Chronic Disease Prevention

Chronic Disease Prevention Infographic



C-Sections and Future Obesity Risk

A new study published last week found some interesting results – children born via c-section are 26% more likely to be overweight and 22% more likely to be obese.  Numerous media outlets reported on the story (here, here, and here). This is not a cause and effect relationship, so if you had a c-section PLEASE don’t worry that you have doomed your child to be overweight or obese. There are many factors that may be the cause of this and the authors even admit the link could be due to confounding variables.

While the rate of elective c-sections is up to almost 33% of all births, only 2.5% of these are because the mom requested a c-section. The others are due to medical factors or inpatient providers. One medical reason that jumps to mind immediately is a large baby. Many of the c-sections I assisted with on my rotation were because the baby wouldn’t fit. Big babies have been shown to have an increased risk of childhood overweight and obesity. For some reason the researchers did not control for birth weight.

I don’t plan to start scaring my patients by telling them that if they have a c-section their child will be overweight or obese. I honestly think that the findings we are seeing are more closely linked to other variables. The birthing process provides many benefits to mom and baby and it is difficult to know what role is plays in future obesity risk.

100 workout

Many people I talk to about running complain about how boring it is. Running on a treadmill is usually torture; especially with the clock staring you in the face. Running outside is better (in my opinion), but it still can get boring. Since my first half marathon, I stopped wearing headphones. Even when I trained for the marathon, I didn’t use headphones. Most people think this is crazy, but I absolutely love it. It lets me think about things I need to process and then it also allows me to totally turn my brain off and just go. It takes practice, but now I can’t imagine going back to headphones (I feel like my head will explode when I wear them running).

Still, sometimes I don’t feel like running and need something to occupy my time. I recently learned about the importance of taking the right number of steps per minute when you run – 180 steps per minute REGARDLESS of your pace. This is 90 steps per foot, so I usually just count one foot. This theory of taking so many steps per minute was confirmed by the UW Health Physical Therapist I saw who specialized in running (including working with UW athletes). Over the last year I occasionally count my steps when I run to make sure I am keeping cadence. This is one way to occupy your time when you run – it sounds silly, but the time actually goes by really fast.

With that, I created my own workout for sprints that doesn’t need a watch or planned route. It is the 100 workout and it uses the running cadence counting to occupy your time. It is a simple set of 10 repeats – 100 steps per foot sprinting and 100 steps walking. This ends up being just over a minute of sprinting, since you should be doing 90 steps per foot for a minute. I don’t know if it would work out this way for everyone, but my last route was about 3 minutes and it took me about 20-25 minutes (I didn’t have a watch so this is a guess based on the times when I left the house and was all done stretching). I was dying after 7 repeats so my pace definitely dropped for the last 3 repeats. Regardless, it was a good workout!

Warm-up: walk 10 minutes

Workout: 100 steps per foot sprint, 100 steps per foot walk – repeat 10 times

Cool-down: walk 5-10 minutes with stretching breaks

Exercise AND Obesity on the Rise

A new public health report  found that exercise rates in the US are up – yeah!!! They also found that obesity rates are continuing to rise. You can read about it all over popular media (here and here are good ones).  What does this mean?

  • The data are from 2001-2011, so this before the effectiveness of more recent efforts can really be measured
  • We need to move more AND eat better
  • People eat more when they move more
    • Their body’s naturally are hungrier to no fault of their own
    • They allow themselves to splurge more and eat more because they exercised (think of that runner who carbo-loads for a 5K or 10K….not necessary)
  • The people are healthier even if their weight doesn’t show

I am a big fan of the last point and am disappointed I haven’t heard that argument. Too often we think of someone’s weight or appearance as the #1 indicator for health, and that couldn’t be further from the truth. It is just an easier proxy that other indicators of health. I don’t want to get on a soapbox, so I’ll save my comments for another post. If this sparked your interest, you should watch this amazing TED talk by a surgeon who had a similar revelation early in his career.

Ignorance is bliss?

A new study looked at stressed Europeans. Those who believed their stress affected their health were 2x more likely to have a heart attack! All of the people in the study were stressed. If your mind had no impact on your health then there would be association between negative events and feeling stress impacts one’s life.

Remember, this study didn’t compare stressed to low-stress/no-stress people. My guess is that a study looking at lower-stress people would look like this:

No/low-stress informed <now/low-stress ignorance < high-stress ignorance < high-stress informed

Raw Milk Debate

I don’t feel like arguing today, so don’t worry, this won’t be a real debate. In general, I don’t see the purpose for raw milk, but I feel that each person has the right to make the decision about what type of milk s/he would like to drink. Too often people innocently jump on a bandwagon that could be harmful – raw milk is one of those bandwagons. This article does an excellent job discussing the background of the raw milk debate. If you have ever found yourself wondering about raw milk or arguing for or against it, I highly recommend you take 15 minutes and read this article so you can be well-informed during your discussions.

The most important points (in my opinion) is that the distance from your cow and your table was only a few hundred feet and the cow was well-kept. These factors are extremely important, because the less time from cow to your mouth, the less time harmful bacteria can grow and multiple. In addition, the better kept your cow, the less harmful bacteria to get in your milk. Most people don’t have a cow in their backyard or even down the street, so be sure to consider these factors when reviewing the literature. 

What NOT to say

A new study has found that talking to overweight kids about dieting and their weight made matters worse. That’s right – WORSE. These kids were more likely to binge eat and use unhealthy dietary practices to try to lose weight. Time and time again we have found that kids who use unhealthy dietary practices not only have a messed up relationship with food for their entire life, but are also more likely to be overweight in the future.

The study did find some positives for parents –  kids with parents who were good role models (when it came to a healthy lifestyle) were less likely to engage in these unhealthy dietary habits.

Take home point – put your money where your mouth is and keep your mouth shut 🙂

Take a Walk

Walking after for at least 15 minutes after a meal can help prevent type 2 diabetes. A recent study compared exercising for 15 minutes after each meal to exercising for 45 minutes once per day. They found that the brief walk after a meal was just as effective at preventing high blood sugars.  Here is an excerpt from the USA Today article:

“You eat a meal. You wait a half-hour and then you go for a 15-minute walk, and it has proven effective in controlling blood sugar levels, but you have to do it every day after every meal.”

Who has 45 minutes? Not many people. Who has 15 minutes after a meal? Most of us 😉