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Taking charge of our health

Friday, February 7, 2014
Dirt Under the Nails
It is important to change our food environment to help combat obesity.

I want to discuss two TED Talks that are quite appropriate at this time. This comes in the wake of a recent article published in the T&T Guardian titled, “Khan: T&T must face obesity epidemic.” 


In the article, Minister of Health Dr Fuad Khan stated that Trinbagonians were lazy and sick, and their irresponsible lifestyles were the cause of the overcrowded conditions at public hospitals. I agree with Dr Khan, as I have seen firsthand the re-admissions of many people to the ICU for failing to change their unhealthy lifestyles. 


T&T Guardian columnist Dr David Bratt was also interviewed for the same article. He felt that Government needed to do more in order to help people make lifestyle changes. He suggested tax incentives on exercise equipment, supporting local farmers and promotion of breastfeeding by increasing the cost of infant formula. 


They are both correct. One cannot be successful without the other. But the problem has much deeper roots, and the likely solution is extremely complex. It involves an integrated effort by all involved, from the general population, to the government, to our healthcare providers. 


This discussion will span two articles, and in this first column I would like to discuss a TED Talk by neuroscientist, Sandra Aamodt.


TED (Technology, Entertainment, Design) is a series of conferences owned by the private non-profit Sapling Foundation. Themed “Ideas worth spreading,” the conferences are highlighted by brief presentations (or TED Talks) that address topics related to the research and practice of science and culture. 


Aamodt’s presentation was titled: Why dieting doesn’t work. 


In this insightful episode, the neuroscientist discusses the concept of “mindful eating.” After battling with weight and unsuccessful dieting herself, she decided to investigate why diets fail. 


Hunger and energy use are unconsciously controlled by a part of the brain called the hypothalamus. It has a set point for what we should weigh, give or take 10-15 pounds. We can move up and down within that range, but it is quite difficult to move out of it. The hypothalamus works like a thermostat, adjusting metabolism, energy expenditure and hunger to help our weight stay within that set point range. 


If we lose a lot of weight, the hypothalamus increases hunger, and our body uses fewer calories. In fact, when we diet, the brain responds as if we are starving and tries to conserve calories. This, says Sandra Aamodt, is the reason most diets don’t work and why we put on more weight when we stop dieting. 


In fact, Dr Rudy Liebel of Columbia University has found that if we lose ten per cent of our body weight, we burn 250-300 calories less everyday because our metabolism has decreased. 


That is why it is important to change our food environment to help combat obesity, and Dr Khan needs to consider this in his Fight the Fat campaign. The Government needs to make unhealthy food less accessible and healthy food cheaper and in greater abundance. However, as citizens, we can also assume responsibility and surround ourselves with healthier foods containing fewer calories.


A recent study looked at the risk of death over a 14-year period based on four healthy habits: eating enough fruits and vegetables, frequent exercise, not smoking and drinking in moderation. If a person was obese, and had none of the above healthy habits they were seven times more likely to die than healthy groups in the study. 


But a healthy lifestyle helps obese people as well. If an obese person had the four healthy habits, then his/her risk of death dropped to that of a person with normal weight. 


Apart from changing the food environment Sandra Aamodt suggested mindful eating, which is another tool citizens can use to help change their lifestyle. This involves understanding one’s body signals so one eats only when hungry and stops when full. This takes time and discipline to learn and understand. However, it can work wonders in this time of fatty abundance. 


Dr Khan is right. We must take charge of our health by controlling our lifestyles. This part is up to us. However, this is a national effort on all fronts, and Dr Bratt is also correct in saying that the Government needs to do its part. We shall explore this in my next column. 


Carla Rauseo, DPT, CSCS is a doctor of physical therapy and a certified strength and conditioning specialist at Total Rehabilitation Centre Ltd in San Juan.


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