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Get hooked on omega-3 fats

31 Jul

Written by: Kaitlin Roke

What are omega-3 fats anyway? Why should I care about omega-3 fats? These are questions I have tried to answer countless times for both friends and colleagues! To answer these questions, we need to start with some general information about dietary fats.

There are 4 main types of dietary fat: saturated, monounsaturated, polyunsaturated and trans. These names might sound a bit strange, but they provide important clues about the different types of fats. Each of these names refers to the structure of the fat. Saturated tells us that each of the molecules are full, which makes them straight in structure. Monounsaturated and polyunsaturated tells us about the number of double bonds, where mono means one and poly means more than one. Trans refers to the direction of the molecular bonds. The more double bonds in a fat, the more bent its structure. As it turns out, the more bent the fat structure, the more fluid the fats usually are at room temperature. This can be seen directly in the foods you eat. For example, butter is rich with saturated fats, while olive oil is rich with monounsaturated fats.

Omega-3 fats are an example of polyunsaturated fats. However, there is a difference between omega-3 fats from plant sources (named alpha-linolenic acid or ALA) and marine sources (named eicosapentaenoic acid or EPA, and docosahexaenoic acid or DHA). ALA is commonly found in certain vegetable oils, walnuts, flaxseeds and soy products, while EPA and DHA can be found in fatty fish (like salmon) and seafood, as well as some fortified products like certain brands of milk and eggs [1].

The reason why we should care about omega-3 fats (specifically EPA and DHA) is because there have been numerous studies highlighting their beneficial health effects [2,3]. These health effects range from improving heart health (in other words, reducing risk of heart disease) [4], brain health (higher IQ score, better memory and mood) [5], as well as whole body health including reduced inflammation [5] and triglyceride levels [7]. This is a pretty long list! Omega-3 EPA and DHA fats seem to be miracle nutrients.

After knowing all of the health benefits, it seems obvious that everyone should try to get more EPA and DHA in their diet. But, do we? Actually, as a population, Canadians consume little to none of these omega-3 fats in our typical diet [8]. One reason is because these types of fats are found mainly in fish and seafood, which many people don’t choose as favourite foods. This could also be partly because there aren’t many quick and easy-to-eat seafood options, in a time where convenient meals are increasingly prevalent.

The Dietitians of Canada [1] have put together a great list of food sources high in omega-3 EPA and DHA fats. For example, one suggestion would be to try having salmon for dinner one night this week. As we are in the summer months, fish on the barbeque can be delicious and easy. Are you going to a pot luck or backyard party? Bring a dip with tuna! If you sneak in some fish with your cheese dip, you are getting a delicious (and nutritious) appetizer, see recipe suggestions below!



  1. Dietitians of Canada
  2. Cleland, L.G.; James, M.J.; Proudman, S.M., Fish oil: What the prescriber needs to know. Arthritis Research and Therapy 2006, 8, 202.
  3. Harris, W.S., Fish oil supplementation: Evidence for health benefits. Cleveland Clinic Journal of Medicine 2004, 71, 208-221.
  4. Kris-Etherton, P.M.; Harris, W.S.; Appel, L.J., Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Arteriosclerosis, thrombosis, and vascular biology 2003, 23, e20-e30.
  5. Morales, E.; Bustamante, M.; Gonzalez, J.R.; Guxens, M.; Torrent, M.; Mendez, M.; Garcia-Esteban, R.; Julvez, J.; Forns, J.; Vrijheid, M., Genetic variants of the fads gene cluster and elovl gene family, colostrums lc-pufa levels, breastfeeding, and child cognition. PloS one 2011, 6, e17181.
  6. Wall, R.; Ross, R.P.; Fitzgerald, G.F.; Stanton, C., Fatty acids from fish: The anti‐inflammatory potential of long‐chain omega‐3 fatty acids. Nutrition reviews 2010, 68, 280-289.
  7. Laidlaw, M.; Holub, B.J., Effects of supplementation with fish oil–derived n− 3 fatty acids and γ-linolenic acid on circulating plasma lipids and fatty acid profiles in women. The American journal of clinical nutrition 2003, 77, 37-42.
  8. Health Canada

Strawberries: Taste the Benefits!

15 Jun

Written by: Emily van Niekerk

Photo provided by: Emily van Niekerk

Image courtesy of Emily van Niekerk


There’s nothing like a fresh, juicy red strawberry on a hot day to really get you in the mood for summer. With strawberry season blossoming in Ontario, what better way to celebrate the delicious berry than to learn a little more about it?

Interestingly, the red flesh of the strawberry we all know and love isn’t the actual fruit of the plant. Strawberries are unique in that the tasty, juicy part is only a receptacle for the small, dry, black specks known as achenes that we commonly identify as “seeds” – these are the botanical fruit (Liston, Cronn, and Ashman, 2014). Since they don’t actually have seeds, strawberries reproduce through runners, which are extensions of the root that grow along the ground and form new plants (Rickson and Fisher, 2000).

Fortunately, strawberries aren’t just pretty: they’re full of phytochemicals, especially phenolic compounds, which give them antioxidant properties (Hannum et al., 2004). Antioxidant rich foods like fruits and vegetables have been shown to lower the risk of developing many chronic diseases including cancer and cardiovascular disease (Meyers et al., 2003). In an in vitro study, strawberry extract was found to be 2.8 times more effective at killing human colon cancer cells than a control, and it was the second most effective berry after black raspberries (Seeram et al., 2006). In an 8 week long human intervention trial, a daily dose of 50 grams freeze-dried strawberry powder, which is the equivalent of 3 cups of fresh strawberries, was found to decrease markers of cardiovascular disease including total and LDL-cholesterol plasma levels in men and women with metabolic syndrome (Basu et al., 2010). Although consuming the dose used in this study would mean having 6 servings of fruit a day, which could be challenging, these results are still promising and will hopefully open doors for more research in this area.

The benefits of strawberries can extend past your health if you choose to buy local. You’ll be lowering your carbon footprint by cutting out transportation costs, thereby reducing the amount of preservatives and chemicals needed to keep the food fresh as it’s transported, and you’ll also be supporting the Canadian economy (Grubinger, 2010). If spending the day in the sun picking your own berries at one of Ontario’s strawberry farms isn’t for you, try buying fresh strawberries from your neighbourhood farmer’s market. You’ll directly support the farmer and it can be a great opportunity for a family activity. Another way to make the most of strawberry season is to choose Ontario strawberries at the grocery store, especially if finding time to go berry-picking between soccer practice and swimming lessons is a challenge.

For the do-it-yourselfers out there, strawberries are also an easy plant to grow at home. They can be planted in a garden that gets lots of sunlight in rows 3-4 feet apart or in planters. Planting should be done as soon as the ground thaws to allow the plant time to adjust and produce flowers which will become berries in mid June to late July. Some strawberry varieties including Everbearing and Day-Neutral can produce berries again in early fall.

Make the most of the warm weather this summer by getting some fresh air, exercise, and fresh-picked strawberries. The benefits to your health and local community, not to mention the delicious taste, will certainly make it worth your while!



Basu, A., Fu, D.X., Wilkinson, M., Simmons, B., Wu, M., Betts, N.M., Du, M., and Lyons, T.J. (2010, July). Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutrition Research, 30(7), 462-469. Retrieved from:

Chen, T., Yen, F., Qian, J., Guo, M., Zhang, H., Tang, X., Chen, F., Stoner, G.D., and Wang, X. (2011). Randomized phase II trial of of lyophilized strawberries in patients with dysplastic precancerous lesions of the esophagus. Cancer Prevention Research, 5(41), 41-50. Retrieved from:

Grubinger, V. (2010, April). Ten reasons to buy local. Retrieved from:

Hannum, S.M. (2004). Potential impact of strawberries on human health: A review of the science. Critical Reviews in Food Science and Nutrition, 44(1), 1-17. Retrieved from:

Liston, A., Cronn, R., and Ashman, T.L. (2014). Fragaria: A genus with deep historical roots and ripe for evolutionary and ecological insights. American Journal of Botany, 101(10), 1686-1699. Retrieved from:

Meyers, K.J., Watkins, C.B., Pritts, M.P., and Liu, R.H. (2003). Antioxidant and antiproliferative activities of strawberries. Journal of Agricultural and Food Chemistry, 5(23), 6887-6892. Retrieved from:

Rickson, C.L., and Fisher, P. (2000, August). Strawberries For Home Gardens. Retrieved from:

Seeram, N.P., Adams, L.S., Zhang, Y., Lee, R., Sand, D., Scheuller, and Heber, D. (2006). Blackberry, black raspberry, blueberry, cranberry, red raspberry, and strawberry extracts inhibit growth and stimulate apoptosis of human cancer cells in vitro. Journal of Agricultural and Food Chemistry, 54(25), 9329-39. Retrieved from:

Black Rice – Superfood for any dish

16 Oct

Written by: Katarina Smolkova

Photo courtesy of: Katarina Smolkova

Photo courtesy of: Katarina Smolkova

Rice is one of the most commonly consumed foods and opting for healthier varieties may significantly improve your health. In fact, the consumption of brown versus white rice has been shown to decrease risk of developing type 2 diabetes by 16% (Sun et al., 2010). But what if there’s yet another variety with a comparable nutritional profile, and more health benefits?

Black rice, also known as purple rice because of its colour after cooking, is a largely unknown variety with a nutty flavour and slightly chewy texture (Yonan, 2014). For centuries it was called “forbidden rice” as it was reserved for the Chinese emperors due to its believed longevity attributes (Soleyman, 2010). As it turns out, this image laid the foundation for today’s nutritional research.

Black rice is superior to brown rice in terms of its protein, fibre and iron contents (Food and Agriculture Organization of the United Nations, 2004). In addition, it is also rich in anthocyanins (Zhang et al., 2010), type of antioxidants studied for their cardiovascular health implications (Wallace, 2010) and cancer combating properties (Faria et al., 2010). Anthocyanins are found in purple-black coloured fruits and vegetables and they are the key to the health benefits of this superfood (Park, Kim, & Chang, 2008). Recent research suggests that a spoonful of black rice bran contains more anthocyanin antioxidants than the same amount of blueberries (American Chemical Society, 2010).

The health potential of black rice in the cardiovascular, cancer, and diabetes research arenas is promising. For instance, black rice extract was shown to lower total and LDL cholesterol as well as some other plasma lipid parameters in rats fed high cholesterol diets typical of Western society (Zawistowski , Kopec, & Kitts, 2009). Similar studies in rabbits (Ling, Wang, & Ma, 2002) and mice (Xia, Ling, Ma, Kitts, & Zawistowski, 2003) found reduced progression of atherosclerotic plaques in animals supplemented with black rice. In addition to these heart health benefits, black rice was also shown in mice to suppress grafted human breast cancer tumor growth and angiogenesis, which would help prevent blood vessels from expanding and minimize cancer cells from spreading throughout the body (Hui et al., 2010). Moreover, diabetes-focused animal research showed an improvement in insulin sensitivity in rats fed a fructose diet with black rice (Guo et al., 2007) and the ongoing human clinical research into the glycemic index of black rice is expected to shed more light into whether black rice is able to impact blood sugar levels too (U.S. National Institutes of Health, 2013).

Surely more research is needed to support the health benefits of this superfood. Meanwhile, don’t miss out! You’ll find that black rice cooks for just about the same time as brown rice, i.e. about 30 min after you bring it to boil (Yonan, 2014) and can bring more flavour to your favourite dish. Be sure to also keep an eye out for black rice bran or extracts in breakfast cereals, cakes, cookies and beverages (Rosolen, 2014). Black rice is perfect for providing natural colouring to foods, from nice pink to dark purple and black hues. So here’s my market prediction: black rice may be the food of 2015. What do you think?


American Chemical Society. (2010, August 27). Black rice rivals pricey blueberries as source of healthful antioxidants. ScienceDaily. Retrieved from

Faria, A., Pestana, D., Teixeira, D., De Freitas, V., Mateus, N., & Calhau, C. (2010). Blueberry anthocyanins and pyruvic acid adducts: anticancer properties in breast cancer cell lines. Phytotherapy research, 24(12), 1862-1869.

Food and Agriculture Organization of the United Nations (FAO). (2004). Rice and human nutrition. Rome: FAO. Retrieved from

Guo, H., Ling, W., Wang, Q., Liu, C., Hu, Y., Xia, M., … & Xia, X. (2007). Effect of anthocyanin-rich extract from black rice (Oryza sativa L. indica) on hyperlipidemia and insulin resistance in fructose-fed rats. Plant Foods for Human Nutrition, 62(1), 1-6.

Hendrick, B. (2010, August 26). Black rice is cheap way to get antioxidants. WebMD. Retrieved from

Hui, C., Bin, Y., Xiaoping, Y., Long, Y., Chunye, C., Mantian, M., & Wenhua, L. (2010). Anticancer activities of an anthocyanin-rich extract from black rice against breast cancer cells in vitro and in vivo. Nutrition and cancer, 62(8), 1128-1136.

Kong, S., & Lee, J. (2010). Antioxidants in milling fractions of black rice cultivars. Food chemistry, 120(1), 278-281.

Ling, W. H., Wang, L. L., & Ma, J. (2002). Supplementation of the black rice outer layer fraction to rabbits decreases atherosclerotic plaque formation and increases antioxidant status. The Journal of nutrition, 132(1), 20-26.

Park, Y. S., Kim, S. J., & Chang, H. I. (2008). Isolation of anthocyanin from black rice (Heugjinjubyeo) and screening of its antioxidant activities. Korean Journal of Microbiology and Biotechnology, 36(1), 55-60.

Rosolen, D. (2014, June 23). Black is the new black. Food in Canada. Retrieved from

Soleyman, P. (2010, September 8). Health benefits of black rice. The Underground Bootcamp. Retrieved from

Sun, Q., Spiegelman, D., van Dam, R. M., Holmes, M. D., Malik, V. S., Willett, W. C., & Hu, F. B. (2010). White rice, brown rice, and risk of type 2 diabetes in US men and women. Archives of internal medicine, 170(11), 961-969.

U.S. National Institutes of Health (2013). Effects of White Rice, Brown Rice, and Black Rice on Postprandial Glucose and Lipid Profiles in Healthy Korean Adults. Clinical from

Wallace, T. C. (2011). Anthocyanins in cardiovascular disease. Advances in Nutrition: An International Review Journal, 2(1), 1-7.

Xia, M., Ling, W. H., Ma, J., Kitts, D. D., & Zawistowski, J. (2003). Supplementation of diets with the black rice pigment fraction attenuates atherosclerotic plaque formation in apolipoprotein e deficient mice. The Journal of nutrition, 133(3), 744-751.

Yonan, J. (2014, April 2). Treat yourself like royalty with forbidden rice. The Washington Post. Retrieved from

Zawistowski, J., Kopec, A., & Kitts, D. D. (2009). Effects of a black rice extract (Oryza sativa L. indica) on cholesterol levels and plasma lipid parameters in Wistar Kyoto rats. Journal of Functional Foods, 1(1), 50-56.

Zhang, M. W., Zhang, R. F., Zhang, F. X., & Liu, R. H. (2010). Phenolic profiles and antioxidant activity of black rice bran of different commercially available varieties. Journal of agricultural and food chemistry, 58(13), 7580-7587.

Can eating spicy foods help you lose weight?

18 Jun

Written by: Caitlin Costello

Image courtesy of: Caitlin Costello

Image courtesy of Caitlin Costello.


Recently, there has been some buzz in the media surrounding the idea that eating spicy foods, mainly hot peppers, can help with weight loss. But is this really the case?

Research has shown that there are bioactive compounds found in hot peppers called capsaicinoids that may be helpful in weight-loss (Whiting et al., 2012). These compounds are responsible for the hot, spicy sensation that you experience when eating these foods. Capsinoids, their sister compounds, have similar physical effects but are less powerful in flavour (Snitker et al., 2009), and more tolerable if you aren’t accustomed to hot spices! Studies have shown that both of these compounds may provide their benefits through reducing appetite and increasing energy expenditure (Whiting et al., 2012). So let’s take a look at the evidence:

One study showed that capsaicinoids, given in the form of 0.9g of red pepper mixed in with tomato juice, 30 minutes before eating, may help reduce self-reported feelings of hunger and improve satiety (Westerterp-Plantenga, Smeets & LeJeune, 2005). A group of healthy adults consumed the red pepper tomato juice before each meal for 2 consecutive days. Feelings of satiety increased and the average energy intake over the 2 days was lower with red pepper consumption, compared to tomato juice alone (Westerterp-Plantenga, Smeets & LeJeune, 2005).

The results of this study are promising however, another study conducted in which healthy adults consumed a lunch containing cayenne (about 1g of red pepper equivalent), showed no significant effects on self-reported feelings of hunger and satiety, or hunger-related gut hormones (Smeets & Westerterp-Plantenga, 2009). Since this study was conducted over a number of hours, compared to the previous study which lasted 2 days, perhaps you have to become accustomed to capsaicin in order to see changes. Although, both of these studies still only represent short-term effects of capsaicinoids on hunger and appetite and more research is needed to see if these compounds have long-term benefits.

Other studies have looked at the effects of capsinoids on energy expenditure as opposed to energy intake. For example, in one study, participants took capsules containing 10mg of capsinoids or placebo capsules and measured changes in energy expenditure in a group of young, healthy males over 2.5 hours (Josse et al., 2010). The results showed an increase in metabolic rate and whole body fat-oxidation with the capsinoid treatment. However, it is important to note that these benefits were only seen for 30 minutes after the participants consumed the capsules, and the effects were not maintained throughout the remainder of the trial. Furthermore, other studies looking at capsinoid supplementation have found no significant effects on energy expenditure (Galgani & Ravussin, 2010; Snitker et al., 2009). Not only has this area of research still not reached a consensus, but the evidence is limited to the effects of capsinoids in concentrated capsules and the doses used in these studies are higher than you would normally get from foods. In order to obtain 10mg of capsinoids from food, you would have to eat about 10 hot chili peppers (Golob, 2011). Since most of us wouldn’t consume 10 chili peppers in one sitting, more research is needed to see if a realistic dose of capsinoids can boost your metabolism enough to make a difference.

In the meantime, if you want to try adding more spice to your diet, good sources of capsaicinoids and capsinoids include green and red chili, cayenne and tabasco peppers (Marie, 2014). If you can’t take the heat, sweet varieties like bell and paprika peppers also contain capsinoids, but in lesser amounts (Marie, 2014). So why not give these foods a try? You may discover some exciting new flavours, and your body just might thank you!


Galgani, J. E., & Ravussin, E. (2010). Effect of dihydrocapsiate on resting metabolic rate in humans. The American Journal of Clinical Nutrition, 92(5), 1089-1093.

Golob, K. (2011). Can Chili Peppers help burn fat and speed up weight loss? Retrieved from:

Josse, A. R., Sherriffs, S. S., Holwerda, A. M., Andrews, R., Staples, A. W., & Phillips, S. M. (2010). Effects of capsinoid ingestion on energy expenditure and lipid oxidation at rest and during exercise. Nutr Metab (Lond), 7, 65.

Marie, J. (2014). Foods that have capsaicin. Retrieved from:

Smeets, A. J., & Westerterp-Plantenga, M. S. (2009). The acute effects of a lunch containing capsaicin on energy and substrate utilisation, hormones, and satiety. European Journal of Nutrition, 48(4), 229-234.

Snitker, S., Fujishima, Y., Shen, H., Ott, S., Pi-Sunyer, X., Furuhata, Y., … & Takahashi, M. (2009). Effects of novel capsinoid treatment on fatness and energy metabolism in humans: possible pharmacogenetic implications. The American Journal of Clinical Nutrition, 89(1), 45-50.

Westerterp-Plantenga, M. S., Smeets, A., & Lejeune, M. P. G. (2004). Sensory and gastrointestinal satiety effects of capsaicin on food intake. International Journal of Obesity, 29(6), 682-688.

Whiting, S., Derbyshire, E., & Tiwari, B. K. (2012). Capsaicinoids and capsinoids. A potential role for weight management? A systematic review of the evidence. Appetite, 59(2), 341-348.





Tofu: A hidden gem

26 Mar

Written by: Sarah Heap 

Photo courtesy of: Sarah Heap

Image courtesy of Sarah Heap.


Meat substitutes are becoming more popular in North America and not just for vegetarians (Xiao, 2008). This may be due to the fact that some studies have shown that red meat consumption increases the risk for cardiovascular disease and certain types of cancer (McAfee, 2010). Restaurants and grocery stores are carrying more meat-free options than ever; making choosing meat alternatives easy and convenient. One such option is tofu, which is made by steaming, cooking, and curdling soybeans (Rutgers, 2003), a type of legume. Soybeans originated in Asia, but are now grown in many Western countries as well (Xiao, 2008). Tofu is sold in the refrigerated foods section of supermarkets and comes in different forms ranging from blocks that are extra-firm, to silken which has a similar texture to yogurt (Rutgers, 2003).

There are pre-conceived notions and hesitation about tofu and meat alternatives in general; namely, they have a reputation of being unappetizing. There may be some truth to this as tofu in particular can have a bland taste and unappealing appearance. However, it absorbs flavours well and can be used in a variety of dishes. Tofu can be used as a meat alternative in sandwiches, soups, stir-fries and salads. As for cooking methods, it can be marinated, grilled, baked, fried, smoked or pickled, to name a few. On top of that tofu is very affordable, especially compared to meat. One package contains around 3 servings and can cost as low as ninety-nine cents in Canada.

It is not only versatile in the kitchen, tofu contains many important nutrients as well. It contains soy protein, the quality of which is comparable to meat protein (Messina, 2010). Soy protein contains all of the essential amino acids making soybeans a complete source of protein, which most legumes are not (Rutgers, 2003). In fact, the United States FDA approved a health claim for foods in 1999 relating 25 g of soy protein per day to a lowered risk of coronary heart disease. Other countries have approved similar claims but Canada is not one of them (Messina, 2010). Soy based foods contain between 2 and 16 grams of soy protein per serving and tofu specifically has 10 g per half cup serving (Eat Right Ontario, 2014). So it is not difficult to consume 25 g per day with multiple servings of these foods.

Soy products have also received scientific attention surrounding bone health and breast cancer.  Although more research is needed, in some cases soy foods may be protective against breast cancer (Fritz, 2013). Compounds in soybeans called isoflavones may delay menopause-related bone loss; however, research in this area is ongoing (Lagari, 2014).

While tofu may not have been your first choice when deciding what to eat, it is extremely versatile, affordable and offers variety to your diet. It is also widely available due to increasing popularity. So, even if you are not a vegetarian, give it a chance!



Eat Right Ontario. (2014). The Scoop on Soy. Retrieved from: Date accessed: February 26, 2014.

Fritz, H., Seely, D., Flower, G., Skidmore, B., Fernandes, R., Vadeboncoeur, S., et al. (2013). Soy, red clover, and isoflavones and breast cancer: a systematic review. Plos One, 8, e81968. doi: 10.1371/journal.pone.0081968.

Lagari, V. S., Levis, S. (2014). Phytoestrogens for menopausal bone loss and climacteric symptoms. Journal of Steroid Biochemistry and Molecular Biology, 139, 294-301.

McAfee, A. J., McSorley, E. M., Cuskelly, G. J., Moss, B. W., Wallace, J. M., Bonham, M. P., & Fearon, A. M. (2010). Red meat consumption: An overview of the risks and benefits. Meat science, 84(1), 1-13.

Messina, M., Messina, V. (2010). The role of soy in vegetarian diets. Nutrients, 2, 855-888.

Rutgers Cooperative Research and Extension. (2003). Tofu: Nutritious and Versatile. Retrieved from: Date accessed: February 18th 2014.

Xiao, C.W. (2008). Health effects of soy protein and isoflavones in humans. Journal of Nutrition, 136, S1244-49.

Preventing and managing disease: Is exercise prescription the answer?

29 Nov

Written by: A. Erin Connelly

Physical activity for good health isn’t a new idea, but there is a recent push to encourage primary care physicians to prescribe exercise plans for patients. It is well known that “being active” is beneficial for health, but recent reports indicate that 85% of Canadians do not meet the exercise guidelines of 150 minutes per week (Colley et al 2011). Similar to medication, increasing physical activity levels works best when patients know what type of exercise, how much, and how often. A number of research studies have shown that specific written exercise programs for sedentary adults result in higher activity levels than just general advice as a prescription provides direction, accountability and the feeling of tangibility that comes with a prescription (Duncan et al 2005; Smidt et al 2005).

Exercise is Medicine (EIM) is one organization that is promoting this idea. The American College of Sports Medicine and the American Medical Association launched EIM in 2007 and an EIM chapter has been recently established by graduate students in the Department of Human Health and Nutritional Sciences at the University of Guelph. The Guelph chapter will be promoting physical activity as a means of prevention and treatment of disease within the Guelph community, and providing information and resources to assist health care providers in prescribing exercise as medicine.

In the same way researchers test the efficacy of a drug or supplement, exercise prescription has been tested in controlled clinical trials. In one study, cardiovascular related outcomes were compared between a group of sedentary adults prescribed a walking program of specific duration, intensity, and frequency compared to a group of sedentary adults given written materials on exercise for health.  All groups exercised for 30 min per session, and the group prescribed exercise for 4 days per week at high intensity, and 7 days per week at moderate intensity, experienced the greatest improvements in cardiorespiratory fitness and positive effects on cholesterol levels (Duncan et al 2005). The group that was not given a specific walking program reported much lower levels of activity and smaller changes in fitness and cholesterol levels.  Another large study used data from 305 controlled trials with a total of 339,274 participants and concluded that exercise intervention studies are the same as or better than drugs in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes (Naci et al 2013).

Specifically, for people with type 2 diabetes, poor fitness level is one of the strongest predictors of all-cause mortality (Church et al 2004), which is part of the reason the Canadian Diabetes Association has created an exercise prescription pad for physicians to use in prescribing exercise to diabetes patients (see figure below).   This type of prescription pad is easy for physicians to use and for patients to understand.   Although the advice is targeted to patients diagnosed with diabetes, adults needing to reduce their risk of type 2 diabetes would benefit as well.

Exercise is a non-specific term. It includes activities that vary in type, frequency, intensity, and environment. It is well known that being active and exercising is a great idea for health and happiness, but many adults find excuses not to exercise.  Exercise prescription is a promising way to get people to actually change their activity levels and improve health.  Check out the Guelph EIM facebook page for more information:


1) Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J and Tremblay MS.  (2011) Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Component of Statistics Canada Catalogue no. 82-003-X Health Reports Statistics Canada. Vol. 22, no. 1

2) Duncan GE, Anton SD, Sydeman SJ, Newton RL, Corsica JA, Durning PE, Ketterson TU, Martin AD, Limacher MC, and Perri MG. (2005) Prescribing Exercise at Varied Levels of Intensity and Frequency. A Randomized Trial.  Arch Intern Med. 165(20):2362-2369.

3) Smidt N, de Vet HC, Bouter LM, and Dekke J. (2005) Effectiveness of exercise therapy: A best-evidence summary of systematic reviews. Australian Journal of Physiotherapy. Vol. 51: 71-85

4) Church TS, Cheng YJ, Earnest CP, Barlow CE, Gibbons LW, Priest EL, and Blair SN. (2004). Exercise Capacity and Body Composition as Predictors of Mortality Among Men With Diabetes. Diabetes Care. vol. 27 no. 1 83-88

5) Naci H and Ioannidis JP. (2013) Comparative effectiveness of exercise and drug interventions on mortality outcomes: metapepidemiological study. BMJ. 347:5577

Human Clinical Trials: Expectations vs. Reality

8 Oct

Written by: Marron Law

Image courtesy of Marrow Law.

Image Courtesy of Marron Law.

It wasn’t until my third year in the Nutritional & Nutraceutical Sciences (NANS) program that I learned about clinical trials. Interested in research, but not particularly drawn towards pure lab work, I started to realize that clinical trial research might be a good fit for me. Therefore, the opportunity to help with a clinical trial investigating a functional food came at a good time when I was fortunate enough to receive an Undergraduate Research Assistantship (URA) working in the Human Nutraceutical Research Unit (HNRU) this past summer.

I’ve since come to learn that reading and learning about clinical trials is very different from actually coordinating one. To highlight this, I’ve created a list of the three things that I found most unexpected about clinical trials.

1. The amount of organization. I hadn’t realized how many documents are required and how much information needs to be documented. The REB application, usually at least 50 pages, was just the start. Three consent forms, instead of the one I had expected, and over 15 different documents were needed for each participant! Almost every interaction with a participant, whether through phone, email or in-person, is logged. Reminders must be emailed before every participant visit and product numbers and expiry dates for all food items given must be recorded.  Although I wasn’t expecting this level of organization, I have learned that in research, especially involving humans, attention to detail is key to reducing error, maximizing efficiency and a successful clinical trial.

2. Recruiting is hard. How slow and long the process was to recruit participants is rarely captured in a research article. Recruiting is not easy. Not every eligible person wants to be in your study and not every person who wants to be in your study is eligible. Of the 150+ people we’ve screened, only 12 have gone on to become participants. We’ve put up posters all over campus and the city, and have posted online and newspaper ads – multiple times! Still, we find ourselves waiting for a phone call or email, hoping the next person is willing and eligible.

3. The unexpected problems. As with many things in life, it’s unrealistic to expect a clinical trial to go off without a hitch. There’s opportunity for all sorts of problems to arise, such as non-compliance with protocol, scheduling conflicts or the grocery store running out of a product you need, just to name a few. While sometimes frustrating, such events are a normal part of clinical trial research and provide opportunities to develop strong problem-solving skills.

This summer was, without a doubt, an invaluable experience to me. It has taken all my preconceptions of clinical trials and given me a reality check on how it really is. However, none of this has dampened my interest and I’m still very keen on doing clinical trial research. So for all those who were like me and only had experience with clinical trials through research articles and the classroom, please know: clinical trials involve lots of files, lots of waiting, and lots of problem-solving.