How Schools Teach our Children to be Fat

A beautiful view of the mountains in Canmore, Alberta. (Dr. Noorali Bharwani)
A beautiful view of the mountains in Canmore, Alberta. (Dr. Noorali Bharwani)

“Our children are getting fatter. They eat more and move less,” says Diane Kelsall, MD, deputy editor, Canadian Medical Association Journal (CMAJ April 7, 2015), in an editorial titled, “How schools teach our children to be fat.”

The editorial goes on to say that nearly 85 per cent of children aged three to four years meet activity levels recommended in Canadian guidelines, but this falls to only four per cent in teens.

Unfortunately, most of our overweight or obese children will not outgrow their weight problem. That means they develop adult diseases like hypertension and diabetes. And our schools hinder the fight against obesity in our youth, says the editorial.

If you look at a typical day for our children when they are at school then you will understand why Dr. Kelsall feels our schools are doing a poor job of preventing obesity. She makes the following points:

  • Our children’s school day starts early, often well before 9 am.
  • They are likely driven or take the bus to school.
  • They are tired when they arrive and sit for most of the day.
  • Physical education classes are usually not required after grade nine.
  • Lunch may be rushed, and food options available in the school may be high in fat or sugar.
  • At lunch or after classes, some students may participate in sports, but most don’t.
  • Students have hours of homework resulting in extended screen time.
  • They go to bed late, and the cycle starts all over again.

No wonder nearly one-third of our school-aged children are overweight or obese. Our schools should be helping our children to be healthy and that should lead to healthy adulthood. How can schools do that? Dr. Kelsall suggests the following:

  • Daily exercise should be mandatory for all school children. It should become part of daily life. Classes should include enough sustained, vigorous exercise to help students meet recommended activity levels, rather than the 20-minute requirement in some jurisdictions.
  • Walking or cycling to school is a good start.
  • Taking public transportation affords more opportunity for exercise than being driven by parents.

Lengthy sitting time has been shown to be a risk factor for early death in adults. The editorial says that a peek into most high school classrooms will show rows of students sitting for classes that are often 75 minutes in length, among the longest in the world. This sends the message that being sedentary is acceptable. Beyond physical education classes, getting students moving during school hours takes creativity.

We should do what Japan does. Make food education a part of the compulsory curriculum. We should encourage our kids to sleep early and get up early. Like adults, tired adolescents are at increased risk of obesity.

“Obesity is a complex disease and prevention requires multilevel intervention,” says Dr. Kelsall. It starts with the individual and family making good choices around exercise and food intake, but broader societal support is necessary. Our battle against smoking is slowly winning and message to people is clear – if you smoke then you kill yourself and hurt others. The message for obesity and overeating is the same – stop hurting yourself and the people you love.

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February Means Heart Month – Have You Been Kind to Your Heart Lately?

Joggers in Seville, Spain. (Dr. Noorali Bharwani)
Joggers in Seville, Spain. (Dr. Noorali Bharwani)

February is Heart Month. The month is almost over but we are still recovering from the chocolates and dinners we had for Christmas, New Year’s parties and Valentine’s Day. Wow… isn’t that something? Who decides on all these occasions where you eat, drink and be merry? That person is a genius.

We got to have fun to stay healthy. As long as our drinking and eating is within reasonable limits. What is reasonable depends on what common sense dictates, what science says and what your heart says.

Your heart has to be healthy to give you good advice. OK, if you have a bad heart then that tells you something as well. Also remember, your heart muscle is the hardest working muscle in the body. It pumps out two fluid ounces – sixty milliliters – of blood at every heartbeat. Every day, the heart pumps at least 2,500 gallons or 9,4500 litres of blood. The heart has the ability to beat over three billion times in a person’s life. That is one more reason to keep the heart healthy and strong.

In spite of all the insults we inflict on our indispensable heart, it continues to take care of us as long as it can. It is relentless in its function. The heart has to be strong for it to pump blood forcefully to all parts of our body – our brain, our fingertips and our toes are miles apart… so to speak. But the blood still gets there most of the time.

Two elements will predict your heath in 2015 and beyond: what you do for yourself and what fate does for you. We have no control over the later but we can do something over things we have control.

You can control what you eat. You can control how much exercise you do. You can control your weight (not so easy, right?). You can control how much alcohol you drink and whether you are going to smoke.

All these subjects are covered in my easy to read book (Dr. B’s Eight Steps to Wellness). Regular physical activity is a very important component in our fight to keep our heart healthy, blood pressure low and prevent stroke. But don’t over do it if you are not in a good shape. About five per cent of the deaths occur after heavy exertion such as shoveling snow, recreational jogging or sexual activity. In U.S. this accounts for 25,000 deaths a year. Similar statistics are reported from Canada and Europe.

I thought death during sexual activity occurs only in the movies… just kidding. If you are not fit then be careful.

There are three main risk factors that are associated with complications during exercise: age, presence of heart disease, and intensity of exercise. If you exercise regularly then you should be pretty safe. But if you are a new starter (after reading this column) then better check with your doctor and start slowly. As they say, “Slow and steady wins the race.”

Eat, drink and be merry… but be heart smart.

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Cancer Drugs are Being Abused by Bodybuilders

Kin Coulee Park, Medicine Hat: A beautiful mild evening look in January. (Dr. Noorali Bharwani)
Kin Coulee Park, Medicine Hat: A beautiful mild evening look in January. (Dr. Noorali Bharwani)

I was surprised when my attention was drawn to an article in MedPage Today titled “Bodybuilders Bulk Up Using… Cancer Drugs.” Should I be surprised?

“The only thing that should surprise us is that there are still some things that can surprise us,” said Francois de La Rochefoucauld (1613 – 1680). He was a noted French author with a clear-eyed, worldly view of human conduct that indulges in neither condemnation nor sentimentality.

Abusing cancer drugs to muscle up your body does call for condemnation. As we know, performance-enhancing drugs are substances used by athletes to improve their performances.

The phrase has been used to refer to several distinct classes of drugs: steroids, human growth hormone, stimulants (caffeine, amphetamine, methamphetamine), painkillers (simple analgesics to narcotics), sedatives, diuretics, blood boosters and others.

What about abuse of cancer drugs?

“Arimidex, also known by its chemical name anastrozole, is an aromatase inhibitor – a breast cancer drug. While steroids and growth hormone make headlines when athletes abuse them, breast cancer drugs are a lesser-known staple of doping regimens, for athletes and ‘weekend warriors’ alike,” says the article. Even common anti-estrogen breast cancer drugs like tamoxifen and exemestane are abused.

The article says these breast cancer drugs are on the prohibited performance-enhancing drugs lists from the U.S. Anti-Doping Agency and the World Anti-Doping Agency. But somehow some athletes manage to find them. How can this be stopped? A difficult question to answer.

Those athletes who abuse performance-enhancing drugs do eventually suffer from side effects. Hopefully, they will learn early in their lives that the best way to improve your health is by exercising regularly, eating healthy and not abusing performance-enhancing drugs. I hope somebody is listening.

Talk to you again soon. Keep smiling.

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Sarcopenia Among Seniors can be Prevented

A senior doing push-ups at a gym. (iStockphoto/Thinkstock)
A senior doing push-ups at a gym. (iStockphoto/Thinkstock)

Sarcopenia is not a disease. But it may kill you. It makes you frail because there is incremental loss of strength, increasing the risk of hospitalization and death. Sarcopenia is a Greek word which means “poverty of flesh.” It is part of aging. The skeletal muscles degenerate 0.5 to one per cent per year after the age of 25. Older adults lose about three per cent of their lean body mass each decade.

In the United States, an estimated 53 percent of men and 43 percent of women over 80 are sarcopenic, says an article in the New York Times.

The European Working Group on Sarcopenia in Older People (EWGSOP) says that for the diagnosis of sarcopenia, there should be presence of low muscle mass and low muscle function (strength or performance). The exact reason for sarcopenia is not known. Lack of exercise increases the likelihood of sarcopenia. Muscle fibres are replaced with fat and there is an increase in fibrous tissue – akin to scar tissue.

As the aging process keeps marching on, there is a tendency to be less physically active. That should be avoided if you want your muscles to maintain bulk and strength. Studies have shown exercise in the very old can increase strength and muscle function and improve balance. This will reduce the risk of falling and breaking bones. Your capacity to live independently will increase.

It has been shown sarcopenia is an important independent predictor of disability, linked to poor balance, gait speed, falls, and fractures. Sarcopenia is very similar to osteoporosis where there is loss of bone caused by inactivity. Osteoporosis can be prevented with regular exercise just like sarcopenia. Combination of sarcopenia and osteoporosis in old age causes significant frailty and risk of falling.

There are two ways to prevent and treat sarcopenia. One is regular exercise and second one is intake of adequate amount of dietary protein.

Regular exercise increases the ability and capacity of skeletal muscle to synthesize proteins in response to short term resistance exercise. Thirty minutes of walking three times a week and light resistance exercise three times a week can do wonders for physical strength in frail individuals. For an elderly person who is not able to lift light weights, should try water aerobics.

Having a good high protein diet is important. In the elderly, it should be more than the amount recommended to prevent deficiency disease, says the Times article quoting one of the experts interviewed by the paper. For older adults, four ounces of fish, chicken or turkey a day, and an additional protein snack in the afternoons to combat a dip in energy will help. Also include vegetarian protein sources like soy or quinoa, to provide variety without dietary fat, says the expert.

Other strategies include: use of testosterone or anabolic steroids, agents such as DHEA and human growth hormone, selective androgen receptor modulators (SARMs), and the fatty acids EPA and DHA contribute to increased muscle strength. Some of these treatments have side effects and some have not proven to be of benefit. So, high protein intake (if there is no kidney disease) and regular exercise to build strength remains the main therapy to prevent and treat sarcopenia.

Remember, November is Seniors’ Falls Prevention Month.

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