The American Diabetes Association Wants Video Games in Your Kids' School Gyms?

A waste of a perfectly good gym?

Last week saw a press release from Konami bragging about the involvement of the American Diabetic Association in bringing their exergame Dance, Dance, Revolution to schools across the United States.

Demonstrating what I would call a questionable understanding of energy balance, the ADA's Director of Youth Markets Mary Baumann was quoted in the release as stating,

"We look forward to the impact the new classroom edition can offer schools to help keep children in the healthy fitness zone for BMIs."

Putting aside the fact that I don't actually understand what a "healthy fitness zone for BMIs" is, let's just assume Ms. Baumann was suggesting that kids can Dance, Dance their way to lighter weights.

So does Dance, Dance, Revolution actually burn a great many calories?

Looking to the medical literature helps. Check out this graph that came from a study published in the journal Pediatrics. It's of the measured energy expenditure of kids at rest and playing Dance, Dance, Revolution.

Looks awesome right, kids playing DDR were expending more than double the calories expended at rest. But wait, that's a strange way to report energy expenditure, isn't it? Usually energy expenditure is reported as calories burned per hour of activity, why not here?

Because reporting it as a function of energy burned at rest is the only way to make this study sound interesting. When you actually crunch the study's numbers you'll find that DDR helps to burn an additional 91 calories/hr.  That's less than half the calories you'd burn leisurely walking, let alone actually running around and playing some sort of sport in a gymnasium.

While I've got nothing against exer-gaming, suggesting that it will provide any sort of health benefit, be it weight management, diabetes prevention, or heart health, is more than just wrong and a gross misrepresentation of the medical literature, it's irresponsible. Unfortunately, at this stage of exer-gaming's evolution, they are much more game than they are exercise, and teaching kids, their parents and their educators otherwise, while understandable from video-game developer Konami, is inexcusable from the American Diabetes Association, as this is the exact sort of misinformation that might preclude actually healthy initiatives from being rolled out in schools. 

[Sadly, it's not just the ADA, today's ridiculousness is also being championed by Let's Move and The National Foundation on Fitness and Sports. Shame on all of them.]

Lanningham-Foster, L., Jensen, T., Foster, R., Redmond, A., Walker, B., Heinz, D., & Levine, J. (2006). Energy Expenditure of Sedentary Screen Time Compared With Active Screen Time for Children PEDIATRICS, 118 (6) DOI: 10.1542/peds.2006-1087

Horrifying new product alert - body fat scales for children

If it's a sign of the times, it's a sign of how truly backwards we are as a society when it comes to weight management.

Scale company Tanita is now marketing a specially designed body-fat/weigh scale for children between the ages of 5-17.

Now I've blogged before about how I think body-fat percentage scales are a bad idea to begin with, but to target them at children bring them to a whole new level of horror.

5 year olds don't need to have their body-fat or their weights measured, they need healthy food and parental role modeling.

So instead of punishing your child by buying them a body-fat percentage scale, may I suggest that if you're not already doing so you:

- Cook healthy meals from whole ingredients for each and every meal.
- Have sit down family dinners each and every night (remembering they don't need to be gourmet - kids do love peanut butter sandwiches).
- Involve your children in meal (and school lunch) preparation.
- Track the added sugars in your childrens' diets and try to limit to no more than 45 grams daily (remembering that some days should be exceptions too - sugar's part of childhood, it just needn't be a daily part).
- Ensure that the only fruit they eat is actual fruit - no juices, rollups, chews, or mashes.
- Make their milk white and skim, not brown and sugary.
- Ensure your children eat protein with every meal and snack, and that they start their days off with a wholesome, protein inclusive, breakfast.
- Make restaurant meals and take out (including supermarket prepared takeout meals) exceedingly rare events.
- Engage your family in family based physical activity - weekend hikes, nightly walks, signing up for community races, landscaping, home improvement projects, push lawnmowers, snow shoveling, etc.

Lastly you've got to remember - if you're worried about your kid's weights, don't put it on them. It's not their problem, it's yours, and if you think you're going to fix it by yelling at them, weighing them, shaming them, food policing them, etc. - you're going to be disappointed, and your kid is going to be miserable.

If you want your kids to change the way they're living, you're going to have to change the way your whole family's living - and frankly it isn't about weight. All of those behaviours up above? Doesn't matter if your kids are heavy or thin, those strategies will benefit each and every family, though the likelihood is, if weight's an issue in your family, those changes will help far more than any scale ever could.

Chewable Lipitor candy for kids?

Thanks to blog reader Craig for forwarding me a report on the EU's approval of a new chewable tablet of Lipitor (the cholesterol lowering medication) geared for use in kids ages 10 and up.

And according to a study published yesterday in the Journal Pediatrics, the market's probably bigger than once thought. The lead researcher of the study, one where over 20,000 kids' cholesterol levels were screened, was quoted by the Wall Street Journal as stating that current pediatric cholesterol screening guidelines would have missed 36% of kids with, "seriously high LDL".

Sigh.

Sign of the times - pharmacies provide free diabetic medications

Ever hear of a "loss leader"?

A loss leader is an item a store sells at a loss to draw people into the store. The premise is that by leading them into the store, the loss will be more than made up by spending elsewhere.

Milk's a pretty common loss leader for pharmacies where it's often sold cheaper than in supermarkets. Of course most everything else in pharmacies is marked up through the roof, but still, that milk is cheap and so often that's where I'll go to get it.

Milk's a good loss leader because most households buy it, it has an expiry date so people won't stockpile it, and you can place it in the back corner of the store so people need to walk through other aisles to find it and in so doing be more likely to grab other, higher priced items.

Items that would make bad loss leaders? Things not enough people want or need as it simply wouldn't draw in enough business to recoup the losses.

So what does that say about Meijer's latest plan to give away free prescription diabetes medications?

Yup, Meijer's, with 191 stores across 5 American States has announced that Metformin, the most commonly prescribed diabetic medication, a drug that retails there for between $14 and $42 monthly, will be dispensed freely to those with prescriptions.

The medical community there is thrilled, and so too I'm sure are uninsured patients.

Me? I don't find it as thrilling. Sure it's wonderful that low income folks will no longer have an issue affording their medication but what does it say about the state of the nation that diabetes medications can be successful loss leaders, and not just at discounted prices but at 100% markdowns?

It says that type 2 diabetes, weight-related diabetes, is now so prevalent that actually giving away the medication for free is a cost effective strategy for improving store sales.

Given the exponential rise in the risk of obesity with rising weight, diabetes rates are set to soar with some predictions suggesting rates are set to more than double by 2050.

That's a lot of free Metformin.

Boy Scouts should be prepared for a rise in sloth.

Why?

Apparently they've just commissioned a new badge for their scouts to earn.

The video game badge.

Yup.

Just checked my calendar and it's not April 1st.

Sad sign of the times.

Sign of the Times - Ikea Video Game Playing Chair

It's called the Ikea Jesper Bench and the catalog picture above helps to explain what it's for.

I wonder when Ikea'll make an Insulin Table with refrigerated drawers, lancet dispensers and glucostrip disposal hole?

The chair can be yours for just $59.99 CAD.

[Hat tip to BMI's fitness director Rob]

Calorie Counting's For the Dogs

Literally.

In one heck of a sign of the times I bring you Pup-peroni's new 50 Calorie snack pouch for pooches.

You see it's not just people who are gaining weight.

According to the organization Stop Canine Obesity,

"The American Veterinary Medical Association (AVMA) has estimated that there are 41.2 million pet dogs in the United States. Other sources estimate 40 percent of those dogs, approximately 17 million, are overweight or obese."

I find this canine obesity epidemic fascinating.

Should we blame lack of gym class? Fast-food? Less walkable neighbourhoods? Maternal imprinting? Air conditioners? Big food advertisements? Celebrity product endorsements? Not fidgeting enough? TVs in their rooms? XBOXs? The internet? Their transition from a manual labour workforce to holding desk jobs? Over-protective parents? Human adenoviruses? High-fructose corn syrup? Artificial sweeteners? MSG? Social networks? Early weaning? Pesticides and industrial chemicals? Sleep deprivation?

Or could it simply be that we're feeding them too much food?

[FYI: One of my favourite authors on the subject of food, politics and nutrition, Marion Nestle, has just released her latest work Pet Food Politics. Not having read it, I can't formally review it, but I can tell you that my copy is en route from Amazon.]

Sign of the Times - Boy Scouts Healthy Eating Badge

If you're a Beaver Scout in the UK, check out the new badge - it's the Healthy Eating activity badge.

Not sure what it says about society. Maybe this is a great idea. Of course even if it is, it makes me a little sad.

Our world is spiraling faster and faster away from healthy living.

Even if you think it sounds like a great idea, what does the eager Beaver Scout need to do to get the badge?

According to ScoutBase UK he's got to:

1. Make a fruit salad
2. Make a healthy snack
3. Make two different sandwiches
4. List some unhealthy foods

Wanna know what they think a healthy snack is (emphasis is mine not theirs)?

"Examples of healthy snacks include omelette, salad, mini pizzas, strawberry smoothie, homemade meatballs, etc."

Yup, it's a strange world alright.

Sign of the Times

If this isn't a sign of the times I don't know what is.

Going through my spam folder yesterday.

Seeing all the usual suspects:

"No Erectile Dysfunction

Make your woman feel happy on holidays! Increase your willy!

Viagra $1,41 per pill. 100mg x 10 pills = $59.95."

Then I came across this one:

Fiber, whole grains may cut pancreatic cancer risk

So I clicked it thinking that perhaps it had been filtered in error.

Of course when I clicked it, it was still just someone trying to sell me Viagra.

I wonder if they know something I don't?

Anti-Obesity Baby Formula?

Here's one of the scarier pieces I've read in a while.

Prof. Mike Cawthorne, a UK scientist is formulating a baby formula designed to prevent future obesity via its inclusion of the hormone leptin.

Leptin is a fairly well understood hunger/satiety hormone. It was discovered in the 90s out of studies of an obese mouse model and it's produced by our bodies' fat cells. Leptin's job is to help let the brain know we're full and binding of leptin to the satiety centre of our brains (the hypothalamus) is one of the body's satiety signals.

Folks with two defective leptin receptors are morbidly obese and providing them with leptin injections confers massive weight loss.

Before you get too excited about the potential for leptin to benefit folks with weight management issues you should know that to date there have only been a few dozen folks worldwide who have been shown to have two defective leptin receptors and that obesity researchers got far too excited about leptin's role in treatment and to date virtually every study ever done on leptin replacement as a weight management tool has been a major disappointment unless you're one of those few dozen individuals with the exceedingly rare combination of two defective leptin genes.

In folks with significant amounts of weight, one of the proposed mechanisms or contributors is in fact leptin resistance whereas their bodies actually produce more leptin (remember it's produced in the fat cells themselves), it's just that their bodies don't seem to respond to it.

Back to the baby formula. Professor Cawthorne is basing his idea off of a couple of rat studies: In the first study suckling rats were given 4 times the amount of leptin normally ingested from their mothers and later in life were found to be lighter and eat fewer Calories. The second study, administered leptin to pregnant rats and found that their offspring were leaner and lighter. Putting these studies together Professor Cawthorne is designing an infant formula that has leptin added to it.

What's fascinating to me is the fact that to an extent, these studies have already been conducted in humans and their results have proven to be woefully disappointing.

You see, we know that folks with significant amounts of weight produce a great deal more leptin than lean folks, and that therefore obese pregnant women's babies are exposed to a great deal more in-utero leptin and more breast milk leptin. Yet we know that having a parent with a significant amount of weight vastly increases the risk of that child being an obese adult. If you were like Dr. Cawthorne and wanted to make an overly simplistic leap, you might even want to paradoxically blame the leptin.

I don't think that would be wise either.

For me obesity is not a single cause issue. At the end of the day there are an incredible myriad of factors that influence how much we eat and how much we burn. When I read stuff like Mike Cawthorne's formula plans the cynic in me wonders how much the fact that there's a 50-100 billion dollar industry out there where folks buy hope in the form of miracle pills, tablets and cures, influences the plans of such formulations.

Scary stuff jumping from bench to bedside in one fell swoop. Who knows what kind of other longterm implications might occur with such a plan, including the possibility of a worsening of future weight, or unforeseen and unrelated after effects.

Me, I'll stick to educating, motivating and supporting.