Tag Archives: obesity

TH - PHSPTrevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy


Canada’s health ministers will meet in Vancouver on January 20, 2016. It is good to know we have a federal government that will engage with the provinces on health care. Let’s hope they will engage on health, not just health care.

Forty years ago, the Trudeau government of the day produced the fabled Lalonde report. It became the first government in modern times to acknowledge that further improvements in the health of the population would not come primarily from more health care. ...continue reading

Kelsall_Diane_01 croppedDiane Kelsall is Deputy Editor at CMAJ, and Editor of CMAJ Open


"Just because obesity is complex, it doesn't mean that we should be paralyzed by inaction."

 So said Dr. Kim Raine, Professor, School of Public Health, University of Alberta, at the opening ceremonies for the 2015 Canadian Obesity Summit. The conference, being held in Toronto, Ontario, from April 28 to May 2, 2015, brings together researchers, clinicians, policymakers and industry to discuss advances in understanding of the causes, prevention and treatment of obesity.

Raine went on to say that making meaningful change in such a complex issue as obesity will require "the cumulative action of many small steps." There is no one single action, no matter how large, that will fix it all.

And so, I decided to look at the conference itself. What small steps did the Canadian Obesity Summit organizers undertake to address obesity ...continue reading

Interview with Paula Brauer, head of the adult obesity working group at the Canadian Task Force on Preventive Health Care. This latest guideline from the Task Force, published in CMAJ, focuses on the growing epidemic of obesity in adults, recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care.

Read full article.


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The November 18th issue summary podcast is presented by Dr. John Fletcher, editor-in-chief, and Dr. Kirsten Patrick, deputy editor.

Dr. John Fletcher, editor-in-chief, CMAJ
Dr. Kirsten Patrick, deputy editor, CMAJ







Dr. Fletcher and Dr. Patrick discuss the following topics:

  • Non-cow's milk consumption and vitamin D levels in kids
  • Taxing unhealthy foods in Canada
  • Research on the Mediterranean diet and metabolic syndrome in the PREDIMED trial
  • C-CHANGE cardiovascular guidelines update
  • Nutrition in dementia
  • Hallucinations case
  • Opposing viewpoints on physician-assisted dying

And more....

...continue reading


Kirsten_headshotKirsten Patrick is Deputy Editor at CMAJ


There's a quote from the film 'When Harry Met Sally', (Meg Ryan, Billy Crystal) that I always thought was rather profound. One of the supporting characters, a writer, says,

Restaurants are to people in the eighties what theatre was to people in the sixties.

That dates the movie, and me, but how much more true it is now, I think. In the past three or four decades food has come to define us socially and has evolved into entertainment more and more.

Earlier this week Dr John Fletcher and I published an editorial in CMAJ called 'A political prescription is needed to treat obesity', which garnered some criticism from two high profile Canadian bloggers. Dr Brian Goldman of CBC's "White Coat Black Art", only mildly critical, suggested that the idea of a donut tax was impractical given the ease of cross border shopping for Canadians. Dr Arya Sharma, who writes the daily blog "Dr Sharma's Obesity Notes", was far more derisive . Dr Sharma misinterprets our editorial and suggests that we are naively arguing that taxation and regulation of  high-calorie and nutrient-poor food products is the ONLY viable approach to the obesity epidemic. Which, clearly, it is not. We are in no way in denial about the need for a multi-pronged, multi-generational approach in response to rising obesity.  In fact, perhaps Dr Sharma did not read the whole editorial before pronouncing judgement as we clearly state: "Strategies that include individual interventions, school-based nutrition and activity interventions, incentives for active commuting and changes to thebuilt environment should continue; however, we also need robust ways to restrict portion sizes and reduce the sale of sugar-sweetened beverages and other high-calorie, nutrient-poor food products."

The problem of population level obesity is multifactorial and has been decades in evolution. Political solutions that involve laws and taxation will take years to show benefits - and obviously effective treatment and lifestyle-choice solutions will continue to be necessary. But that does not mean that we shouldn't back political solutions as part of a more comprehensive strategy for treating obesity and NCDs in the longer term. ...continue reading

Randy_Fransoo_pic_smallDr Randy Fransoo is a Senior Research Scientist and Acting Associate Director of Research at Manitoba Centre for Health Policy, and an assistant professor in the Faculty of Health Sciences at the University of Manitoba. He is currently blogging from the 5th International Conference on Recent Advances in the Prevention and Management of Childhood and Adolescent Obesity


The theme for the final morning of the conference was Resilience, and featured presentations on various aspects of that topic by Dr. Rod McCormick (Thompson Rivers University), Dr. Christine Wekerle (McMaster) and Dr. John Walker (Manitoba). A clear theme in all three talks was the importance of connection in its numerous forms, including family, community, culture, and history, among others.

Dr. Allison Dart
(Manitoba) presented data from the Manitoba-based iCARE study of kidney disease among youth with Type 2 Diabetes. This cohort study is unique because of its aim to understand the influence of psychological health on physical and physiologic outcomes in youth. Some key early findings include the paramount importance of stress and distress in the lives of kids with type 2 diabetes. Preliminary results suggest significant relationships between stress and physiological measures of HPA axis activity, and inflammatory processes (another novel feature of the study). The results also connected to the resilience theme ...continue reading

Randy_Fransoo_pic_smallDr Randy Fransoo is a Senior Research Scientist and Acting Associate Director of Research at Manitoba Centre for Health Policy, and an assistant professor in the Faculty of Health Sciences at the University of Manitoba. He is currently blogging from the 5th International Conference on Recent Advances in the Prevention and Management of Childhood and Adolescent Obesity


Dr. Stuart Shanker of York University opened the second day of the conference today with his refreshingly interactive and compelling keynote on the concept of self regulation and how it is related to obesity. He stressed that self-regulation is not the same as self-control; self-regulation is has deeper physiological roots, and is not at all about 'willpower' or similar concepts. Identifying and working to resolve the causes of the underlying stressors that are interrupting self-regulation is the key to addressing this issue, according to Dr Shanker. He spoke about the pervasive and inter-generational impact of toxic stress, which really resonated with conference participants, creating considerable buzz for conversations thereafter.

In the concurrent session on Policy, two speakers ...continue reading


DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

Fat people eat more ice cream. That’s not an evidence based, statistically validated or methodologically robust observation. It just looks that way to me.

Yet it fits with the Global Burden of Disease Study published this week. “British girls become the fattest in Europe” shouted the Times of London headline on Friday, and this was echoed in almost every other UK newspaper. Canadians will be relieved to know their figures are better, but those for the USA are much worse.

Overall, the world wide prevalence of obesity has increased although, interestingly, it appears that the rate of increase has slowed in developed countries.

Now back to the anecdotal evidence. Just when I fancy an ice cream, and far away from international obesity data, it’s almost certain that I will meet some obese teen ambling along, slurping a giant ice cream cone. It puts me off. It is not politically correct, however, to imply that obesity is someone’s fault. You might think that, as a doctor, you could reasonably suggest in a consultation that someone lose a little weight. But, beware! To imply, even obliquely, that someone might be fat because they eat too many chocolate donuts, candies, or biscuits is to risk a major argument. Like almost everything in health, someone else must be to blame.

Muffin tops are the norm. Jeans bursting at the button. Great wobbly bellies, man boobs, and enormous reinforced bras. Clinicians see the fat mountain daily. We already know about inflated clothes sizes and airplanes with larger seats. But, as a population, we seem blind to the need to re-calibrate portion size and challenge the nature of fast food.

The wrong food is cheap, convenient and there are too may vested interests. We live in a world of giant sized soft drinks and buckets of popcorn where even children going to the cinema consume enough calories to feed a family in Africa. Yet, we cannot accept that we are creating generation O-for-Obesity.
Controversial? I can feel the rage of overweight people saying that I do not understand; they have big bones, eat very little, must have something wrong with their glands, or it’s genetic (it’s not). But, I do concede that we are all a little to blame. We tolerate a fast food society, allow governments to capitulate to the food lobby and make it so difficult for people to be physically active.

Fat is a complicated issue.