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Progress and Challenges in the Prevention and Control of Obesity
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Abstracts / Can J Diabetes 37 (2013) S217eS289
THURSDAY, MAY 2: PLENARIES A.M. 501-PL Progress and Challenges in the Prevention and Control of Obesity WILLIAM H. DIETZ Atlanta, Georgia, United States of America After almost 30 years, the rapid increase in the prevalence of obesity in adults and youth in the United States appears to be slowing or has plateaued, and in some locations and some population groups the prevalence of childhood obesity is decreasing. The reasons for the change in slope of the obesity epidemic is uncertain, but, like the changes that occurred when cigarette consumption began to decline, may be attributable to increased awareness of the adverse effects of obesity. The declines in childhood obesity have occurred in locations that have targeted multiple behaviors, often in multiple sectors. Foundations and federal agencies have provided support for state and community policy, system, and environmental interventions. Federal efforts to sustain community initiatives are threatened by the financial crisis and shifts in the public’s perceptions of what constitutes a healthy weight. Although community programs are likely to prevent obesity and reinforce weight loss after it occurs, the caloric deficit necessary for weight loss by obese individuals will probably not be achieved by policy change. Improved clinical interventions for weight control will require changes in interprofessional education, the care paradigm, and primary and tertiary care delivery systems.
children with MHCs treated with these classes of medications will be reviewed.
503-PL Is It Time to Address Lack of Sleep in Health Promotion? JEAN-PHILIPPE CHAPUT School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada Sleep curtailment has become an endemic condition in modern societies, with population statistics revealing that sleep duration has decreased by more than 1 hour over the past few decades in children and adults. A growing body of evidence shows that insufficient sleep is a contributor to weight gain and obesity. A number of mechanisms have been invoked to account for this association, including an up-regulation of appetite-stimulating hormones, a longer exposure to an obesogenic environment and a decrease in spontaneous physical activity. Individuals attempting to lose weight should also consider getting adequate amounts of sleep in addition to limiting calorie intake and increasing physical activity to improve the success of their weight loss interventions. Recent results by our research group also lend support to the effect that increasing sleeping time in short-duration sleepers has the potential to limit adiposity gain over time. Collectively, the preponderance of the evidence supports taking a pragmatic approach and encouraging a good night’s sleep as an adjunct to other health promotion measures. Interestingly, the Canadian Obesity Network has included adequate sleep in its new set of obesity management tools for physicians (5As of Obesity Management).
502-PL Obesity and Metabolic Disturbances in Children with Mental Health Conditions CONSTADINA (DINA) PANAGIOTOPOULOS Department of Pediatrics, University of British Columbia, and BC’s Children’s Hospital, Vancouver, British Columbia, Canada An estimated 15% of Canadian children and youth are affected by a mental health condition (MHC) each year. Mental health conditions in childhood and adolescence span a wide range of disorders including; anxiety disorders, disruptive behaviour disorders, mood disorders, pervasive development disorders, and psychotic disorders. Children and youth with MHCs frequently struggle with complex physical and emotional issues that impact motivation, self-esteem, and self-efficacy. In addition, many of these children are socially isolated and marginalized from physical activity, and are at risk for unhealthy eating habits, thus increasing their risk for obesity, diabetes, heart disease and other complications such as body image concerns. In addition, certain MHCs including schizophrenia and bipolar disorder in adulthood have been independently associated with an increased risk for type 2 diabetes. The combined effect of the burden of psychiatric illness and the side effects related to the medications used to treat MHCs in adults is a 19% greater mortality rate than in the general population. In youth, the burden of psychiatric illness combined with prolonged medication use is not yet known. Some of the most commonly prescribed psychotropic medications in youth include second-generation antipsychotic medications (e.g., risperidone, quetiapine, olanzapine, aripiprazole,), antidepressants [namely, serotonin-specific reuptake inhibitors, including fluoxetine, fluvoxamine, citalopram], and mood stabilizers [e.g., lithium, valproic acid]. In this presentation, the growing body of literature related to obesity and metabolic disturbances in
THURSDAY, MAY 2: PUBLIC HEALTH IN FOCUS (HOST BY HSFC) 504-WK Physical Activity and Weight e What Really Makes the Difference for Heart-Health? MANUEL ARANGO Director, Health Policy, Heart and Stroke Foundation of Canada, Ottawa, Ontario, Canada There has been some debate regarding the respective roles that physical activity, nutrition and obesity/overweight play with respect to cardio/cerebrovascular health: Some experts argue that physical activity and nutrition are the most important predictors of cardio/cerebrovascular health, and that weight does not play a unique role or is not an independent predictor of circulatory health. From this point of view, weight is simply a "marker" for ill health. These experts point to evidence indicating that some obese/ overweight individuals can be "healthy" if they are physically active. They also express concerns regarding the potential stigmatization that an obesity/overweight focus might have on obese/ overweight individuals. At the other end of the spectrum, some experts point to evidence that obesity/overweight independently contributes to cerebro/cardiovascular disease, irrespective of other risk factors such as physical inactivity. From this perspective, the beneficial effects of physical activity do not appear to be enough to offset the harmful impact of obesity, thus underscoring the unique/ independent roles of both these factors in cardio/cerebrovascular health and the need for both the prevention of weight gain and regular physical activity. This session will explore these two provocative perspectives.
Abstracts / Can J Diabetes 37 (2013) S217eS289
THURSDAY, MAY 2: PLENARIES A.M. 501-PL Progress and Challenges in the Prevention and Control of Obesity WILLIAM H. DIETZ Atlanta, Georgia, United States of America After almost 30 years, the rapid increase in the prevalence of obesity in adults and youth in the United States appears to be slowing or has plateaued, and in some locations and some population groups the prevalence of childhood obesity is decreasing. The reasons for the change in slope of the obesity epidemic is uncertain, but, like the changes that occurred when cigarette consumption began to decline, may be attributable to increased awareness of the adverse effects of obesity. The declines in childhood obesity have occurred in locations that have targeted multiple behaviors, often in multiple sectors. Foundations and federal agencies have provided support for state and community policy, system, and environmental interventions. Federal efforts to sustain community initiatives are threatened by the financial crisis and shifts in the public’s perceptions of what constitutes a healthy weight. Although community programs are likely to prevent obesity and reinforce weight loss after it occurs, the caloric deficit necessary for weight loss by obese individuals will probably not be achieved by policy change. Improved clinical interventions for weight control will require changes in interprofessional education, the care paradigm, and primary and tertiary care delivery systems.
children with MHCs treated with these classes of medications will be reviewed.
503-PL Is It Time to Address Lack of Sleep in Health Promotion? JEAN-PHILIPPE CHAPUT School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada Sleep curtailment has become an endemic condition in modern societies, with population statistics revealing that sleep duration has decreased by more than 1 hour over the past few decades in children and adults. A growing body of evidence shows that insufficient sleep is a contributor to weight gain and obesity. A number of mechanisms have been invoked to account for this association, including an up-regulation of appetite-stimulating hormones, a longer exposure to an obesogenic environment and a decrease in spontaneous physical activity. Individuals attempting to lose weight should also consider getting adequate amounts of sleep in addition to limiting calorie intake and increasing physical activity to improve the success of their weight loss interventions. Recent results by our research group also lend support to the effect that increasing sleeping time in short-duration sleepers has the potential to limit adiposity gain over time. Collectively, the preponderance of the evidence supports taking a pragmatic approach and encouraging a good night’s sleep as an adjunct to other health promotion measures. Interestingly, the Canadian Obesity Network has included adequate sleep in its new set of obesity management tools for physicians (5As of Obesity Management).
502-PL Obesity and Metabolic Disturbances in Children with Mental Health Conditions CONSTADINA (DINA) PANAGIOTOPOULOS Department of Pediatrics, University of British Columbia, and BC’s Children’s Hospital, Vancouver, British Columbia, Canada An estimated 15% of Canadian children and youth are affected by a mental health condition (MHC) each year. Mental health conditions in childhood and adolescence span a wide range of disorders including; anxiety disorders, disruptive behaviour disorders, mood disorders, pervasive development disorders, and psychotic disorders. Children and youth with MHCs frequently struggle with complex physical and emotional issues that impact motivation, self-esteem, and self-efficacy. In addition, many of these children are socially isolated and marginalized from physical activity, and are at risk for unhealthy eating habits, thus increasing their risk for obesity, diabetes, heart disease and other complications such as body image concerns. In addition, certain MHCs including schizophrenia and bipolar disorder in adulthood have been independently associated with an increased risk for type 2 diabetes. The combined effect of the burden of psychiatric illness and the side effects related to the medications used to treat MHCs in adults is a 19% greater mortality rate than in the general population. In youth, the burden of psychiatric illness combined with prolonged medication use is not yet known. Some of the most commonly prescribed psychotropic medications in youth include second-generation antipsychotic medications (e.g., risperidone, quetiapine, olanzapine, aripiprazole,), antidepressants [namely, serotonin-specific reuptake inhibitors, including fluoxetine, fluvoxamine, citalopram], and mood stabilizers [e.g., lithium, valproic acid]. In this presentation, the growing body of literature related to obesity and metabolic disturbances in
THURSDAY, MAY 2: PUBLIC HEALTH IN FOCUS (HOST BY HSFC) 504-WK Physical Activity and Weight e What Really Makes the Difference for Heart-Health? MANUEL ARANGO Director, Health Policy, Heart and Stroke Foundation of Canada, Ottawa, Ontario, Canada There has been some debate regarding the respective roles that physical activity, nutrition and obesity/overweight play with respect to cardio/cerebrovascular health: Some experts argue that physical activity and nutrition are the most important predictors of cardio/cerebrovascular health, and that weight does not play a unique role or is not an independent predictor of circulatory health. From this point of view, weight is simply a "marker" for ill health. These experts point to evidence indicating that some obese/ overweight individuals can be "healthy" if they are physically active. They also express concerns regarding the potential stigmatization that an obesity/overweight focus might have on obese/ overweight individuals. At the other end of the spectrum, some experts point to evidence that obesity/overweight independently contributes to cerebro/cardiovascular disease, irrespective of other risk factors such as physical inactivity. From this perspective, the beneficial effects of physical activity do not appear to be enough to offset the harmful impact of obesity, thus underscoring the unique/ independent roles of both these factors in cardio/cerebrovascular health and the need for both the prevention of weight gain and regular physical activity. This session will explore these two provocative perspectives.