Doctor's Review: Medicine on the Move

October 19, 2017
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Who's more likely to gain weight?

In March, the first Learning Retreat on the Principles and Practices of Interdisciplinary Management of Obesity for Dietitians was held in Winnipeg. Here are a few of the highlights:

Don’t let baggy shirts fool you

Since 2006, healthcare practitioners have been encouraged to take the waist measurement of their patients. Have you? People with a normal BMI, but a waist measurement over the recommendations are at a higher risk of developing heart disease and diabetes. South Asian and Chinese populations are more likely to have higher amounts of abdominal fat, and the waist measurement standard should actually be lower for them than for people of European descent. We lack data on other populations so for the moment we’re unfortunately still treating these populations on the same standard as Europeans.

Hypertriglyceridemic waist (HTGW)

Men with a waist measurement of 90 centimetres or more coupled with a triglyceride level greater than two mmol/L and women with a waist measurement of 85 centimetres or more and a triglyceride level of 1.5 mmol/l are at risk. Looking at both the waist measurement and triglyceride level will help screen for patients that may need more encouragement to maintain their weight.

Even the thin should weigh in

It’s easier to prevent or slow down weight gain than it is to lose it. Consider a nutrition and exercise intervention as soon as someone suffers, say, a back or ankle injury so they don’t gain excess weight. A lifestyle intervention is good for menopausal women so they too minimize weight gain. Track weight yearly, but also over five-year periods. Putting on two pounds in a year isn’t a problem, unless it happens every year. The resulting 10-pound gain over five years is enough to have significant implications.

Take a big picture

Studies suggest that adequate sleep (seven to eight hours per night) is correlated to weight maintenance. Recent studies show that an obese person who’s fit is actually at a lower risk of developing CVD and diabetes than a thin couch potato.

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Comments

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  1. On April 27, 2010, C. Lam, MD said:
    Kindly let me know the reference in the printed version, number 4, and the source for the last statement that 'an obese person who's fit is at lower risk of developing CVD and diabetes than a thin couch potato'. Thank you. C. Lam, MD

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