Welcome to the CanHealth Report. This blog is dedicated to presenting information on matters of public health in an approachable and readable fashion. Postings will include information on health research, Canadian health policy and matters of public interest. If you enjoy what you read, please consider supporting this blog financially to keep it operating.

Wednesday, March 31, 2010

Diabetes: An Introduction

"Diabetes in Canada is reaching epidemic proportions."

Those were the words my biology professor opened with during a lecture on Tuesday evening.

Karen Ross is part of the faculty of science at Thompson Rivers University and her research interests lie in the field of diabetes. Her topic could hardly be more timely.

According to the Canadian Diabetic Association more than 3 million Canadians have diabetes. If the population of Canada is just over 30 million, than that means according to this statistic, 10 per cent of the population is diabetic.

While that number may be a little inflated, if even six to eight per cent of Canadians have diabetes then it is far too prevalent. Especially considering that one can make certain life choices that decrease the risk of acquiring Type 2 diabetes.

While this post will not go into the pathophysiology of diabetes there are several articles that have brought the topic back to the centre of public interest.

The main risk behaviours for acquiring Type 2 diabetes include sedentary lifestyle, obesity, and a high-glucose (sugar) diet. According to a recent article in the Vancouver Sun drinking coffee or tea regularily may reduce the risk of acquiring Type 2 diabetes.

However, think about how much sugar one pours into the average double-double or triple-triple (and, yes, I've heard of people ordering quadruple-quadruples).

So for those readers who are wondering, "why should I care when I take care of myself?" consider the following article from the Vancouver Sun.

"The rising rates of diabetes in Canada could cost the economy as much as $17 billion by the year 2020, according to a new report that calls on the federal government to do more to ease the economic burden," the article reports.

That money has to come form somewhere. If more Canadians are educated about this disease and how best to avoid it then that number can be reduced. Either way, it's going to be our tax dollars that fund the treatment.

Sunday, March 28, 2010

An observation on healthcare funding

The link between tobacco consumption and the prevalence of cancers like lung, esophageal, and mouth cancer are definite; however, if it fair for tobacco-users to put such a burden onto the healthcare system?

Tobacco products in Canada are taxed at very high levels. The governing philosophy is that the health complications due to consumption will be paid for by the taxes that a smoker pays over his lifetime.

But is this the correct approach? And how do the numbers measure up? A diagnosis of cancer is not guaranteed merely because someone smokes, but paying taxes on cigarettes is.

We must first establish what the purpose of the tobacco tax is. Does it serve to discourage use because of cost, or is it designed to recoup the cost of providing healthcare to individuals who develop health complications from consumming the product?

While people will disagree on what purpose the tax serves, what remains clear is that it is expensive to smoke and expensive to treat someone for lung cancer.

Allow me to submit a topic for debate: Would it be better to keep tobacco taxes as they are, raise them even more to help offset the rising costs of healthcare, or abolish the taxes completely and subsequently charge people out of their own pockets for cancer treatment if they were smokers?

The issue at stake revolves around one's view on individual rights in a society. Do you possess the right to engage in harmful behaviour that will cost the state many dollars to treat? What happens if the state decided that it no longer wanted you to ahve that right because it could not afford the consequences of your actions.

If you have a comment or opinion on this issue (I'm certain everyone has opinions on this issue), then please feel free to either post it or e-mail me at 'gregory.sawisky(at)gmail.com.

UPDATE: Here is an interesting article in the New York Times that comments on this issue.

Tuesday, March 23, 2010

High Cholesterol hits huge numbers

More than 41 per cent of Canadians have a high total cholesterol according to a new report by Statistics Canada.

According to Statistics Canada, "Blood tests of thousands of Canadians showed 41 per cent of adults had a high total cholesterol level."

Cholesterol, which is like a fat can come in two varieties: High density lipoprotein (HDL) and low density lipoprotein (LDL). High density lipoproteins have traditionally been thought of as 'good cholesterol' as it helps prevent the narrowing of arteries while low density lipoprotein is often thought of as 'bad cholesterol' and high levels and lead to cardiovascular disease.

In truth, it is best to keep concentrations of both cholesterol's in check.

The CBC published an article on the study available here.

Optimism is good for your health

Don't worry, be happy.

Those words, original composed and sung by Bobby McFerrin, may just carry more weight than we expect.

A recent joint study published in Psychological Science conducted by the University of Kentucky and the University of Louisville has concluded that being optimistic boosts the immune system.

Two articles, one from sciencedaily.com and the other at e!ScienceNews.com wrote about the implications of the study and the optimistic state of mind.

The study followed 124 law students who were assessed as to their general outlook on life and success in their first year of law school. They were then injected with a solution generated to create an immune system response .

The ScienceDaily article writes that, "At more optimistic times, they'd have bigger immune responses; at a more pessimistic time, a more sluggish immune response. So, being optimistic about success in a specific, important domain may promote better immunity against some infections."

While it may be difficult to corroborate this evidence, or even prove conclusively how our outlook on life affects our immune system, it certainly can't hurt.

Thursday, March 18, 2010

Extremely Drug Resistant Tuberculousis

Tuberculosis. It is a disease that many people regard as having been "defeated" and no longer a major health concern to us.

They could hardly be more wrong.

Several recent articles have examined instances of a new strain of tuberculosis called Extremely Drug-Resistant Tuberculosis (XDRTB).

A recent CBC article reports that the World Health Organization doesn't know what effect they have had in combating this strain of tuberculosis.

In addition to that, the disease has reached record levels in Western Russia according to another article.

And Aboriginals in Canada are 30 times more likely to have tuberculosis than non-aboriginals. In order to treat tuberculosis, one is usually given antibiotics to take for an extended period of time. Unfortunately, many people stop taking the drugs once they feel better. Now tuberculosis is mutating and becoming stronger.

The video posted below is the work of the famous conflict photographer James Nachtwey. He documented this outbreak around the world over the course of a year. The images say so much more than words ever can.

The original video is available here. or on YouTube.

Tuesday, March 16, 2010

How much sugar is there?

I found this informative video on YouTube. It provides a more visual explanation on sugar content.

No more pepsi in schools.

In an intriguing article published by the CBC today, it was announced that PepsiCo is removing all sodas and suger-filled drinks from schools in more than 200 countries by 2012.

The official press release is visible here.

That's great news! Right? What happens if we're merely paying lip service to the issue?

PepsiCo can be lauded for doing the right thing. Removing sugar-laced beverages from schools will have a positive effect on childhood obesity. But they are a for-profit company. Clearly they don't want to lose money. So what are they going to be selling instead of Pepsi or Mountain Dew?

Sugar-laced juices perhaps? Fruitopia (a coke product) is labled a juice. The amount of calories? Between 100 and 250 depending on the beverage. How much sugar is in a Minute Maid Cranberry Juice? For a 591 mL bottle it is 32 grams. In fact, the cranberry juice has two more grams of sugar and 20 more calories than a 591 mL bottled of traditional Coca-Cola.

Fighting childhood obesity? Hardly.

Wednesday, March 10, 2010

Q&A on Trans Fats

I recently spoke with Professor Levente Diosady, a chemical engineer at the University of Toronto on the topic of trans fats. Professor Diosady has been working in the field of edible oils for more than 40 years. He had some very surprising things to say about trans fats.
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First off, what exactly is a fat?
A fat is a triglyceride molecule. There are typically 18 carbons with one, two, three or four double bonds. The unsaturated bonds can have two configurations. They can be cis or trans. If the chain continues on the same side of the carbon then we have cis, if the chain comes in on one side of the carbon and goes out the other it's called trans. In nature, in a chemical process, the cis and trans have approx the same probability of forming. However in most animals and plants the double bonded fatty acid are built up enzymatically and are inevitably in the cis form.

What is the difference between fats with the cis form and the trans form?

The naturally occurring long chain fats, unless they are coming from a dairy animal, are always in the cis form. The cis form has a relatively low melting point. Typical vegetable oils are liquid at room temperatures and contain one, two or three double bonds. If you need to have a product which has a solid or plastic fat then you have to do something to raise the melting point. There's only two ways to raise the melting point: One is by incorporating saturated fats which naturally have a high melting point or incorporating trans fats which have an almost as high melting point as the saturated fat.

How do you chemically alter a fat to be a solid at room temperature?
To obtain a hardened fat, like a margarine or butter, you can use a process called hydrogenation where you attach hydrogen atoms to the double bonds. if this reaction goes to completion the double bond is used up and it becomes a single bond and is no longer cis or trans. If you fully hydrogenate a fat in effect you eliminate all cis or trans double bonds.

If there any problems with this process?
The problem comes from the fact that these processes occur fast on the catalyst. Usually they are hydrogen starved. As a result some of the double bonds pick up one hydrogen abut then give that hydrogen up and rearrange in the process. Instead of having all cis, up to 50 or 60 per cent of the bonds will reform as trans. In the typical process you are forming some trans double bonds.

Why have we only been talking about trans fats in the last few years?
Historically these were not thought to be negative. There a positive thing in terms of the process [of hydrogenation] itself because you use a lot less hydrogen to get a higher melting point because the trans have high melting points. But research in the 1970s has shown that the body doesn't recognize trans fat as an unsaturated fat. It recognizes it as if it is a saturated fat. In effect it doesn't incorporate it into the body. Instead it burns it up for energy just as if it were a saturated fat. Earlier studies have shown that in terms of developing arteriole plaques and cholesterol deposits trans fats behaved very much like saturated fat. There was a very good ground-breaking study by a pair of researchers in 1981 which was the first one to show that trans fats do contribute to heart disease. Even to this point it was thought to essentially be equivalent to saturated fat.

What changed?
About four or five years ago there were a series of well-designed studies that showed that [trans fats] were somewhat more harmful than saturated fats and it was picked up by the popular press and everybody else. Everybody got onto the band-wagon to get rid of trans fat. It's been something we've been saying as researchers for 30 years but now it had momentum. The problem that has been presented to the public has been exaggerated. The trans fats are worse than saturated fats but they're not 50 times worse or 100 times worse. Maybe 5 or 10 per cent worse.

So what should people be conscience of when it comes to trans fats?
It's a good idea to avoid trans fats, because after all your body is not designed to metabolize them and they aren't terribly good for you. The fact is having an excess amount of any kind of fat is bad for you and having saturated fats has long ago been shown to be bad for you. The only way you can get solid fat is by having saturated fat, usually a short-chain saturated fat. Now margarine has no trans fats but its absolutely loaded with tropical oils because there is no other way around it. Even though there is some very good research, the fact still remains that you need a certain amount of saturated fat in the product to give you the functionality: The melting characteristics so that it's spreadable but melts in the mouth. Trans fats are there. They are undesirable but they are not nearly as dangerous as the public was lead to believe. Nonetheless I'm all for trying to eliminate them.

So trans fats occur naturally?
A number of natural products contain them in small amounts. Not huge amounts. A whole slew of microbial oils and in some conditions under normal conditions for example.

Can we consume them safely?
Sure. You look at the demographics. This stuff has been eaten in large quantities for 60 years. We didn't see people dropping dead from trans fats. They are dropping dead from heart disease because they are eating way too much fat period. The fact is you can have a small amount. It is desirable to limit that to as small an amount as possible. I think [consumption of trans and saturated fat] should be minimized but they can't be eliminated unless you want to eliminate all solid fat products. That would eliminate half the bakery products in the world. You can't really make bakery products with an oil you need to use a shortening which is partially solid fat.

Tuesday, March 9, 2010

Brief: Town considers banning all fast foods

A fascinating article just posted on the Globe and Mail's website reported that the town of Tofino, B.C. is considering a municipal ban on fast food franchises.

While the idea has commissioned a report, it would be the first Canadian municipality to ban fast food chains. The ban would extend from McDonald's to Tim Hortons and Starbucks.

How much sugar is in it?















In following up with the previous blog post, I wanted to find out just how much sugar was in one bottle of a soda beverage. I chose to examine a bottle of A&W Cream Soda (currently unavailable in Canada). According to the nutritional information there are 74 grams of sugar in one bottle. Each sugar cube measures approximately 4 grams (according to the packaging) and so there is roughly the equivalent of 18 sugar cubes in one bottle. Now that's a lot of sugar.

Soda's unsurprising link to Diabetes

Before you pop a twoonie into the pop machine, consider the following: According to a U.S. study, increasing consumption of soft drinks contributed to 130,000 new cases of diabetes in the last decade.

The study, lead by Dr. Kirsetn Bibbins-Domingo at the University of California concluded that the more soda people consummed, the more negative the consequences to human health. In addition to the cases of diabetes, the study linked 14,000 new cases of heart disease to soad consumption as well.

"The finding suggests that any kind of policy that reduces consumption might have a dramatic health benefit," Dr. Bibbins-Domingo was quoted as in an article on medicinenet.com

The author of the article did manage to talk to a representative from the American Beverage Association which represents the major beverage companies in the United States.

"What we do know is that both heart disease and diabetes are complex conditions with no single cause and no single solution," said Maureen Storey, senior vice president for science at the American Beverage Association.

Monday, March 8, 2010

Does bottled-water cause cavities?

I was reading a publication from Merck.com about human physiology and nutrition today and came across a section on the flouridation of water. Flouride is a compound made up of flourine and is added to municipal water supplies to prevent tooth decay. The question that immediately came to my mind was, "How does the preponderance of bottled water affect our teeth? Have cavities in adults increased significantly since bottled water became so popular?" At the moment I don't have any answers but check back with the CanHealth Report in the coming weeks as I investigate these questions.

Sunday, March 7, 2010

Banning junk foods in school

The topic of junk food in schools has been hotly debated over the past few years. Some schools in North America have moved to try and ban all junk food completely. But the reverse argument is that if a student really wants junk food then he will walk to a nearby convenience store anyways.

But banning junk food in school may assist in preventing childhood obesity according to a San Francisco State University study. The article, published in the March issue of Health Affairs was also presented on the website sciencedaily.com

The study examined eight years of data on body mass indexes from fifth and seventh grade students. Between 2003 and 2005, California Governor Arnold Schwarzenegger signed into law several bills banning junk food from schools. Before the law took effect obesity was on the rise in both groups in the study. The result of the new laws? The increase in the number of overweight boys in grade five and boys and girls in grade seven.

While childhood obesity in Canada isn't as major a topic of discussion as in the United States, Canadian school boards could learn a few things about choosing healthy foods for students to eat.

Ongoing research into Vitamin Water

I am currently compiling research and information about vitamin water products, including Glacéau's 'Vitamin Water,' Dasani's 'Plus' and Aquafina's 'Plus.' Preliminary research has revealed that there is a significant amount of sugar in each of these products and at least one of the products does not list the amount of daily recommended vitamins one consumes when drinking a bottle. Of you have a comment or more information about vitamin water please contact me at 'greg-sawisky@mytru.ca'

Where are your pills?

Where do you keep your vitamins? They're probably in your kitchen near the glasses so you remember to take them each morning with breakfast. Or perhaps they are in the bathroom above or near the sink? Is there anything wrong with that?

Yes there is according to a new study. According to an article by Jennifer Warner for medicine.net, researchers at Purdue University in Indiana concluded that humidity can affect the potency of vitamins.

The process is called deliquesence and occurs when humidity causes a water-soluble substance (e.g. a vitamin pill) to dissolve.

The study was published in the Journal of Agricultural and Food Chemistry .

According to the article, "The first signs of nutrient degradation are usually brown spots, especially on children's vitamins," and recommends discarding any vitamin that shows signs of spots or moisture inside the bottle.

Keeping your vitamins in an area of your home with as little humidity as possible is recommended.

Saturday, March 6, 2010

Microwaving Tupperware

Microwaves are great, aren't they? You can pop in last night's leftovers, zap them for a few minutes and have a hot lunch ready to go. But there is a huge potential that microwaving a tupperware container, even labeled 'microwave safe' may have health consequences.

A google search of 'microwaving tupperware' yields 341,000 results. At the top of the list are websites discussing the topic of whether or not there is danger in microwaving tupperware.

At the moment there is no conclusive evidence that microwaving tupperware is dangerous; however, studies are being conducted and there is also no evidence that they aren't having long-term health effects either.

One of the major concerns is that the microwave may cause the tupperware container to leech chemicals into the food product that is then consummed. As mentioned before, there is little evidence of this as of now. A report from the John Hopkins Bloomberg School of Public Health states that no link is currently established between microwaving plastic and chemical leeching if the plastic is designed as microwave safe.

If you are concerned about the possibility of chemical leeching by microwaving tupperware products then the CanHealth Report recommends you invest 50 cents into a ceramic bowl or plate at your local discount or thirft store and have it on have to microwave your food.

Tuesday, March 2, 2010

Effects of more screen time

A recent study published in the Archives of Pediatrics & Adolescent Medicine and reviewed by ScienceDaily.com concludes that teenagers who spent more time in front of a screen playing video games reported feeling less attachement to their parents and friends.

The study surveyed 3,043 adolescents aged 14 and 15 in 2004.

"Overall, the more time teens spent watching television or playing on a computer, the more likely they were to report low attachment to parents (in other words, difficulty forming a relationship or emotional bond). The risk of having low attachment to parents increased 4 percent for every hour spent viewing television and 5 percent for every hour spent playing on a computer. Conversely, teens who spend more time reading and doing homework reported a higher level of attachment to parents," reported the press release on March 1, 2010.

Health Canada Issues massive warning

I received five (yes, five) warning e-mails from Health Canada warning Canadians about a variety of products to be wary of consuming. I've condensed the list here. If you have any of these products, you should follow the link for more information. The five products are 2H & 2D, STRO Emperor Capsules, Tian Yang Xu Huo Oral Ulcer Capsule, sexual
enhancement dietary supplements sold by Atlas Operations Inc. and 65 bodybuilding products
sold through Bodybuilding.com.

Product #1
"Health Canada is advising consumers not to use the unauthorized health
product 2H & 2D because it contains undeclared tadalafil. Tadalafil is a
prescription drug and should only be used under the supervision of a health
care practitioner."


Product #2
"Health Canada is advising consumers not to use the unauthorized health
product STRO Emperor Capsules because it contains undeclared tadalafil.
Tadalafil is a prescription drug and should only be used under the
supervision of a health care practitioner.[...][I]t may have been brought into the country by travellers or purchased over the Internet."


Product #3
"Health Canada is advising consumers not to use the unauthorized health
product Tian Yang Xu Huo Oral Ulcer Capsule because it contains undeclared
aristolochic acid, a naturally occurring toxic substance associated with
serious health risks such as kidney failure and cancer."


Product #4
"Health Canada is advising consumers not to use certain lots (Lot Numbers
494, 520, 520A, 520B, 520C, 521, 705, 706, 779 and 807) of sexual
enhancement dietary supplements sold by Atlas Operations Inc."


Prodcut#5
"Health Canada is advising consumers not to use 65 bodybuilding products
sold through Bodybuilding.com"