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Mr Epidemiology

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Childhood obesity drops 40% in the last decade. Or not really, but who’s checking?

“A lie that is half-truth is the darkest of all lies.”
― Alfred Tennyson

Last week, a study published in the Journal of the American Medical Association looked at the prevalence of childhood obesity over the last 10 years. The study, performed by Cynthia Ogden and colleagues at the CDC, aimed to describe the prevalence of obesity in the US and look at changes between 2003 and 2012. The study itself had several interesting findings, not least among them that the prevalence of obesity seems to have stabilized in many segments of the US population. However, they made one observation that caught the media’s attention:

“There was a significant decrease in obesity among 2- to 5-year-old children (from 13.9% to 8.4%; P = .03)”

This is where things get interesting, as the focus was not on the 5.5 percentage points difference. Instead of reporting the absolute difference, i.e. how much something changed, news outlets focused on the relative difference, i.e. how much they changed compared to each other. In that case, it would be (5.5/13.9 =) 40%. Which is much more impressive than the 5.5% change reported in the study. So you can guess what the headlines loudly proclaimed.

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Physicality in Sports: How can you cheer when people are getting seriously injured?

As I write this post, I’m sitting here watching the 49ers take on the Seahawks. It’s been a great game so far, although the sheer number of injuries have been terrifying, culminating in an absolutely horrific injury to 49ers linebacker NaVorro Bowman where his leg bent in ways it shouldn’t under any circumstances.

 

Like a lot of people, I like sports. In fact, I was one of the 56 million people who tuned into that NFC Championship game mentioned above – more than the entire population of Spain, and the total population of California and Florida together. Getting together with friends, watching football, hockey, UFC, or any other sport is one of my favourite passtimes. The drama that comes along with professional sports in the form of redemption stories, a veteran’s final chance at a title, and the bad blood associated with historic rivalries all lead to a great afternoon/evening/day. In addition, there’s the sheer skill and athletic ability of the competitors and watching years of practice and training pay off. Along with this comes one of the most exciting things for any spectator, especially those who like football or hockey, to witness.

The Bone Crushing Hit.

You know what this is. A player gets the puck/ball and runs towards the goal/endzone, and a defensive player absolutely destroys them. You’re sitting at home, miles away, and you cringe with the sheer impact. It makes every highlight reel, and transcends sports, appearing on highlights reels for the NHL and the NFL. Sometimes this is illegal but more often than not, it’s perfectly legal, and considered “part of the game.” This is where I have trouble.

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Guest Post: Dear (Food) Diary …

Mr Epidemiology: Today, I’m welcoming Natalie Causarano to the blog. You can find out more about Natalie at the end of this post.

The summer is finally on its way, bringing us BBQs, cottages, and …wait for it…the often dreaded BATHING SUIT SEASON! That moment of truth when we must face the effects of our winter hibernation (which might make us want to stay in hibernation).

Vanity aside, the benefits of maintaining a normal weight is a long-championed public health message. Yet the combined effects of increased portion sizes and our increasingly sedentary lifestyle are making it difficult for us to maintain a healthy weight. So, where should we start to lose? The diet industry seems to be growing as fast as the obesity epidemic and the price of weight loss products is even more discouraging.

One inexpensive weight loss strategy is to self-monitor with a food and / or exercise diary, which has been found to be an effective weight loss strategy by numerous studies (1). I know what you’re thinking, there’s no more room in your purse or murse for a food journal!

Fear not, the internet has the solution!

Continue reading “Guest Post: Dear (Food) Diary …”

Guest Post: The Evolution of Sedentary Time

Mr Epidemiology: Today, I’m welcoming Lindsay Kobayashi back to the blog. You can find out more about Lindsay at the end of this post.

How sad.

The negative health effects of sedentary behaviour are a hot topic gaining scientific and popular attention. Any Canadian reading the news should be aware that sitting is killing us – Maclean’s, the Globe and Mail, and the CBC have all recently published on the topic. Given the tsunami-like obesity epidemic that has risen over North America over the past few decades, critical investigation of our sedentary behaviour is highly warranted.

Every time I hear someone talk about how sitting is killing us, I return to the same question – If I was born 50 or 100 years earlier, would I be less sedentary than I am now? In the figure above, I’ve depicted my average 16-hour day (waking hours only). Exemplary of a big question in the sedentary behaviour research domain, I am what you would call an “active couch potato” – I spend 7-8 hours week engaged in moderate-to-vigourous exercise, yet I still spend 50% of my waking hours sitting in front the computer! What does this mean for my health? And yours too – if you are reading this, you are likely somewhat similar to me. Is this sort of sedentary behaviour a new phenomenon of the latter part of 20th and early 21st century? Continue reading “Guest Post: The Evolution of Sedentary Time”

Guest Post: What determines health?

Mr Epidemiology: Today, I’m welcoming Lindsay Kobayashi to the blog. You can find out more about Lindsay at the end of this post.

Health inequity is a global and a local problem.

As epidemiologists, we are concerned with uncovering the factors in populations that determine who gets sick, who stays healthy, who lives, and who dies. Human life is inherently social, and looking toward our societies and geography can help explain who is healthy or sick, and why. “Location, location, location” is a mantra that rings true with respect to life expectancy. In Canada and the United States, men can expect to live to 79 or 76 years, respectively, while women can expect to live over 80 years (1). The story is similar for most wealthy and developed countries. By contrast, take Afghanistan or any one of several sub-Saharan African countries, where a baby born today could expect to live only until his or her mid-40s or 50s(1).

Temporarily setting aside biologic limitations on health (a loaded issue for another blog post), human-made health limitations clearly exist in our world. A person’s life chances greatly depend on where he or she is born and lives and some people do not reach the same level of health achievable by others. Inequities in life expectancy exist within countries as well: Canada-wide, women residing the poorest neighbourhoods live two years less on average than women residing in the richest neighbourhoods, and this difference is four years for men(2). This striking inequity brings us back to the original question: What determines health?

Continue reading “Guest Post: What determines health?”

Romance is not a romantic comedy: The importance of good exposure measurement

If you live in Kingston, you may have come across this headline:

Kingston, ON is the most romantic city in Canada

Wonderful you think – after all, Kingston does have that small city charm, with lots of historical buildings, quaint little cafes and restaurants as well as being right on the water. Lots of romantic movie potential, where big city Sandra Bullock moves to a small town only to fall for lovable country mouse Ryan Reynolds.

It's like if you had this movie set in Kingston, instead of Alaska! .... which I wouldn't know because I've never seen it *cough*

And then you read the article more closely, and determine how they measured the “romanticness” of a city:

The online retailer bases its list by comparing sales data of romance novels, sex and relationship books, romantic comedy DVDs and CDs by Canadian crooner Michael Buble since Jan. 1 on a per capita basis in cities with more than 80,000 residents.

Wait, what?

Continue reading “Romance is not a romantic comedy: The importance of good exposure measurement”

How many calories are in that burger?: Do our estimates become more accurate with labelling

ResearchBlogging.org Recently, there has been a push to mandate labelling in fast food restaurants and stores. In the US, this is a huge initiative, passed as part of the 2010 Health Reform Bill (for another view on this, check out Dr Yoni Freedhoff’s post). This Bill mandated that all restaurants with more than 20 locations nationally had to post nutritional information on their website.

There’s a lot of ammo on both sides: some think that people should be responsible for their food choices, and that restaurants shouldn’t have to put up nutritional information. After all, they don’t *force* you to eat it. On the other hand, others advocate that knowing what is in your food will help you make a more informed decision.

Do you know how many calories are in a regular Big Mac? Take a guess. The answer is at the end of this post.

Regardless of your viewpoint, it all becomes irrelevant if the nutritional information doesn’t actually make a difference; if people don’t read and remember them, then what is the point?

And this is where today’s paper comes in.

More after this word from our sponsors … (click read more)

Continue reading “How many calories are in that burger?: Do our estimates become more accurate with labelling”

Don’t call kids “obese”: Parental preferences for what you call their child

ResearchBlogging.org Obese youth are often stigmatized by society, and this stigmatization can have drastic, and long lasting consequences ranging from decreased self esteem to increased suicidal ideation. And for those youth who remain obese into adulthood, they also face worse employment, educational opportunities and even stigmatization by healthcare professionals.

Knowing that obese youth face this sort of discrimination, and the toll this can take on parents, you have to wonder what effect Pediatricians can have. Given that parents put a lot of trust in pediatricians, and often pediatricians form the first port of call for parents concerned about their child’s weight, the words they use and the policies they promote can make a lot of difference to those concerned about their weight.

The Rudd Center for Food Policy and Obesity is a world leader in obesity stigma research

This led to a study being conducted Dr Rebecca Puhl and colleagues at the Rudd Center for Food Policy and Obesity at Yale University, where they asked parents what terms they would like pediatricians to use when talking about a child with a higher than ideal weight, and also what action they would take if their doctor used stigmatizing language. As I’ll talk about later, the article caused a bit of a firestorm online.

Continue reading “Don’t call kids “obese”: Parental preferences for what you call their child”

Attitudes to Publically Funded Obesity Treatment and Prevention

ResearchBlogging.org In countries where healthcare is funded by taxpayers, concerns over whether or not obesity treatment should be included under the umbrella of national healthcare is an ongoing concern. While this is also a concern in countries with private healthcare, in the public healthcare system the cost may be borne by society as a whole.

Perhaps the biggest issue in supporting obesity treatment programs is *not* whether or not there is a need for treatment: it’s obvious these people need help. The underlying issue is whether or not there is *public support* for treatment. Skim through the comments section on any CBC or Globe and Mail piece on obesity, and it is clear that this is a very contentious issue.

Hospital's can provide treatment for obesity. But is there public support for extreme measures such as surgery?

Prejudice and discrimination against the obese is not new, and last year the Canadian Obesity Network, along with partners, hosted the 1st Canadian Summit on Weight Bias and Discrimination (for more information, see the executive summary.) Knowing this prejudice exists, researchers in Denmark set out to investigate public support for obesity treatment, and to identify predictors of this support.

Continue reading “Attitudes to Publically Funded Obesity Treatment and Prevention”

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