Tuesday, September 30, 2014

Practical Guide To Obesity Prevention in Schools in Developing Countries

Practical Guide To Obesity Prevention in School-Aged ChildrenObesity in school-age children is not just a problem in the affluent West – this issue if of growing importance in countries where one may not quite expect this to be an issue like South Asia or Africa.

Now, researchers from the University of Montreal and McGill University have released a comprehensive practical guide to developing and implementing obesity prevention programs for school-aged children and adolescents in developing countries.

As the authors discuss,

“What is most challenging in low and middle-income countries is the urgency of preventing obesity while also tackling the problem of malnutrition. Again, the school setting is likely the most appropriate to address the dual burden of malnutrition, but interventions are needed at different stages of the lifecycle, beginning with girls, in order to break the intergenerational cycle of malnutrition and its impact on vulnerability to obesity and other chronic diseases.”

This guide is a product of TRANSNUT (for nutrition transition), a WHO Collaborating Centre comprised of 10 researchers from the Department of Nutrition and other units of the University of Montréal.

In the words of the authors,

“This manual is designed to provide a hands-on guide for health and nutrition professionals to plan, implement and evaluate obesity prevention programmes for school-age children and adolescents in developing countries, particularly in the school setting. Several practical tools are suggested, including for the assessment of obesity and of its proximal determinants, that is, eating and physical activity patterns. Models and conceptual frameworks are discussed because action has to be grounded in sound theory. We provide a 5-step guide to planning healthy nutrition promotion and obesity prevention interventions, which we adapted from the PRECEDE-PROCEED of Green. The steps consist of community and individual assessments, identification of targets for change(community, family, individual level), choice of objectives, design of programme methods, and procedures for theevaluation. In order to foster effective programmes to promote healthy nutrition and lifestyle among school-agechildren and adolescents, we discuss theoretical models of behaviours change that may be appropriate (Health Belief Model, Theory of Planned Behaviour, Social Cognitive Theory, Stages of Change, Transtheoretical Model).”

This document should provide an interesting read to anyone interested in the prevention of childhood obesity in developing countries or elsewhere.

A copy of this guide can be downloaded here

@DrSharma
Charlottetown, PEI

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Monday, September 29, 2014

Does Lean Tissue Have More To Say About Your Health Than Your Body Fat?

Carla Prado, PhD,  Assistant Professor and CAIP Chair in Nutrition, Food and Health, University of Alberta, Edmonton, Canada

Carla Prado, PhD, Assistant Professor and CAIP Chair in Nutrition, Food and Health, University of Alberta, Edmonton, Canada

The common assumption is that people with more body fat are at greater risk for illness and overall mortality.

Surprisingly, an increasingly robust body of evidence now suggests that how much lean tissue you have may be far more important for your health than the amount of body fat.

This evidence as well as the methodologies used to study lean body mass are discusses in a paper by Carla Prado (University of Alberta) and Steve Heymsfield (Pennington Biomedical Research Center), in a paper published in the Journal of Parenteral and Enteral Nutrition.

As the authors point out,

“The emerging use of imaging techniques such as dual energy x-ray absorptiometry, computerized tomography, magnetic resonance imaging, and ultrasound imaging in the clinical setting have highlighted the importance of lean soft tissue (LST) as an independent predictor of morbidity and mortality.

The paper discusses in depth the advantages and limitation of the many methods that can be used to assess body composition in research and clinical settings.

The paper also discusses the current definition and importance of sarcopenic obesity and notes that,

“The identification of different body composition phenotypes suggests that individuals have different metabolism and hence utilization of fuel sources.”

Thus,

“It is clear from emerging studies that body composition health will be vital in treatment decisions, prognostic outcomes, and quality of life in several nonclinical and clinical states.”

My guess is that it will not just be the absolute or relative amount of lean tissue mass that is important. Rather, similar to the increasingly recognised role of differences amongst fat depots, I would assume that different lean soft tissue depots may well play different roles in metabolic health.

@DrSharma
Charlottetown, PEI

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Sunday, September 28, 2014

Obesity Weekend Roundup, September 26, 2014

As not everyone may have a chance during the week to read every post, here’s a roundup of last week’s posts:

Have a great Sunday! (or what is left of it)

@DrSharma
Orlando, FL

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Friday, September 26, 2014

Bariatric Surgery In Kids And Adolescents

sharma-obesity-bariatric-surgery21Earlier this week I spoke at the 5th Conference on Childhood and Adolescent Obesity, organised by Jon McGavock and colleagues from the University of Manitoba in Winnipeg, where one of the topics discussed in depth was the role of bariatic surgery in children and adolescents with severe obesity.

This is obviously an issue fraught with social, psychological, medical and ethical issues – no one wants to have to do surgery on these kids but there are often no other alternatives when behavioural interventions are simply not enough.

Now a review of this rather complex field by Halley Wasserman and Thomas Inge from the Cincinnati Children’s Hospital and Medical Center appears in Pediatric Annals.

The paper discusses in depth the indications and potential benefits of bariatric surgery in adolescents with severe obesity but also highlights the important acute and long-term complications that must be monitored during follow-up (usually by their general pediatricians).

This article should of interest to anyone who counsels children and adolescents with severe obesity in their practice.

@DrSharma
Orlando, FL

ResearchBlogging.orgWasserman H, & Inge TH (2014). Bariatric surgery in obese adolescents: opportunities and challenges. Pediatric annals, 43 (9) PMID: 25198448

 

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Thursday, September 25, 2014

Health Is Not Measured In Pounds

OAC LogoToday, I am on my way to Orlando, where I will give the opening Keynote talk, “Health is Not Measured in Pounds”, at the annual convention of the Obesity Action Coalition.

This US non-for profit organisation has nearly 50,000 members and is dedicated to giving a voice to the individual affected by the disease of obesity and helping individuals along their journey toward better health through education, advocacy and support. Our core focuses are to raise awareness and improve access to the prevention and treatment of obesity, provide evidence-based education on obesity and its treatments, fight to eliminate weight bias and discrimination, elevate the conversation of weight and its impact on health and offer a community of support for the individual affected.

Major initiatives involve advocacy for access to better treatments and campaigns to address weight bias and discrimination. The OAC is a partner and works closely with the Canadian Obesity Network on some of these issues.

For more information on the Obesity Action Coalition – click here.

For more information on the Canadian Obesity Network – click here.

@DrSharma
Winnipeg, MB

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In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

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