Canada will have enough doses of the COVID-19 vaccine to fully inoculate all those 12 and over — a milestone the government originally had planned to reach this September.

An Overview of Weight Loss the “Healthy Way”

A program targeting weight loss helps clients decrease overall body weight. Further, this bodyweight change ideally and intentionally focuses on losing fat but can also unintentionally consist of protein, muscle, and other bodily substances. 

A group of patients question why their applications for an exemption to use psilocybin, the psychedelic compound in what are commonly called magic mushrooms, for therapeutic purposes have gone unanswered by Health Canada.

A substantial number of  people living with obesity in need of knee-replacement surgery will have either been flatly denied surgery, or told to lose weight prior to qualifying for surgery. This common practice is largely based on the notion that outcomes in people with elevated BMI are generally poor, operations are riskier, and the life of the prosthesis due to loosening or wear may be drastically shortened. 

But, is this really the case?

Not, according to a large observational cohort study by Jonathan Thomas Evans and colleagues, just published in PLOS.

The researchers examined data from over 490,000 total knee replacements collected in the National Joint Registry (NJR) for England, Wales, Northern Ireland, and the Isle of Man from 2005 to 2016.

While individuals with higher BMI were slightly more likely to undergo revision surgery within 10 years of receiving their prosthesis, revision rates in all BMI classes remained well withing the accepted 10-year benchmark of 5%. 

Moreover, all BMI categories saw important improvements in function scores, which were only marginally (below the minimal detectable change) compared to patients with “normal” BMI.

Finally, there was no indication of increased mortality risk in higher BMI patients. In fact, 90-day mortality rates were significantly lower in patients with overweight and class I obesity than  in those with “normal” BMI. 

Thus, the authors suggest that policies limiting access to knee-replacement surgery based on BMI may no longer be justifiable. 

On the other hand, it may be important to note that this cohort most certainly represents a substantial selection bias with surgeons perhaps selecting fitter patients with raised BMI for surgery (“healthy-patient effect”). 

Or, as the authors put it,

“It appears that even if some patients with raised BMI are at risk of poorer outcomes, the outcomes remain acceptable by contemporary standards, and the selection process of orthopaedic surgeons is effective at identifying the correct patients to operate on at a population level.”

Be that as it may, I would probably predict that if a staging system like the Edmonton Obesity Staging System (EOSS) were to be applied to this cohort, any residual effect of BMI will likely disappear – I would expect outcomes to be poorer the higher the EOSS stage, irrespective of BMI. 

For now, these data can certainly be used to initiate discussions on official or unofficial policies that restrict access to knee replacements based on BMI.

@DrSharma,
Berlin, D

Tokyo reported its highest number of new coronavirus infections on Tuesday, days after the Olympics began. The Japanese capital reported 2,848 new COVID-19 cases, exceeding the earlier record of 2,520 cases on Jan. 7.

Hi friends! How’s the morning going? I hope you’re enjoying the week so far. I’m here with the girls, enjoying the cooler weather, and looking forward to some adventures later today.

For today’s post, I’m popping in with a little WIAW aka What I Ate Wednesday (on a Tuesday). Keeping things wiiiiild. 😉 I’ve been following the macro plan I created for myself with Precision Nutrition, and thought I’d share some of the goods. The girls are home and things have been busy, so lots of quick and easy meals around here.

WIAW

Here’s what a full day of eats looks like lately:

7:35 I finish off the rest of the gluten-free peanut butter pretzels while I wait for my coffee to heat up. (These are the Quinn brand from Thrive Market and they’re insanely delicious.) I always have a little bite of something while I’m making coffee, whether it’s half a Go Macro bar, a protein ball, a bite of chocolate (real life) or something random like this.

Collagen coffee + supplements for the day:

And a little while later (around 8 or so): some eggs with two rice cakes + almond butter and jelly

10am Post-workout: smoothie with 1 cup almond milk, 1 cup blueberries, riced cauliflower, Truvani protein powder, spinach, and a tablespoon of chia seeds

1pm: lunch! Siete tortillas with mayo, avocado, tomatoes, spinach, and chicken breast + some chopped carrots

4pm-ish afternoon snack: An apple, a turkey jerky, + Organifi red juice (SO good in the afternoon)

7:00 Dinner: Quick and easy shrimp pasta meal. I boiled some Banza rotini and while it was cooking, I sautéed some zucchini with 2 cloves of garlic, 1/2 teaspoon oregano, salt and pepper. I also sautéed 1 lb of shrimp in a separate pan, with butter, 3 cloves of minced garlic, salt, and pepper. When the noodles were finished cooking, I drained them, added the shrimp to the noodle pot, and stirred in half a block of soft vegan cheese with herbs (it was the Miyoko’s vegan garlic and herb cashew cheese). I added about 3/4 cup of almond milk to thin it out to make a sauce, stirred the noodles back in, and boom. Dinner was done in less than 20 minutes.

(LOVE these bowls. We finally updated our dinnerware after 84 years and feeling like grown adults since everything matches now. Also, I’m sorry for the photo quality here. We’re all glad I’ve mostly transitioned out of my ol’ food blogger ways.)

Wins from the day: I feel like I did a good job balancing my meals for the day. Since I’ve been following the Precision Nutrition plan I created for myself, it’s made it so much easier to check off the boxes for protein, carbs, and healthy fats and feel satisfied and energized throughout the day (without needing to calculate, measure, or weigh anything). Sometimes it’s hard for me to hit my protein goal, but I made it happen. Having the chicken in the fridge already cooked for lunch made a huge difference. I’m also pumped that I didn’t skip any meals. It’s something that happens in life but is counter-productive. You really feel better and see results when you fuel yourself.

What I could have done better: I was a bit low on veggies I’m really trying to get in more veggies and leafy greens, and while I hit a few (cauliflower, spinach, carrots, zucchini), I usually like to get a bit more. This day also didn’t include wine or chocolate, so not my #1 day of meals. 😉

So tell me, friends: what’s the best thing you ate yesterday? Any favorite high-protein meals you’d like to share? I’m compiling a bunch together now for a bonus recipe guide, so please share some of your faves!

Have a wonderful day and I’ll see ya soon!

xo

Gina

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