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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.

Top 10 News Stories of 2009

Wednesday, December 30, 2009 Author: Peter Janiszewski, PhD 3 Responses

While we try to feature a mix of the latest obesity and exercise research along with a healthy dose of weight-loss product reviews on Obesity Panacea, often we also discuss key news stories that relate to health and fitness. In the last post of 2009, we look back at the headlines of this year that managed to grab our ever-fleeting attentions. Enjoy!

1. Does obesity cause global warming? Researchers predict the increase in green house gas emissions emanating from a world getting increasingly more plump.

2.Berlin Brothel Embraces Active Transportation. New promotion by a brothel in Berlin (where prostitution is legal), gives a €5 (~$7.50 USD) discount to patrons who commute by bike or public transit.

3. 500 lb Inmate Hides Gun in Folds of Fat. The 500 lb man was apparently searched 3 times before arriving at his prison cell, but none of these searches found the 9mm pistol hidden deep within his rolls of adipose tissue.

4. Obesity as defense for DUI charge? A defense lawyer claims that the tests used to assess the defendant's sobriety were inappropriate given that he is obese.

5. Hydroxycut Recall. Best-selling weight-loss gimmick is pulled off shelves due to FDA's exposure of health hazards (i.e. death) associated with use of product.

6. Obesity as a defense for a murder charge? According to this defense lawyer (not the same guy from #4 above), his client was too obese to commit the murder of his son-in-law.

7. American Heart Association says "Sugar Is Bad". Aside from the propaganda of Big Food, was there ever any doubt?

8. Santa Claus Advocates an Unhealthy Lifestyle? Jolly old St. Nick comes under attack for his gluttonous and irresponsible lifestyle.

9. Calorie Counts on Restaurant Menus. The debate over this issue was fierce and continues to make headlines into 2010.

10. TIME magazine erroneously concludes that exercise won't make you thin. The author of the story selectively reports on singular studies, often incorrectly, misquotes experts, often showcasing his naive understanding of physiology, all in order to arrive at his apparently preconceived (and largely absurd) notion that not only will exercise not help you lose weight – it may actually make you fatter.


Happy New Year!

Peter Janiszewski

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Top 10 Obesity-Related Research Posts of 2009

Monday, December 28, 2009 Author: Travis Saunders 0 Responses


Peter and I try to discuss the latest obesity and fitness related research on Obesity Panacea at least once a week.  In the past year we have reported on research ranging from drugs that make people fatter (and healthier), to text messages as a means of improving weight loss interventions, and everything in between.  Here are our favourite research related posts from 2009.

10. Obese, but metabolically healthy individuals: at lower risk for death? Most obese individuals experience increased metabolic risk, but a significant minority are metabolically healthy.  Do these "healthy" obese individuals have a lower risk of death compared to other obese individuals?  Peter interviews Dr Jen Kuk on her important new findings.

9. Physical activity reduces risk of childhood fat gain. New research suggests that a 15-minute increase in daily moderate-to-vigorous physical activity at age 12 is associated with a 10% reduction in fat mass at age 14.

8. The fatter we get, the less we seem to notice. As a population, we are all getting fatter. Interestingly, the fatter we all get, the less we seem to notice.  This is even true at the local scale - in a related post, we examine a paper that reports that self assessment of obesity in chilren is influenced by body weight of peers.

7. Grow more fat and improve metabolic health: insights from TZD treatment. It is not excess fat itself that results in health problems – it is the inability of the fat cells to expand enough to store new calories. In other words, if metabolically unhealthy individuals could somehow develop more fat cells, they could theoretically become healthier.  New research suggests that this is exactly what happens in response to TZD treatment.

6. Big breasts: an indicator of dangerous fat deposition? Last year, a large epidemiological study suggested that women with large breasts at age 20 are at increased risk of diabetes in middle age.  This (very cool!) study by Peter, myself, and Dr Bob Ross explores one reason why breast size may be a predictor of chronic disease risk.

5. Public transit users are more likely to reach physical activity targets. Want to incorporate physical activity into your day, but live too far from work to commute by foot or by bike?  This study reports that individuals who use public transit perform significantly more physical activity than those who commute by car.

4. What is the ideal exercise prescription for obese seniors?  This new study in the Archives of Internal Medicine (and authored by our good friend Lance Davidson) suggests that a combination of resistance and aerobic exercise provides the optimal strategy for improving functional capacity as well as insulin resistance (a precursor to type-2 diabetes) in elderly men and women.

3. Fast food lunches contain RIDICULOUS amounts of calories.  Ever wonder just how bad fast food is for your health?  You won't once you see how many calories are in even the "healthy" options.

2. Text messages - the panacea for obesity? Normally we are being sarcastic when we suggest that something is the "cure" for obesity, but this interesting new study suggests that targeted text messages may be a valuable tool for individuals who are trying to lose weight.

And our favourite research post from 2009 was....

1.Can sitting too long kill you? We all know that physical activity is important.  But this important study reports that independent of physical activity, individuals who sit too much are at dramatically increased risk of death over a 12-year period.  In a related post, we also examine a new study showing that spending too much time in front of the TV reduces the benefits of physical activity.


To peruse all of our research related posts, check out our page on ResearchBlogging.org.  And to have posts delivered directly to your inbox, be sure to subscribe to Obesity Panacea.

What do you think is the most interesting obesity-related research study from the past year?

Travis Saunders

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Top 10 Weight Loss Gimmicks of 2009

Wednesday, December 23, 2009 Author: Peter Janiszewski, PhD 7 Responses


Since the inception of Obesity Panacea just over a year ago, we have reviewed over 30 weight loss products – many of which fall clearly into the gimmick category. Given that we are nearing the end of the year, we thought we’d look back over the past year of Obesity Panacea product reviews and list our top 10 weight loss gimmicks of 2009. (Click each product link to read further).

In no particular order:

1. Acai Berry Products: Pills, juices, and potions containing the “magical” acai berry were the rage throughout the year. First, we reviewed one such product, AcaiBurn, which was marketed as a weight loss aid – we had our share of criticisms. Apparently, we were onto something as not that long afterwards, the Center for Science in the Public Interest released a consumer warning, stating:

“There's no evidence whatsoever to suggest that a├žai pills will help shed pounds, flatten tummies...”

2. Equmen Core Precision Undershirts: In essence, the Equmen core precision undershirts are the all-in-one solution for abdominal obesity, chronic back pain, and lack of athletic ability. That is, as long as you weren’t planning on breathing while wearing them!

3. The SMART device: While jaw wiring seems to have gone out of fashion as a treatment for excess weight, a new gadget entered the market which works in a similar way. The SMART (Sensor Monitored Alimentary Restriction Therapy) device is basically jaw wiring 2.0, or more accurately a retainer that while does nothing for your overbite will make eating less comfortable. Brilliant, right!?

4. The Shake Weight: This ridiculous gimmick was all the rage on YouTube, and even made appearances on daytime TV (The Ellen Show). Unfortunately, the attention the Shake Weight received was not due to the products effectiveness at sculpting your arms, but rather the hilarious commercial. Shortly after the release of the Shake Weight, the same company unveiled the Shake Weight for Men – complete with possibly the worst (or best, depending on how you look at it) commercial ever.

5. Powerpops: "Can you imagine... a lollipop with the amazing Power to Suppress the appetite and give you a burst of energy." So begins a brochure promoting Power-Pops, a lollipop which claims to reduce appetite, increase energy, and help you lose weight. Well, you might as well keep imagining!

6. Slender Shaper: The very first weight loss gimmick reviewed on Obesity Panacea. According to the manufacturer, the Slender Shaper is “revolutionary total body shaping equipment [which] actually does the exercise for you!” Unfortunately, the passive movement of subcutaneous fat accomplished by the vibrating Slender Shaper belt is unlikely to give much more than a rash.

7. Air Climber: The Air Climber isn't your grandmother's stepping machine - this stepping machine is powered by "Air Technology"! While the manufacturers suggest the Air Climber is “one of the most effective weight loss and body shaping programs ever”, it is actually roughly as effective (in relatively healthy, overweight men) as walking at a very leisurely pace. Wow!

8. The Chocolate Diet: A diet which allows you to lose weight while enjoying as much chocolate as you like - sounds tempting, doesn’t it? Unfortunately, there exists no evidence that chocolate promotes weight loss.

9. Leptothin: Every so often someone comes out with a treatment that "cures" leptin resistance. This is somewhat of a holy grail for obesity treatments. But, since absolutely no research suggests that LepToThin's active ingredient is associated with weight loss in humans, and since the makers of LepToThin have a poor understanding of basic physiology, this product doesn't seem like a likely cure for obesity.

10. Scala Bio-Fir Anti-Cellulite Pants: They may look like regular tights, but these contain crystals which heat up on contact with the skin. Magically, this heat is so small that you can't feel it, yet is somehow powerful enough to melt your fat cells, while causing no damage whatsoever to muscle or other cells. If for some reason you desperately want to have pants that cause your legs to heat up, we suggest a nice pair of snow pants, which have been keeping us Canadians warm for centuries.

Vote for your pick for worst weight-loss gimmick of the year on the right hand side of the screen (email subscribers must log onto the site to vote).

If this list of dubious weight-loss products has gotten you down, fret not. There do exist products and resources (no magic potions or quick fixes, I’m afraid) that we recommend that can actually help you attain your health, fitness, and weight loss goals (click here to browse).

Happy Holidays,

Peter

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Holiday Weight Gain: Fact or Fiction?

Monday, December 21, 2009 Author: Travis Saunders 11 Responses



Today I'd like to revisit an issue which we first reported on last January, and which unfortunately appears to be happening again this holiday season.  Several of our colleagues attend a major Canadian fitness chain (I have decided not to post the name yet, but it shouldn't be too hard to guess) which has a poster of a chubby gingerbread man on the wall throughout the holidays (both in 2008 and again this year).  Under the gingerbread man is a caption that reads "The average person gains 7-10 lbs over the holidays!".  This poster immediately raises a few questions:

1. Where does this information come from? Who is the "average" person they are speaking of? Aged 18-80? Does it include kids? Seniors? Different ethnicities?

2. If the average person gains 7-10 pounds, that means that some people are gaining much more. Is that even physically possible over a 1 or 2 week period (the definition of 'holiday season' varies pretty widely from person to person)? Canada has a population of roughly 33 million - if we gained an average of 9 lbs over the holidays, as a nation we are about to put on 297 million lbs this year alone!  In the USA, it would mean a collective holiday weight gain of roughly 3 billion lbs!!

This 7-10 lb weight gain statistic seems a bit strange, so I decided to look it up on Google Scholar. Fortunately, I came across an excellent article from the New England Journal of Medicine which examines this very issue. Back in 2000, Yanovsky and colleagues examined the amount of weight gain during the American holiday season (from American Thanksgiving until New Year's). Then, as now, this claim of 7-10 lbs holiday weight gain was quite common - Yanovsky reports that organizations ranging from CNN to the Texas Medical Association used the information in press releases during the holiday season of that year. In addition, self-report studies tell us that people believe that they gain 5 lbs or more over the holidays, but that does not necessarily mean that they do.

Fortunately, Yanovsky and colleagues objectively measured the body weight of 195 men and women over the course of the year. They report that the average weight gain from mid-November to mid-January was less than 1 lb! Less than 10% of the participants gained 5lbs or more. The weight gain during the holiday season was, however, significantly greater than that during the pre- or post-holiday period, and the holiday weight-gain was not lost over the course of the year.

So, what does this study tell us? First of all, it tells us that the statement on the gingerbread poster is complete bunk. While it might be appealing to rip on the gym chain for spreading this information, the same information has been peddled by medical associations, so it's hard to say they are completely to blame. Still, the article by Yanovsky and colleages was published 9 years ago (and was the first study to pop up on Google Scholar), so it wouldn't have been too tough to realize that the statistic might be questionable.  Keep in mind that I also emailed the Yanovsky paper to the gym chain last February to alert them to the issue, and I received a pleasant reply stating that my feedback had been passed along for future consideration.  So I was more than a little bit disappointed when I heard that the posters are back up on the walls this holiday season (it appears that Obesity Panacea may have less clout than I had hoped!). 

On a somewhat more serious note, the Yanovsky study also tells us that on average, people do gain a small but significant amount of weight over the holidays which is maintained throughout the course of the year. Not enough to warrant fear mongering, but enough to cause some concern - a pound or two a year can add up over time. And some people do experience significant weight gain, a phenomonen which was sigificantly more common in overweight and obese individuals. It is an issue which is worth following, but one that I hope people aren't losing sleep over.

So remember, as we move deeper into the holiday season, don't let the gingerbread men (whether on your plate or a poster) get you down.

Big thanks to our friends Wendy and Geoff Stephen for letting us know about the poster and for their helpful comments.

UPDATE: We now have a picture of the poster itself, which you can see at the top of this post.

Travis Saunders

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Yanovski JA, Yanovski SZ, Sovik KN, Nguyen TT, O'Neil PM, & Sebring NG (2000). A prospective study of holiday weight gain. The New England journal of medicine, 342 (12), 861-7 PMID: 10727591




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This Week: In Brief

Saturday, December 19, 2009 Author: Travis Saunders 0 Responses


While we regularly post lengthy discussions on Obesity Panacea, there are many research updates, news stories, videos, etc. in the field of obesity, physical activity and nutrition that we come across on a daily basis that never grace the pages of the blog. Most of these mini-stories we share with our followers on Twitter, and we encourage those of you with active Twitter accounts to communicate with us there to get real-time updates of all the stuff we are discussing (Follow Peter and/or Follow Travis). For those of you who shy away from Twitter, enjoy below the best mini-stories that we came across during the prior week along with links to the original source so that you can follow the full story.

Want to join the movement to increase childhood physical activity?  Join the discusssion at the Canada Gets Active and Spark Together for Healthy Kids Facebook pages.

Sand playgrounds reduce the risk of childhood arm fracture (PLoS Medicine).

Does teenage stress cause weight gain? (Dr Sharma's Obesity Notes).

What is causing the obesity epidemic and how can we move toward a healthier future?  A terrific debate between obesity researcher Kelly Brownell and Big Food lobbyist Melanie Leech (The Economist).

Physical activity may prolong survival after colon cancer (US News & World Report).

New research suggests that obesity is taking hold in Africa (Daily Nation).

A great new video from the Canadian Liver Foundation (Youtube).  For a great discussion of the video en francais, be sure to check out Le Nutritionniste.

Experts say it's time fruit juice loses its wholesome image (LA Times).

5 exercises you're doing wrong (Foxnews).

New Reebok's that probably won't tone your butt (Natural Bias).

Bad news - exercise doesn't seem to help with menstrual pain (BBC).

My weekly picks from the best blogs posts discussing peer-reviewed Health and Clinical Research (Research Blogging).

Have a great weekend, and to know what we're reading in real-time, be sure to follow us on twitter!



Travis Saunders

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Santa Claus: Advocating an Unhealthy Lifestyle?

Friday, December 18, 2009 Author: Peter Janiszewski, PhD 4 Responses

So suggests an intriguing and witty editorial in the British Medical Journal.

Given Santa’s tremendous popularity, particularly among children, the authors argue the public should become aware of some of the less-than-ideal lifestyle practices apparently advocated by jolly St. Nick.

Their basic thesis is the following: “Santa’s behaviour and public image are at odds with contemporary accepted public health messages.”

The first issue they raise in support of their argument is the pervasive use of Santa Claus to advertise basically everything during the holidays, especially unhealthy food choices such as Coca-Cola products. Apparently, it was the Coca-Cola company in the 1930 that developed through advertising the contemporary appearance of Santa Claus that we all recognize today – I wonder if he was abdominally obese prior to Coke’s make-over?

This brings us to the authors' second point: Santa Claus is one of a few (only?) global icons who is obviously obese. The authors state that Santa’s image “promotes a message that obesity is synonymous with cheerfulness and joviality.” (I’m sure the likes of Chris Farley, Seth Rogen (before the weight loss), and many other overweight comedians had something to do with that as well).

The past US surgeon general is quoted as saying:
“It is really important that the people who kids look up to as role models are in good shape, eating well and getting exercise. It is absolutely critical.”

Personally, I’m not 100% convinced that in a time when discrimination against obese individuals is already rampant, and the large majority of the population is overweight or obese – it may not be a bad idea to have a public character who remains in good spirits DESPITE his expanded waistline. Then again, ending the whole “milk and cookies” routine is probably a good idea for the health of Santa, and likely mom and dad as well (who will be the ones more likely disposing of the snacks).

Additionally, the authors go on to suggest that Santa has a number of other unfortunate characteristics or bahaviors such as:
- smoking (he was often used in smoking ads in the past)
- drunk driving (another tradition is to leave some Brandy for Santa, and given the number of houses he visits, his alcohol level would surely be above the limit)
- unsafe driving (does not obey road rules, excessive speeds, no harness or seatbelt)
- since Santa (think local mall variety) is apparently sneezed or coughed on up to 10 times a day, he is also a great source of potential infections. (“What would you like for Christmas little Jimmy? How about some H1N1?”)

Although the article is a fascinating read, despite the authors suggestions, I doubt that Santa will be dieting or commuting in a Toyota any time soon.

Somehow, I don’t think that’s such a bad thing.

Happy Holidays,

Peter

[Thanks to Dr. Jennifer Kuk for technical assistance]

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Grills, N., & Halyday, B. (2009). Santa Claus: a public health pariah? BMJ, 339 (dec16 1) DOI: 10.1136/bmj.b5261

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Too Much TV Reduces the Benefits of Physical Activity

Wednesday, December 16, 2009 Author: Travis Saunders 11 Responses

Image by Dailyinvention.

One of my personal interests is the relationship between sedentary time (e.g. the amount of time that we spend sitting) and chronic disease risk.  Several interesting papers have come out in the past few years suggesting that spending too much time sitting down is a risk factor for obesity, chronic disease, and even death, independent of physical activity levels.  In other words, no matter how physically active you are, the more time you spend sitting, the greater your risk of death and disease.

This is a very new area of study, so a lot of questions remain unanswered.  For example, consider two situations:

1)  An individual who does a 60 minute run every morning, but spends the rest of the day being completely sedentary.
2)  An individual who spends all day on their feet, walking and moving at a slow pace, but never raising their heart rate above 100 beats per minute.

All else being equal, which of these individuals is at a lower health risk?  Up until a few years ago, I think almost all physiologists would have said that the first condition was much better than the second - in other words, as long as you're meeting the physical activity guidelines, it doesn't matter what you do with the rest of your day.  But several recent studies have started to bring that into question, and a new study in the International Journal of Obesity makes it increasingly difficult to believe that performing 60 minutes per day of structured exercise somehow inoculates us against the damage done by excessive amounts of sedentary behavior.

In this new study, Dr GF Dunton and colleagues at the National Cancer Institute used a phone survey to collect information on a sample of 10,000 non-underweight Americans above the age of 21.  Participants self-reported their height and weight, as well as the amount of time that they had spent engaging in both physically active and sedentary behaviors in the past 24 hours. Not surprisingly, time spent engaging in sedentary behaviors like watching TV and driving in a car were associated with increased body weight, while high levels of physical activity were associated with lower body weights.  But what is really interesting is that sedentary behaviors altered the relationship between physical activity and obesity.  To help illustrate, I have recreated a graph from the paper below.




Adapted from Dunton et al., 2009.

As you can see, in individuals who reported watching TV for less than one hour per day, those who performed at least one hour of moderate to vigorous physical activity (MVPA) had significantly lower BMIs.   However, in individuals who reported spending more than an hour per day watching TV, BMI was not lower in those who performed more than one hour of MVPA per day.  In other words, for individuals who spent too much time watching TV, physical activity was no longer associated with body weight.  Interestingly, while time spent watching TV seems to influence the relationship between physical activity and BMI, physical activity did not seem to affect the relationship between TV watching and BMI. 

There were also interesting interactions found for active vs sedentary modes of transportation.  I find these things tricky to describe in text, so I have re-created one other graph to illustrate the findings.


Adapted from Dunton et al., 2009.

As you can see, among those who performed no active transportation, individuals had similar BMIs regardless of how much time they spent commuting by sedentary means.  However, in individuals who performed at least some active transportation (defined as one minute or more), there was a positive relationship between sedentary transportation and BMI. 

So what does it all mean?  Well, the results of this study suggest that if you spend too much time watching TV, you are likely to have a higher BMI regardless of how much physical activity you perform.  Similarly, if you spend >80 minutes in the car commuting everyday, you are likely to have a high BMI even if you also do some active transportation. These findings (along with other studies we have discussed in the past) suggest that no matter how much exercise you perform, it is important to minimize the amount of time you spend sitting. 

Now this study has some important limitations that are worth mentioning.  First off, the information was self-reported, which tends to make things a bit messier.  In these situations body weight tends to be under-reported, while people may forget about some bouts of sedentary behavior (it's not that easy to remember all the time you spent sitting down or watching TV in the past 24 hours).  Perhaps even more importantly, all of these results are cross-sectional.  So people may be heavier because they watch too much TV, or they may watch more TV because they are heavier.  Same thing with physical activity - a lack of physical activity may be a cause of weight gain, but weight gain may also cause a reduction in physical activity (my guess is that it's probably a bit of both). Now that's not to say that cross-sectional studies aren't interesting or important (Peter and I have published several cross sectional studies), but it's definitely worth keeping in mind.  Just to say that one more time, this study does not prove that too much sedentary time causes obesity.  But it's a very cool paper nonetheless.     

So let's return to my question at the top of this post - is it better to get an hour of physical activity but spend the rest of the day being sedentary, or to spend the entire day engaging in very low intensity physical activity?  Given the limitations I just mentioned, this study obviously doesn't settle the issue one way or the other.  But it is one more piece of evidence suggesting that no matter how much physical activity you perform on a daily basis, too much sedentary time (and especially too much TV) is a very bad thing.

Which do you think is worse - too much sedentary time, or too little physical activity?

Travis Saunders

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Dunton, G., Berrigan, D., Ballard-Barbash, R., Graubard, B., & Atienza, A. (2009). Joint associations of physical activity and sedentary behaviors with body mass index: results from a time use survey of US adults International Journal of Obesity, 33 (12), 1427-1436 DOI: 10.1038/ijo.2009.174

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SurfShelf Treadmill Desk: A Review

Monday, December 14, 2009 Author: Travis Saunders 2 Responses

SurfShelf

Regular readers of Obesity Panacea will know that Peter and I are big fans of Non-Exercise Activity Thermogenesis, or NEAT.  NEAT refers to any and all caloric expenditure which takes place outside of structured exercise sessions.  Things like walking to the bus stop, walking up and down stairs, and carrying groceries all fall into the category of NEAT.  Although individually these activities may not burn many calories, over the day they can add up, and are likely to have a substantial impact on health.

There are lots of ways to increase the amount of NEAT that you get on a daily basis.  You can commute to work by bike or public transit, and you can go for walk meetings rather than sitting around a conference table (for our previous post on the top 10 ways to increase NEAT, click here).  But what about the days when you have to work at a desk?  Believe it or not, several companies have recently come out with treadmill desks, which allow you to perform all of your normal office activies while walking at a leisurely pace of 1-2 miles per hour.  That might seem a little ridiculous, but there is a bit of science behind it - James Levine, the researcher who coined the term NEAT, reports that working at a treadmill workstation rather than sitting at a desk increases caloric expenditure by about 100 calories per day.  Now that's not a huge amount, but it's a step in the right direction.  And given the strong associations between sedentary time and mortality, anything that gets you off your duff is probably a good thing.

Typical examples of these new treadmill desks include the Sit-to-Walkstation which can accommodate just about any type of office activity that can be done on a regular desk (see picture below), and can actually be moved up and down, so that it can be used as a normal desk when you're not walking. 



Sit-to-Walkstation

While the Sit-to-Walkstation has great functionality, it also has a huge pricetag - Amazon.com lists it at $4,899 USD!  That is why I was so excited when I came across the SurfShelf Treadmill Desk earlier this fall on Weighty Matters.  The SurfShelf is basically a music stand that you strap onto your treadmill, elliptical machine or exercise bike.  You can then use it to hold your laptop, a DVD player, or one would assume just about anything else (see the picture below).  It's much smaller and less functional than the Sit-to-Walkstation, but it's also a lot cheaper - $39.95. 


SurfShelf

Now I haven't used the SurfShelf personally, but I can see it being pretty handy.  I often read on my stationary bike at home, and it would be extremely useful to be able to work on my laptop as well.  If I could do simple things like marking assignments, reading articles, and writing papers (or blog posts) while walking or riding at a leisurely pace, it would be a welcome change!  I like to do my actual workouts outside whenever I can, so the prospect of watching DVDs while working out is less appealing to me, although I can understand why this would be attractive for a lot of people.  And the Surfshelf instructional video claims that attaching and removing the unit is quite simple, which I assume means that you can take it to the gym if you don't have a treadmill of your own.

So, are treadmill desks worth it?  I'm not convinced that the more expensive models are worth the cost ($5,000 for a treadmill?!?), but I can see simpler versions like the SurfShelf being quite useful.  In fact, building one of your own looks like it would be pretty simple as well (I have friends that have done as much with little more than a piece of wood and a clamp).  If you have used any type of treadmill desk, feel free to share your experiences in the comments section below.  Do you think they are worth the expense?  Have you made your own treadmill desk?  We'd love to hear your story if you have!

Both the Sit-to-Walkstation and SurfShelf can be purchased through Amazon.com.

UPDATE:  The TreadDesk is another "fully functional" treadmill desk which costs roughly $2,300.  Still a little pricey for me (ok, WAY too pricey for me) but it's still much more affordable than some options.  Thanks to Amanda Rudelt for letting us know about it.   

UPPERDATE: The TrekDesk Treadmill Desk is a scaled down, but still fully functional treadmill and desk that retails for just under $500 US.  We'll continue to keep our eyes peeled for cheaper treadmill desks, and please feel free to add your own to the comments section below.


Travis

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This Week: In Brief

Saturday, December 12, 2009 Author: Peter Janiszewski, PhD 0 Responses

While we regularly post lengthy discussions on Obesity Panacea, there are many research updates, news stories, videos, etc. in the field of obesity, physical activity and nutrition that we come across on a daily basis that never grace the pages of the blog. Most of these mini-stories we share with our followers on Twitter, and we encourage those of you with active Twitter accounts to communicate with us there to get real-time updates of all the stuff we are discussing (Follow Peter and/or Follow Travis). For those of you who shy away from Twitter, enjoy below the best mini-stories that we came across during the prior week along with links to the original source so that you can follow the full story.

According to Heart and Stroke Foundation, “trans-fat free” = 5% trans fat. (Weighty Matters)

Genetic obesity in kids absolves parents of child abuse accusations? (Dr. Sharma’s Obesity Notes)

How to eat healthy when you have no time. (Summer Tomato)

Looking for holiday gifts? Check out this great list of physically active toys (Saskatchewan In Motion)

Overweight and obese women in the workforce experience a significant wage-penalty: (http://bit.ly/5Loj0I)

Obesity Linked With Poorer Breast Cancer Outcomes: (http://bit.ly/7fp0p3)

Best time of the day to exercise? Afternoon/evening; athletic performance is worst in the morning: (http://tr.im/Hgx0)

55% of Canadians are not willing to give up watching TV for extra 5 years of life: Would you? (http://bit.ly/89KjvV)

Want to get fit at your desk? Here's a well-meaning but a tad silly office workout routine, complete with 14 exercises: (http://bit.ly/8bAetz)

RECALL: Slim-fast diet drinks contaminated with bacteria causing diarrhea & vomiting - that will surely help with the weight loss: (http://bit.ly/5orVKx)

Post-humous liposuction for cash? Peru gang accused of removing the fat from corpses to sell on the black market: (http://bit.ly/6cu0W0)

Did we miss any relevant news that you came across this week? Let us know by leaving a comment!

Enjoy the weekend,

Peter


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Obese, but Metabolically Healthy Individuals: at Lower Risk for Death?

Friday, December 11, 2009 Author: Peter Janiszewski, PhD 8 Responses

Very recently, an interesting study was published looking at the risk of early mortality among metabolically-healthy obese individuals – a topic we’ve covered on a number of occasions on Obesity Panacea. The authors of this landmark study published in the journal Diabetes Care are actually close friends of ours (Dr. Jennifer Kuk and Dr. Christopher Ardern), and both are alumni of Queen’s university. Now that the media frenzy surrounding their recent study has subsided, Dr. Kuk was kind enough to answer a few questions about the study and enlighten our readers.

Dr. Kuk is currently an Assistant Professor at the School of Kinesiology and Health Science at York University. Before Dr. Kuk was at York University, she did her PhD in the same lab that I am currently in (Queen’s university). Dr. Kuk has been instrumental in shaping my research interests while at Queen’s and beyond, and over the years has provided tremendous guidance in many areas. I could not be happier to showcase some of her pioneering research on Obesity Panacea.

Without further adieu, enjoy the interview.

OP: If you were to sum up the main findings of your study to a non-scientist at a dinner party, what would you say?

Dr. Kuk: I don't get invited to dinner parties, but if I were, I'd say that "My study shows that individuals who are obese and do not have common diabetes and heart disease risk factors die at the same rate as those who do. This means being overweight alone puts you at higher risk for dying, even though you do not high blood pressure, high cholesterol or high blood sugar. This highlights the negative health impact of body weight alone".

OP: Why do you think the prevalence of metabolically-healthy obesity in your study was so much lower than previously reported in others (6% vs 20-30%)?

Dr. Kuk: The prevalence was lower in our study as compared to others simply because we used a more strict definition of metabolically normal. Other studies used insulin resistance or the metabolic syndrome (3+ risk factors) alone, but we defined 'metabolically healthy' as the absence of insulin resistance or any metabolic syndrome criteria. We felt this would be a more accurate definition of 'metabolically healthy' as each of the metabolic syndrome criteria are associated with morbidity and mortality alone.

OP: How do you reconcile the findings from the current study with those of prior studies suggesting that metabolically-health obese individuals are at no greater risk for developing type-2 diabetes or cardiovascular disease than normal weight individuals?

Dr. Kuk: Although I don't know which studies you are referring to exactly, but in our study, 80% of the deaths in the metabolically-healthy obese were due to cancer and 'other' causes. Other causes are likely traumatic injuries, which highlights an important point. Obese individuals are less likely to survive a trauma as compared to normal weight individuals despite similar injuries. This is related to longer transport times due to their higher body weight, and difficulty assessing and treating the injuries due to their increased size. Further, they are less likely to see their physicians regularly, which may be in part why cancer is generally diagnosed in obese individuals at later stages. Thus, this study fits in line with the idea that these indiviudals are not more likely to develop these metabolic diseases, but still die from other causes.

OP: Recently, Drs. Sharma and Kushner proposed a new staging system for obesity treatment suggesting that obese individuals without established metabolic risk should be counseled to maintain current weight, rather than lose weight (Read about this on Dr. Sharma's Obesity Notes blog). Do the results of your study agree or disagree with these recommendations?

Dr. Kuk: One can examine this question from a theoretical or practical standpoint. From a theoretical stand, weight loss improves metabolic factors, functionality and serveral psychological and social factors, and thus it would be intutitive to recommend that all obese lose weight. However, from a practical perspective it may be unethical to recommend an individual who is not presenting with overt disease to try to lose weight as most indiviudals fail to maintain their weight loss over the long term. Repeatedly failed attempts to maintain weight loss has been shown to elevate one's risk for diabetes, CVD and cancer for a given BMI. In other words, it may be better to recommend maintenance of weight rather than prescribing weight loss, knowing that they are likely to fail and be worse off because of it. Though we did not examine this issue, Sharma and Kushner's staging system examines non-metabolic consequences as well, and it is reasonable to assume that these are equally important to examine as they are also important aspects of health, and inclusions of these factors may alter the associations observed.

OP: Are metabolically-healthy obese individuals actually healthy?

Dr. Kuk: I think that whether metabolically-healthy obese are actually healthy is dependent upon the accuracy of the definition. As we see that obese without CVD or diabetes risk factors are at elevated cancer risk implies that our definition of metabolically healthy is not capturing cancer metabolic risk factors. Similarly, risk for trauma events may also reflect aspects of health that may or may not be captured by metabolic risk factors, but are crucial aspects of health. For example, musculoskeletal fitness would be a predictor of risk of falling or functionality.

Thus, if we used a more encompassing definition, we would likely see that these metabolically-healthy obese may be at lower risk for mortality and are healthy. However, as our definition only identified 6% metabolically healthy obese, I would suspect that an all encompassing definition for healthy obese would be a very minuscule proportion of the population.

OP: What was the most interesting point raised by a reviewer during the publication process of this study?

Dr. Kuk: The most interesting point was surrounding whether metabolically normal obese should lose weight. I don't think there is a clear answer, but this study definitely provides food for thought.

OP: What came as the biggest surprise to you in doing this study?

Dr. Kuk: Our main finding was the biggest surprise. We actually expected that the metabolically normal obese were at lower risk for mortality.

Thanks very much to Dr. Jennifer Kuk!

Have a great weekend!

Peter

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Kuk, J., & Ardern, C. (2009). Are Metabolically Normal but Obese Individuals at Lower Risk for All-Cause Mortality? Diabetes Care, 32 (12), 2297-2299 DOI: 10.2337/dc09-0574

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The Lancet: Active Transportation Could Cut Ischemic Heart Disease Prevalance by 25%

Wednesday, December 09, 2009 Author: Travis Saunders 2 Responses
Photo by Kamshots.

With the world's leaders currently meeting in Copenhagen to discuss strategies to reduce climate change, one of the world's most prestigious medical journals, The Lancet, has released a series examining the public health benefits of various strategies aimed at reducing greenhouse gas emissions.  One of these papers focuses on the impact of widespread adoption of active transportation, and the estimated public health benefit is nothing short of astonishing.

In the article titled Public Heath Benefits of Strategies to Reduce Greenhouse-Gas Emissions: Urban Land Transport, Paul Wilkinson and colleagues calculated the estimated changes in morbidity and mortality if there were to be widespread adoption of low carbon-emission vehicles, widespread adoption of active transportation, or a combination of the two.  Low carbon-emission vehicles were defined as those emitting roughly half of the average vehicle today (95 g/km CO2 for cars compared with 177 g/km at present), while the level of active transportation that was analyzed was similar to that seen in continental European cities such as Copenhagen, Amsterdam, and Freiburg.  Outcomes were morbidity and mortality related to changes in physical activity, air pollution, and the risk of traffic injury, and the calculations focused on London, England, and Delhi, India.

So, what did the authors find?  In comparison to continuing on with "business as usual", substantially increasing active transportation by 2030 (either alone or in concert with reductions in vehicle carbon-emissions) is estimated to result in dramatic reductions in both morbidity and mortality.  Due to increased physical activity alone, increased active transportation is estimated to result in a reduction of 352 premature deaths per million people per year, as well as 6040 less years of life lost, and 816 years lost due to disability in Delhi, India.  In London, increasing active transportation to levels seen in Copenhagen would result in 528 less deaths per million people per year, as well as 5496 less years of life lost, and 2245 less years lost due to disability.  These reductions were related to lowered prevalence of heart disease (by up to 19% in London and 25% in Delhi), cerebrovascular disease (18% in London and 25% in Delhi), dementia (8% in London), depression (6% in London), diabetes (17% in Delhi), and breast cancer (13% in London) - all diseases which are negatively associated with physical activity.

In addition to the benefits seen as a result of increased physical activity, there are also estimated reductions in morbidity and mortality as a result of lowered air pollution in both cities.  While increased active transportation is expected to reduce the overall number of fatalities related to traffic crashes in Delhi by 67 per million people per year, there is an estimated increase of 11 fatalities per million per year in London.  On the whole, simply increasing active transportation could reduce fatalities by 511 per million inhabitants per year in Delhi, and 530 per million inhabitants in London.

Now this type of study is obviously very speculative (and the mathematical models they used are complicated to say the least!).  But I think it serves as a nice jumping-off point for a discussion of the ways that increased active transportation and other simple strategies can dramatically improve the health of our societies.  Even minor reductions in morbidity and mortality could save our health care systems (and us taxpayers) and load of money, not to mention increasing the quality of life of our friends and family.  Once a chronic disease like breast cancer or diabetes is present, it can be extremely costly to treat.  Increasing active transportation might be a simple way to increase the health of our communities, our environment, and our wallets.

What do you think about The Lancet's estimates? 

Travis

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ResearchBlogging.orgWilkinson, P., Smith, K., Davies, M., Adair, H., Armstrong, B., Barrett, M., Bruce, N., Haines, A., Hamilton, I., & Oreszczyn, T. (2009). Public health benefits of strategies to reduce greenhouse-gas emissions: household energy The Lancet, 374 (9705), 1917-1929 DOI: 10.1016/S0140-6736(09)61713-X

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Low Carb Diets: Doing More Harm Than Good?

Monday, December 07, 2009 Author: Peter Janiszewski, PhD 12 Responses

An intriguing editorial published recently in the prestigious New England Journal of Medicine suggests that low-carb diets may not be all they’re cut out to be, and in fact may be more dangerous than the “deadly” Western diet.

Given that I grew up in a Polish household (albeit not always in Poland), I know a little bit about having a high-carbohydrate diet. In fact, in most eastern European homes, it is not uncommon to have sliced bread (buttered, of course) with every meal of the day. Also, a dinner short of potatoes is simply not dinner. Since moving out on my own almost 10 years ago, my diet has changed considerably – a change that becomes most evident when I politely decline to ingest all the bread, potatoes, cakes, pastries that I am offered when I visit my folks (without fail, my mom is always offended by such a gesture). Adopting a diet low(er) in carbohydrates was not necessarily an intentional move, but sort of just happened. Slowly, I started cutting back on the obvious excesses of sweets, gummy candies, chips, pop, and most recently my beloved pretzels. I also cut back on my intake of white pasta (a staple of the undergraduate student), white bread, and to be honest, rarely eat potatoes or French fries outside of my parent’s home. Now, I find that if I consume too much carbohydrate, I simply don’t feel good. Thus, I have been living on a fairly low carb diet for a while now, and would often remind my parents (based on things I had read or heard) that a diet high in carbs is not ideal.

Well, I should have known better; mom is always right…

Dr. Steven Smith, the author of the editorial, suggests that the low-carb diet, despite being in the spot-light for quite some time is nothing more than a fad diet, something he eloquently describes as “a bright flash that quickly fades, only to be followed by another best-seller and a new face on the talk-show circuit.”

The crux of Smith’s criticism of the low-carb diet rests on the results of a recent paper by Foo and colleagues which investigated the effects of different diets on the formation of atherosclerotic plaques (fat build-up in the arteries) in mice.

In the study, 3 groups of mice were each fed different diets and monitored over time: 1) regular diet (low fat, moderate protein, high carbohydrate – think Polish diet), 2) Western diet (high fat, moderate protein, moderate carbohydrate), or 3) high fat, high protein, but low carbohydrate diet.

The surprising finding of this study was that the mice fed the low-carb diet had developed twice the atherosclerotic plaque formations as compared to the mice on the Western diet (typically thought of as “atherosclerotic” diet).

The interesting thing here is that despite the significant difference in the progression of vascular disease in the mice on the low-carb diet – their metabolic profile (levels of blood cholesterol, for example) was indistinguishable from that of the mice on the Western diet. This suggests that factors other than those commonly measured in clinic may explain how a low-carb diet may be so atherogenic (plaque forming).

The two suggested candidates are an increased level of free fatty acids in the blood (released from insulin resistant fat cells and implicated in the initiation of inflammatory processes) or a reduced level of circulating endothelial progenitor cells (produced in bone marrow and help maintain the health of the blood vessels).

The key argument made by Smith is that we have previously looked only at “classical” risk factors (cholesterol, glucose, insulin) for cardiovascular disease when investigating the effect of various diets on health. In fact, some studies have shown that low-carb diets may reduce levels of blood cholesterol in the short-term. However, as well stated by the author, the low-carb diet “might increase the risk of cardiovascular disease through mechanisms that have nothing to do with these "usual suspects" and so provides a note of caution against reliance on the traditional cardiovascular risk factors as a gauge of safety.”

While more research on low-carb diets needs to be conducted in humans, for the time being, it may be a good idea to avoid jumping on the low-carb bandwagon.

In the end, my mom may have been right all along, and Dr. Atkins (originator of the low-carb craze) had it all wrong.

Peter

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Smith SR (2009). A look at the low-carbohydrate diet. The New England journal of medicine, 361 (23), 2286-8 PMID: 19955530

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This Week: In Brief

Saturday, December 05, 2009 Author: Travis Saunders 0 Responses


Welcome to our weekly wrap-up of our favourite obesity news, research, and commentary from across the World Wide Web.  While we regularly post lengthy discussions on Obesity Panacea, there are many research updates, news stories, videos, etc. in the field of obesity, physical activity and nutrition that we come across on a daily basis that never grace the pages of the blog. Most of these mini-stories we share with our followers on Twitter, and we encourage those of you with active Twitter accounts to communicate with us there to get real-time updates of all the stuff we are discussing (Follow Peter and/or Follow Travis). 

1.  Biases among obesity researchers skew the results of obesity science: http://bit.ly/5htWS4

2.  "Fructose is ethanol without the buzz".  Our friend Darya Pino at Summer Tomato has a fantastic video of Dr Bob Lustig explaining why sugar, and especially fructose, are a driving force in the obesity epidemic.  I had the pleasure of speaking with Dr Lustig earlier this year and he is absolutely phenomenal.  If you work in obesity management or are looking to make a healthy change to your own lifestyle, this is a video that you should not miss: http://summertomato.com/for-the-love-of-food-30/ .

3.  Lincoln university removes the ill-fated "too fat to graduate" rule.  It seems that being blasted by the media helped put the final nails in the coffin: http://bit.ly/5y2rzf.

4.  "Maybe You Should Get Out More".  Tremendous ad by Subaru Canada that takes the piss out of that terrifying Snuggies commercial.  We love this ad!!! http://is.gd/5cgIV

5.   Is the increase in US obesity offsetting the beneficial health effects of the decline in smoking? http://bit.ly/7roBTw
 
6.  From the New York Times: Exercise More During the Day, and You Will Sleep Better at Night: http://bit.ly/6faW8s

7.  Despite earlier promises, Health Canada will continue to allow sales of unlicensed natural health products: http://bit.ly/5z7YT7

8.  Nutrition superstar Marion Nestle details a San Fransisco attorney who is taking on Kellog's ridiculous health claims: http://tiny.cc/ubWj3

9.  Lancet estimates that increased active transportation could have dramatic impact on greenhouse gases and public health: http://tiny.cc/ZClY6

10.  Every Wednesday, I select my favourite Health-related blog posts from the previous week on ResearchBlogging.org.  Here are my favourite from the past week:

i.  Take that pharmacology!  In The Secret to Good Health – Listen to the Data! Brain Blogger reports on a new study showing that simply eating a healthy diet, exercising, and avoiding obesity reduces your risk of chronic disease by 80 percent!

ii.  You know how chocolate is bad for dogs?  Well it turns out it’s not much better for coyotes.  A surprisingly entertaining and informative post by The Lay Scientist titled Using Chocolate to Exterminate Coyotes

iii.  Ironically, despite the obesity epidemic, we North Americans waste a ton of food.  How much?  Journal Watch Online explains in America, Clean Your Plate!

iv.  The Lay Scientist rounds out the list with another can’t-miss post titled Is Rob Houben’s “Voice” a Hoax?

To read the top posts in other research areas, be sure to visit ResearchBlogging.org/news.

To see what we're reading as it happens, be sure to follow us on twitter!  And even if you don't have your own Twitter account, you can still follow our updates to see what we are reading.  Have a great weekend!


Travis

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Supersized PE: A Review

Friday, December 04, 2009 Author: Travis Saunders 6 Responses

 
We all know the stats - 1 in 3 North American children is overweight or obese.  This is obviously of real importance from a public health standpoint, because one-third of our youth are at serious risk for numerous chronic diseases.  But it also has implications for physical education teachers - overweight and obese children have specific needs, and it is the role of the physical education (PE) teacher to meet those needs.  For example, obese children are reported to be less physically active, more sedentary, and have worse motor proficiency than their normal-weight peers (details here).  As we have discussed before, obese kids are also at higher risk for psychological problems, and one highly publicized study even found that obese kids have lower health-related quality of life than cancer patients.

Now obviously these issues not only influence a child's ability to participate in PE, but they are all things that can be helped by a good PE program.  Thus we now have Supersized PE - the first PE textbook focused explicitly on helping teachers meet the needs of overweight and obese kids. The book is broken into 7 short chapters:
  1. Reality Check - What Teachers Can Do Now
  2. A Summary of the "Overweight" Epidemic
  3. Living in an Overweight Body
  4. Top 10 Tips for Teaching Overweight Students
  5. Obesity - A Disability?
  6. The Motivation Factor
  7. Lesson Plans for Achieving the National [American] Standards
When I first picked up the book I had high hopes for it, because I think that people in general, but especially teachers, should be aware of the issues related to overweight and obesity.  Unfortunately, the book doesn't always deliver, and in some places it goes clear off the rails. Here are my thoughts.

The Good:

Some parts of the book are spot on - they mention that teachers should focus on healthy behaviours like physical activity rather than outcomes like body weight, and that teachers should employ a wide range of activities (dodgeball everyday does not make an effective PE course), and promote an inclusive, student-centered environment.  They also mention several times that PE teachers should campaign for healthier lunch-options, less vending machines, and even less high-calorie juice - all great things.  The chapters on obesity as a disability and ways to motivate overweight and obese children were especially informative, and there are lesson plans provided throughout the book.  In general, the book was also a very easy read (it only took a couple days to get through the whole thing), and at 121 pages, it is very approachable.

The Bad:

While the Foreward to the book calls the writing style "folksy", at times it came across as quaint or even naive.  The information is often vague, and the citations are often for textbooks or organizations, rather than actual research articles.  Important issues like the role of body fat distribution, and the fact that body weight and body fat are not completely synonymous, are completely avoided.  Although the authors mention that healthy behaviours are more important than body weight, they never mention that it is likely healthier to be overweight and active than to be normal weight and sedentary.  In fact, the focus is almost entirely on body weight at every turn.  The "Health at Every Size" message is an important one, and one that people need to hear.  This book would have been an ideal place for that message.

The link between obesity and poor motor skills is also a critical message for PE teachers - children with poor motor skills are less likely to engage in physical activity, and more likely to be overweight or obese.  Without those fundamental movement skills, it is unlikely that any child will develop a lifelong love for physical activity.  Unfortunately motor skills receive only a few sentences in the entire book, when they deserve a full chapter, if not a book of their own.

The Ugly

Unfortunately a few parts of the book are problematic to say the least.  For example, after a nice explanation of weight-bias, the authors suggest that university physical education programs should consider mandatory BMI standards for all teacher candidates.  One of the reasons is that "fit looking (e.g. non overweight) individuals are hypothetically more likely to be considered for teaching jobs than significantly overweight candidates".  First off - BMI standards are clearly discriminatory against overweight individuals.  Second - they are giving advice on how to use weight discrimination as a way to improve your chances of getting hired.  That is not ok.  And let's remember that body weight is influenced by a multitude of factors, only some of which are under an individual's control, as well as the importance of physical activity and proper diet regardless of body weight.  They are right to say that PE teachers should lead by example, but are completely wrong about how that should be achieved.

Another cringe-worthy moment is from a lesson plan titled "Obesity Awareness".  In this lesson, students get to feel what it is like to be overweight.  How?  By piling all of their textbooks into their backpacks, and seeing how much harder it is to walk around the schoolyard with that extra weight on their backs.  Really?  I can't believe that anyone ever thought that was a good way to help students learn healthy behaviours or develop a lifelong love for physical activity.

Overall Impression

If we are going to teach our kids how to live healthy, active lifestyles (which we absolutely must do from both an ethical and a public health standpoint) PE is a great place to start.  Both in Canada and the USA, elementary school PE is typically taught by general class-room teachers (as opposed to PE specialists). However well-intentioned, these individuals receive little or no training in how to teach PE, let alone how to cater to children with a wide-array of diverse needs and abilities, which means that this book fills a very important niche.  The authors deserve a lot of credit for opening a dialogue on these important issues, which I think will be the most important contribution of this book.  However, the lack of scientific information, and the at-times questionable advice, will severely limit its effectiveness.

Final Verdict:

6/10

Special thanks to Dr Meghann Lloyd for lending me her copy of the book for this review.  Supersized PE can be purchased through Amazon.com and through the National Association for Sport and Physical Education website (the price is much lower on the NASPE website).  For more comprehensive resources for teachers who will be instructing PE for any age, I strongly recommend you check out the Ontario Physical and Health Education Association website.  Although the information is not obesity-specific, they have detailed curriculum resources for all grades.

Have a great weekend!

Travis

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Physical Activity Reduces Risk of Childhood Fat Gain

Wednesday, December 02, 2009 Author: Travis Saunders 6 Responses

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.

All of this brings me to a very interesting paper that has just been published in the British Medical Journal, which is available for free on the BMJ website. Author Chris Riddoch and colleagues asked 7159 12-year-old children to wear accelerometers for a full week. Accelerometers measure movement, and allow for the direct measurement of both the volume (minutes, hours, etc) and intensity (light, moderate, vigorous) of physical activity. This is the gold-standard for measuring physical activity, and a tremendous improvement over self-report questionnaires. They then had all of these participants come back to the lab at age 14, where they had their body fat mass directly measured using Dual Energy X-Ray Absorptiometry (also a gold-standard).

What did they find? The more physically active kids were at age 12, the lower their fat mass at age 14. Interestingly, these results were independent of fat mass at age 12. In other words, no matter how much fat mass a child had at age 12, if they were more physically active, they had less fat at age 14. In fact, for every 15-minute increase in daily moderate-to-vigorous physical activity at age 12, there was a 10% reduction in fat mass at age 14. Further, the authors also estimate that 12 year old children "who meet current health related recommendations of 60 minutes of moderate-vigorous physical activity a day would be expected to have around 4.3 kg less fat mass at age 14 than children who do no moderate-vigorous physical activity" [emphasis added]. That's almost 10 lbs of body fat in just 2 years!!! As the authors point out, this type of strong relationship is not likely to play a trivial role in the development of obesity or chronic disease.

So, what is the take-home message? This well-designed study, with a HUGE sample size, clearly suggests that kids who are more active today have less fat mass tomorrow. That's certainly not a huge surprise, but it's an important finding, and one that directly counters the argument that physical activity is useless for obesity prevention. It also suggests that previous studies might not have seen any relationship between physical activity and obesity because their measures just weren't very sensitive. Traditional measures like body weight and self-reported physical activity are far less precise than those used in this study, and it makes sense that when we reduce the amount of error involved, we might get a clearer picture of what is truly going on (Not surprisingly, when the authors substituted body weight instead of directly measured fat mass in the present analysis, the relationships between physical activity and obesity diminished dramatically).

Even if you still don't buy that physical activity could reduce your risk (or your child's risk) of gaining excess fat mass down the road, keep in mind that irrespective of body weight, increased physical activity is associated with dramatically lower risk of just about every chronic disease there is. Just a few more reasons to work a bit of physical activity into your day!

Travis

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ResearchBlogging.orgRiddoch, 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


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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.

Disclaimer

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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