On March 25, U of T Medicine’s April Kemick sat down with the Hockey Hall of Famer to chat about health, how he stays fit, and the lifestyle advice he plans to pass along to his seven-month-old daughter.

When you were a kid, did you just play hockey or did you enjoy other sports or activities?

That was the best part of growing up. My two brothers [one older and one younger] and I were allowed to do anything we wanted in terms of sports. We played hockey, soccer, tennis and golf. Our parents made sure we were active and kept us in different activities and sports.

What types of food were on the menu on game days – did you have a favourite pre-game meal?

When you’re a professional athlete, you look to be as good as you can be in all areas – not only training and working on skills as a hockey player, but you also understand that sleep, what you eat, how you prepare yourself off the ice is just as important as what you do on the ice.

You learn from an early age to eat lots of different vegetables and fruits - get all the different criteria of food into yourself to prepare and play hockey at the highest level.  Nutrition is always very important for a professional athlete, as well as anyone.

When you stop working out one to three hours each day, you have to change the way you eat. But I think I eat as good as I did when I played, just a little bit less.

With a physically demanding schedule – practices, games, workouts, travel – what kept you motivated during your professional hockey career?

I was fortunate. Playing hockey has always been my hobby and my biggest passion. To have that as your work was easy for me. The travel wasn’t a problem. It’s a young mans’ sport and I used to be able to cope with the travel. It helps to be young to play a sport at a professional level.

Now I’m in the middle of my life, hopefully, but in terms of hockey I think the average career for a hockey player is five years and I played for almost 18, so I was fortunate to stay healthy, compete and play at the highest level.

As an athlete, tell me about the role doctors, physiotherapists and trainers played in keeping you healthy all those years?

I was fortunate to have great support on every level in terms of nutrition and doctors to help when you’re hurt or have other problems – these people play a major role when you’re a professional athlete and recovering from various injuries. They help you stay healthy for a long period of time.

What was the worst injury you had to recover from?

Obviously every hockey player loses their teeth, pretty much. It happens to everyone.  The most serious injury was losing part of my vision in my left eye.  I got a puck in my eye - we were playing Ottawa - and I ended up losing about eight to nine per cent of my vision. It doesn’t really affect me in daily life, but it was scary when it happened.

Now that you’re retired, how do you stay fit?

Really nothing changes. I think exercising from a young age taught me a lifestyle and I keep doing it. I exercise, stay fit and make sure I get good nutrition.  It’s not at the highest level like in the NHL, but three to four times a week I do a workout and make sure I eat properly.

I run, ride a bike and try to do things that I enjoy. I cross-country ski and I play hockey still a little bit at charity events over the year. I’m actually going to prepare because the Maple Leafs and Detroit Red Wings have an alumni winter classic coming up so the veteran guys have a big game on December 31.

What types of healthy lifestyle habits do you and your wife hope to pass along to your daughter?

You realize as you get older that exercise is important, but also nutrition.  It sounds like a cliché, but breakfast is the most important meal of the day to start your metabolism.  It’s like a car – you have to fill up the tank before you start working.  [I’ll encourage my daughter to eat] lots of fruit and lots of vegetables and stay away from processed food. Try to get lots of sleep – you realize how good sleeping habits are important for a healthy life. It’s not complicated – simple things keep us healthy

Will you encourage your daughter to play sports when she’s older?

Yes, I am already planning. She looks like she will be tall – maybe six feet - so I’ve got to get a tennis racquet in her hand.  She’s only seven months now, so I’m going to wait a couple more months before I  buy her first tennis racquet. Start them young!  I’m just kidding, we will let her do whatever she wants, but we will encourage her to be active. I think it’s very important for a healthy life to get her in different activities. Whether its sports or dance, we will encourage her to try different things.

Other than hockey, what is your favourite sport to play?

[I grew up in an active family so] I’m into to all kinds of sports - lots of outdoor activities like camping and fishing in the summertime. Sweden has lots of mountainsides –it’s similar to Canada and I enjoy a lot of outdoor activities.

[In terms of watching sports], hockey is always going to be a passion and close to my heart. But I watch soccer, tennis and some other sports. I watch everything.

If caught early, colon cancer is curable, yet many people don’t get screened.  In recognition of colon cancer awareness month, U of T researchers are encouraging people to get screened by sharing a video featuring a colon cancer survivor.

“Fear was one of the biggest barriers cited.  Fear of the test.  Fear of the answer.  Fear of dying,” says Dionne Gesink, Associate Professor in the Dalla Lana School of Public Health who asked Ontarians what stops them from getting screened for cancer.  “As one participant said, ‘Anybody that I know that’s had it, has died from it.’”

Gesink's project is funded by Cancer Care Ontario, an arm of the Ontario government responsible for delivering cancer treatment and prevention programs in the province. The video is available on YouTube and is being shared directly with clinicians and organizations across Ontario for use with their patients and clients.

Dani says he survived colon cancer thanks to his boss urging him to get screened.

“If I’d waited until I had symptoms to get checked out, I wouldn’t be here right now,” he says

March is colon cancer awareness month.  Approximately 23,000 Canadians will be diagnosed with colon cancer this year and about 9,000 will die from it.

The Portrait of a Colon Cancer Survivor can also be viewed at www.getscreened.ca.

Faculty of Medicine research received a big boost today, as the federal government announced five new Canada Research Chairs (CRCs) within the Faculty and renewed several more. The funding came as part of a nationwide government announcement of 23 new and renewed Chairs backed by $18.7 million in funding.

Investigating topics ranging from lung transplantation to growing new blood vessels, the Faculty’s new CRC recipients are:

• Brian Cox, Department of Physiology, CRC in Placental Development and Maternal-Foetal Health
• Marcelo Cypel, Department of Surgery and the University Health Network, CRC in Lung Transplantation
• Jason Fish, Department of Laboratory Medicine & Pathobiology and the University Health Network, CRC in Vascular Cell and Molecular Biology
• Michael Wilson, Department of Molecular Genetics and the Hospital for Sick Children, CRC in Comparative Genomics
• Minna Woo, Departments of Medicine and Medical Biophysics and University Health Network, CRC in Signal Transduction in Diabetes Pathogenesis

These recipients join the ranks of five other medicine researchers whose existing CRC was renewed, including:

• Patricia L. Howell, Department of Biochemistry and the Hospital for Sick Children, CRC in Structural Biology
• Jeff Meyer, Department of Psychiatry and the Centre for Addiction and Mental Health, CRC of Neurochemistry of Major Depressive Disorder
• Lauence Pelletier, Department of Molecular Genetics and Mount Sinai Hospital, CRC in Centrosome Biogenesis and Function
• Ren-Ke Li, Department of Surgery and University Health Network, CRC in Cardiac Regeneration
• Molly Shoichet, Departments of Chemistry and Chemical Engineering & Applied Chemistry, and Institute of Biomaterials & Bioengineering, CRC in Tissue Engineering

“The Canada Research Chairs program is a key component of the university’s efforts to attract and retain the world’s most promising researchers,” said Professor Peter Lewis, U of T’s Associate Vice-President, Research and Innovation. “We are grateful to the government of Canada for its continuing support of this program.”

U of T’s total number of Canada Research Chairs is 238, the largest number of any university in the country.

Canadians can track how much salt they’re eating and identify the main sources of sodium in their diet using a new online Salt Calculator. Developed by researchers at the University of Toronto (U of T), the Ottawa Hospital Research Institute (OHRI), and the Institute for Clinical Evaluative Sciences (ICES), the tool is among the first of its kind in North America.

On average, Canadians consume approximately 3,400 mg of sodium per day, which is more than two times the recommended amount. Too much sodium can lead to high blood pressure and is a major risk factor for stroke, heart disease and kidney disease. High sodium intake has also been linked to an increased risk of osteoporosis, stomach cancer and severity of asthma.

“Many Canadians think the biggest source of salt in their diet comes from a salt shaker, but that’s not the case - it’s the hidden sodium added during food production that’s the biggest culprit,” says JoAnne Arcand, a Postdoctoral Fellow in the Department of Nutritional Sciences at U of T, who helped develop the calculator.  “Enabling people to monitor their sodium intake has personal benefits – like lowering blood pressure and risk of heart disease – but it can also dramatically reduce overall health care costs.”

The Salt Calculator – located online at http://www.projectbiglife.ca – contains 23 questions and takes less than five minutes to complete. It was developed by analyzing the sodium levels of more than 20,000 grocery and restaurant foods, and is based on Canadian eating patterns and the most up-to-date data on sodium levels.

The calculator asks questions such as:

• How often do you eat out?
• Where do you eat out (fast food, table service or fine dining establishments)?
• How often and how much do you eat per day, week or month?
• What types of food do you eat (breads, prepackaged food, cheese etc.)?

“We know that Canadians are eating too much salt. But the calculator helps zero in on the exact sources in their diet that are responsible,” says Professor Mary L’Abbé, Chair of the Department of Nutritional Sciences. “Armed with this information, people can change their eating habits and re-evaluate using the calculator over time.”

Bread products, processed meats, soups and canned/pickled vegetables contribute the most sodium to the Canadian diet.

"I don’t know my patient’s sodium consumption level and my patients don’t know their levels. Even patients with hypertension and heart disease don’t know their sodium levels,” says Doug Manuel, a primary care doctor and scientist at ICES and OHRI. “Because of that information gap, I prescribe drugs more than lifestyle change. More importantly, how can we have informed public policy when individual Canadians don’t know how much sodium they consume?”

Sodium Awareness Week runs March 11–17.

Deep Brain Stimulation (DBS) may help patients with chronic, severe and treatment-resistant Anorexia Nervosa improve their body weight, mood, and anxiety, according to a team of researchers at the University of Toronto, Krembil Neuroscience Centre and University Health Network.

Researchers treated six chronically anorexic patients with DBS, a neurosurgical procedure that moderates activity of dysfunctional brain circuits. Brain imaging has shown that anorexia patients and healthy people have structural and functional differences in brain circuits that regulate mood, anxiety, reward and body-perception.

“Eating disorders have the highest death rate of any mental illness and more and more women are dying from anorexia,” says Professor Blake Woodside in U of T’s Department of Psychiatry and medical director of Canada’s largest eating disorders program at Toronto General Hospital. “Any treatment that could potentially change the natural course of this illness is not just offering hope but saving the lives for people who suffer from the extreme form of this condition.”

Patients – who suffered from anorexia for 18 years on average - were awake when researchers implanted electrodes into the part of their brain involved with emotion and depression. During the procedure, researchers stimulated the electrodes to look for changes in the patient’s mood, anxiety or adverse effects. The electrodes were connected to an implanted pulse generator below each patients’ right clavicle, similar to a heart pacemaker.

Researchers tested patients one, three, and six months after activating the pulse generator devices. The team found that half of the patients gained more weight than they’d ever gained in the past. For these patients, this was the longest period of sustained weight gain since the onset of their illness.

“We are truly ushering in a new of era of understanding of the brain and the role it can play in certain neurological disorders,” says Andres Lozano, Professor and Chairman of Neurosurgery at U of T and neurosurgeon at the Krembil Neuroscience Centre of Toronto Western Hospital. “By pinpointing and correcting the precise circuits in the brain associated with the symptoms of some of these conditions, we are finding additional options to treat these illnesses.”

To watch a video with Lozano, Woodside and study participant Kim Rollins, click here (password: nervosa).

To view the full study, click here.

For more information, please contact:

Alexa Giorgi
Senior Public Affairs Advisor
Krembil Neuroscience Centre, Toronto Western Hospital
University Health Network
416. 603. 5800 x6776
alexa.giorgi@uhn.ca

Most people know fast food burgers and fries aren’t the healthiest choice, but the first-ever systematic study of sodium levels in Canadian chain restaurants shows sodium levels that are off the charts — and far worse than expected.

A U of T study of foods from 85 Canadian chain restaurants found that on average, a single menu item from a sit-down restaurant (such as one hamburger, sandwich or stir-fry) contained nearly 100 per cent of the daily recommended amount of sodium, while side dishes contained nearly 50 per cent. Single menu items from fast food restaurants contained two-thirds (68 per cent) of the daily recommended amount of sodium.

“We expected sodium levels to be high, but we didn’t expect them to be as alarmingly high as we found in the study,” says Mary Scourboutakos, a PhD student in U of T’s Department of Nutritional Sciences, and lead author of the study. “These findings demonstrate the need for a population-wide sodium reduction strategy to address the high levels of sodium in Canadian restaurant foods.”

Limiting salt intake is important because high dietary sodium is a risk factor for hypertension, which is the leading preventable risk factor for death worldwide.

Scourboutakos’ team collected nutrition information from chain restaurant websites in 2010 and 2011 and analyzed 4,044 meal items.  Sodium levels were compared to the daily adult adequate intake level of 1,500 milligrams and the tolerable upper limit of 2,300 mg per day.

The study found that a single meal item with no side dish from a sit-down restaurant (such as a hamburger, sandwich or stir fry) contained on average 1,455 mg of sodium per serving, while fast food meal items contained 1,011 milligrams. Side dishes contained, on average, 736 milligrams of sodium.

As many as 40 per cent of sit-down restaurant meal items exceeded the daily tolerable upper limit for sodium — and that doesn’t include the side dishes that would normally be consumed with a main dish.

“This study is important as Health Canada has not yet set targets for restaurant foods — a major gap in our Canadian sodium reduction efforts,” says Professor Mary L’Abbé, Chair of the Department of Nutritional Sciences and senior author on the study.

To read the full study, click here.

Second-year medical student Michael Fridman has two passions in life—saving lives and romancing the stage. That is why the budding actor-cum-future doctor is part of Daffydil 2013, the Faculty of Medicine’s annual musical production.

Now in its 102nd year, the musical comedy—called Dreaming Nights Under Hospital Lights— is produced, directed and performed by Faculty of Medicine students. While organizers are staying tight-lipped about this year’s plot, they promise a wacky, over-the-top show that takes a quirky look at the daily realities of health care. Daffydil’s Facebook page also reveals some juicy details.

“Daffydil features some incredible music, choreography and acting.  It’s a great quality production, comparable to an off-Broadway—well, make that off-off-Broadway—show. It’s going to be a hilarious night that you don’t want to miss,” says Fridman, slipping oh-so-slightly into character.

The show is more than just a Faculty tradition for first-year Speech-Language Pathology student Mary Bowden—it’s a family legacy. Bowden’s mother was also part of the play when she was in medical school at the University of Toronto some 40 years ago.  “Daffydil truly represents the interprofessional future of health care. Students from all areas of the Faculty are coming together to fight help cancer,” says Bowden, who is one of dozens of students involved in the show.

Proceeds from ticket sales support the Canadian Cancer Society, and the production has raised more than $600,000 for the charity since it first began in 1911.

“Daffydil is hugely important to us,” says Susanne Morphet, Manager of Corporate & Community Partnerships at the Canadian Cancer Society. “With the support of long-standing donors such as the Faculty of Medicine, we can continue to fund life-saving cancer research year after year. We look forward to continuing this partnership for many more years to come.”

To see Bowden, Fridman and the rest of the gang in action, check out www.daffydil2013.com for behind the scenes photos and other show-related information. You can also follow them on Twitter.

Event details

Dates:
The show runs from Wednesday, February 20, 2013 to Saturday, February 23, 2013. Saturday is Alumni Night.

Showtime:
8 p.m. (Doors open at 7:30 p.m.)

Venue:
Hart House Theatre
7 Hart House Circle
Toronto, ON
M5S 3H3

Cost:
In advance

• Adult - $25.00
• Student - $20.00
• Senior - $20.00

At the door

    Everybody - $30.00

Tickets:
Visit UofTtix to purchase tickets.

Today, Ethiopia’s first-ever class of family medicine residents start training with help, in part, from the Department of Family and Community Medicine (DFCM) at the University of Toronto. In three years, the residents will graduate from Addis Ababa University to become the first family physicians in a country of 90 million people.

The introduction of family medicine to Ethiopia is backed by an international collaboration that includes the Toronto Addis Ababa Academic Collaboration (TAAAC)  and the University of Wisconsin. Since 2008, U of T faculty physicians have assisted colleagues at Addis Ababa University to develop a family medicine residency curriculum, including developing a role for family medicine in the Ethiopian health care system.

The Ethiopian Federal Ministry of Health will give its formal commitment to family medicine, signaling the beginning of family medicine training in the country, at an inauguration ceremony in Addis Ababa on February 4. The Ethiopian Minister of Health, His Excellency Dr. Kesete Birhan Admasu, and the Canadian ambassador, His Excellency David Usher, are expected to attend. Dr. Lynn Wilson, Professor and Chair of the Department of Family and Community Medicine at U of T, will also attend.

“The introduction of family medicine to Ethiopia will strengthen primary care.  The emphasis of family medicine on comprehensiveness of care, the doctor-patient relationship and dealing with undifferentiated symptoms of illness will reduce health inequity and further the goal of ‘good health for all.’  It is an honor to work with our Ethiopian colleagues and in so doing we are fulfilling our social responsibility and also learning a great deal about primary care innovation, particularly in resource-constrained environments.  This is learning that we can bring back to our clinical settings and learners in the DFCM,” said Wilson. “We are delighted to be witness to history.”

Fifty one per cent of physicians in Canada are family physicians. The DFCM is the largest Family Medicine department in the world and has trained 36 per cent of province-trained family physicians. It is recognized internationally for its clinical, educational and research excellence.

Dr. Dawit Wondimagegn is the program director in the Department of Family Medicine at Addis Ababa University.

“I think family medicine is going to change the face of primary care in Ethiopia. Given the contextual difference it will evolve to define itself,” Wondimagegn said. 

The Ethiopian family medicine residents will address a constellation of medical problems significantly different from the patterns seen by their peers in Canada. They will treat more infectious diseases, such as TB, malaria and HIV. They will encounter higher rates of perinatal and maternal mortality and poverty-related conditions, especially malnutrition. Like most countries in sub-Saharan Africa, Ethiopia is experiencing an increase in non-communicable diseases such as diabetes and heart disease. Combined with the ongoing challenge of infectious diseases, this has given rise to the phenomenon of a “double burden” of disease.

U of T Assistant Professor Dr. Jane Philpott says, “In the face of a severe shortage of human resources for health, Ethiopia has undertaken an unprecedented expansion of medical education. The new program in family medicine will build a cadre of physicians providing comprehensive care who are well-trained, supported and valued. There is good evidence that the development of this physician workforce with a strong focus on primary care will significantly improve health outcomes.”

For more information about the Department of Family and Community Medicine in the Faculty of Medicine at the University of Toronto, please visit: www.dfcm.utoronto.ca.

For more information, please contact:

Danielle (Simpson) Wintrip
University of Toronto, Faculty of Medicine, Department of Family and Community Medicine
416-978-8793
danielle.simpson@utoronto.ca
 

Smokers who quit when they are young adults can live almost as long as people who never smoked, groundbreaking new research has found.

Smoking cuts at least 10 years off a person’s lifespan. But a comprehensive analysis of health and death records in the United States found that people who quit smoking before they turn 40 regain almost all of those lost years.

“Quitting smoking before age 40, and preferably well before 40, gives back almost all of the decade of lost life from continued smoking,” said Prabhat Jha, head of the Centre for Global Health Research at St. Michael’s Hospital and a professor in the Dalla Lana School of Public Health at the University of Toronto.

“That’s not to say, however, that it is safe to smoke until you are 40 and then stop,” said Jha. “Former smokers still have a greater risk of dying sooner than people who never smoked. But the risk is small compared to the huge risk for those who continue to smoke.”

His findings were published today in the New England Journal of Medicine.

Jha’s team found that people who quit smoking between ages 35 and 44 gained about nine years and those who quit between ages 45-54 and 55-64 gained six and four years of life, respectively.

The study is unique as it examines the risks of smoking and the benefits of stopping among a representative sample of Americans.  Earlier studies had examined specific groups such as nurses or volunteers who are healthier than average Americans overall.  Importantly, the study is among the first to document the generation of women who started smoking when they were young and kept smoking through their adult lives.

“Women who smoke like men, die like men,”Jha said. For women, the risks of dying from smoking-related causes are 50 per cent greater than found in the studies conducted in the 1980s.

Click here to watch a video of Jha discussing the study's findings.

Women and men who smoke both lost a decade of life. Current male or female smokers ages 25-79 had a mortality rate three times higher than people who had never smoked. Never smokers were about twice more likely to live to age 80 than were smokers.

This study adds to recent evidence from Britain, Japan and the United States that smoking risks involve about a decade of life lost worldwide. This includes a review of 50 years of smoking mortality in the United States published in the same issue of the New England Journal of Medicine and led by Dr. Michael J. Thun and other researchers from the American Cancer Society.

While about 40 million Americans and 4 million Canadians smoke, most of the world’s estimated 1.3 billion smokers live in low- and middle-income countries. Worldwide about 30 million young adults begin smoking each year (about half of all young men and 10 per cent of young women) and most do not stop.

In many high-income countries more than half of people who ever smoked have quit, cessation remains uncommon in most low- and middle-income people. On current trends, smoking will kill about 1 billion people in the 21st century as opposed to ‘only’ 100 million in the 20th century.

Professor Amartya Sen, the noted Harvard University economist who won the 1998 Nobel Prize in economics, said “the inability to develop an appropriate public policy about smoking has been one of the bigger failures of public action in India, China and most other developing countries, in contrast to strong tobacco control in most western countries.

“This study brings out how great the threat actually is, and shows that risks of death from smoking are even larger than previously thought,” said Professor Sen, who was not involved in the study.  “The result is of great global significance.”

Jha noted that smoking rates in the United States, China and India would decline much faster if their governments levied high taxes on tobacco, as seen in Canada and France. Taxation is the single most effective step to get adults to quit and to prevent children from starting, he said.

Jha’s research used data from the U.S. National Health Interview Survey in which a representative cross-section of the population is surveyed every year about a broad range of health topics. More than 200,000 survey participants were linked to the National Death Index, which includes death certificate information for all Americans since 1986.  The researchers related about deaths of about 16,000 people to their past reported smoking.

Jha advises various governments around the world on disease control strategies.  He is the principal investigator of the Million Death Study in India, one of the largest studies of premature deaths in the world.

The research was funded by the National Institutes of Health, the Canadian Institutes of Health Research and the Disease Control Priorities-3 project of the Bill and Melinda Gates Foundation.

Obese and overweight people are gaining weight rapidly in low-and middle-income countries while those who are severely undernourished are not experiencing similar weight gains, according to a University of Toronto and Harvard School of Public Health study.

This growing divide may force governments in the developing world to care for people who fall dramatically short on their calorie intake while simultaneously treating health problems associated with obesity, including diabetes and heart disease.

“One might think that as a country grows economically, the majority of the underweight population would move into the average BMI range, but our study shows the opposite: people of average weight are disappearing,” says Fahad Razak, the study’s lead author and a U of T clinical fellow working at St. Michael’s Hospital’s internal medicine unit.

“This growing trend of body weight extremes is going to pose a major challenge for health care and policy leaders,” says Razak. “They will need to balance their priorities between addressing health issues afflicting the underweight who happen to be poor, and health issues afflicting the obese and overweight – the upper middle-class and rich.”

The study uses information collected in Demographic and Health Surveys (DHS), an American-led project that tracks health and population trends in developing countries.  Researchers analyzed the Body Mass Index (BMI) of 730,000 women living in 37 countries between 1991 and 2008 and found that as the average BMI in a population increases, the numbers of overweight and obese women are increasing at a much faster rate than the decline in the number of underweight women.

BMI is an indicator of body fat calculated by dividing a person’s weight in kilograms by their height in meters squared. Obesity is defined as having a BMI of more than 30.0 kg/m2. Compared to people with a healthy weight (a BMI between 18.5 and 24.9 kg/m2), obese individuals and overweight individuals (who have a BMI between 25.0 and 29.9 kg/m2) have an increased risk of diabetes, heart disease and stroke, and tend to die younger.  At the same time, people who are underweight (BMI less than18.5) also have an increased risk of death, perhaps from complications related to being malnourished.

“The study is novel because for the first time we are showing that increases in BMI are not happening equally across the board; rather increases in average BMI are largely driven by populations that are already overweight or obese, with little to no change among underweight individuals,” says S V Subramanian, professor of Population Health and Geography at Harvard School of Public Health, the senior author of the study. “This divergence in the population with fat getting fatter and lean remaining lean is aligned with general patterns of divergence on other domains such as income, and wealth, which of course, are primary drivers of weight status in these countries."

The researchers’ future work will test whether these patterns are also observed in more developed countries.

The study, “Change in the Body Mass Index Distribution for Women: Analysis of Surveys from 37 Low- and Middle-Income Countries,” is published in the January 15, 2013, issue of PLOS Medicine.

For more information, please contact:

Nicole Bodnar
Media Relations and Communications Specialist
Faculty of Medicine, University of Toronto
416-978-5811
Nicole.bodnar@utoronto.ca