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Fall/Winter 2007/08 Volume I  ·  Number 2  ·  $4.

95

Index
sets world
standard
see page 13
Size matters
New help for
choosing portions
see page 10

Dr. Sue Pedersen,


Faculty of Medicine,
University of Calgary

inside
The obesity-asthma connection
Bariatric designs
for hospital furniture
COMMON GO LS

FOC SED VISION

HEALTHY M SSION

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CONDUIT a moving tribute

W
Fall/Winter 2007/08  ·  Volume I  ·  Number 2
The official publication of elcome to the second issue of CONDUIT, the official publication of the
the Canadian Obesity Network (con)
© 2007 Canadian Obesity Network Canadian Obesity Network (CON). Once again, we’ve scoured the coun-
executive editor
Dr. Arya M. Sharma, try to find outstanding examples of ingenuity and dedication in obesity
con Scientific Director
and related research. The following pages highlight just some of the people who are
editor
Owen Roberts making real progress in the fight against the disease, and celebrate the partnerships
associate editors
Kim Waalderbos
that make it all possible.
Brad Hussey
I am pleased to report that CON’s move to the University of Alberta (with adminis-
project co-ordinator
Arthur Churchyard trative offices located at the Royal Alexandra Hospital) in Edmonton is progressing
project management
Lilian Schaer
well. We hope to announce our new contact information and staffing details very
copy editor soon, and we look forward to the new opportunities that await us in the Capital
Barbara Chance
design
Health Region of Alberta.
linddesign
On that note, I would like to express the network’s appreciation for McMaster
Printed at Ampersand Printing
Address correspondence to:
University’s support over the first two years of our mandate. I also thank current
Canadian Obesity Network
Royal Alexandra Hospital Room 102
and former staff members who worked tirelessly to
Materials Management Centre get us up and running, and who helped CON achieve
10240 Kingsway Avenue, Edmonton, ab t5h 3v9
E-mail: conduit@obesitynetwork.ca so much in a short period of time.
For address changes, contact:
info@obesitynetwork.ca Their efforts – as well as the
Please put “conduit Magazine Address
Change” in the subject line. efforts of our board of directors, our
conduit is a publication designed to promote members and our partners – have not
dialogue and understanding about obesity
research and networking activities across gone unnoticed. CON has made great
Canada. The opinions expressed in the articles
do not necessarily reflect those of con, its strides in attracting new members,
members, its partners or its supporters. con
does not endorse any products, services, building partnerships and collaborat-
methods or research results contained herein.
conduit is written and co-ordinated by ing with numerous stakeholders on
students in the Students Promoting Awareness
of Research Knowledge (spark) program at the
innovative knowledge-sharing and
University of Guelph in Ontario, Canada. Read
more about spark at www.sparkguelph.ca.
outreach programs too numerous
con is funded by the federal Networks of to summarize here (but check out
Centres of Excellence program (www.nce.gc.ca),
a joint initiative of the Natural Sciences and www.obesitynetwork.ca for more New furniture for obese patients. See page 12.
Engineering Research Council, the Canadian
Institutes of Health Research, the Social information). Recently, we were
Sciences and Humanities Research Council
and Industry Canada. pleased to learn that CON’s core funding has been continued by the Networks
Visit the con website: www.obesitynetwork.ca of Centres of Excellence program, following an in-depth review of our progress
Publications Mail Agreement Number 41467026
Please return undeliverable Canadian
to date.
addresses to: I hope you enjoy this issue of CONDUIT, and I look forward to your ongoing and
Canadian Obesity Network
Royal Alexandra Hospital Room 102 active membership in the Canadian Obesity Network.
Materials Management Centre
10240 Kingsway Avenue, Edmonton, ab t5h 3v9

Dr. Arya M. Sharma


Scientific Director
Canadian Obesity Network

cover photo by charles hope photo: sittris conduit 3


CONTRIBUTORS
Kaitlyn Little, a third-
year public management
student at Guelph, is
interested in policy and
human behaviour within
organizations. Inside this
issue, she looks at the
effects of new Canadian
obesity guidelines for
practitioners (page 6) and
how accommodations
are being made for obese
people (page 12).

As a fourth-year biological
engineering student at
the University of Guelph,
Ashley McCarl has
a passion for intricate
science. In this edition of
CONDUIT, she writes about In his third year of
how safflowers are being Guelph’s arts and sciences
developed to produce program, Arthur
insulin and about scanning Churchyard is exploring
software that distinguishes links between science and
between types of body fat. social issues. He pursues
For more, see pages 14 more connections in his
and 17. articles about obesity-
Mihiri De Silva is related asthma rates
in her third year of on page 8 and public
environmental science awareness of healthy
at Guelph and keen to weight on page 16.
learn more about the
role of sustainability and
regulations in consumer
choices and healthy diets.
Turn to page 10 for her
article about tableware
designed to help people eat
healthy food portions.

condu it 4
CONTENTS Fall/Winter 2007/08  ·  Volume I  ·  Number 2

6 New
 guidelines prepare
practitioners

8 Obesity-linked
 asthma
may be reversible

10  ortioned plate
P
encourages weight loss

12 Safe, comfortable furniture


designed for obese patients

13 Worldwide standard set


for glycemic index test

14 Healthy messages missing


from children’s food packaging

16 Survey finds gaps in


Canadians’ knowledge
of fat dangers

17 Software pinpoints fat


types in medical scans

18 Ultrasound technology
measures overweight
Student thesis competition
health risks winner Navneet Singh, left,
accepts his award from Prof.

20 Safflowers give rise Jay Rosenfield, vice dean


of Undergraduate Medical
to cholesterol and Education at the University
of Toronto. See page 18.
diabetes treatments

|||  All contributors to conduit are part of the University Have a story idea for conduit? Want to give us your
of Guelph research writing program called Students suggestions? Contact us at conduit@obesitynetwork.ca.
Promoting Awareness of Research Knowledge (spark). Check out con online at www.obesitynetwork.ca
www.sparkguelph.ca for network news, events and networking opportunities.

opposite: olivia brown  ·  top: robert skeoch conduit 5


Information to help public,
practitioners, policy-makers

New guidelines
set to fight fat
By Kaitlyn Little experts. The resulting guidelines address
major gaps of knowledge in the treatment

M
ost consumers don’t see obesity as a serious and prevention of obesity, and establish
public health problem – rather, they consider priorities for future research and policy.
it a simple cosmetic or body-image issue. But Dr. Shafiq Qaadri, a family practitioner
it’s an epidemic, and Canadian researchers have developed and member of the Ontario parliament
comprehensive guidelines to put it in the spotlight by more for Etobicoke North, says the guidelines
clearly defining the problem and how it can be addressed. (see sidebar) have the power to directly
They hope the guidelines will help practitioners improve influence public policies. They not only
patient care and be an information piece for the public and address gaps in knowledge but also outline
policy-makers. possible areas for research funding and
“The serious personal and societal consequences of inaction development.
on the obesity epidemic can no longer be ignored,” says Dr. “Like all guidelines, they give us the goals
David Lau of the University of Calgary and chair of the Cana- we want to achieve but also show us what still
dian Obesity Network’s science committee. “Obesity should needs to be done,” says Qaadri.
be considered a pressing societal and public health issue, and Now that the guidelines have been created,
we hope these guidelines will better define it as such.” reviewed and published in the Canadian Medical
Lau co-ordinated and chaired the Canadian clinical prac- Association Journal, the challenge shifts to communi-
tice guidelines committee on the management and preven- cating the findings and recommendations to the audience
tion of obesity in adults and children. This expert panel, they were intended for, he says.
made up of a large number of leading Canadian researchers “Guidelines itemize what we need to do. They give detailed
and clinicians, did a rigorous literature review focused on messages, but they can only be successful if we communi-
clinical trials to create evidence-based recommendations. cate them properly.”
Before publication, the recommendations were sent out
for external review and validation by leading international dcwlau@ucalgary.ca

condu it 6
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Guiding
obesity
management
C anadian researchers have
developed comprehensive
guidelines to better define obesity,
so it can be managed. These
guidelines are intended to be a
tool for practitioners when treat-
ing patients and a touchstone
for the public and policy-makers.
Some of the key recommendations
for health practitioners are:
|||  Measure body mass index and
waist circumference in all adults
and adolescents to determine the
degree and distribution of body
fat.
|||  Assess and screen for depres-
sion, eating disorders and mood
disorders.
|||  Gauge readiness to change and
barriers to weight loss.
|||  Provide dietary counselling and
prescribe optimal energy-reduced
dietary plan for achieving weight-
loss goals (an example being five
to 10 per cent of body weight over
six months).
|||  Prescribe 30 minutes of daily
activity of moderate intensity,
increasing to 60 minutes or more
when appropriate.
|||  Assess and treat obesity-
related health risks.
|||  Do regular reviews and
reinforce goals for weight loss or
maintenance, as well as preven-
tion of weight regain.
For the complete list of guide-
lines and recommendations, visit
www.cmaj.ca.

brian fray conduit 7


|||||||||||||||||||||||||||||||||

Out of breath
but not out of time
By Arthur Churchyard

O
besity and asthma are sometimes a package
deal, Université Laval researchers have found.
Multiple studies have demonstrated the
impact of obesity on respiratory problems, including
one recent survey of 330,000 adults that revealed obese
individuals are significantly more likely to have received
a diagnosis of asthma. The large-scale Canadian study,
led by Laval respirologists, sets this country dead centre
in the trend.

Weight loss
encourages
recovery from
obesity-related
respiratory
problems, which
affect women
in particular,
according to a
recent Canadian
survey.

condu it 8 simon mcconico


|||||||||||||||||||||||||||||||||
Boulet cautions, however, that not all shallow breathing
seen in obese patients is the result of asthma. Asthma is
characterized by bronchial inflammation that leads to
Recovery is possible for women, increased airway “twitchiness,” as he describes it. The
who are more susceptible airway responsiveness is greater, closing more easily if trig-

to obesity-linked asthma gered by allergens or stress. He says it’s unclear whether


obesity actually causes asthma or whether the extra weight
forces temporary changes in airway integrity. He points to
animal research that shows obesity can increase hormones
in the body that promote asthma. Another possibility is
Dr. Louis Philippe Boulet of Laval’s Department of that asthma and obesity are genetically more likely to occur
Medicine has found that obese Canadians – particularly together.
women  –  report higher asthma rates. Canadians are also That makes it tough to give an accurate diagnosis, says
more likely to use asthma medication when they have a asthma researcher Dr. Shawn Aaron of the University of
higher body mass index ratio (a measurement of weight Ottawa. A misdiagnosis could lead to unnecessary use of
class based on weight and height). expensive inhalers, medication and injections currently
“Obesity is frequently associated with asthma-like respira- used to treat asthma.
tory symptoms, and it’s important to confirm the diagno- Aaron is studying reported asthma cases in eight large
sis of asthma in order to provide adequate treatment and Canadian cities to see how many patients actually have the
counselling,” says Boulet. “Doctors should be warning their condition. He estimates that 30 per cent of obese patients
patients that significant weight gain may be detrimental not who have been diagnosed with asthma because of short-
only for heart disease and diabetes but also for respiratory ness of breath may have been misdiagnosed and may
problems.” not have active asthma at all. His study will clarify some
For the study, he analyzed data from the most recent of the reasons behind obesity’s connection to asthma. It
Canadian Community Health Survey to establish the will also promote weight loss and public awareness of the
connection between obesity and asthma. But his personal connection.
practice has led him to believe this trend is reversible for Aaron and Boulet – both Canadian Obesity Network
some patients. He has seen weight-loss surgery patients members – agree that losing weight isn’t easy, especially
recover from asthma symptoms after losing a significant in cases of extreme obesity. Deeper understanding of the
amount of weight. mechanisms that link obesity and asthma could make it
Improvements can be seen even with milder degrees of possible to find treatments that stop asthma early on for
weight loss, Boulet adds. Losing 10 to 15 per cent of body people with obesity.
weight may also be associated with significant asthma New treatments aren’t the only solution. Both physicians
improvements. stress that using Canada’s food and exercise guidelines
“It’s fascinating to see such improvements achieved in would not only reduce obesity-related breathing problems
respiratory function simply by losing weight,” he says. but would also help asthma patients already at a healthy
Although obese patients can reduce severe asthma attacks weight. The end result is health-care dollars in the bank and
by shedding extra pounds, the mechanisms by which weight more opportunities to breathe deeply at work and play.
loss improves lung function need to be studied more care-
fully, he adds. LPBoulet@med.ulaval.ca

conduit 9
Study finds partitioned plate
encourages weight loss

Drawing the line


on portions
By Mihiri De Silva

P
eople with diabetes, especially those on medica-
tion, could benefit from a new plate that outlines
appropriate portion sizes. That’s the word from a
study on “The Diet Plate,” a trademarked set of dishes that
were found to be as effective as weight-loss medications,
without the side effects or a need to cut out favourite foods.
The six-month study was led by Dr. Sue Pedersen, an
endocrinologist at the University of Calgary’s Faculty of
Medicine and a member of the Canadian Obesity Network.
Pedersen emphasizes that although poor food choices are
strongly correlated with obesity, inappropriate portions
cause just as many problems.
“People today don’t understand what an appropriate
portion is,” she says. “Patients with diabetes are taught to
use their fists or palms as measuring tools, but this advice is
impractical and not often followed.”
The Diet Plate and its accompanying breakfast bowl are
carefully calibrated using lines and visuals to help users
ration carbohydrates, proteins, cheese and sauces. The
plates allow different calorie counts for each gender and are asked to use the plate once daily with their largest meal and
designed for a wide variety of foods; the bowls are unisex the breakfast bowl whenever they ate cereal.
and used only with cereal. The dishes proved to be effective, says Pedersen. Those
The study involved 130 clinically obese subjects with type 2 using them were more than three times as likely to lose
diabetes. Half of the participants were assigned to a control five per cent of their body weight compared with those not
group and maintained their usual diet routine. The other using the plate and bowl. This loss in body weight is clini-
half were given a Diet Plate and breakfast bowl and were cally significant for people with obesity because it reduces

condu it 10
the risk of heart disease and cancer, as well as other weight-
related illnesses, she says.
Using portion-control tools to manage weight is nothing
new, but Pedersen’s clinical study of The Diet Plate is the
first of its kind. Her results are especially promising because
they showed success despite three-quarters of the partici-
pants taking medication to treat diabetes. Almost half of the
participants regularly used insulin, a hormone known to
stimulate weight gain.
Pedersen also found a decline in the amount of medication
needed to control blood glucose levels, reported by 26 per
cent of the intervention group and 11 per cent of the control.
This decline could take the edge off cumulative costs of
daily diabetic medication, along with associated side effects,
she says. Lower medication needs counter the tendency of
patients with type 2 diabetes to increase medication doses
over time, she adds.
Overall, says Pedersen, the plate improved eating habits
by demonstrating appropriate portion sizes and reduced
dependency on weight-inducing diabetes drugs, making it
an effective ingredient in the recipe for healthy daily choices.
She notes that anyone who is overweight could use the plate
to lose weight.
Dr. Arya Sharma, scientific director of the Canadian
Obesity Network, hails Pedersen’s results as a much-needed
development in society’s shift towards healthy eating habits.
“These special plates are a practical option for managing
portion sizes,” he says. “Any tool that makes it easier for
people to make the right choices when it comes to eating
is extremely useful, and to now have validation that this
particular approach works is good news for those who are
counselling patients to manage their weight.”

Tableware outlined with |||  Others involved in this research were Dr. Gregory
balanced portions is a new Kline and post-graduate student Jian Kang of the Faculty
and creative mealtime of Medicine at the University of Calgary. Funding was

approach to weight control. provided by the Stewart Diabetes Education Fund. Plates
and bowls were donated by Diet Plate Ltd.

Sue.Pedersen@calgaryhealthregion.ca

charles hope photography conduit 11


The shape of “Patient and caregiver safety is
a paramount concern,” she says.

things to come “Bariatric hospital suites are impor-


tant as they make people more willing
to seek out health care and enable
New designs increase both safety health-care professionals to do their
and comfort levels job safely and more efficiently, lead-
ing to a decrease in lengths of stay for
By Kaitlyn Little hospital patients.”
Forhan, who works in the research

T
he unique needs of obese and service unit called Accessibly
people have long been over- Yours at McMaster University, recently
looked when it comes to design- led a meeting of key stakeholders
ing accommodating furniture. This is interested in obesity accessibility and
especially noticeable in the hospital mobility equipment. She gathered
setting, where something as basic as together designers, engineers, retail-
a well-designed chair that could boost ers, clinicians, nurses and patients to
patients’ comfort and safety levels lay out several directions for future
– and be a boon to health-care profes- Comfort and safety are the central research initiatives to secure funding
sionals as well – is often missing. features of this special hospital for equipment that meets the need
furniture for people with obesity.
Industrial designer Helen Kerr, presi- of obese patients. The report from
dent of Toronto-based design firm Kerr armrests that provide a sturdy grip that meeting is available online at
and Company Inc., is helping to fill for pushing out of the chair, cut-outs www.obesitynetwork.ca.
this unmet need with a chair designed along the outer edges between the “Helping people with obesity is beyond
specifically for obese patients that is back and seat that allow caregivers to a moral obligation,” she says. “It’s a
both functional and visually appealing. help patients stand up, and reinforced safety issue in the same way that access
“An enormous portion of the popula- legs to secure the chair. to care is a fundamental right. The
tion going into the hospital has been Inclusive and accommodating cost of the suites is nothing compared
completely overlooked in terms of their health-care environments are also with the costs of accidents and loss of
need for bariatric furniture,” says Kerr. of key interest to Mary Forhan, an productivity incurred if we don’t make
To begin, she toured bariatric clin- occupational therapist and Canadian the changes.”
ics to gain an understanding of what Obesity Network (CON) member. The hospital setting is not the only
this population needs from furniture. Forhan plans to evaluate the impact place where researchers are helping to
She says there’s a lot to be considered of bariatric suites in hospitals to deter- make room for obesity. Ambulances,
when designing new furniture, includ- mine how an ideal room could be offices and automobiles are also being
ing how people fit into chairs, how designed to meet the needs of obese better outfitted to accommodate the
the furniture enables them to breathe patients and their caregivers in hospi- growing number of people who are
and the degree to which patients can tal environments. She is a graduate obese.
access the chair. of CON’s 2007 Obesity Summer Boot
Kerr’s design features strong flat Camp. studio@kerr-co.com

condu it 12 sittris
Passing the GI test
Canadian researcher is setting worldwide standard
to measure food’s influence on blood sugar
Lentils, pearl barley
By Matt Teeter Eating a high-GI food raises blood and spaghetti are
three favourite
sugar rapidly, which the body coun-

D
low‑glycemic
iet and exercise play an important role in ters by flooding the blood with insu- foods for Prof.
preventing and controlling diabetes and obesity. lin. Insulin plunges blood sugar lower Thomas Wolever
of the University of
People with diabetes make special room in their again, which creates more hunger Toronto. He created
diet for foods that increase blood sugar levels slowly. These and leads to metabolic processes that a standardized
test that measures
are known as foods with a low glycemic index (GI). store more calories as fat. the influence of
Prof. Thomas Wolever, a Canadian Obesity Network The whole cycle is what functional carbohydrates on
blood sugar.
(CON) member in the University of Toronto’s Department food developer Saul Katz, CEO of
of Nutritional Sciences, helped develop the GI, a tool to low-GI energy bar manufacturer Solo GI Nutrition, calls
measure the speed at which a food’s carbohydrates increase “spike, crash and crave.” This cycle increases risk for diabetes,
blood sugar. The index was developed to aid people with obesity and cardiovascular disease by keeping blood sugar
diabetes and is now catching on for weight management, in a chronically unbalanced state. This might suggest that
but Wolever says GI measurements have been inconsistent carbohydrates are bad, but Katz says that’s not the case.
across the food industry. “Carbohydrates are the preferred energy source of the body.
“So far, it’s been difficult for industry to implement GI It’s the quality of the carbs that matters, not the quantity.”
measurements because they vary so widely,” he says. Katz agrees with Wolever that consistent testing is
In response, Wolever created the Glycemic Index Labora- required. He points to Australia’s leadership in including GI
tories to provide reference testing for members of the food measurements on food labels. But current Health Canada
industry. Food companies from around the world contract regulations prevent such labelling.
the firm to ensure that testing of their products is done “GI information should be seen as nutrient content, not a
accurately and confidentially and to refine their own testing health claim,” says Wolever. “Industry must lead the charge
protocols. to get this changed.”
His U.S. clients can use the test results in product advertis- He and Katz say consumers, as well as industry, need to be
ing, but in Canada, current regulations don’t allow GI claims, better educated about the value of the GI. Education is one
so these companies are building the knowledge for potential of the reasons they’re members of the CON, with Wolever
future use. describing the network as a valuable forum for raising aware-
To calculate a food’s GI, Wolever compares it with a refer- ness. Both he and Katz are working to educate consumers
ence food, usually pure sugar or glucose, which is assigned about GI to encourage healthier eating choices.
a GI of 100. A food that produces half the blood sugar
response of the reference is assigned a GI of 50. thomas.wolever@utoronto.ca

arthur churchyard conduit 13


Is
fun fo
fair?
By Ash ley Mc Carl

S
upermarket marketing strategies used for
most children’s food products may promote poor
eating habits, says a Carleton University researcher.
Canadian Obesity Network (CON) member Charlene
Elliott of Carleton’s School of Journalism and Communica-
tion evaluated food products targeted specifically at children
in supermarkets and found that kids’ fare typically empha-
sizes the entertainment and artificial or unnatural aspects
of food.
“The supermarket is important because it’s an overlooked
area when it comes to researching the impact of food promo-
tion on children,” says Elliott. “There is much focus on the
influence of television advertising of junk and fast food on
children’s food preferences, but less attention is placed on
supermarkets and the ways that ordinary foods have been She found that messages contained on fun food labels were
designed to appeal to children.” strongly focused on entertainment. Whereas adult products
For the study, she analyzed the expanding category of fun tended to emphasize natural functions, tastes and textures,
foods in Canadian supermarkets. Fun food is not junk food the children’s food focused on more unnatural qualities,
– rather, it’s food symbolically positioned as children’s fare such as yogurt tubes that glow in the dark and drink mixes
and often framed in contrast to so-called adult food. that “magically” change colour.
Fun foods are identifiable by their packaging and graphics Fun foods were once limited to the cereal aisle in super-
or by the unusual shapes, tastes and colours of the food itself. markets but are now seen throughout the entire store. Elliott
Elliott assessed 367 products for package claims, images and argues that promoting food as sport or entertainment to
nutritional profile. young children has significant implications.

condu it 1 4
ood Researchers evaluate
food products and
messages being
promoted to kids

is highly complex, but is clearly understood by the multi-


billion-dollar food marketing industry.
“Ultimately, if advertising did not have an impact, then
who would bother spending all that money?”
With the recent surge in physical activity messaging,
Faulkner is finding that food companies are increas-
ingly sending messages about “energy balance” rather
than healthy eating – suggesting that it doesn’t matter
Kids and parents can reach for what children eat as long as they become more active to
healthy foods instead of foods compensate for the extra calories. This affects the choices
marketed to entertain. shoppers make as they examine packaging at the point of
purchase.
In future research, Elliott will study the parental role in
children’s food choice behaviour, to see if the adult healthy-
eating messages are being passed down. She’s also conduct-
“Behaviour modification programs for overweight adults ing focus groups with children to test their understanding
stress that particular habits, such as eating when bored or of nutrition claims and to see how they respond to the food
for entertainment, work to make people fat,” she says. “Yet products specifically marketed to them.
the very habits proven to encourage obesity in adults are
being promoted to children through the messages of fun
food. Viewing food solely entertainment is an unhealthy |||  Funding for Elliott’s project was provided by the
message to be sending to our children.” Canadian Institutes of Health Research and Carleton
CON member Prof. Guy Faulkner of the University of University.
Toronto’s Department of Physical Education and Health
says the impact of media messages on human behaviour charlene_elliott@carleton.ca

sean locke conduit 15


Canadians struggle
with basic health messages
Survey of six major cities identified 102 centimetres as the
finds health lessons at-risk point for men, and even fewer
not being taken to heart could identify 88 cm as the cut-off for
women. Only 12 per cent of survey
By Arthur Churchyard respondents had ever talked to their
doctor about obesity.

C
anadians are in denial about Tytus stresses that doctors can’t act
the personal health conse- as educators about health basics with-
quences of extra weight. out more open communication lines.
That’s the message from a recent “How many people even know how
report card survey conducted by the to measure their waist circumference?
Canadian Obesity Network (CON). It Doctors could easily explain that waist
revealed that a majority of Canadians size is measured at the top of the hip
know they’re overweight and believe bones, not over the belly button. But
extra weight carries health conse- these conversations are not being
quences, but they don’t think they’re initiated.”
Canadians aren’t making the
very much at risk themselves. necessary link between obesity Dr. Bob Dent, director of the Weight
The survey drew information from and personal health risks, says Management Clinic at the Ottawa
Dr. Richard Tytus.
4,990 respondents in the Vancou- Hospital and head of the CON’s mental
ver, Edmonton, Calgary, Hamilton, even if they were overweight, although health section, blames lack of funding
Ottawa and Montreal areas. It shows general awareness of obesity health in the health-care system for the short
Canadians are aware of health risks risks was high. amount of time Canadian doctors
associated with being overweight but One health risk escaped many survey spend with patients. The average
aren’t taking the lesson to heart, says a respondents’ awareness, however. Only patient gets three minutes of attention.
McMaster University physician. half knew that fat concentrated in the But Dent also notes studies have
“There’s this disconnect between abdominal area poses greater health shown that if a health professional
what we know about the consequences risks than fat distributed around the takes time to point out weight prob-
of obesity and what we believe will body. Tytus says it’s well-known in the lems, patients are much more likely
happen to us personally,” says Dr. Rich- medical community that, for every to take action than if they’d initiated
ard Tytus of McMaster’s Department inch of extra flab around the midsec- discussion themselves.
of Family Medicine, who was involved tion, the risk of heart disease and The survey was conducted by Ipsos-
in the study. diabetes increases dramatically. Reid Canada on behalf of Sanofi-
He says that fewer than a quarter of He notes that knowledge about Aventis Canada Inc. and the CON.
respondents in the Hamilton region healthy waist size was alarmingly
thought they had a higher health risk absent – only 25 per cent correctly rick@drtytus.com

condu it 16 robert skeoch


Martel explains that fat tissues in the human body

Fat, pixel
take two forms: fat that lies directly under the skin
(subcutaneous) and fat that surrounds internal
organs (intra-abdominal). Research has recently

by pixel
focused on the intra-abdominal fats, which are
linked to higher rates of diseases such as diabe-
tes. The SliceOmatic allows for quick and easy
differentiation between the fats, so that disease
risks can be more easily identified.
New tissue-tagging program His original interest in medical analysis software
slices and dices body composition was fostered by Prof. Bob Ross of the Department of
Physical and Health Education at Queen’s Univer-
By Ashley McCarl sity, also a CON member. In the late 1980s, Ross
was completing his thesis on fat tissues displayed

D
ifferentiating fat types using medical in full-body medical scans at l’Université de
scans is easier thanks to Montreal-based Montréal. He needed a user-friendly way to analyze
TomoVision’s cutting-edge software that MRI images and turned to Martel to develop a solu-
accurately tags and tabulates specific fat tissues. The tion. Since then, Martel has continued to improve his
software sets the standard for measuring fat and program, and it has taken off in popularity with the
is used in obesity research across North America. research community.
TomoVision is a partner of the Canadian Obesity The program, developed entirely in Canada, has
Network (CON). been verified and used in dozens of studies around the
TomoVision president Yves Martel says medical world. Ross says it has helped researchers learn more
scans such as magnetic resonance imag- about the relationships between disease
ing (MRI) and computed tomography Body scans can reveal various and different body shapes of obese
types of fat distribution
(CT) are commonly used to determine using images produced by people, and how those relationships are
body composition. But differentiating specialized software. affected by gender, age and race.
between fats with MRI scans has always “SliceOmatic has been used by numer-
been a consuming and daunting manual task because there ous researchers to understand the effects of differences in fat
was no software to support it. That’s why he developed a distribution in groups of people,” says Ross. “It’s an accurate
program he’s dubbed “SliceOmatic.” tool that can be adapted to individual needs.”
“There was a need for a program that could help differenti- One adaptation Martel made was to develop image format
ate between the various fat types in medical images,” says converters. At one point, there was a different image format
Martel. “SliceOmatic fills this need and gives researchers the for each individual scanner. He says a lot of those old scan-
same standard tool to use.” ners are still being used, producing images that are difficult
SliceOmatic allows users to semi-automatically tag each to import to a computer. His software now has the tools
pixel – an individual point in an image – on an MRI or CT to read scanner archives and convert images to a standard
scan. Once this is complete, the program tallies the tagged format.
pixels to calculate the volumes of different fats and other
tissue ratios. martel@tomovision.com

bob ross conduit 17


Student wins Canadian Obesity Network
thesis competition with research paper
on ultrasound technology

Sound progress
By Arthur Church yard Singh’s research paper suggests that echocardiographic
measurement of epicardial fat could be a competitive way to

E
chocardiography and the echo generation share assess risk for obesity-related diseases, but it remains to be
a common champion: Navneet Singh, the 2007 proven over time as obesity interventions are carried out.
winner of the Canadian Obesity Network (CON) Singh, who just completed a term as co-chair of the CON’s
thesis competition. Singh’s winning paper about echocar- Students and New Professionals initiative, an organization he
diography – a new way to measure a risky type of fat around co-founded that links students and mentors in the network,
the heart – shows the ingenuity young people can bring to says mentors have defined his research career. Dr. Gianluca
the fight against obesity. Iacobellis of McMaster University’s Department of Endocri-
“At this point, researchers are playing catch-up to see nology and Dr. Arya Sharma, CON’s scientific director, have
how well fat around the heart can predict obesity-related both inspired and guided him through his research.
health risks,” says Singh. “Echocardiography is undoubtedly Iacobellis, who was the first to propose and validate epicar-
a good technique to measure this fat, but it requires more dial fat measurement by echocardiography, says Singh’s
investigation.” enthusiasm and genuine interest made all the difference
Echocardiography measures the thickness of visceral in his research paper, which was published in the McGill
epicardial fat (found around the heart and blood vessels). Journal of Medicine this year.
The emerging technique helps determine a person’s risk for “Navneet has the potential to become an excellent clinical
obesity-related diseases such as heart disease. scientist,” says Iacobellis. “His work with me in epicardial fat
Singh notes in his thesis that echocardiography has signif- measurement and other clinical studies has been tremendous.”
icant advantages over other risk-measurement techniques. Singh remains in an advisory role on the Students and
It uses ultrasound technology that health practitioners can New Professionals board at the University of Toronto, where
easily implement, and it’s less expensive than MRI scanning, he’s in his second year of medical school. He continues to
which is often inaccessible for obese people. do research with Iacobellis on the effect of weight loss on
Still, he acknowledges there is another way to measure epicardial fat.
disease risk that is even faster and relatively simple.
Measuring waist circumference can serve as a good warn- |||  Singh’s winning research paper was supported by
ing flag for obesity-related diseases. The only catch is that the John D. Schultz Scholarship provided by the Heart
waist measurements include both the subcutaneous fat just and Stroke Foundation of Canada. CON received dozens
under the skin and the deeper abdominal fat surrounding of submissions for this year’s contest, which was
the organs, but it’s the latter that poses the greater health adjudicated by a panel of multidisciplinary obesity experts
risk. chosen from the network’s membership.

condu it 18
conduit 19
Safflower power

Alberta company
develops home-grown
solution to treat
obesity-linked diseases
“The advantage of using plants is that we can increase
By Ash ley Mc Carl production of these proteins with less money and low capital.
Using safflower to produce pharmaceuticals such as insulin

S
afflower has traditionally been known as an opens a lot of doors globally.”
oilseed-producing plant grown mainly in Califor- Moloney has found that safflower is an ideal production and
nia for use in the food industry. But it also provides packaging plant for insulin or Apo AI. The genes that code
a sustainable method of producing insulin at a price people for the synthesis of the proteins can be inserted into safflower
worldwide can afford. plants to make them mini-solar factories that produce either
That’s the word from a Calgary-based pharmaceutical insulin or HDL. The genes direct the flowers to produce
company called SemBioSys. It’s working with the plant to the proteins, which are packaged in
Safflowers are being
develop treatments for diabetes and high cholesterol by bundles and then moved to storage designed to yield oil
integrating the genes for two important proteins – insulin with the oil of the seeds. The proteins containing insulin and
and a high-density lipoprotein (HDL) called Apo AI – into are extracted through grinding the a protein that binds
cholesterol.
safflower. These proteins are key components in treatments seeds and mixing with water, which
for people with diabetes and heart disease, both of which are allows the protein-rich oil to rise to a top layer, where it can
commonly linked to obesity. easily be removed and purified to separate out the protein.
SemBioSys chief scientific officer Maurice Moloney says The gene for Apo AI was identified by Italian scientists.
current production techniques for insulin and HDL are In later clinical trials in the United States, it was found that
expensive, increasing the cost of treatment and making it Apo AI could bind to cholesterol and remove years of plaque
unaffordable for many around the world. buildup in the arteries. That meant, for the first time in medi-
But because safflower can be grown on low acreage with cal history, a drug could reverse arterial damage built up over
high yields, the plant can provide a significant boost to insu- time. That excited the medical community, which is likewise
lin and Apo AI production, he says. enthused about the Apo AI gene being incorporated into

condu it 2 0 sembiosys
safflower to produce HDL medicines efficiently and cheaply, Fellow researcher Prof. Peter Jones, who holds the
and to help reduce the risk of heart attack. Canada Research Chair in Nutrition and Functional Foods
Safflower has also been modified to produce insulin, which at the University of Manitoba, focuses on the disease triad
is expected to be increasingly in demand as user-friendly of diabetes, obesity and heart disease. With more people
inhalers are used more frequently. Compared with the injec- becoming affected by these diseases worldwide, Jones notes
tion method, inhalers require 10 to 20 times more insulin the need for alternative production methods.
to be effective. Moloney says safflower-derived insulin could “For the first time in history, our children will have a
meet this increased demand. And he notes that Canada, shorter life expectancy than their parents,” he says. “We
where insulin was discovered in 1922, could provide the right need leading-edge, innovative solutions to these problems,
agricultural climate to grow the insulin-producing safflower. and using safflower is a great example of that.”
“It would be poetic to have the birthplace of insulin also
become the world’s major supplier,” he says. moloneym@sembiosys.com

The Canadian Obesity Network’s


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the Canadian Obesity Network home page at
obesitynetwork.ca
        In collaboration with 
PARTNERSHIPS
The full weight of the obesity problem in Society of Obstetricians Atlantic Health Promotion
CON Supporting Institutions & Organizations and Gynaecologists Research Centre, Halifax,
Canada is only now coming into focus, and of Canada N.S.
As of September 1, 2006
Universities (Canada) Canadian Council for Food and Nutrition
Dalhousie University, Halifax, NS Canadian Diabetes Association
Lakehead University, Thunder Bay, ON Canadian Hypertension Society
Laval University, Quebec City, QC Canadian Public Health Association

Put Your Strength The Arthritis Society Canadian Health Services


McGill University, Montreal, QC Canadian Society for Clinical Nutrition
McMaster University, Hamilton, ON Canadian Urological Association

the news so far is bleak. The crisis is rooted


Memorial University, St. John’s, NL Conference Board of Canada
Queen’s University, Kingston, ON Dairy Farmers of Canada
Ryerson University, Toronto, ON Dietitians of Canada

Research Foundation
Simon Fraser University, Burnaby, BC Heart and Stroke Foundation of Canada

Behind Us
Université de Sherbrooke, Sherbrooke, QC Obesity Canada
University of Alberta, Edmonton, AB Society of Obstetricians and Gynaecologists of Canada
University of British Columbia, Vancouver, BC The Arthritis Society

Non-Government
University of Calgary, Calgary, AB
University of Guelph, Guelph, ON Non-Government Organisations (International)

in a complex web of economic, psychosocial, Centre for the Advancement


University of Manitoba, Winnipeg, AB European Association for the Study of Obesity
University of Montreal, Montreal, QC International Association for the Study of Obesity
University of New Brunswick, Fredericton, NB International Obesity Task Force

Organizations
University of Ottawa, Ottawa, ON

of Minimally Invasive
University of Prince Edward Island, Charlottetown, PE Industry
University of Saskatchewan, Saskatoon, SK Abbott Laboratories Ltd.
University of Toronto, Toronto, ON Boehringer Ingelheim Ltd.
University of Victoria, Victoria, BC Glycemic Index Laboratories Inc.

behavioural, biological and other contributing


University of Waterloo, Waterloo, ON Innovus Research Inc.

(International) Surgery, Alta.


University of Western Ontario, London, ON Isotechnika Diagnostics
York University, Toronto, ON Johnson & Johnson Medical Devices Division
JSS Medical Research
Universities/Institutes (International) Eli Lilly
Karolinska Institutet, Sweden Medtronics Inc.
Max Delbruck Centrum fur Molekulare Medizin, Germany Merck Frosst Canada Ltd.

European Association Connex Health


Mayo Clinic Department of Medicine, Rochester, MN New Era Nutrition
Medical University of Gdansk, Poland Novartis Nutrition

factors, and its negative impact on our health,


Pennington Biomedical Research Center, Baton Rouge, LA Novartis Pharmaceuticals
Rockefeller University, New York, NY Pfizer
The Royal Veterinary and Agricultural University, Denmark Sanofi-Aventis

for the Study of Obesity


University of Cincinnati, Cincinnati, OH TM Bioscience

Child and Family Research


University of Colorado, Denver, CO University Technologies International
University of Kansas, Lawrence, KS Wyeth

Provincial/Communal Governments Other

quality of life and economy is profound. International Association Institute, Vancouver, B.C.
Canadian Institutes of Health Research - INMD Acting Living Alliance
Ontario Ministry of Agriculture, Food and Rural Affairs Advanced Foods and Materials Network, Guelph, ON
Ontario Ministry of Education and Training Atlantic Health Promotion Research Centre, Halifax, NS
Ontario Ministry of Health Promotion Canadian Health Services Research Foundation
Public Health and Community Services, Hamilton, ON Center for Advancement of Minimally Invasive Surgery, Alberta

for the Study of Obesity


Child and Family Research Institute, Vancouver, BC

Dairy Farmers of Canada


Hospitals/Health Care Networks De Dwa Da Dehs Nye>s, Aboriginal Health Centre, Hamilton, ON
Capital Health, Primary Care Division, Edmonton, AB Firestone Institute for Respiratory Health, Hamilton, ON
Hamilton Health Sciences Corporation, Hamilton, ON Golden Horseshoe Bioscience Network, Hamilton, ON
Hôpital Laval Research Centre, Sainte-Foy, QC Obesity Surgery Journal
Ottawa Hospital, Ottawa, ON Ontario Science Centre, Toronto, ON

International Obesity Task


St. Boniface General, Winnipeg, MB Ontario Training Centre in Health Services and Policy Research,

De dwa da dehs nye>s


St. Joseph’s Healthcare, Hamilton, ON Hamilton, ON

There will be no simple solution to the


MaRS Discovery District, Toronto, ON
Non-Government Organizations (Canada) Metabolic Modulators Research Ltd., Edmonton, AB
Active Healthy Kids Canada PATH, McMaster University, Hamilton, ON

CANADIAN OBESITY NETWORK


Force
Canadian Association of Bariatric Physicians and Surgeons Population Health Research Institute, Hamilton, ON

Aboriginal Health Centre,


Canadian Association of Cardiac Rehabilitation Society of Rural Physicians of Canada, Shawville, QC
Canadian Association of Gastroenterology Technical Standards and Safety Authority, Toronto, ON

problem. Significant improvements in the


The Canadian Obesity Network is hosted by
McMaster University
The Canadian Obesity Network is funded by the federal
Networks of Centres of Excellence program (www.nce.gc.ca)
09/06 The Obesity Society Hamilton, Ont.
Drug Information
understanding, prevention and treatment of Industry and Research Centre
Hospitals/Health-Care Abbott Laboratories Ltd. Food and Consumer
obesity that result in tangible humanistic and
Networks Boehringer Ingelheim Ltd. Products of Canada
economic benefits for Canadians can be made Capital Health, Primary Care GeneOb Inc. Firestone Institute
Division, Edmonton, Alta. Global Diagnostics for Respiratory Health,
only through a collaborative effort across Hamilton, Ont.
Hamilton Health Sciences Glycemic Index Laboratories
many sectors and disciplines. Corporation, Hamilton, Ont. Inc. Golden Horseshoe
Bioscience Network,
Hôpital Laval Research Innovus Research Inc. Hamilton, Ont.
Centre, Sainte-Foy, Que. Isotechnika Diagnostics
The Canadian Obesity Network is pleased to Obesity Surgery
Ottawa Hospital, Ottawa, Johnson & Johnson Medical
work with the following partners: Ont. Ontario Science Centre,
Devices Division Toronto, Ont.
St. Boniface General, JSS Medical Research
Winnipeg, Man. Ontario Training Centre in
Eli Lilly Health Services and Policy
Universities (Canada) Mayo Clinic Department of St. Joseph’s Healthcare,
Medicine, Rochester, Minn. Medtronics Inc. Research, Hamilton, Ont.
Dalhousie University Hamilton, Ont.
Medical University of Merck Frosst Canada Ltd. MaRS Discovery District,
Lakehead University Toronto, Ont.
McGill University
Gdansk, Poland Non-Government Natural Factors
Pennington Biomedical Organizations (Canada) New Era Nutrition Metabolic Modulators
McMaster University Research Center, Baton Research Ltd., Edmonton,
Active Healthy Kids Canada Novartis Nutrition
Memorial University Rouge, La. Alta.
Canadian Association of Novartis Pharmaceuticals
Queen’s University Rockefeller University, New Bariatric Physicians and PATH, McMaster University,
Pfizer Hamilton, Ont.
Ryerson University York, N.Y. Surgeons
Sanofi-Aventis Population Health Research
Simon Fraser University The Royal Veterinary and Canadian Association
Agricultural University, of Cardiac Rehabilitation TM Bioscience Institute, Hamilton, Ont.
Université de Sherbrooke
Denmark Canadian Association University Technologies Refreshments Canada
University of Alberta
University of Cincinnati, of Gastroenterology International Society of Rural Physicians
University of British
Cincinnati, Ohio Canadian Association of Wyeth of Canada, Shawville, Que.
Columbia
University of Colorado, Occupational Therapists Technical Standards
University of Calgary Other
Denver, Colo. Canadian Council for Food and Safety Authority,
University of Guelph Acting Living Alliance Toronto, Ont.
University of Kansas, and Nutrition
Université Laval Lawrence, Kan. Advanced Foods and
Canadian Diabetes … and more partners are
University of Manitoba Association Materials Network,
Université de Montréal Government Guelph, Ont. coming on board daily.
Canadian Hypertension
University of New Brunswick Canadian Institutes of Society
University of Ottawa Health Research — INMD
Ontario Pharmacists
University of Prince Edward Communications Research Association |||  If you’d like to know more about how to
Island Centre Canada
Canadian Physiotherapy partner with the Canadian Obesity Network
University of Saskatchewan Health Canada, Office Association
of Nutrition Policy and or if you have suggestions for possible
University of Toronto Promotion Canadian Public Health
University of Victoria Association partnering opportunities, contact:
National Research Council
University of Waterloo Canada Institute for Canadian Society
Information Technology for Exercise Physiology
University of Western
Canadian Society for Clinical
info@obesitynetwork.ca
Ontario Ontario Ministry of
York University Agriculture, Food and Rural Nutrition Canadian Obesity Network
Affairs Canadian Urological
Association Royal Alexandra Hospital
Universities/Institutes Ontario Ministry of
(International) Education and Training Conference Board of Canada Room 102, Materials Management Centre
Karolinska Institutet, Ontario Ministry of Health Dietitians of Canada 10240 Kingsway Avenue
Sweden Promotion Heart and Stroke
Max-Delbrück-Centrum Public Health and Foundation of Canada Edmonton, ab t5h 3v9
für Molekulare Medizin, Community Services, Obesity Canada www.obesitynetwork.ca
Germany Hamilton, Ont.

condu it 22
Eating Bien manger
Well with
Eating avec le manger
Bien
Canada’s
Well with Guide avec le
Canada’s
Food Guide Guide
alimentaire
Food Guide alimentaire
canadien
Canada’s Food Guide canadien
Le Guide alimentaire canadien
recommends eating well and recommande de bien manger et
Canada’s
being activeFood
everyGuide
day. Le Guide
d’être alimentaire
actif chaque jour. canadien
recommends eating well and recommande de bien manger et
For more
being information
active and
every day. Pour obtenir
d’être actifde plus amples
chaque jour.
interactive tools you can use in informations et des outils interactifs
For more
your information
practice, including and
Canada’s quePour obtenir
vous pouvez deutiliser
plus amples
dans le cadre
interactive tools you can use in
Food Guide and Canada’s Physical de votre pratique, y compris leinteractifs
informations et des outils Guide
your practice, including Canada’s
Activity Guides, visit us online at: que vous pouvez
alimentaire canadien utiliser
et lesdans le cadre
Guides
Food Guide and Canada’s Physical de votrephysique
d’activité y compris le Guide
pratique,canadiens,
www.healthcanada.gc.ca/
Activity Guides, visit us online at: alimentaire
consultez notrecanadien
site Web : et les Guides
foodguide
d’activité physique canadiens,
www.healthcanada.gc.ca/ www.santecanada.gc.ca/
consultez notre site Web :
foodguide guidealimentaire
www.santecanada.gc.ca/
guidealimentaire
PHOTOS COURTESY OF: ArcticNet • Canadian Institute for Photonic Innovations • Canadian Language and Literacy Research Network • Canadian Stroke Network • ISIS Canada

Mobilizing Research
Excellence, Creating Value
Canada has 23 Networks of Centres of Excellence Currently the NCE Program supports more than
(NCE). Each network builds partnerships between 6,000 researchers and highly qualified persons in
academia, industry and government to put new 71 Canadian universities. The program partners
knowledge, research and technology to work to include 756 Canadian companies, 329 provincial
create a better Canada. Their work in the natural, and federal government departments, and
social and health sciences involves everything 525 agencies from Canada, along with
from improving children’s literacy skills, to the 430 international partners – making it a truly
quality of the food we eat and the water we drink. national and international program.
NCE are helping to keep our forests flourishing
and ease the impacts of climate change. By in- In 2006, the networks stimulated outside
volving thousands of talented young Canadians in cash and in-kind investments totaling almost
their work, they are training tomorrow’s scientific $70 million, including more than $27 million
leaders and ensuring Canada’s continued role as by the participating private sector companies.
a world science and technology leader. With the program’s own investment, the total
dedicated to research, commercialization and
knowledge transfer was more than $149 million.

NCE PERSONNEL NCE EXPENDITURES

Ontario 40.9%

Québec 23.9%

2 British Columbia 11.5%


Networks of 54
Centres of Alber ta 10.8%
Excellence 5.0%
Manitoba
56
694
868 79 Newfoundland & 2.8%
159 1,337 Labrador
192 Nova Scotia 2.4%
2,408 231
New Brunswick 1.2%

Saskatchewan 1.0%

Prince Edward Island 0.6%

www.nce.gc.ca