Friday, October 30, 2009

Stress and mental health at work: the Swedish example

Stress caused by an economic crisis is such that it is directly associated with a marked increase in heart attacks, depression and burnout among the population.

These findings emerge from studies in Sweden and other Scandinavian countries in recent years by Dr. Tores Theorell, professor emeritus of psychosocial and environmental medicine at the Institute Karolinska1-2. It was one of the speakers present at the Symposium of mental health at work which has involved hundreds of researchers, business representatives and workers.3.

The economic crisis of the early 1990s and the one we saw being led to the departure of thousands of Swedish workers on sick leave, says Dr. Theorell3.

"In this difficult context, the stress rises considerably and takes several forms, demonstrates Tores Theorell. Companies are reorganizing, they push their employees to produce more and create an overload. Under stress, these employees lose confidence in their ways and eventually crack and suffer from depression or burnout. "

The solution: educate managers

The situation has forced the Swedish government to act. In 1991, he voted an amendment to the Act on the working environment. Now, companies would have to promote a safe work environment, both psychologically and physiologically.

A social project which has attracted strong support from employers, says Tores Theorell, despite some holdouts who have provided action plans without actually comply.

The researcher observed a general reduction of attrition rate on sick leave. He said the establishment of outreach programs to stress for managers give excellent results.

Dr. Theorell presented at the symposium, the results of an ongoing study. With his research team he has followed a group of 120 managers in training on stress management for 12 to 18 months.

In the first group, the program included traditional interventions. In the second, managers using an artistic approach. Background music, they were invited to express their impressions of poetry related to difficult ethical situations. The participants met monthly to discuss their progress.

Decreased rates of stress hormones was noted in both groups. The results are even more marked in the group with the artistic approach.

"We need to urge managers to engage in training and awareness, the specialist again. A boss organized, efficient, attentive and committed to his employees helps to reduce stress in his team, "says the researcher.

Wednesday, October 28, 2009

Displaying calories on menus: New Yorkers are not afraid!

The posting of calories in restaurants and menus do not appear to give the desired results. Worse, it seems to backfire!

This emerges from a study conducted in New York City, which was the first to adopt a regulation requiring some restaurants to display caloric content of their dishes.

In reaching this conclusion, the researchers conducted a field investigation in areas of disadvantaged socio-economic development.

They followed nearly 1 200 customers in 19 restaurants belonging to 4 chains - McDonald's, Wendy's, Burger King and Kentucky Fried Chicken - before and after application of the law.


Only 50% of the customers noticed the signs - but prominently - displaying calories for each dish. Of these, 28% said that the panel had an influence on their command. And 88% of them said they had bought a dish with fewer calories on the display.

However, analysis of bills issued after the purchase of meals has revealed that on average, participants did not eat fewer calories before display (825 cal), even after its inception, they consumed a little more (846 cal) - a difference of 21 calories.

A measure inefficient

  According to nutritionist Marie-Josée Leblanc, posting the calories on posters or in the menus is "not normally an interesting measure.

"Everything is not about calories: there are foods that have high nutritional value and contain many calories, we think of a salad with nuts and olive oil" illustrates Dr. nutrition Extenso2 attached to the portal.

  Same story on the side of the Quebec Coalition on the issue of weight. "By focusing on calories, such a display removes the nutritional quality of foods, exercise more pressure on those who are overly concerned with their weight," says Suzie Pellerin, director of the agency.

She said it would be preferable to "favor a regulation or guidance that would address the contents of the plate - the quality and portion sizes - and that would provide better access to healthy food."

A matter of education and money?

The study of New York was voluntarily conducted in poor neighborhoods because there has been a greater increase in obesity in the general population.

"But the results would have been different if the experiment had been conducted in a more favored or in restaurants with more elaborate menus, shade Marie-Josée Leblanc.

"The number of calories of a food is an abstract information for many people," she agrees. Moreover, not all are able to understand the nutrition information.

"The fast food chains were the first to provide nutrition information of their products through their website, says she. It is easy to know the fiber content of a Big Mac, but will look for this information and understands it? "

Marie-Josée Leblanc goes further in its thinking. "People know that fast foods are not the best places to eat, but we must take into account other parameters in the analysis: the food is cheap and in a difficult economic environment, it is a food affordable solution, "says nutritionist.

Preventing diabetes: lose weight first

For people at risk for type 2 diabetes, weight loss is central to preventing the onset of the disease.

  This was said Dr. David Nathan, in 20th World Congress on Diabetes, which was attended by more than 10 000 specialists in Montreal from October 18 to 22.

"Every pound lost is equivalent to a risk reduction of 16%," he says. Conversely, having a body mass index (BMI) greater than 35 increased from 91% risk of developing diabetes over a period of 14 years.

  American scientist attached to the Massachusetts General Hospital, Dr. Nathan is the author of a major study - Diabetes Prevention Program (DPP) 1 - published in 2002 and conducted among 3 200 people pre-diabetic. The results show that it is possible to prevent and combat diabetes simply by changing his lifestyle. He has since signed more than 100 studies on diabetes.

Until then, we believed only virtues of the pharmaceutical approach to living with the disease advances there. "But we know now that even those newly diagnosed with diabetes, a 10% weight helps control blood sugar and pressure by reducing the use of drugs," said David M. Nathan 2.

No need to go to the gym

Besides heredity, or certain genetic predispositions, the main risk factors for diabetes are related to modifiable behaviors: diet high in saturated fat, abdominal obesity, hypertension and sedentary lifestyle.

That is what has retarded the DPP: the program was a change in behavior of participants in setting realistic goals and tailored to participants' daily.

"No need to enroll in a gym or a cooking class: it was enough, for example, walking at a brisk pace at 150 minutes per week and change his diet to lose 5% to 10 % of body weight - notably by reducing by 25% the amount of saturated fat, "says Dr. Nathan.

The DPP, which continues today, is not the only one to have given similar results. Similar studies conducted in Japan, Finland and India, have also shown that it is possible to prevent diabetes in people at risk by changing some habits.
Preventing with or without medication?

In a forum where he discussed with Dr. Jean-Louis Chiasson, University of Montreal, Dr. Nathan said that weight loss combined with physical activity also reduces the risk of metabolic syndrome 41%. And even reverse glucose intolerance.

"Besides edit and lifestyle can reduce the risk of certain risk factors for cardiovascular diseases including hypertension, bad cholesterol and chronic inflammation," he listed.

  But is it realistic to believe that people at high risk of diabetes adopt better habits of life and they keep the long term? This is the real issue, according to Dr. Chiasson.

"We can prevent the disease by eating better and moving more, but it is true that if we persevere, says he. Now we know that after 3 years, only 10% of participants continue their good habits. "

According to Dr. Chiasson, this is a problem that requires medication. And he argues that another drug - acarbose - can do better than metformin. "Acarbose was more effective in preventing diabetes and reducing the risk of cardiovascular disease in all age groups," he said.

But Dr. David Nathan persists. "In Finland, a study has shown that the effect of healthy lifestyle reduced by 58% the risk of developing diabetes after 4 years. And among those who continued to move and eat better after 7 years the risk was further reduced by 43%, excluding the effect on their quality of life in general - that are not drugs, "he said .

In 2010, Canada will have more than 3 million with type 2 diabetes. About 60% suffer from hypertension, and a similar percentage has a high cholesterol, making them at risk for cardiovascular disease.