Thursday, December 22, 2005

Why newspapers are bad sources of medical information

I'm not even going to bother doing the work here. The anaethetist blogger I mentioned before did a great job of deconstructing news reports that suggest that based on a recent study, getting a chest XRay to rule out cancer is a good idea.

Bottom line - quite often, mass media is an atrocious place to look to for medical information....unfortunately that probably also includes blogs (but not this one or bookofjoe :-) ).

Always ask yourself, who's the source and what's their motivation. In the case of the media, the motivation may simply be sales. An article entitled, "Chest XRay screening doesn't help to prevent lung cancer" will sell less articles than the one that says, "Get a chest XRay - it may save your life!"

That being said, there are some excellent medical journalists out there - you just need to learn who you can trust.

Cool scanner

Sorry that it's been so long since I posted. I got derailed by a bachelor party in Las Vegas.

Glad I didn't have this scanner there to tell me that I was not living in a healthy manner.

To my eyes it looks like it rivals MRIs in quality. Hopefully the $1,800,000 price tag will come down given that the technology, if CT scanner based ought to be a heck of a lot cheaper.

Wednesday, December 14, 2005

Fibre - not a miracle, but still great

So a very solid report came out today in the Journal of the American Medical Association that looked at studies that pooled over 725,628 men and women for up to 20 years to determine whether or not diets high in fibre reduced the risk of colon cancer.

The facts are straightforward, people eating diets higher in fibre do have a lower risk of colon cancer BUT it's probably not because of the fibre. It's probably because people who have diets high in fibre often live healthier and make healthier choices overall.

The fact is that dietary fibre DOES help reduce cholesterol levels, it DOES help keep calories under control, it DOES help reduce the body's resistance to insulin and overall is still a great idea to include in a healthy life.

Monday, December 12, 2005

3DPS vs. Measuring tape

Talk about overkill.

A report on the news about a 3-dimensional photonic image scanner which uses 4 lasers to measure over 2 million points on the body.

What's it for?

It's to measure the incidence of abdominal obesity, otherwise known as apple-shaped. Not a bad thing to measure given that there is greater risk with abdominal obesity.

Want to know what I use in my office?

A tape measure.

Measure at roughly the umbilicus. More than 35 inches in women and more than 40 inches in men is said to confer greater risk.

Saturday, December 10, 2005

How many calories a day do you burn?

So if you want to lose weight, one of the most important things you need to know is how many calories a day you actually burn.

Over the years there have been many methods and equations used to make this determination. The picture in this post is an old standard called a, "Douglas Bag". Basically it allows docs to figure out how much oxygen you've burned and extrapolate from there how many calories you've burned.

Newer methods include such things as indirect calorimeters and some even fancier devices.

While there are some places that have indirect calorimeters (like us at the Bariatric Medical Institute), at least 90% of the time the equations are pretty accurate.

The best equations I've found are located here.

Once you know how many calories you burn then if you simply keep track of calories using a food diary or an online service, so long as you eat less than you burn, you'll lose weight.

The trick is, you've got to like the way you're living - that's where keeping track of calories is so helpful. By having an idea of how many calories you burn and keeping track of how many calories you have it allows you to answer a very easy question, "Is it worth the calories" when you're considering having something to eat. The other thing to remember of course is that sometimes, it ABSOLUTELY is worth the calories. Food plays a role in comfort, celebration and just like that decisions. If you lose the ability to choose less than perfectly from time to time, well then you're on a diet, and guess what, diets fail over 98% of the time.

Thursday, December 08, 2005

DARE to exercise - it could save your life!

Dr. Ron Sigal, from my hometown Ottawa, recently presented the largest study ever of its kind looking at the effect of exercise on type II diabetes (formerly known as adult onset diabetes until children as young as 8 began developing it due to our toxic food environment)at the Canadian Society for Exercise Physiology conference.

To summarize, Dr. Sigal's work proved that after 22 weeks of close to 200 minutes per week of exercise, that aerobic plus resistance strength training were as good as taking a medication for diabetes.

While this doesn't mean go off your drugs and go and exercise, you may well be able to reduce your diabetic medications by getting in shape.

If you want more reasons to exercise - Ron's work demonstrated that exercise translated for many patients into a 15-20% reduction in the risk of heart disease and up to a 30% reduction in the risk of diabetic complications such as blindness and kidney failure.

Exercise need not be brutal - you don't need the sweat bursting out of your brow for it to count. Start with a great pedometer and set the simplest of goals - more steps than yesterday.

You may just save your own life.

Tuesday, December 06, 2005


The Institute of Medicine released a report today that stated that targeting children with advertisements for high calorie foods and beverages likely contributes to rates of childhood obesity.

Of course they do.

The fact is that children under the age of 11 cannot differentiate truth from advertisement.

Just as it is now a crime to target children with advertisements for smoking, so too should it be for crappy foods.

Call your local member of parliament, congressman or senator and tell them it should be some countries it already is!

Unless your doc runs a weight loss program, don't let them give you weight loss drugs

Just a quick post. A study published recently in the New England Journal of Medicine, confirmed something anyone involved in medical weight loss already knows - the drugs aren't so great all by themselves.

If your family doc prescribes you Meridia, Xenical or Phentermine but does not offer you guidance or support in lifestyle change, you're probably wasting a great deal of money. On the other hand, using these drugs in conjunction with a behavioural weight loss program can be quite beneficial.

If it were as simple as, "Here take this pill", over 65% of North America wouldn't be overweight. If it sounds too good to be true, of course it probably is.

Monday, December 05, 2005

Does Drinking Make you Skinny?

A friend just sent me an article stating that drinking moderately is associated with a lower risk of obesity.

The newsfeeds are of course all over it, even so far as to suggest that if you need to lose weight, you should consider NOT giving up alcohol.

That's just news-spin hogwash.

If you actually take the time to read the article you'll see that the "moderate" drinkers are also better educated, rate themselves as healthier and have higher incomes than the non or heavy drinkers. That probably means that they've got better access to health care, take better care of themselves and as my friend pointed out, if they are able to moderately consume alcohol, they can probably also moderately consume foods.

The Healthy Eating Pyramid

Wondering what you should eat?

Trust in your government's recommendations?

You probably shouldn't.

Both the US and Canadian governments seem to believe that politics, lobbyists and industry shills are important stakeholders in the foods they recommend.

Instead of the USDA Food Pyramid and Canada's Food Guide I prefer the work of Dr. Walter Willett, the Chairman of Nutrtion at Harvard. He did what our governments should have done - he created a food pyramid based solely off of evidence-based medicine. By sifting through over 40 years of dietary research Dr. Willett created the Healthy Eating Pyramid. It's at the same time easier to follow and healthier to consume than the political equivalents created by North American governments.

Such a sad statement that Health Canada and the USDA care more about politics and industry than about the health of their nations.

Sunday, December 04, 2005

Orange juice, the greatest marketing campaign ever!

Really quick question?

If I put a tiny dollop of Vitamin C in Coca Cola would that make it good for you?

If you answered no, and if you've also been having orange or any other juice as a means to be healthier, you'd better stop drinking it.

Did you know that drop for drop orange juice (and most juices) have more calories than Coca Cola?

Now before you get all excited and start talking to me about Vitamin C you should also know that never in the history of medicine has Vitamin C ever been shown to help to reduce or prevent the common cold, cancer or heart disease.

What's even more amazing is that medical health professionals including doctors and dietitians often will tell their patients' that juice is healthy.

Quite frankly, it's not.

Here's a comparison of orange juice with a "fizzy" soda and a diet "fizzy" soda.

Bottom line, if you want a fruit, EAT ONE.

Saturday, December 03, 2005

Winter Walking Safety

If you're like many folks out there, walking in the winter can be a scary endeavor. Even without having any pre-existing problem with balance, unseen ice fills ERs in winter climates the world over.

Many folks who are active in warmer months head indoors in winter due to this fear.

Well, no longer. The Yaktrax Pro is a fantastic product that gives tremendous traction at a cheap price in an elegant package. You can even use it as a runner, especially now that the Pro version has an additional retention strap crossing over the top of your shoe.

Products like this one can be especially valuable to folks with balance difficulties or known osteoperosis, but there is one word of warning that I can give you from experience - they're VERY slippery on indoor ceramics and tiles.

Friday, December 02, 2005

The Amazing Wovel

Living in Ottawa with winter coming I'm sure many folks are debating the merits of shovel vs. snowblower vs. snow removal service.

Having had a snow removal service destroy the front of my lawn last year, my debate was between shovel vs. snowblower.

Definitely more calories burned shoveling, but it was quite time consuming, and for folks with pre-existing heart disease, it can be quite dangerous.

Enter the Wovel. It's like a shovel on steroids. The manufacturer says it's 3x faster than a shovel and half the effort.

Sounds like a fair trade to me.

Thursday, December 01, 2005

Condemning your child to being overweight?

On the newsfeeds today is a story about linking your future child's weight to the weight you might gain during pregnancy. What the study found was the children of women who gained more weight during pregnancy had a higher likelihood of being overweight at age 3.

The conclusions being drawn on the newsfeeds is that the issue of obesity in North America must therefore be due to weight gain during pregnancy. The fact is there are literally thousands of variables that affect weight and even more that affect eating behaviour.

Interestingly the only controls mentioned in the experiements were for race, parental smoking, household income and fetal growth during pregnancy. The only control I would want to know about is the eating habits of the household to begin with because guess what, children eat what parents buy and if the household has calorie dense choices, parental inactivity and poor nutritional education that's far more of a culprit in childhood obesity than anything else.

By far the best way to help your children is to live well yourself and let them learn from you.

First post

Have to admit, never pictured myself as a blogger. I was inspired by the anaesthetist who maintains one of my favourite blogs.

My name is Yoni Freedhoff and I'm a medical doctor who specializes in obesity medicine and I'm located in Ottawa, Ontario CANADA. I run a multi-disciplinary medical weight loss centre that relies on behavioural change rather than drugs or diets to help patients lose weight. My office's website is

In this blog I hope to report my thoughts on news items and stories related to weight loss as well as products and items that interest me.