to join the campaign by signing The Spark Promise to our Children, which advocates for healthy, active places for kids to play.  People are also invited to join the Spark Facebook Group where they can connect with other individuals who feel strongly about childhood obesity, physical activity, and nutrition.  To me, the Facebook group is the coolest thing about this initiative, and I would encourage readers from anywhere in the world to check it out by clicking here.  Ending the childhood obesity epidemic is going to require that we come together as a community to advocate for positive changes, and this Facebook page is a great way to connect with like-minded individuals.  I've also got to say that it's nice to see a campaign like this using new media to engage their audience, and I hope that this becomes the norm for other public health initiatives.

The final, and perhaps most important part of the Spark Campaign are its Community Advocacy Grants, which awards up to $25,000 to communities in order to advocate for increased access to physical activity and healthy food.  I should point out that many grants cannot be used for advocacy purposes whatsoever, so this grant fills a niche that most other grant programs don't.  I have embedded a video below detailing a YMCA which received a Spark Grant to advocate for healthier schools in Muskoka, Ontario (email subscribers can view the video on the Obesity Panacea website).  If you are interested in advocating for improved health in your school or community but need funding to support your project, this may represent a great opportunity.

Have you been involved with a project that has received a Spark Community Advocacy Grant?  We'd love to hear about your experience in the comments section below.


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Limit Screen Time With TimesUpKidz!

Friday, October 23, 2009 Author: Travis Saunders 3 Responses

It's not often that Peter and I come across a an exercise product that actually makes sense.  The GoWear Fit Armband was one, and pedometers are another.  In contrast to the many gimmicks that we have reviewed in the past, these useful products tend to be simple, evidence-based, and easy to implement.  Earlier this week I came across another product which I feel holds quite a bit of promise, and it is enthusiastically titled TimesUpKidz!.

TimesUpKidz! is a program which allows you to limit how much time individual users can spend on any computer.  It is aimed at limiting time for children, but I see no reason why it couldn't be used for adults as well.  You decide how much time a person is allowed to use the computer on any given day of the week, and during what hours.  Further, you can set mandatory breaks, such as a 15 minute break following every continuous hour of computer time.  Once the time limit is exceeded, users are locked out of the computer for a specifically designated period of time.


Although I have not tried this product (nor do I have any children on whom to test it), it is appealing to me for several reasons.  It is simple, cheap ($29.95 USD) and likely to have a very measurable impact on screen time.  This last point is key, given the strong relationship between screen time and health risk in children.

For example, Drs Amy Mark and Ian Janssen examined the relationship between screen time and the metabolic syndrome in a representative sample of 1800 American adolescents in the National Health and Nutrition Examination Survey (NHANES).  Screen time was measured by self-report questionnaire, and included all time spent watching TV, playing video games, and using a computer. The metabolic syndrome (a cluster of risk factors which predisposes to both diabetes and cardiovascular disease) was defined as having 3 or more of the following: high triglycerides, high fasting glucose, high waist circumference, high blood pressure and low HDL cholesterol.

What did they find?  The risk of having the metabolic syndrome increased with screen time, such that individuals with the highest amount of screen time (> 5 hours/day) had three times the risk of those with less than one hour/day.  Additionally, eight percent of the youth who accumulated greater than 5 hours/day of screen time had the metabolic syndrome - that's huge!  Remember, these are adolescents - they should not have 3 or more risk factors for serious chronic diseases like diabetes or cardiovascular disease!  And screen time was self-reported, which tends to under-estimate negative behaviors like screen-time, so it is possible that the true relationship between screen time and metabolic risk may be even stronger than the one observed in this study.

There is now a wealth of evidence suggesting that screen time is something that we should need to limit for everyone, but especially for children and youth.  So in the absence of hard data, I am willing to go out on a limb and say that TimesUpKidz! and similar programs like Computer Time that make it impossible for children to spend too much time in front of at least one screen could be quite useful in reducing screen time, and time spent in sedentary behaviors.  Now of course children could fill their time with other sedentary activities, but limiting one opportunity for screen time is better than nothing at all.  I haven't used any of these programs myself, so if you have, feel free to share your experiences in the comments section below.  For more information on TimesUpKidz!, please visit their website here.

Have a great weekend,


ResearchBlogging.orgMark, A., & Janssen, I. (2008). Relationship between screen time and metabolic syndrome in adolescents Journal of Public Health, 30 (2), 153-160 DOI: 10.1093/pubmed/fdn022

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The Perfect Push Up: Just Another Gimmick.

Wednesday, October 21, 2009 Author: Peter Janiszewski, PhD 4 Responses

Do you find doing push-ups excruciatingly painful? Are they too confusing and difficult for you to execute? Do you often sprain your wrists when attempting the exercise?

No? Oh, alright…

Nevertheless, the fact that the push-up is one of the most rudimentary exercises in existence has not stopped multiple companies from producing ridiculous gimmicks to help you do the Perfect Push-up!

For example, one such gimmick comes courtesy of Perfect Fitness, a company based out of Northern California, founded by two fellows: a veteran of the US Navy SEALs and a former college athlete – both certified push-up experts! (No, not really…)

According the commercial (see video below), “Big arms, ripped chest, and cut abs can be yours with the Perfect Push Up!”

Well, sign me up!

But wait, there’s more – “The Perfect Push Up is designed to work with the natural motion of your arms and shoulders to maximize results and minimize stress on your body.”

For no conceivable reason that I can muster, the Perfect Push Up system comes in a variety of colours such as red, black and grey and even includes a starter kit with an instructional DVD. In addition to giving you hours of instructions on how to do a push-up, the DVD also teaches you how to breathe and blink – what a steal!

But before we get onto customizing the colour of your Perfect Push Up system, we should consider if a regular push-up is really that stressful on the body and yet so ineffective at producing results?

In short, no.

As a regular exerciser, and someone who performs push-ups on a regular basis, I have never incurred an injury or suffered tremendous pain while performing the exercise. Furthermore, in a recently published study from our laboratory, senior citizens performed push-ups as part of their regular exercise program and none of them were injured – I supervised many of them during their sessions. Come to think of it – these older adults also became much stronger and were able to do many more repetitions of push-ups at the end of the study in contrast to their baseline scores.

And imagine – all this without the need of some gimmicky handles that rotate (the Perfect Push Up in a nutshell).

Not to be outdone, HeavyLift has developed the MegaPex Elite to ensure you get the most out of your push-ups without suffering a mortal injury. And what is the MegaPex Elite? According to the website peddling this gadget, it “is the professional way to transform the ordinary push-up into a powerful workout.”

More succinctly and accurately, the MegaPex Elite is the Perfect Push Up gimmick but with metal versus rubber handles, and about three times the cost ($99.95 versus $29.99-39.99).

So what are you, our loyal reader, to do in order to get the “big arms, ripped chest, and cut abs” that can apparently be only obtained by using the aforementioned gimmicks? How about trying a regular push-up or two?

There are countless variations on how to perform a push up, but the 3 general methods in order of increasing difficulty are:

1. Beginner: Stand closely facing a wall. Place your hands on the surface of the wall at shoulder height with the hands spread approximately the width of your shoulders. Now take a step back while maintaining your hands flat on the wall in front of you, so that you are now standing a foot or two away from the wall with your arms outstretched. Slowly bend your elbows, and try to bring your nose to the wall. When your nose touches the wall, push away to return to original position. Repeat.

2. Intermediate: This is also sometimes called the “Female Push Up” – though I’d advise guys to not be fooled – they may be easier, but they are far from easy – especially when just starting out. For this variation you basically lay on the floor on your stomach (using a mat). Place your hands underneath your shoulders with palms on the floor. Raise your feet off the ground, such that your toes are pointing behind you. Now use your arms to push your body off the ground while using your knees as the point of contact with the floor. Once your arms are fully outstretched, slowly return toward the floor until your nose is close to touching. Repeat.

3. Advanced: This is a full push-up. Basically, it is exactly the same as the intermediate push-up above but instead of using your knees as the point of contact with the floor, you now use the tips of your toes.

There you have it – progress from beginner to advanced variations, increase the number of repetitions, vary the distance between the hands during the movement to spice things up (i.e. hands shoulder width apart, close together, or wide apart), and you could also get a ripped chest – without the use of fancy and truly unnecessary push-up aids. You’ll also save yourself $29.99-99.95.


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The Cardio Twister - Let's Twist Again!

Tuesday, October 20, 2009 Author: Travis Saunders 0 Responses

It is amazing how many fitness products are based on simple stepping machines.  What's even more amazing, is that each and every one claims to be an "amazing breakthrough" which will change your body - and your life - forever.  Earlier this year I reviewed the Air Climber ("one of the biggest breakthroughs in exercise technology"), which is essentially a regular stepping machine that uses "Air Power Technology" (aka "air") to provide resistance, rather than the hydrolic pistons which provide resistance on most commercial stepping machines.  The machine is promoted by self-proclaimed "International Fitness Expert" and former American Aerobics Champion Brenda Dygraf.  Despite being hailed as "one of the most effective weight loss and body shaping programs ever" by the Air Climber promotional video, Brenda hasn't rested on her Air Climber laurels.  Thankfully, she is now promoting the even more advanced Cardio Twister stepping machine.

Like the Air Climber, the Cardio Twister is also essentially a stepping machine.  But, instead of stepping straight up and down, you step up and down and from side to side.  The stepper also has handlebars that move from side-to-side as you step, which they claim works your core and upper body as well as your legs, providing you with the ever-elusive whole body workout (if only walking, running, rollerblading, swimming, or any other free activity engaged both the upper and lower body!).  The Cardio Twister is a bit hard to describe, so for a better idea of how this "exercise breakthrough" works, I've embedded the promotional video below (email subscribers will have to visit the Obesity Panacea site to view the video).

Like the Air Climber, the Cardio Twister makes lofty claims (in fact, the websites for the two products are nearly identical, although the testimonials are unique for each product).  The Cardio Twister website suggests that you can use the Cardio Twister to "Lose 10 pounds or 10 inches in 10 days!", although they provide no information on how this is possible (or healthy) and the fine print is less enthusiastic - "Your results may vary.  You may be less successful".  They also claim that the moving handlebars keep your body in the "ideal workout position" for toning your abs, arms, chest and back.  Which is surprising, since the handlebars are actually moved by the motion of the steps, and not by your upper body.  Somehow your arms, chest, and back muscles are being sculpted by merely twisting your upper body back and forth!  That's a bit like dancing to The Twist as a way to define your arm and chest muscles!  Somehow that seems less than ideal.

Exercise and weight loss gimmicks products tend to fall into two general categories - those that are at least plausible, and those that are completely insane. Like the Air Climber, The Cardio Twister could produce fitness benefits, placing it in the former category. However, like any other stepper, rowing machine, or thigh master, I think that very few people are going to enjoy this product enough over the long-term for it to have a lasting impact on their health and longevity.  And at a retail price of $159.80, I think we should expect more from something touting itself as an exercise breakthrough.  Especially when the health benefits of free activities like walking and cycling are so well-established.

For more information on the Cardio Twister, you can visit their website here.


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Berlin Brothel Embraces Active Transportation

Friday, October 16, 2009 Author: Travis Saunders 0 Responses
Active transportation is one of the single easiest ways to get more physical activity into your day.  We all commute several times a day, and each of these trips represents an opportunity for physical activity through walking, cycling, or taking transit (which usually involves at least some walking) rather than driving. Active transportation may not sound like a tremendous way to reduce your health risk - I can understand if people doubt that a short walk or bike ride can have a long-term impact on health and longevity.  To illustrate the benefits of even minor increases in physical activity I have created the following graph using data from a paper by Michael F. Leitzmann in the Archives of Internal Medicine, which followed 250 000 Americans aged 50-71 from 1995 until 2001.  At baseline, all subjects completed a questionnaire detailing their level of physical activity, which the researchers used to then calculate the number of hours per week spent in moderate and vigorous physical activity, and to compare the risk of death associated with increasing amounts of activity.

This graph shows the relative risk of mortality across different levels of moderate physical activity (measured in hours/week).  As you can see, individuals who are completely inactive have by far the highest risk of mortality, while those with the most physical activity have the lowest risk.  But what is most interesting to me is that the greatest reduction in risk does not come from increasing physical activity among those who are already active. To be sure, moving from 1-3 hours of moderate activity per week to 4-7 hours of activity will reduce the relative risk of mortality. But, the greatest reduction in relative risk is seen when moving from complete inactivity to even minor levels of physical activity - less than one hour/weekThat is less than 10 minutes/day!  These results are only slightly attenuated by control for confounding factors including BMI, smoking status and family cancer history.  These results are cross-sectional, so we can't use them to infer causality (although I realize I am doing so to a degree).  Similar results have been presented in numerous studies, and for just about every major cause of mortality, to the point that I believe even slight increases in physical activity among those who are currently inactive could have a profound public health impact.

All of this brings me to a strange article that I came across in The Telegraph yesterday.  It reports on a new promotion by a brothel in Berlin (where prostitution is legal), which is now giving a €5 (~$7.50 USD) discount to patrons who commute by bike or public transit.  To receive the discount, patrons merely provide proof of their transit fare, or show their bike helmet or lock.  Thomas Goetz, the owner of the brothel, claims that the promotion has been a success for both the business and the community:

"We have around 3-5 new customers coming in daily to take advantage of the discount," he said, adding the green rebate has helped alleviate traffic and parking congestion in the neighbourhood.

The ethics of prostitution are well outside the scope of this blog, so don't take this to suggest that Obesity Panacea supports prostitution (legal or otherwise) in any way.  But this anecdote does seem to suggest that people will use active transportation when incentives (even minor ones) are in place.  This agrees with work by Ugo Lachapelle, which has shown that individuals who have access to a subsidized transit pass are more likely to meet daily physical activity recommendations than those who do note have access to such a pass (Mr Lachapelle discussed his work in an interview with Obesity Panacea earlier this year).

Let's imagine that this promotion were being offered not by a brothel, but by a popular coffee chain like Tim Horton's or Starbucks.  I would wager that some individuals who are currently inactive would choose to walk or take the bus in order to get the discount.  And over time, that could contribute to a reduction in health risk for those individuals.  It's not going to cure obesity, but keep in mind that the available cross-sectional evidence suggests that a relatively small increase in activity could dramatically reduce the risk of mortality in sedentary individuals.

What is also worth pointing out is that organizations that cater to individuals who commute by active transportation may also increase their business (just as Mr Goetz claims has happened for his operation).  Many people like myself already commute by bike or by bus the majority of the time, and I would gladly patronize an establishment which provided me a discount as a result (I am obviously speaking here of businesses in general, as opposed to brothels).

Promotions aimed at increasing active transportation really are a win-win for all parties:
  • People who use active transportation are likely to experience health benefits as a result
  • Businesses which provide active transportation discounts are likely to attract customers who already commute actively
  • Roads and parking lots around these establishments are likely to become less congested for those who choose to commute by car
  • The environment (and everyone else) benefits from less greenhouse gas emissions 
Active transportation is a great way to get more physical activity whether you are completely sedentary, or regularly active (don't forget that there is almost always a benefit to increased activity, the benefit is just greatest for those who are inactive).  It is pretty easy to work in 10 minutes of moderate activity each day, when you consider that those 10 minutes can include behaviors such as walking to the bus, or even just taking the stairs rather than the elevator at work.  And if you are currently inactive, those 10 minutes could have a noticeable impact on your health and longevity (although it is worth emphasizing that 10 minutes/day is not the ideal amount of physical activity, it is still a step in the right direction).  Let's hope that more businesses and communities here in North America realize the value of incentives for active transportation.

Have a great weekend,


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ResearchBlogging.orgLeitzmann MF, Park Y, Blair A, Ballard-Barbash R, Mouw T, Hollenbeck AR, & Schatzkin A (2007). Physical activity recommendations and decreased risk of mortality. Archives of internal medicine, 167 (22), 2453-60 PMID: 18071167

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Shake Weight For Men: Move Over Dumbbells!

Thursday, October 15, 2009 Author: Peter Janiszewski, PhD 2 Responses

What weighs about 2 lbs, is shaped like a phallus, and is used exclusively by women?

That’s right – it’s the Shake Weight!

Now, what is also shaped like a phallus but is longer and heavier specifically to be used by men?

You guessed it – The Shake Weight For Men!

Using the Shake Weight for men, you can get “your arms ripped, your shoulders pumped, and your chest sculpted” without “working out for hours with big, bulky equipment or boring, slow dumbbells!”

Take that you “boring” and “slow” dumbbells!

In “just six minutes a day” you can get the body of your dreams along with the harshest ridicule of your existence!

To better understand, please view the video below [Email subscribers must log onto Obesity Panacea to view the video].

For a full body workout, I also recommend supplementing your Shake Weight routine with a pair of Power Balls!

As I stated before, "A vibrator and a set of power balls is an exercise regimen everyone can get their hands on – men, women; young and old!"

I dare any guy to buy a Shake Weight, go to a public gym for a Shake Weight workout, and record the whole session – that would be a YouTube classic in no time. We will do our part by posting it on Obesity Panacea – any takers?


[Thanks to Ryan Graham for bringing this gem to my attention.]
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Obese Pets: How to Help Your Furry Friend Stay Slim

Wednesday, October 14, 2009 Author: Peter Janiszewski, PhD 3 Responses

Given that today is National Pet Obesity Awareness Day, I thought I would touch on the topic and provide some handy references and tips for those pet owners concerned about the size of their furry companions.

According to the Association for Pet Obesity Prevention, an estimated 33 million (44%) of US Dogs and 51 million (57%) US Cats are Overweight or Obese.

“Pudgy pooches and fat cats are now the norm.” states Dr. Ernie Ward, founder and President of the Association for Pet Obesity Prevention (APOP) in a recent press release. He goes on to suggest that “the majority of today’s overweight pets will endure painful and expensive medical conditions – all of which can be avoided.”

But how can you tell if your pet is overweight or obese?

Here are a few simple guidelines provided by APOP:

Your Pet is Overweight if…
- Difficult to feel ribs under fat
- Sagging stomach – you can grab a handful of fat!
- Broad, flat back
- No waist is apparent

More specifically, you can refer to the Body Conditioning Scoring System for Dogs and Cats which has an easy to follow grading system (with pictures) : 1 (very thin), 2 (underweight), 3 (ideal), 4 (overweight), 5 (obese).

The APOP website also offers a helpful Pet Obesity Info Sheet which lists the proper weights of various breeds of dogs and cats, their regular dietary needs (calories), as well as nutritional information for various pet treats and foods.

For example, did you know that your Golden Retriever should not be exceeding 75 lbs while your regular domestic cat should stay under 10 lbs?

Much as in humans, excess weight among pets is associated with increased risk of numerous diseases including: osteoarthritis , diabetes, hypertension , cardiovascular disease , and cancer.

And what are the factors predisposing your pet to gaining excess weight?

A 2003 study conducted by Robertson in Murdoch University, Australia used a random telephone survey of 2326 households in the Perth metropolitan region to interview the 657 owners of a total of 860 dogs. In this study, most dogs (69.7%) were considered by their owners to be the correct-weight or body-condition, while 25.2% were considered overweight or obese - numbers that are lower than those documented in the US.

The study found that dogs that were overweight or obese were more likely to be neutered, fed snacks, be of older age, and ate only one meal a day. Additionally, for every hour of exercise performed by the dog each week their risk of obesity fell by 10%.

As your pet’s owner, you are responsible for ensuring little Mr. Bojangles lives a long and healthy life. To do so, you have to keep your cat or dog at a normal weight.

Once again, the APOP provides very helpful advice for managing your pet’s excess weight (Read: weight management for dogs and weight management for cats).

In the end, the strategies are quite similar to that for obese humans.

First, the pet should be checked by a vet for any possible disease states predisposing to obesity, and making weight loss potentially difficult.

Second is calorie balance – increasing the amount of daily exercise your pet gets (easier with dog than cat), while limiting the number of calories they ingest – being particularly careful to not exceed their nutritional requirements with snacks and scraps of “people food” or by using a self-feeder.

Keeping a daily log of activity, caloric intake, and regular weigh-ins is a good way to track progress. For a sample food and activity log for your pet click here.

And finally, if you would like your pet to participate in today's national effort to raise awareness of pet obesity, and help establish reliable data on the severity of the issue, please fill out the online Pet Obesity Data Form.

To help you figure out how to make the necessary measurements, like waist circumference, please watch the below videos (one for dog owners, and one for cat owners). [Note to email subscribers to log onto Obesity Panacea to view videos]

For more help or instruction please log onto the APOP website, which is the best website I have come across specifically addressing pet obesity.


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Robertson, I. (2003). The association of exercise, diet and other factors with owner-perceived obesity in privately owned dogs from metropolitan Perth, WA Preventive Veterinary Medicine, 58 (1-2), 75-83 DOI: 10.1016/S0167-5877(03)00009-6

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Cell Phone Text Messages – the Panacea for Obesity?

Friday, October 09, 2009 Author: Peter Janiszewski, PhD 11 Responses

For once there may actually be a grain of truth to my usually sarcastic title.

We are well aware that regular physical activity and proper nutrition are key to reducing risk of many diseases and associated mortality. These same bahaviors are also the cornerstone of weight management. Unfortunately, we are much less sure how to get the public to adopt these healthy behaviors. For example, we know that while physicians may counsel their patients about the benefits of a healthy lifestyle, seldomly do the patients change their behavior.

In other words, we are in desperate need to find new and innovative ways to make healthy lifestyle changes EASY for the majority of people.
What is absolutely not a viable strategy: physicians telling their patients to “eat less and move more.”

So what are the alternatives?

A very interesting study just published in the Journal of Medical Internet Research suggests that an intervention using personalized cell-phone text messages may be one novel way to make a healthy lifestyle change more probable.

In the study, Patrick and colleagues from the University of California, San Diego, randomized 75 overweight men and women for 4 months into one of two interventions: 1) receipt of monthly printed materials about weight control; (2) an intervention that included personalized text or multi-media (picture) messages sent two to five times daily to the participants phones, along with the same printed materials received by the previous group.

The time the text messages were received was dictated by each participant, as were the number of messages per day. Approximately half of the messages requested a reply, with the remainder providing tips, suggestions, and encouragement for improved behaviors.

The topics of the text messages included the following: “goal setting and self-monitoring, understanding calories, portion control, pedometers and physical activity, personal strategies for weight loss and overcoming barriers, volumetrics (consuming foods that are healthy and make one feel “full”), replacement and substitution, routine physical activity, organization and meal planning, strategies for eating out, strategies for creating healthy food and exercise environments, strength training, emotion eating, managing tough social situations, body image, and sticking with it.”

The messages went something like this:

“Control your portions by setting aside a large snack package into smaller bags or buy 100 calorie snack packs!”

“In a rush? Buy pre-cut vegetables like carrots, celery, and mushrooms for a quick, easy, and low calorie snack!”

And what were the results?

At the end of the 4 month intervention, those receiving regular messages to their phones lost about 4.5 kg (or about 10 lbs) in contrast to no change in the other group.

And all it took were regular text messages provided by a more or less automated system.

Finally, 92% of the participants in the texting group stated they would recommend the intervention to their friends and family – suggesting a very high overall satisfaction with the program.

While this study is the first to evaluate the effectiveness of tailored text messages for weight loss, the same technology is being used in Africa to increase AIDS awareness and education.

A key component to such an intervention is that it is EASY for the participant – they just receive small “nudges” towards healthy behaviors, and slowly but surely they begin to adopt them.

Secondly, such an approach in today’s fact paced world may be more feasible in contrast to forcing people to exercise a la boot camp style for hours each day and go on very-low calorie diets, as popularized on misguided TV shows.

And lastly, getting informative and helpful “nudges” may simply be more fun than reading diet books and being yelled at by a personal trainer.

If you have any doubt as to the veracity of the fun factor in helping people adopt healthy behaviours – look no further than the video below which showcases the most innovative method for getting people to adopt a simple behavior like taking the stairs. (Note to our email subscribers, you must log onto Obesity Panacea to view the video).

Have a great (Canadian) Thanksgiving weekend.


Credit to BJ Fogg for the fun video, via Twitter.

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Patrick, K., Raab, F., Adams, M., Dillon, L., Zabinski, M., Rock, C., Griswold, W., & Norman, G. (2009). A Text Message–Based Intervention for Weight Loss: Randomized Controlled Trial Journal of Medical Internet Research, 11 (1) DOI: 10.2196/jmir.1100

This post was chosen as an Editor's Selection for

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Age-related changes in total and regional fat distribution

Wednesday, October 07, 2009 Author: Travis Saunders 3 Responses

As many of our readers know, I performed my MSc under the direction of Dr Bob Ross at Queen's University (Peter is nearing the completion of his PhD in the same lab).  Dr Ross is a world leader in the measurement of body fat and body fat distribution, which is why many of our publications focus on the associations of various body fat depots with markers of metabolic risk.  During my time at Queen's I was also fortunate to work with Drs Jen Kuk and Lance Davidson (now at York and Columbia respectively), who were also studying with Dr Ross.  In the current issue of Ageing Research Reviews, Drs Kuk, Davidson, Ross, and myself review age related changes in body fat distribution in a paper creatively titled "Age-related changes in total and regional fat distribution".

Research from Dr Ross' lab, as well as research done by other groups, has consistently shown that visceral fat is strongly associated with increased metabolic risk.  As part of her PhD thesis, Dr Kuk has even shown that visceral fat is an independent predictor of mortality.  In contrast, after controlling for abdominal fat, the accumulation of lower body subcutaneous fat (the fat just beneath the skin) is often reported to be associated with reduced metabolic risk.  Take for example my MSc thesis which found that after control for abdominal fat, lower body subcutaneous fat is negatively associated with triglyceride levels, and positively associated with HDL cholesterol in elderly men and women.   In other words, if two people have the same amount of abdominal fat, the one with more leg and butt fat is likely to be the healthier of the two.

All of this brings me to our current review, which summarizes the changes in these and other fat depots with normal ageing.  As you might expect, the changes are not good - there is a progressive increase in total abdominal fat (and especially visceral fat), as well as a progressive loss of lower body subcutaneous fat.  So there is more of the bad fat, and less of the good fat.  What's more, these changes can occur even without changes in body weight or waist circumference.  So even without gaining weight, body fat percentage tends to increase with age, and the increase is mostly due to increases in the worst fat depots.  These changes can be seen especially clearly in this image that I created for my thesis introduction (I knew this would come in handy someday!).  Note that although both individuals have a waist circumference of 106cm, the older individual has dramatically more visceral fat, and less thigh subcutaneous fat.

Unfortunately there are other negative changes in body fat distribution with age, including increased fat storage in the heart, liver, bone marrow, and skeletal muscle, all of which are associated with increased metabolic risk, as well as increased risk of fractures in the case of bone marrow.  And as mentioned before, none of these changes are readily apparent when obesity is being measured by BMI or waist circumference alone, which are the most common measures used in the field (and which are pretty accurate in their own right).

But wait - it's not all bad news.  As part of his PhD thesis, Dr Davidson has previously shown that exercise is able to reduce total fat and visceral fat, as well as dramatically improving metabolic risk and functional health in elderly men and women.  So while normal ageing is associated with detrimental changes in body fat distribution, exercise can dramatically reduce these effects.  For what it's worth, Dr Davidson's work has also shown that a combination of aerobic and resistance exercise is the ideal strategy for improving both metabolic and functional health in the elderly.  It doesn't have to be intense (Peter and I helped oversee the resistance exercise in that study, and it was very low intensity for some individuals), but it can have a large impact on your quality of life.  Remember - no matter what your age, it's never too late to improve your health with a little exercise.


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Kuk, J., Saunders, T., Davidson, L., & Ross, R. (2009). Age-related changes in total and regional fat distribution Ageing Research Reviews, 8 (4), 339-348 DOI: 10.1016/j.arr.2009.06.001

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Psychosocial changes in overweight youth attending weight loss camp

Monday, October 05, 2009 Author: Travis Saunders 2 Responses

Picture by Theslowlane.

This post was chosen as an Editor's Selection for ResearchBlogging.orgTwo weeks ago I wrote a post on the psychosocial problems that are often encountered by overweight and obese youth.  Today, I would like to discuss a new paper in the same issue of the International Journal of Pediatric Obesity which examines psychosocial changes in overweight youth following attendance at a weight loss camp.

The study was performed by Dr Nicole Quinlan and colleagues at Duke University, and followed 130 overweight and obese youth who spent their summer at a weight loss camp in the United States.  The treatment program included a balanced diet, nutrition classes, extensive physical activity (5 hours/day, which seems excessive, but that's a topic for another post) and weekly group counseling sessions.  Before and after their stay, campers completed questionnaires on their attitudes towards body weight and dieting, self-esteem and quality of life, as well as having their height and weight measured by camp staff.

After an average stay of 4.3 weeks, campers lost an average of 7.5 kg, which was equivalent to a BMI reduction of 2.9 kg/m2.  Not surprisingly, campers who spent 7-8 weeks at the camp lost roughly twice as much as those who stayed 3-4 weeks.  While these changes in body weight are to be expected, the really interesting changes were in the psychosocial measures.  Following the camp, participants reported significant reductions in anti-fat attitudes and the value placed on appearance, and significant increases in body-esteem, self-esteem, physical comfort and weight efficacy.  In other words, these campers felt better about themselves, and their ability to control their own body weight.  But what was most interesting?  With the exception of physical comfort "...changes in BMI were not related to post-camp psychosocial outcomes."  In other words, these psychosocial benefits weren't due to the changes in body weight.

Now I find these results to be quite interesting.  The magnitude of the changes weren't huge (most were light to moderate) but they still suggest that comprehensive group weight-loss interventions may ameliorate the psychosocial issues which are often faced by overweight and obese youth.  More importantly, it suggests that weight loss is not a pre-requisite for these benefits, which is a very good thing, since long-term weight loss and weight maintenance can be extremely difficult.  It is promising to know that like physical health, psychosocial health can be improved even without changing body weight.


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Quinlan, N., Kolotkin, R., Fuemmeler, B., & Costanzo, P. (2009). Psychosocial outcomes in a weight loss camp for overweight youth International Journal of Pediatric Obesity, 4 (3), 134-142 DOI: 10.1080/17477160802613372

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Obesity and car crashes - does fat provide a protective cushion against injury?

Friday, October 02, 2009 Author: Peter Janiszewski, PhD 2 Responses

While Travis and I often focus on the cardiometabolic and sometimes psychological complications of obesity, the consequences of carrying excess weight reach far beyond these two areas.

Take for example automobile collisions.

By and large, most cars on the road today are not built specifically to be driven by obese drivers. More importantly, the US Federal Motor Vehicle Safety regulations and New Car Assessment Program testing uses a crash test dummy with a BMI of ~25.5 kg/m2 to gauge how safe a given car, and what type of damage may be sustained by a passenger or driver of that car upon collision. Unfortunately, it is very likely that given the same type of vehicle and mode of collision, the mechanics of the trauma incurred by the driver and passenger will vary greatly when the BMI of these parties is 45 kg/m2 rather than 25.

Indeed, previous studies have found that increasing weight is associated with a greater mortality risk from a car crash, even when other factors such as seatbelt use, age, gender, seating position, and car weight are accounted for. Such a finding, however, does not allow us to deduce whether obese individuals are more injury prone given the same crash or simply if given the same injury sustained, obese people are more likely to die from complications.

For instance, some have previously hypothesized that excess fat among overweight and obese people may actually function as an “intrinsic airbag” or “protective cushion”, thereby potentially reducing the risk of injury during a car crash. These notions were purely hypothetical and not based on any scientific evidence.

In a recently published study in the journal Obesity, Kent and colleagues investigated the crash mechanics of obese versus normal weight subjects. Given that obese crash test dummies are not available, the researchers used 3 obese and 5 normal weight cadavers for their studies, in which the effects of a frontal collision travelling at 48km/h were investigated.

First, the authors found that during the crash the obese subjects generally experienced greater maximum forward movement from their seat towards the dash before their motion was arrested by the seatbelt – obviously, not so good.

Second, the obese cadavers tended to have a more reclined torso during the crash, with the hips sliding out of the seat more than among normal weight cadavers – a difference which may increase the risk of rib fractures and pulmonary trauma, as documented previously.

However, the authors observed that the increased hip excursion and decreased torso flexion forward in the obese cadavers may reduce the risk of the head striking some component of the vehicle interior in frontal or near-frontal impacts, thus explaining the previously documented reduced risk of head injury during a car crash among heavier drivers or passengers.

Thus, while the mechanics of the trauma seem to vary between normal weight and obese individuals, there seems to be not much evidence supporting the concept of obesity being protective against injury during a car crash. With the exception of a possibly lesser chance of head injury, obese subjects may actually be more injury prone during an automobile collision.


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Kent, R., Forman, J., & Bostrom, O. (2009). Is There Really a “Cushion Effect”?: A Biomechanical Investigation of Crash Injury Mechanisms in the Obese Obesity DOI: 10.1038/oby.2009.315

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About Us

We are PhD students in the School of Kinesiology and Health Studies at Queen's University in Kingston, Ontario. Our research focuses on the relationships between obesity, physical activity, and health risk. This blog is our attempt to consider the many "cures" for obesity that we read about on a daily basis. Enjoy.


The opinions expressed here belong only to Peter and Travis and do not reflect the views of any organization. Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.

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