MONTREAL (PasseportSanté.net) September 26, 2006 – “In an ideal world, an obese patient should be able to be referred by his doctor to an interdisciplinary care team, made up of a nutritionist, a kinesiologist, a psychologist and ‘a nurse, so that he is not left on his own. “
This is the wish formulated by the DD Johanne blais1 of the Center hospitalier universitaire de Québec (CHUQ). She gave a conference as part of a continuing education day on “New features in obesity”, organized for Quebec physicians.
According to her, a multidisciplinary approach is required to personalize care for individuals struggling with excess weight. “This would make it possible to support the person, to see where he is in his approach to improve his health and, thus, better direct him”, continues the DD Blais.
But, in the field, the multidisciplinary approach is not valued in Quebec, believes, for his part, Dr.r Rafik Habib, director of the Laval Cardiovascular Center. “It will take years before governments and insurance companies take an interest in it … It’s already difficult to have a dietitian in a clinic,” he laments.
Perceptions to change
According to the DD Johanne Blais, physicians must learn to aim for long-term results with their patients who are overweight. “They have to develop a collaborative approach with the patient, starting by moving beyond the perception that people have to lose weight at all costs,” she says.
According to her, doctors would benefit from asking certain questions in front of an obese patient, in order to arrive at a real collaboration. “Does the patient really have to lose weight? Maybe not taking it is a good start? Is this the right time for the patient to start a diet? Are Weight Loss Goals Realistic? », She raises.
Subsidize food?
The fight against obesity also involves promoting healthy eating habits. And the benefits are tangible for heart health. This remains the most effective way to avoid myocardial infarction, recalls Dr.r Habib. “Regularly consuming fruits and vegetables reduces this risk by 30%, compared to 14% for physical activity and 9% for moderate alcohol consumption,” he lists, referring to the prestigious INTERHEART study.2.
This is why, like the DD Blais, he militates in favor of the adoption, by the State, of fiscal means or other strategies to “encourage people who buy more fruits and vegetables or who go to fitness centers”.
“We could take an example from Finland which, in the 1970s, adopted measures to increase the consumption of fruits and vegetables, which made it possible 30 years later to reduce the number of heart attacks by 75%”, evokes the Dr Habib.
While waiting for Canada’s new Food Guide
And what about Canada’s next Food Guide, slated for release in late 2006 or early 2007? Will it play a role in the fight against obesity? Since its creation in 1947, no way has been put forward to assess its impact on the eating habits of Canadians, according to some health professionals.
But according to Chantal Martineau, responsible for revising the Guide at Health Canada, the next version “clarifies the messages as well as the notions of portion”.
It will also include more examples that take into account the age and gender of the people who consult it. For example, for grain products, we recommend seven servings per day for male adolescents, and eight for men.
Emphasis will also be placed on achieving and maintaining a healthy weight, according to the principles of energy balance. Specifying the foods to favor and to limit, this guide will encourage the consumption of fish at least once a week, to obtain a minimum of omega-3, so useful for the cardiovascular system.
Among the other new features of Canada’s Food Guide, it should be noted that soy beverages will integrate the dairy products section, such as milk, yogurts and cheese. Finally, people aged 50 and over will be recommended to take a daily supplement of vitamin D, which is involved in the absorption of calcium, a nutrient essential for bone health.
Martin LaSalle – PasseportSanté.net
1. The DD Johanne Blais is an assistant clinical professor at the Center hospitalier universitaire de Québec (CHUQ).
2. According to 2004 data from the INTERHEART study (which includes 52 countries). For more information: www.cihr-irsc.gc.ca [consulté le 26 septembre 2006].
