Tuesday, December 28, 2010

New Years Resolutions

I've never done them. Ever. They don't work. I work in retail pharmacy, an industry that arguably is the only one to see higher sales in January than in December. We have so many people buying vitamins, minerals, herbals, detox kits, weight loss pills, etc. to realize New Years Resolutions. The sad thing about New Years Resolutions is that the majority of them crash and burn. Weight loss is the most common of course. The first Weight Watchers meeting after January 1 is standing room only. In obesity treatment circles we say that a diet consists of the least amount of calories and most exercise that a patient can tolerate. A healthy lifestyle is the least amount of calories and most exercise a patient can enjoy. That is, there is no point making any lifestyle change unless it is something you can continue forever. Going to the gym 5 times per week at 6:00 am is not likely to be one of those unless you are a fitness buff to begin with. So this year, do yourself a favor. Don't make any New Years Resolutions. Instead, aim to make small, sustainable changes in your life every day of the year that will accumulate into a healthier you by next December.

In the meantime, if you're feeling like some self-masochistic exercise, I dare you to do this workout and not feel like you want to die at the end. (Yes, the freeze frame is purposefully provocative.)

Wednesday, December 22, 2010

I am officially a Bodyrocker

It's amazing the things you find while randomly perusing Youtube. I was watching a hilarious video of Cookie Monster doing vocals for Rammstein's Du Hast when I saw an intriguing thumbnail on the side. I will openly admit it was not the subject matter that intrigued me. Anyone who sees this video will understand why I originally clicked on it. I'm not going to sugarcoat it people.

Now, aside from the obvious visual candy this video provides, I must say I was interested in this concept. I really do enjoy working out but I HATE weights, I don't want to go to a gym because it just won't happen, it's too damn cold outside to exercise outdoors, treadmills and ellipticals bore me, and a man can only do so many pushups and situps before he dies from boredom. So the thought of having a nearly endless smorgasboard of bodyweight exercises I can do in my own home makes me salivate. (Okay, maybe it's the scantily clad instructor causing the salivation, but I need motivation so I'll take what I can get.)

From where does the impetus for this come might you ask? Well, if you recall, I did a post exactly two months ago on getting back on track with Weight Watchers. It hasn't turned out so well. I had one good week and then it all went to hell from there. I have been baking for about the last month at least twice a week to produce this cornucopia of sweetness.

I bake every year at this time. I love it. It relaxes me and I give away a bunch of goodies to friends and family. But I INSIST on the highest quality in my finished product which means a LOT of quality control. That translates into my pants fitting quite snug. I got a little bummed out when I looked in the mirror the other night. Yes, men have body image issues too. Well, at least some men. My bigger concern though is what the image represents. Love handles are more scientifically known as central adiposity and they are a significant risk factor for cardiovascular disease and diabetes. See below for more on that.

So I thought, I'm going to become a Bodyrocker. Not only am I going to get my ass back on track with Weight Watchers (I know how to do it, I just have to smarten up and actually do it and realize finally 20 pounds later than I'm not invincible anymore) but I'm going to get in shape. Honestly, working with people with diabetes, cardiovascular disease, and metabolic syndrome every day makes me really want to get in shape so I'm here to see my grandchildren grow into adults. And I also realized, after feeling to keep my weight off for more than a year, that keeping your weight off WITHOUT exercise is next to impossible. The scientific evidence supports that and I loves me some scientific evidence, but when it comes to my personal life I usually turn a blind eye to it.

I started with Bodyrocks Absolute Beginners series that you can get on Youtube. Then once I slaughtered myself doing that I am now joining in on her nightly exercises. They are different every night and usually fairly short, like 20-30 minutes. They're fun and they make you sweat like mad. Seriously. Check the one out tonight. 75 high knee jump ropes followed by 25 squats. Repeat 9 more times. Puke. This woman did all 10 sets in 18 minutes! It took me 35 minutes and now I can barely walk up the stairs. Seriously. That's half the reason I'm writing this post. I can't get out of the computer chair. And Zuzana did this with a freakin 8kg sandbag on her back for the squats. You have to respect that. And her form sickens me. I look like a gyrating ectomorphic mass most of the time. But that is why she looks like this (yes, they're fake),

and I look like this (mine're all real).

But some day I will be a certified Bodyrocker too! Wait and see!

Current weight: 185lbs
Current BMI: 28.1

Goal weight: 164 lbs
Goal BMI: 24.9

PS-For all you BMI naysayers, a MASSIVE study published in the New England Journal of Medicine recently looked at mortality in 1.5 million white adults over a period of 10 years. It found that the healthiest weight was one with a BMI of 20-24.9. Death rates in the group 20-22.4 were similar to those in the 22.5-24.9 group. They used to think lower was better but now it appears a 22.5-24.9 BMI is just as healthy, which is good news for us who struggle with weight as it is much more attainable and sustainable. Even being a bit overweight (25-29.9) increased risk of mortality by 1.13X. Those with BMIs 40-49.9 had the highest mortality rates, increasing their risk over normal weight individuals by 2.51. To give you an example of how big that is, I'd have to weigh 265 lbs on a 5'8" frame.

Sunday, November 14, 2010


My wife spent the weekend in Edmonton having a little time with her sisters before baby #3 comes along. She brought home a sticker book for Sacha filled with dinosaur stickers and tons of facts about dinosaurs. It states a fact about a dinosaur and then has an outline of the sticker you need to place there. While going through the book with him, he made so many astute observations I just had to share them. Keep in mind this boy is only 4 years old.

1. Book-"Dinosaur X was a speedy carnivore and hunted its prey at night."
Sacha-"Oh, cool. That means he is nocturnal."

2. Book-Showed various dinosaurs and where they were first discovered. They showed one dinosaur that was discovered in Argentina.
Sacha-"Oh, yeah, just like the Argentinosaurus."

3. Book-Shows a picture of a velociraptor a la Jurassic Park, that is, hard scaly features, not feathers. Paleontological evidence proves that velociraptors had feathers because arm bones have been found of them with quill knobs in the bone. Sacha has learned about velociraptor feathers on his favorite show, which is also highly educational, Dinosaur Train, on PBS.
Sacha-"Hey, that picture is wrong. That velociraptor has got no feathers."

4. Book-Shows a veritable cornucopia of pterosaurs.
Sacha-Pointing to one of the smallest picture on a page of probably 30 different pterosaurs says, "Hey, there's a peteinosaurus." And he was right.

5. Book-Shows a picture of an archaeopteryx.
Me-"Do you remember what 'archaeopteryx' means?"
Sacha-Somewhat incredulous that I had the nerve to ask. "Uh yeah, it means 'old wing'."

6. Book-Shows a picture of a pterosaur flying low to the ground and says "Pterosaurs had to be careful not to be eaten by spinosaurus."
Sacha-"Daddy, but spinosaurus eats fish."
Daddy-"Well, maybe they ate birds too."
Sacha-"No. Pterosaurs aren't birds. They aren't dinosaurs either. They're just pterosaurs."
And he's right. They were flying reptiles, not birds, not dinosaurs. Silly daddy.

The kids knows more about dinosaurs than me.

Wednesday, November 10, 2010

The Great Pacific Garbage Patch

I saw a hilarious video today on YouTube narrated by Jeremy Irons that mocks nature films and describes the life of the "majestic plastic bag". Then when I started to recall the truth about this video, a phenomenon known as the Great Pacific Garbage Patch, it made me sad. There is a floating mass of plastic trash in the north Pacific that some estimates state is the size of Texas. There are some very disturbing pictures here. Or you can just Google Image "Great Pacific Garbage Patch" or "North Pacific Gyre" or "Pacific Trash Vortex". That's the last time I forget my reusable bags in the car. How depressing.

Other wasteful human behaviors visible in my community that enrage me:

1. Running your unnecessarily large truck for 45 minutes when the outside temperature is a devastating -1C.
2. Producing 4 full garbage bins of waste every week for a family of 3.
3. Throwing out easily recyclable materials like paper and cardboard.
4. Driving past a collection of 3 houses where no special events, holidays, or birthday parties are occurring, only 1 family lives in each house, yet there are over 10 vehicles parked outside.
5. Making 4 even more depressing, driving down a residential street on which every single house has a double car garage but not a single one has a vehicle parked in it. The garages are full of stuff that long ago lost all utility even though when they were purchased they were considered a "need".

Sunday, November 7, 2010

Terrestrial Energy

When I first moved here two years ago I was interested in nuclear energy more for what it represented as an economic prospect for this town than as an energy production method in and of itself. In the ensuing years I heard so much misinformation and emotional banter thrown around about nuclear power I decided to dig deeper. I did a lot of research from trusted sources on the Web. The more I dug, the more this incredible technology interested me. So, I did what I always do and I bought two in-depth books on the subject.

Now, don't get me wrong, I really did try to find a book that presented the anti-nuclear viewpoint. I just couldn't. I found a few but when I read the excerpts it was very clear they were not looking at the issue from an objective standpoint. When I research something in the scientific literature I want to see references to back up statements. The few anti-nuke books I found were so devoid of references as to be essentially personal diatribes against the industry. Not so for the two balanced yet conclusively pro-nuke books I finally purchased.

The first is called Power to Save the World by Gwyneth Cravens. Cravens is a former anti-nuclear protester turned pro-nuclear supporter after she set out to find as much about the industry as she could to fight it. What she found so astonished and amazed her that she couldn't help but support the cause, which she did by writing this overview of the entire nuclear industry from uranium extraction right on to handling of nuclear waste. The book is exhaustively researched and well documented. It's a thick sludge of a read at times but for the most part is quite captivating, especially for those of a scientific mindset.

I am now onto the second book, called Terrestrial Energy by William Tucker. In contrast to energy sources derived from solar energy (wind, biofuels, fossil fuels, solar) terrestrial energy is that which comes from the Earth. Geothermal energy is the most obvious form of terrestrial energy, but believe it or not, nuclear power is a naturally occurring phenomenon that is responsible for the balmy molten core of the Earth. The book attempts to look at the entire energy picture, starting with discussing the ongoing public disagreement about the causes of global warming, then moving onto fossil fuels, solar and renewables, and finally onto nuclear, ending the book with a discussion of the nuclear industry in France, world leaders in nuclear energy.

Honestly, if every Albertan were to read these two books, or even just excerpts, Alberta would be jumping on the nuclear bandwagon. We would be able to stop importing electricity from British Columbia and possibly even start exporting some at a net economic gain. According to Alberta Energy, we currently net import $110 million worth of electricity per year. We would also stop emitting more greenhouse gases than any other province in Canada. According to Statistics Canada, in 2005 Alberta produced 30 million more tons of GHG emissions than Ontario, a province with a population 4 times that of Alberta. If Alberta were to replace one 4000MW coal plant with one 4000MW nuclear plant, that single act alone would make us achieve our carbon emission reduction targets for 2030 (I cannot reference this statement; it is from an engineering study done internally by a company for which a colleague works).

So why aren't we? Well, like I said, read the books. I'm seriously considering sending my copies to Ron Liepert, Alberta Minister of Energy, once I'm done with them. Although, I think a bulky package arriving in his office might arouse suspicion. But for those of you reading this, I treat you to an excerpt from Mr. Tucker's incredible book that I found truly awe inspiring. Enjoy. (Emphases added.)

"[Speaking of the incredible energy inside the earth that makes its core hotter than the surface of the sun]...anywhere from 60 to 90 percent by most estimates comes from a remarkable diminutive source--the slow breakdown of two of the ninety naturally occurring elements found in the earth--uranium and thorium...Because of their size, they are "radioactive", meaning they are unstable. The internal "binding energy" that overrides the mutual repulsion among positively charged protons is occasionally overcome itself. This releases large quantities of energy, which sets subatomic particles in motion, creating large amounts of heat. Incredibly, the slow breakdown of these two radioactive elements, uranium and thorium, is enough to raise the earth's internal temperature beyond the level of the surface of the sun...Drill down ten miles almost anywhere on earth and you will encounter enough heat to boil water...But here's a better idea. Why don't we just take the source of that heat---the uranium or thorium--bring it to the surface, and reproduce or even accelerate the process that produces this heat in a controlled environment?
This is what we do in a nuclear reactor.
[This process] is really no different than tapping fossilized solar energy...We find stored solar energy beneath the earth's surface. We mine it, we bring it to the surface, we concentrate it. We ignite it, starting a chain reaction where the energy released from one molecular breakdown triggers a breakdown of the next. We capture the heat to boil water, to produce steam, to drive a turbine, to generate electricity...A nuclear reactor is nothing more than terrestrial energy brought to the surface, just as a coal plant is stored solar energy brought to the surface. There is nothing sinister or diabolical about it. We are not defying the laws of nature. Rather, we are working with a process that already takes place in nature. (In fact, nuclear fission chain reactions have been found to occur in natural uranium deposits near Oklo, Gabon)....
There is one great difference between terrestrial energy and solar energy, however, and that is the energy density. Terrestrial energy is far more concentrated--by a factor of about two million...This distinction is the key to understanding why terrestrial energy offers such a remarkable possibility for powering the planet without disrupting the environment....
Consider a gallon of gasoline. The "orbital" energy (that contained within the electrons orbiting the nucleus) stored in this gallon is enough to propel a 3,000 pound automobile about 30 miles--an extraordinary feat when you think about it...Yet if we could tap the binding energy stored in the nucleus of those same molecules it would be enough to propel the same automobile 60 million miles, almost all the way to Mars...
[Let's compare two power plants, one coal, one nuclear]...The North Omaha Power Plant in Omaha, Nebraska, produces 500MW of electricity, about one-fifth the power needed to run the city. Every three days, a 110-car unit train arrives and each car is loaded with 125 tons of coal (13 750 tons every 3 days). One car produces twenty minutes of electricity. (Roughly 36 hours of electricity produced by the whole train.) The plant occupies more than two square miles. Each day's consumption of 4500 tons of coal at North Omaha will combine with atmospheric oxygen to form 15000 tons of carbon dioxide. Across the country, America has 600 similar coal plants that provide half our electricity and put 3 billion tons of CO2 into the atmosphere each year--10 percent of the world's total...
About thirty miles south of Omaha lies the Cooper Nuclear Station on the banks of the Missouri River. The plant occupies two square miles...Every eighteen months, a single tractor-trailer arrives carrying several dozen bundles of 18-foot nuclear fuel rods. These rods are only mildly radioactive and can be handled safely with gloves. They are loaded into the reactor core, where they will undergo nuclear fission for three years...The Cooper Station produces no sulfur emissions, no mercury, no soot, no particulate matter, no ash, no slag, and no greenhouse gases. And it does produce more electricity than North Omaha--750MW...
Solar energy in its many forms has accustomed us to the idea that using energy must create huge environmental impacts, either by polluting or by occupying vast tracts of land. Terrestrial energy is so highly concentrated that it can provide us with enormous amounts of energy while barely leaving a trace."

Anti-vaccine fears have consequences

The fears of the anti-vaccine movement are not only unsubstantiated, but they create more disastrous outcomes than the very worst of their ignorant prognostications. Case in point: my colleague had to deal with an elderly Native man having a transient ischemic attack (mini-stroke) right in the pharmacy. It was a harrowing incident for her and many in the store. Unfortunately the gentleman refused to go to the hospital even after the paramedics arrived and confirmed my colleague's diagnosis because he "felt better". What did this lead to in our store? An outpouring of congratulations to my colleague and the brave way she handled the whole situation? Frustration at a man who was generously helped by a caring health professional but then refused to take responsibility for his own health? Nope. The spreading of unsubstantiated rumors that he had been given the stroke by the flu vaccine my colleague is giving patients right now. First of all, there is absolutely no evidence linking vaccines to strokes, not even in the most ridiculous assertions of the online anti-vaccine movement. Second of all, the GUY NEVER EVEN GOT THE FLU VACCINE.

The truly ironic fact of the anti-vaccine movement is that while they are willing to accept thoroughly disproved scientific tenets they refuse to accept well documented truths. For example, North American lifestyle causes much more morbidity and premature mortality than even the most outlandish prediction of vaccine-induced adversity ever would. More importantly, acceptance of their argument and application of their solutions to this non-existent problem would cause and DOES cause even more suffering as evidenced by an incredible article in The Guardian.

Vivienne Parry does a phenomenal job documenting the consequences of the anti-vaccine movement. The most depressing aspect of this article is that anti-vaccine fears of affluent North Americans that are able to fend off infectious disease with relative ease are causing the most harm to those least able to defend themselves against infectious disease: the impoverished in developing nations. Read the article. If after reading it you still harbor animosity toward vaccines then give your head a shake. And spare the rest of us. If you want to put your own life at risk by not getting vaccinated against dangerous diseases, fine. But don't put the rest of the world at risk by spreading your virulent misinformation.

Friday, October 29, 2010

Teething Tabs Recall. Science: 1 Quackery: 0

Natural does not mean safe. Repeat after me. Natural does not mean safe.

Myself and my colleague have repeated this mantra to patients many times. They come in wanting something "natural" for a relatively serious medical condition like high blood pressure or high cholesterol. We warn them that these herbal medications do not have scientific evidence supporting their effectiveness and may in some cases be as harmful as prescription medications. We're almost always met with a look of complete disbelief as though there must be some hidden agenda tainting our advice.

The most egregious example of this logical fallacy so prevalent in the laity is homeopathic medicines. Homeopathy is a pseudoscience that aims to dilute compounds in a preparation so much that there is no actual active ingredient remaining. The method of mixing the ingredients is said to impart the "energy" of the substance into the preparation. They use substances that would cause the symptom you're trying to treat if that substance were given in a sufficiently large dose. By diluting it down they attempt to trigger the body to heal itself.

There are many problems with this. First, theoretically, there is nothing in the preparation as homeopathy aims to dilute each substance down to a level where no molecules of the substance remain in the preparation. So you're essentially buying expensive distilled water. Second, homeopathy has not a single shred of evidence supporting its effectiveness in treating medical conditions. Third, people develop a false sense of security with these products. If done correctly there really should be no harm to these products. But this field is loosely regulated and inconsistently enforced, so you don't necessarily know what you're getting. Case in point: Hyland's Teething Tabs.

These absolutely useless sugar pills were just pulled from the market in Canada after their manufacturer received word from the US FDA that children given the products experienced belladonna toxicity. Belladonna is a plant native to Europe and also extremely toxic. We have taken many medications from it including atropine, hyoscyamine, and scopolamine. All of these drugs are useful if used appropriately but can also be extremely dangerous. Hyland's Teething Tabs contain 3X belladonna, or a 1:1000 dilution. Turns out they put more in there than they should have. Symptoms of belladonna toxicity include but are not limited to blurred vision, rapid heart rate, slurred speech, urinary retention, constipation, confusion, hallucinations, delirium, and convulsions.

Can you imagine being a frustrated parent looking for some solution to your child's incessant teething and instead of using something effective like Advil or Tylenol or non-drug treatments like cold cloths and gum massaging you get lured in by the marketing from the makers of Hylands? "A Safe Solution To Every Problem" It's fairly obvious now that this is NOT a safe solution

So next time you think you might want to try something "natural" because it'll be better for you and much safer, think of Hylands Teething Tabs. Or morphine. That's natural. So are arsenic, strychnine, and cyanide. And lots of cancer meds. And digoxin....nicotine, alcohol, marijuana, magic mushrooms, peyote, mescaline........................................

Monday, October 25, 2010

This makes me weep


I've been seeing this for years in my practice and am sure so have many other health professionals. I've seen 12 year olds with high blood pressure and 10 year olds on diabetes medications for obesity-induced diabetes, not Type 1. And people wonder why I'm so concerned with maintaining a healthy body weight, encouraging my patients to do the same, and teaching my children to eat and live healthy.

Sunday, October 24, 2010

Weight update

I weighed in at Weight Watchers on Thursday. Came in at 174. That means I'm 5 lbs down in 2 weeks. Not too bad for being half crippled the whole time because of my knee surgery. The thing that's been quite welcome is I haven't felt like I've been depriving myself and I haven't been too obsessively tracking things. Just not getting out of hand if I slip. Seems to be working okay right now. We'll see what two weeks from now brings. For information sake, I have posted two pictures below, and will continue to take pictures at each weigh in to chart my progress. I also took some shirtless pictures but those shall remain on my computer only! The picture on the left will always be from last Thanksgiving. I was at 158 lbs then, my slimmest in 10 years. The picture on the right will be right after the most recent weigh in. Keep wishing me luck!

PS-I'm going to kick my wife's butt for not telling me my glasses were insanely crooked in the current shot. Whatever. I don't have the energy to walk upstairs and take another picture.

Monday, October 18, 2010

If only we were all so passionate

I'm a big believer in exercising my democratic right to vote and I believe everyone else should be as well. I'm trying to raise my children to hold this principle dear. So far it seems to be working. I've voted in every election since I turned 18, federal, provincial, and municipal, so this year was to be no different.

In order to justify an excursion from the house, I told Sacha all about voting and that it would be fun. He really bought into it. He was so excited to go voting this morning.

When we arrived at the voter's station to register he asked the lady if he could have a paper so he could vote. She had to inform him that he couldn't vote. Just so we're clear, the impression I gave him is that he would be helping me vote, not voting himself. But he wanted to go one step further. Oh, he was mightily ticked when he was told he couldn't.

He did his trademark "I'm unhappy with the world" stance: shoulders raised, big frown, furled eyebrows, hands under his armpits closed in fists and stomped off to the voting booth. "I don't like that the lady told me I couldn't vote. I really want to vote." I told him he only had to wait 14 more years and then he could vote. He seemed happy to help me mark my X's, a difficult task given his inability to stay in the lines which could have spoiled my ballot. But it worked just fine. He even got to put the little papers into the ballot box.

On the way out, he said, "I thought you said this was going to be fun. It was boring instead." Then he talked all day about how he wasn't allowed to vote.

My wife's friend came up with a great idea. For the kids that come to vote with their parents, have colorful little ballots with felt pens and their own voting station. They could put it into a colored box with some colorful decorations on it. It'd get them excited about the process.

Weight Update

Staying true to my promise, I'm here to update you on my weight loss goals. However, I'm a firm believer in sticking to the same scale. So since Weight Watchers pegged me at 179, I'd like to believe my new scale is correct when it says 172, but I'll have to wait until Thursday to give you the right number when I weigh in.

In the meantime, here's another interesting obesity fact.

3500 calories is roughly the energy equivalent of 1 pound of fat. Therefore, if you were to consume, on average, 100 less calories a day for a whole year you'd lose 10 pounds. 100 calories per day X 365 days in a year=36500 calories. There are 3500 calories in 1 pound of fat so 36500/3500=10.4 pounds. So you can see the significant impact of making a very small change in your diet. For example, if you're someone who drinks a can of Coke or Pepsi every day, cutting that out would put you down 150 calories, or 15 pounds in a year, assuming you changed nothing else in your diet.

So, next time you see that tasty cookie at Timmie's, realize that if you added one of those to your work week coffee stop for a whole year you'd gain 16 pounds. Surely a Fruit Explosion Muffin would be a better choice, right? Wrong! 360 calories. 130 more than the chocolate chunk cookie. It would put 26 pounds on your frame in a year of 50 work weeks. While we're on the topic, how about your extra large double-double? 280 calories my friend. I know some people that get one every day. 28 pounds in a year. Ouch. I find this more useful than calories because it gives you a number you can envision. And the mental picture you get is not pretty!

Next time you go to pick something up, divide the caloric value by 10, and think about yourself that many pounds heavier a year down the road. It'll make you wonder whether you really need it.

Saturday, October 9, 2010

On the upswing

Last week I was lucky enough to attend a talk by the internationally renowned obesity expert, Dr. Arya Sharma here in little Peace River. Although I was one of the main people involved in arranging the talk and have taken additional training in obesity management, I was still amazed and delighted by the talk.

For those of us in the crowd that struggle with overweight and obesity there were many statements he made that, although true and backed up by research, were very depressing. For example, there is a substantial body of evidence showing that exercise plays very little role in helping people to lose weight. It is important for preventing regain of weight, but the biggest impact that one can make on their lifestyle when wanting to lose weight is in the diet. I won't get into specifics, but suffice it to say that once Dr. Sharma finished his explanation, we all agreed.

The other statement he made that I love is that obesity and overweight is not a problem of the individual or a sign of sickness of the human body. In fact, it is quite the opposite. The reason modern North Americans are overweight and obese is precisely BECAUSE our body is so good at regulating our caloric inputs and outputs. We're designed for handling long periods of famine, not perpetual abundance. His conclusion: "Obesity is the response of a very healthy natural system to an unhealthy environment."

This helped me mentally prepare for a later statement: over the long-term, weight loss efforts are only moderately successful. At best, with lifestyle change alone, long-term weight loss will be roughly 3-5%, meaning that someone like myself starting at 200 lbs when I started on Weight Watchers can expect, at best, a 10 lb weight loss long-term. Of course, this is based on population studies so you cannot predict any individual's success. Looking at long-term studies, roughly 50% of weight loss from behavioral interventions is regained after 1 year.

And this brings me to "on the upswing".

As the chart above so sadly shows, I started Weight Watchers in October 2008 at roughly 200 lbs. In roughly 5 months I was finally a healthy weight (164 lbs). I maintained that weight for almost 7 months. In October 2009, my wife and I went to Edmonton on a weekend away from the kids. I let loose. Put on like 3 lbs in a week. Ever since then I have not been below 164 lbs once. But until recently I've been hovering close enough to the mark that I've only had to pay at Weight Watchers two months. (As a Lifetime Member, as long as I weigh in once a month at no more than 2 lbs above my goal weight (=164 lbs for me + 2=166) I don't have to pay to attend). But then this September we went to New Brunswick to visit friends and I ate an unhealthy amount of seafood. This week when I weighed in at Weight Watchers for the first time since that trip, I was devastated to see that I was threatening 180 lbs (179 to be precise).

What have I done wrong? Sadly, my scientific mind jumps to all the above data and concludes that I'm really just abiding by population statistics. The graph of my weight loss and subsequent regain is eerily similar to that shown by Dr. Sharma to chart weight regain in large populations of obese and overweight patients. My emotional side does not want to accept that though. It seems much too defeatist.

So, in some soul-searching with myself, my wife, and my glorious sister Andi, (who has managed to stay within a 2 lb window all summer despite no longer explicitly tracking what she eats and being injured and unable to run), I have identified the following character flaws that lead me to gain weight.

1. Although tracking what you eat has been shown to aid in weight loss and maintenance, it is honestly something I cannot see myself doing for the rest of my life. I've been doing it for 2 years now, and I've just had enough. It's so exhausting. And as Dr. Sharma and his colleague, Dr. Freedhoff, say in their newly published incredible book Best Weight, "If you do not like the way you are living while you are losing your weight, you will almost certainly re-gain the weight when you go back to the way you were living before you lost it." ie. anything you do to lose weight must be sustainable...FOREVER.

2. I am a grazer. When I'm bored, tired, excited, depressed, anxious, happy, or just generally alive, I enjoy grazing our kitchen. My mind shuts off, all my tracking mechanisms go to sleep, and I consume. I need a hobby to replace it.

3. I hate wasting food. As such, I almost always clean off the food my children leave behind. Not into the garbage. Into my mouth.

4. I am a consummate offender in the all-or-none department. My Weight Watchers leader explained this nicely once. "If you were taking an egg out of a carton to make an omelet and accidentally dropped it would you throw up your hands in despair and smash the other 11 on the ground? No. You'd clean up the broken one and continue on as before." But when I slip and have a piece of cake that really wasn't worth it, my natural response is, "Well, I've shot today all to hell now. Might as well pig out and make it worth my while". Or if I decide that running would be a good way to burn some calories and keep off the weight but then realize for it to make an appreciable difference I'd have to do it 5-6 days a week my response is not to still do it when I can because something is better than nothing, but to plant my tush on the couch.

So here I am, telling you that I'm kicking my own ass back into gear. I'm going to recognize these character flaws and work with them to achieve my goals. I'm only going to weigh myself once a week. I'm going to try and go for a walk whenever I can but not beat myself up if I don't get the chance every day. I'm going to start tracking what I eat again, not so much to make a lifelong habit of it, but to regain awareness of the cumulative effect of consuming small amounts of unhealthy foods over prolonged periods of time. I'm not going to do celebratory Dairy Queen Thursdays anymore. I will still go to Dairy Queen and get a small treat if the scale proves to me I've done well. However, it will stop there. I got in the habit of celebrating just a little too much on Thursday nights after weigh-in. I think my Thursday night consumption was starting to approach 2 days worth of calories. Calories don't follow calendars. Speaking of calendars, I'm going to stop making excuses for special occasions. You'll see if you start to do this that every weekend has a special occasion of some sort or another. I will limit special occasion culinary celebration to Christmas, Thanksgiving, Easter, our anniversary, and my birthday. That is all that is necessary, really. When you're starting to use Victoria Day as an excuse to eat more food, you know you have a problem.

Most importantly, I'm going to start publishing regular updates of my progress on this blog. Not only is tracking what you eat an incredibly effective way to lose weight, but so is having a strong social support system. I figure the more I divulge about my struggles here, the more likely I am to succeed. As payment for subjecting you to this, I will focus each week on something interesting about obesity management. You'll be surprised to find out how little you actually know about this incredibly complex topic.

Here's a teaser.

Many people want to know the secrets to long-term weight loss maintenance. Thankfully, the work has already been done for us. The National Weight Control Registry has, for many years, been tracking roughly 5000 individuals who have lost 30 lbs or more and kept it off for 1 year or more. From this incredible study have come key behavioral components necessary to successfully maintain weight-loss (after all, losing weight actually isn't that hard; keeping it off is a real pain in the ass). Some of the most interesting findings from the study are:

1. Registry members have lost an average of 66 lbs and kept it off for 5.5 years.
2. Almost half of the members lost the weight on their own; the other half used a program of some type.
3. The most frequently reported form of activity is walking.
4. Almost 80% of them eat breakfast EVERY DAY.
5. 3/4 of them still weigh themselves once a week.
6. 90% exercise, ON AVERAGE, about 1 hour per day.
7. Most of them continue to consume low-fat, low-calorie diets.
8. They consume regular meals (less than 3 out per week and less than 1 fast food per week)

Sunday, October 3, 2010

Compounding our problems

I did a guest post for Scott over at Science-Based Pharmacy on problems with specialty compounding. Enjoy!

Monday, July 26, 2010


Two months since the beginning of gardening season in Peace country and harvesting has begun in earnest. Weeks ago I harvested spinach and have been continuously harvesting lettuce and peas, the latter of which never made it to the house because they're just too darn tasty coming out of the garden. Now some of my beets have been picked as well as some carrots and some potatoes. Not only have I learned that for me, gardening is one of the most wonderful pastimes I could have taken up. But I've also learned more about our industrial food system than I could have hoped to from the legion of books I've read on this topic to date. Ever notice a few differences between fresh garden produce and store bought produce? The first, most obvious difference, is that garden fresh produce tastes infinitely better. The more subtle difference is qualitative. When I went to harvest my beets I was expecting to find the swollen, monstrous tubers of grocery store fame. When I saw these 1.5 inch shrimps I thought to myself, "They're not ready." But then I read in my gardening books that beets are to be harvested between 1.5-3 inches in diameter and are at their best flavor at 1.5 inches. Where along the line of modern food production did we lose this knowledge and decide that all of our vegetables needed to be monstrous to be worthy of purchase? And what of their look? Have you looked at store-bought carrots? They all look the same and, yes, they look beautiful. Garden carrots look dwarfish and ugly. But goodness do they taste better. You know, cucumbers used to grow curled and crooked until we humans stepped in and bred them to grow straight so they'd be easier to fit in a box for shipping. That for me is the saddest thing I've read in a long time. I hate cucumbers. I really do. Or at least that's what I said until I tried some garden grown ones by a local gardener. They're phenomenal. I wonder if the declining consumption of fruits and vegetables in North America is a result of our attempt to "standardize" them. What a shame more people don't garden. If only they knew what they were missing.

Tuesday, May 25, 2010

More vaccine fear

So even though I knew that all the anti-vaccine fear out there was based on exactly that, fear, I never knew the origins of the whole charade. Thanks go out to Science-Based Pharmacy for filling me in! Read the short but eloquent account of Dr. Andrew Wakefield's fall from grace in Britain after being exposed for his self-serving demonization of the measles-mumps-rubella vaccine which was later completely ripped apart by those concerned with facts. Dr. Wakefield recently had his medical license stripped. Interestingly, he is still a hero in the irrational American anti-vaccination camp.

Thursday, April 1, 2010

Dutch brilliance

So it's no secret I'm a big fan of the Dutch. Being of Dutch heritage myself, I take every opportunity I have to enjoy all things Dutch. Gouda, pickled herring, ridiculously bright orange soccer jerseys, olliebollen, and the little wooden shoe I wear around my neck given to me by a charming old Dutchman who wears real wooden shoes, every day of the year, even in the dead of a Canadian winter. It was with little surprise then when I read in Discover magazine of Oostvaardersplassen, a most incredible idea dreamed up by none other than the Dutch.

A little background: in traditional ecology-think, there is a theory known as succession. That is, that if you leave any given northern habitat alone, it will eventually become a closed canopy forest, like the great Boreal forest covering large swaths of North America. But a Dutch scientist saw a hole in this theory and questioned how, if this were in fact true, why did prehuman Europe have so many large grazing animals? Grazers cannot survive in a closed canopy forest. Nor can oak trees, which require ample light and for which there is substantial evidence of existence throughout Europe in prehistoric times. In order to test his theory, he needed a massive tract of undisturbed land. Coming by that in the most densely populated nation in Europe could not be easy. But as luck would have it, a large land area that had been reclaimed from the sea by the Dutch to build factories on had been abandoned when the economy tanked in the 80s. And so you have Oostvaardersplassen.

This Dutch scientist set about implementing something called rewilding. Essentially what he has done is turned the theory of succession on its head. Instead of saying that the forest is the default ecosystem and animal behavior follows this trajectory, his thought is that if humans would just keep their hands off, animals themselves shape the land and it will become what the animals make of it. He has introduced species into Oostvaardersplassen that closely mimic large grazers that would have existed in prehistoric times: red deer, wild horses, and wild cattle. The genius is that he just lets them be. If they have a tough winter, they die. Unfortunately (in my eyes), special interest animal protection groups got involved and he had to compromise by having wildlife officers watch out for animals that were clearly to weak to continue living and kill them, which is apparently the compassionate thing to do. The amazing thing is that these processes have allowed a vibrant grassland/wetland ecosystem to take hold and no signs of a forest taking over have emerged. The other amazing thing is that it has brought strength back to an eagle species that hasn't been seen in significant numbers in Europe for a century. The most amazing thing? This is happening only 20 minutes outside of Amsterdam.

It's an incredible story and again exposes for me the folly of human thinking that we always know best. One thing that was interesting in the story was that in North America, there is very little evidence of forest fires before woolly mammoths went extinct. The thinking is that they foraged all the combustible detritus. When they died off, BOOM, forest fires. Yet now we selectively cull certain animal populations that are "getting out of hand", do controlled forest fires, relocate wolves, and on and on. Of course, the problem is that if we just let nature do its thing, we think we wouldn't be able to continue doing our thing: building houses wherever we feel like and filling them with lots of stuff we don't need that were produced from the very ecosystems we are trying to save in some lame attempt at repentance for our sin of living grossly beyond our means.

Check out the pics at http://oostvaardersplassen.biofaan.nl/

For this and many other fascinating stories, pick up a copy of Discover magazine some time. I've been a subscriber for 10+ years and have never been disappointed!

Sunday, March 7, 2010


I haven't blogged in a while, but I just had to intervene on this infuriating commercial Chevrolet keeps running about how their Malibu is so much better than the Toyota Camry or Honda Accord in fuel mileage ratings. They also run equally annoying ads about how their cars and trucks have better fuel economy than Toyota and Honda and that they are first in class. Now, I didn't get the chance to read the miniscule writing that clarifies their statements but allow me to challenge this since I'm of the mind, correctly or not, that non-American cars are superior in every way, not the least of which is fuel economy.

First, the Malibu claim.

I don't bother looking at manufacturer's claims of fuel economy because they're notoriously unreliable. So I look at two references: the Government of Canada's Energuide ratings and Globe Auto's ratings. According to Globe Auto, on Highway Fuel Economy, which Chevrolet claims is the best on Malibu, Malibu equals Accord and is bested by the Camry. It is better than Accord on combined fuel economy but is slaughtered by the Camry. Energuide looks like maybe Malibu slightly edges out both in their tests on highway.

Next, the "best-in-class" claim. For this I will use Energuide because they rank by class. The ONLY Chevrolet vehicle that has best-in-class fuel economy is the Chevrolet Express Cargo Van. Top seller for sure. The Impala has a decent showing at 4th in its class. So if Chevy doesn't top the classes in combined fuel economy, who does? (For this I have looked only at 2010 models with automatic transmissions and gasoline engines just to avoid bias toward the diesels and manual transmissions)

Two-seater: Smart Fortwo

Subcompact: Toyota Yaris; Chevy Aveo comes in behind Yaris and Honda Civic

Compact: Top 4 cars are hybrids; top non-hybrid is VW Golf GTI Clean Diesel; Kia Rio (my car!) is #1 of compact regular gasoline cars; Chevy falls at 14th behind Hyundai Accent, Toyota Corolla, and Kia Rio.

Mid-Size: Again, top 4 are hybrid, including Prius (our car!); top gasoline car is Nissan Versa
The illustrious Chevy Malibu is beaten by the following foreign cars: Nissan Sentra, Toyota Camry, Nissan Altima, Hyundai Elantra. In fairness to American car makers, Ford Fusion and Fusion Hybrid make respectable showings.

Full-size: Chevy's best showing, with a 5th place Impala behind the superior Hyundai Sonata and Honda Accords with 2 different trims. Toyota Avalon is left in the dust in this case.

Station-wagon (if you're so inclined): Audi A3 TDI wins if you can afford one; VW TDI Clean Diesel for real people; Chevy has no cars in this lineup but the Pontiac Vibe gets creamed by the Honda Fit, Nissan Cube, and Kia Soul. Toyota again makes a poor showing. Wondering if bad brakes and stuck accelerators are all they need to worry about?

Pickup Trucks: For the smaller engines, Chevy Colorado got beat by Toyota Tacoma, Mazda B2300, and Ford Ranger.

Minivans: Mazda5 leaves everyone else so far behind it's hard to compare. But Chevrolet Uplander is way behind even their domestic competition.

Too bad some people believe what they see in commercials.